You Are What You Eat

Whose parents didn’t encourage them to eat better by saying, “you are what you eat?” Shan and colleagues used data from 75,230 women in the Nurses’ Health Study (NHS) and 44,085 men in the Health Professionals Follow-Up Study (PHFS) to examine the relationships of dietary intake to mortality and cause of death. The NHS and PHFS recorded the intake of 130 foods at baseline and at 2- to 4-year intervals and calculated dietary scores using four different dietary assessments. Suffice it to say, that your mother (and father) would have been happy because all four dietary scores rewarded participants for higher intake of fruits and vegetables. Participants had a mean age in the early 50s at the start of the study, and they were followed for up to 36 and 34 years in the NHS and PHFS, respectively. Higher scores by all four dietary measurements were associated with reduced total mortality rates as well as reduced deaths from cardiovascular disease, cancer, and, surprisingly, respiratory disease. Two of the scores, the Alternate Mediterranean Diet score and the Healthful Plant-based Diet Index, were also associated with reduced deaths from neurodegenerative diseases. The authors suggest that this observation could be because those two scores increase with the intake of nuts and monounsaturated fats. The results require replication because health professionals represent a unique population, but there were no obvious differences in the results among racial and ethnic subgroups. This is an amazing study because of its size, length of follow-up, and results. The results for cardiovascular disease and cancer are not unexpected, but the lower death rates from respiratory disease and neurodegenerative disease are clearly food for thought. Your parents were right. You should eat your fruits and vegetables and encourage your patients to do the same. We need to make sure these results can be generalized to other populations and also to determine whether fruits and vegetables are good or if the other food sources are deleterious. This will allow us to design non-dietary approaches to increasing longevity for those unwilling to listen to their parents’ advice.

This was also published as follows:

Thompson PD. A commentary on: Healthy Eating Patterns and Risk of Total and Cause-Specific Mortality. PracticeUpdate website. Available at: https://www.practiceupdate.com/content/healthy-eating-patterns-and-risk-of-total-and-cause-specific-mortality/147184/65/2/1. Accessed January 27, 2023