Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 180, Issue 10, Pages 978-988Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwu229
Keywords
aging; cohort; Consortium on Health and Ageing: Network of Cohorts in Europe and the United States; diet; longevity; meta-analysis
Categories
Funding
- Directorate-General for Research & Innovation in the European Commission [242244]
- Regional Government of Andalucia, Spain
- Regional Government of Asturias, Spain
- Regional Government of Basque Country, Spain
- Regional Government of Murcia, Spain
- Regional Government of Navarra, Spain
- Regional Government of Vasterbotten, Sweden
- Dutch Ministry of Public Health, Welfare, and Sports
- Netherlands Cancer Registry
- LK Research Funds
- Dutch Prevention Funds
- Dutch Zorg Onderzoek Nederland
- World Cancer Research Fund
- Statistics Netherlands
- Danish Cancer Society
- Hellenic Health Foundation
- Stavros Niarchos Foundation
- Intramural Research Program of the National Institutes of Health
- National Cancer Institute
- Wellcome Trust [064947/Z/01/Z]
- MacArthur Foundation
- National Institute on Aging [1R01 AG23522]
- Erasmus Medical Center
- Erasmus University Rotterdam
- Netherlands Organization for Scientific Research
- Netherlands Organization for Health Research and Development
- Research Institute for Diseases in the Elderly
- Netherlands Genomics Initiative
- Ministry of Education, Culture, and Science
- Ministry of Health, Welfare, and Sports
- European Commission
- Municipality of Rotterdam
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The World Health Organization (WHO) has formulated guidelines for a healthy diet to prevent chronic diseases and postpone death worldwide. Our objective was to investigate the association between the WHO guidelines, measured using the Healthy Diet Indicator (HDI), and all-cause mortality in elderly men and women from Europe and the United States. We analyzed data from 396,391 participants (42% women) in 11 prospective cohort studies who were 60 years of age or older at enrollment (in 1988-2005). HDI scores were based on 6 nutrients and 1 food group and ranged from 0 (least healthy diet) to 70 (healthiest diet). Adjusted cohort-specific hazard ratios were derived by using Cox proportional hazards regression and subsequently pooled using random-effects meta-analysis. During 4,497,957 person-years of follow-up, 84,978 deaths occurred. Median HDI scores ranged from 40 to 54 points across cohorts. For a 10-point increase in HDI score (representing adherence to an additional WHO guideline), the pooled adjusted hazard ratios were 0.90 (95% confidence interval (CI): 0.87, 0.93) for men and women combined, 0.89 (95% CI: 0.85, 0.92) for men, and 0.90 (95% CI: 0.85, 0.95) for women. These estimates translate to an increased life expectancy of 2 years at the age of 60 years. Greater adherence to the WHO guidelines is associated with greater longevity in elderly men and women in Europe and the United States.
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