What diet leads to healthy aging?

Keypoints

Greater odds of healthy aging were associated with larger intakes of fruits, vegetables, whole grains, unsaturated fats, nuts, legumes, and low-fat dairy products, whereas higher consumption of red or processed meats (or both), sugary drinks, salt, and trans fats had an inverse relationship. 

The results suggest that dietary patterns rich in plant-based foods, combined with moderate inclusion of nutritious animal-derived foods, may promote overall healthy aging, informing future dietary recommendations.

Higher consumption of added unsaturated fats–especially polyunsaturated fatty acids–was strongly linked to reaching age 70 with maintained physical and mental abilities.

Although following all dietary patterns was linked to healthy aging in both sexes, the connection was notably more pronounced among women for most diets. The links were also more evident in individuals who smoked, had a BMI over 25 kg/m², or engaged in less physical activity than the average.

A higher intake of ultra-processed foods was linked to a 32% lower likelihood of aging healthily. It was also tied to decreased chances of preserving cognitive and physical abilities, maintaining good mental health, avoiding chronic illnesses, and living past 70 years of age.

Surprisingly, fast and fried foods away from home, and snacks, were also positively associated with living up to the age of 70. Even though fried foods are often tied to heart disease, they don’t appear to raise the risk of all-cause mortality. Social factors, like dining out with others, might partly explain this link, but more studies are needed to understand it fully.

Healthy, balanced plant-based diets with moderate animal products and low meat intake consistently showed better results regarding healthy aging compared to exclusively plant-based diets.

While liquor consumption, in general, was associated with a lower chance of healthy aging, moderate wine intake was a part of some healthy diets, such as the Alternative Mediterranean diet.

Examples of Healthy Diets

The eight diets used in this research are:

• Alternative Healthy Eating Index (AHEI) - high in fruits, vegetables, whole grains, nuts and legumes, omega-3 and polyunsaturated fats, and low in red and processed meats, sugar-sweetened beverages, fruit juices, trans fats, and sodium. 
• Alternative Mediterranean Index (aMED) - high in fruits, vegetables, whole grains, nuts, legumes, fish, seafood, and monounsaturated fats, low in red and processed meats.
• Dietary Approaches to Stop Hypertension (DASH) - fruits, vegetables, whole grains, nuts, legumes, and low-fat dairy, low in red and processed meats, sugar-sweetened beverages, fruit juices, and sodium. 
• Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) - high in berries, vegetables, leafy green vegetables in particular, nuts, legumes, beans, organ meats, fish, seafood, and olive oil, low in red and processed meats, sweets, desserts, fast and fried foods, butter, margarine, and cheese.
• Healthful plant-based diet (hPDI) - high in fruits, vegetables, whole grains, nuts, legumes, vegetable oils, tea and coffee, low in potatoes, refined grains, total meats, eggs, fish and seafood, animal-based foods, sweets, desserts, animal fat, sugar-sweetened beverages, fruit juices, and total dairy.
• Planetary Health Diet Index (PHDI) - high in fruits, vegetables, whole grains, nuts, legumes, soybeans, fish, seafood, and added unsaturated fats, low in added saturated and trans fats, added sugar, and fruit juices.
• Empirically inflammatory dietary pattern (EDIP) - high in fruits, leafy-green vegetables, wine, coffee, and high-fat dairy, low in tomatoes, red meat, processed meats, poultry, eggs, other fish, French fries, butter, margarine, creamy soup, sugar-sweetened beverages, low-energy beverages, and low-fat dairy.
• Empirical dietary index for hyperinsulinemia (EDIH) - high in leafy-green and dark-yellow vegetables, snacks, pizza, fruit juices, wine, beer, tea, and coffee, low in tomatoes, other vegetables, refined grains, red, processed, and organ meats, sugar-sweetened beverages, and low-energy beverages. 

The study also looks at a diet high in ultraprocessed food consumption.

Although all dietary patterns encourage fruits, vegetables, and whole grains while limiting red and processed meats, each has unique focuses. The aMED diet highlights olive oil, fish, and nuts; MIND emphasizes berries for brain health; DASH limits sodium for blood pressure; PHDI promotes low-emission plant proteins; and hPDI favors healthy plant foods while excluding animal-based ones.

Results

Following any of the first eight diets closely during mid-life was associated with healthy aging. The Alternative Healthy Eating Index had the strongest association, followed by the Empirical Dietary Index for Hyperinsulinemia, and leaving the Healthful Plant-Based Diet in last place.

Of all the dietary patterns examined, the Alternative Healthy Eating Index showed the strongest link to healthy aging, while the Healthful plant-based diet demonstrated the weakest connection.

References

1. https://www.nature.com/articles/s41591-025-03570-5
2. https://nurseshealthstudy.org/about-nhs/history
3. https://hsph.harvard.edu/research/health-professionals/