JOURNAL ARTICLE
MULTICENTER STUDY

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

Nicole Jankovic, Anouk Geelen, Martinette T Streppel, Lisette C P G M de Groot, Philippos Orfanos, Edith H van den Hooven, Hynek Pikhart, Paolo Boffetta, Antonia Trichopoulou, Martin Bobak, H B Bueno-de-Mesquita, Frank Kee, Oscar H Franco, Yikyung Park, Göran Hallmans, Anne Tjønneland, Anne M May, Andrzej Pajak, Sofia Malyutina, Růžena Kubinova, Pilar Amiano, Ellen Kampman, Edith J Feskens
American Journal of Epidemiology 2014 November 15, 180 (10): 978-88
25318818
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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