How do changes in diet influence mortality risk?

It is not hard to think about a relationship between a healthy diet and the risk for chronic diseases, considering diets can act not only in the prevention for some chronic diseases but also as an adjuvant in the treatment.

But there is more than it! Recently, studies have shown that dietary patterns may change mortality outcomes.

These outcomes are related not only to the maintenance of an adequate diet during the life but also to improvements in dietary patterns in there; and the worsening in the diet quality is a major factor contributing to death and health complications.

Besides that, dietary pattern analysis has been used as a better method to single nutrients analysis, assuming the synergism of the food components.

How?

Using the parameters of diet quality scores (DASH diet, Mediterranean diet and Health eating index), common food groups in each score was found, considering that diet quality is a combination of multiple components and does not correspond to a single diet plan to achieve healthy eating patterns

Which common food groups determine high diet quality?

In these different patterns were observed high consumption of vegetables, fruits, nuts, whole grains and fish, reduced consumption of sodium and red meat and moderate consumption of alcohol (15g/ethanol/day).

What are the mechanisms?

The synergistic action of nutrients such as magnesium, fiber, potassium and flavonoids are proposed as the reason of the multiple biological effects.

Which are the results?

In a systematic review published in 2015 and in a longitudinal study published in 2017, in a 24 years follow-up of participants from two studies, the Nurses' Health Study and the Health Professional Follow-up Study (a total of 47,000 women and 25,000 men), were found associations between high diet quality associated and:

• reduction in the risk of mortality from any cause between 8% and 22%, in the mortality from cardiovascular disease between 19% and 28%, and in colorectal cancer.

• reduction in the manifestation of type 2 diabetes.

Improvements in diet quality over a 12-year period was associated with reduced risk of death in the subsequent 12 years and worsening diet quality over 12 years was associated with an increase in mortality risk of 6% to 12%.

That means, it’s never too late!

These studies emphasize that moderate improvements in diet quality over time can significantly reduce the risk of death and that these changes are not hard to do!

The inclusion/increase in consumption of nuts and legumes to 1 serving per day and the reduction in consumption of red meat and processed meats will result in an improvement of the diet.

The authors also emphasize that generalizability may be limited because participants was only north Americans.

But these dietary improvements certainly won’t be bad.

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Sotos-Prieto M, Bhupathiraju SN, Mattei J, Fung TT, Li Y, et al. Association of Changes in Diet Quality with Total and Cause-Specific Mortality. N Engl J Med. 2017

Schwingshackl L, Hoffmann G. Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension score, and health outcomes: a systematic review and meta-analysis of cohort studies. J Acad Nutr Diet. 2015