Western Diets Linked with Less-Healthy Aging

A Western-style diet can undermine healthy aging, a new study finds. A Western diet includes fried foods, sweets, processed and red meats, refined grains and high-fat dairy products. The study included 5,350 middle-aged adults who provided information about their diets. Researchers kept track of their health for the next 16 years. About 4% went through "ideal aging." They had no long-term (chronic) conditions, such as diabetes or heart disease. They also had high scores for physical and mental functioning. About 3% of the total group died of a heart attack or stroke during the study. Another 13% had nonfatal events. About 7% died from other causes. The other 73% survived and had "normal aging," researchers said. People who followed a Western-style diet were less likely to have ideal aging than those with healthier diets. They were more likely to die of a heart attack, stroke or other causes. The American Journal of Medicine published the study. HealthDay News wrote about it April 17.

By Howard LeWine, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

It's hardly news that changing from a Western-style diet to one that is more Mediterranean is good for you. A Western-style diet contains large amounts of sugary foods and drinks, fried foods, processed and red meats, refined grains and high-fat dairy products. A Mediterranean-style diet is loaded with vegetables, whole grains, healthy oils such as olive oil, fish and fruits.

We already know that eating a Mediterranean diet helps you keep a healthier weight and decreases your risk of diabetes and heart disease.

What makes this study different is the focus. The researchers took a more holistic approach rather than looking just at the risk of specific diseases related to what we eat. They wanted to see if your diet in middle age affected your overall health as you get older.

The researchers had access to detailed information about the diets of 5,350 adults. Their average age was 51 when the study started. Using a tool called the Alternative Healthy Eating Index, the researchers rated their diets. A high score meant that what people ate was closer to a Mediterranean-style diet than to a Western-style diet.

The researchers also had information on what happened to people during an average of 16 years after the start of the study. They divided people into 5 groups based on their health outcomes as they got older:

• Ideal aging, defined as having no chronic conditions AND high performance in physical and mental abilities
• Non-fatal heart attack or stroke
• Death related to heart or blood vessel disease
• Death from any other problem
• "Normal" aging

Most people (73%) remained alive and fell into the "normal" aging category. This outcome is vague and a bit hard to accept as meaningful. But what is impressive is that many more of the people in the ideal-aging group followed the healthier diet. And more of those who had a heart attack, stroke or died stuck to a Western-style diet.

What Changes Can I Make Now?

Here's a guide to a very healthy eating pattern:

• Four or more servings of vegetables a day. A serving is ½ cup of raw or cooked vegetables, 1 cup of raw leafy greens or ½ cup of vegetable juice.
• Four or more servings of fruit a day. A serving is ½ cup of fresh, frozen or canned fruit; ¼ cup of dried fruit; one medium-sized piece of fruit; or ½ cup of fruit juice.
• At least 4 tablespoons of olive oil a day.
• One handful (about 1½ ounces) of nuts, 3 or more times per week.
• Three or more servings of legumes (beans, peas and lentils) per week. A serving is ½ cup.
• Six or more servings of whole grains a day. A serving is 1 cup of dry breakfast cereal; ½ cup of cooked cereal, brown rice or whole-grain pasta; or one slice of whole-grain or multi-grain bread.
• Three or more servings of fish (especially fatty fish) a week. A serving is 4 ounces.
• One serving of yogurt or cheese a day.
• If you enjoy alcohol, limit yourself to 1 (for women) or 2 (for men) drinks a day. One drink is 5 ounces of wine, 12 ounces of beer or 1½ ounces of liquor.

Specifically avoid:

• Soda and sugary drinks
• Sweets, pastries and commercial bakery goods
• Red and processed meats
• Margarines and most tub spreads

What Can I Expect Looking to the Future?

The evidence for a Mediterranean-style diet over a Western-style diet as a path to a healthier life is overwhelming. Food companies have already gotten the message. We will continue to see more products on grocery shelves reflecting these changes.