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.

Additional Metadata
Keywords Aging, Cohort, Consortium on Health and Ageing, Diet, Longevity, Meta-analysis, Network of Cohorts in Europe and the United States
Persistent URL dx.doi.org/10.1093/aje/kwu229, hdl.handle.net/1765/84938
Journal American Journal of Epidemiology
Citation
Jankovic, N, Geelen, A, Streppel, M.T, de Groot, L.C.P.G.M, Orfanos, P, van den Hooven, E.H, … Feskens, E.J.M. (2014). Adherence to a healthy diet according to the world health organization guidelines and all-cause mortality in elderly adults from Europe and the United States. American Journal of Epidemiology, 180(10), 978–988. doi:10.1093/aje/kwu229