Higher diet quality relates to decelerated epigenetic aging.

BACKGROUND: DNA methylation-based epigenetic age measures have been used as biological aging markers and are associated with a healthy lifespan. Few population-based studies have examined the relation between diet and epigenetic age acceleration. OBJECTIVES: We aimed to investigate the relation between diet quality and epigenetic age acceleration. METHODS: We analyzed data from 1995 participants (mean age, 67 years; 55% women) of the Framingham Heart Study Offspring Cohort. Cross-sectional associations between the Dietary Approaches to Stop Hypertension (DASH) score and 3 whole-blood DNA methylation-derived epigenetic age acceleration measures-Dunedin Pace of Aging Methylation (DunedinPoAm), GrimAge acceleration (GrimAA), and PhenoAge acceleration (PhenoAA)-were examined. A mediation analysis was conducted to assess the mediating role of epigenetic age acceleration in relation to DASH and all-cause mortality. RESULTS: A higher DASH score was associated with lower levels of DunedinPoAm (ß = -0.05; SE = 0.02; P = 0.007), GrimAA (ß = -0.09; SE = 0.02; P < 0.001), and PhenoAA (ß = -0.07; SE = 0.02; P = 0.001). All 3 epigenetic measures mediated the association between the DASH score and all-cause mortality, with mean proportions of 22.1% for DunedinPoAm (Pmediation = 0.04), 45.1% for GrimAA (Pmediation = 0.001), and 22.9% for PhenoAA (Pmediation = 0.03). An interaction was observed between the DASH score and smoking status in relation to the epigenetic aging markers. The association between the DASH score and epigenetic aging markers tended to be stronger in "ever-smokers" (former and current smokers) compared to "never-smokers." The proportions of mediation were 31.3% for DunedinPoAm, 46.8% for GrimAA, and 10.3% for PhenoAA in ever-smokers, whereas no significant mediation was observed in never-smokers. CONCLUSIONS: Higher diet quality is associated with slower epigenetic age acceleration, which partially explains the beneficial effect of diet quality on the lifespan. Our findings emphasize that adopting a healthy diet is crucial for maintaining healthy aging.

Mediterranean, DASH, and Alternate Healthy Eating Index Dietary Patterns and Risk of Death in the Physicians' Health Study.

OBJECTIVE: Our primary objective was to examine the associations of the Mediterranean (MED), the Dietary Approaches to Stop Hypertension (DASH), and the Alternate Healthy Eating Index (AHEI) diet with total mortality. Our secondary objective was to examine the association of these three dietary patterns with cardiovascular disease (CVD) and cancer mortality. RESEARCH: Design and Methods: We prospectively studied 15,768 men from the Physicians' Health Study who completed a semi-quantitative food-frequency questionnaire. Scores from each dietary pattern were divided into quintiles. Multivariable Cox regression models were used to estimate hazard ratio's (95% confidence intervals) of mortality. RESULTS: At baseline, average age was 65.9 ± 8.9 years. There were 1763 deaths, including 488 CVD deaths and 589 cancer deaths. All diet scores were inversely associated with risk for all-cause mortality: Hazard ratios (95% CI) of all-cause mortality from lowest to highest quintile for MED diet were 1.0 (reference), 0.85 (0.73-0.98), 0.80 (0.69-0.93), 0.77 (0.66-0.90), and 0.68 (0.58-0.79); corresponding values were 1.0 (reference), 0.96 (0.82-1.12), 0.95 (0.82-1.11), 0.88 (0.75-1.04), and 0.83 (0.71-0.99) for DASH diet and 1.0 (reference), 0.88 (0.77-1.02), 0.82 (0.71-0.95), 0.69 (0.59, 0.81), and 0.56 (0.47-0.67) for AHEI diet, after adjusting for age, energy, smoking, exercise, BMI, hypertension, coronary heart disease, congestive heart failure, diabetes, and atrial fibrillation. For cause-specific mortality, MED and AHEI scores were inversely associated with lower risk for CVD mortality, whereas AHEI and MED scores were inversely associated with lower risk for cancer mortality. CONCLUSION: Within this cohort of male physicians, AHEI, MED, and DASH scores were each inversely associated with mortality from all causes.

Adherence to the dietary approaches to stop hypertension (DASH) diet in relation to all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis of prospective cohort studies.

BACKGROUND: Although previous investigations have proposed an association between Dietary Approaches to Stop Hypertension (DASH)-style diet and lower mortality from chronic diseases, the exposure-response relationship is not clear. The present systematic review and meta-analysis aimed to explore the linear and non-linear dose-response association between adherence to the DASH diet and all-cause and cause-specific mortality. METHODS: Database search was performed in PubMed, Scopus, and EMBASE for prospective cohort studies investigating the association between adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and risk of mortality. Summary hazard ratios (HRs) and 95% confidence intervals (CI) were estimated with the use of a random-effects model for the linear and nonlinear relationships. The two-stage hierarchical regression model was applied to test the potential non-linear dose-response associations. RESULTS: The inclusion criteria were met by 17 studies (13 publications). The scores reported for adherence to the DASH diet in different studies were converted to a conventional scoring method in which the adherence score might range between 8 to 40. The linear analysis revealed that summary HRs were 0.95 (95% CI: 0.94-0.96, I2 = 91.6%, n = 14) for all-cause, 0.96 (95% CI: 0.95-0.98, I2 = 82.4%, n = 12) for CVD, 0.97 (95% CI: 0.96-0.98, I2 = 0.00%, n = 2) for stroke, and 0.97 (95% CI: 0.95-0.98, I2 = 63.7%, n = 12) for cancer mortality per each 5-point increment of adherence to the DASH diet. There was also evidence of non-linear associations between the DASH diet and all-cause and cause-specific mortality as the associations became even more evident when the adherence scores were more than 20 points (P < 0.005). CONCLUSION: Even the modest adherence to the DASH diet is associated with a lower risk of all-cause and cause-specific mortality. The higher adherence to the diet also strengthens the risk-reducing association. REGISTRATION: This review was registered in the international prospective register of systematic reviews (PROSPERO) database (registration ID: CRD42018086500).

Mediating-Moderating Effect of Allostatic Load on the Association between Dietary Approaches to Stop Hypertension Diet and All-Cause and Cause-Specific Mortality: 2001-2010 National Health and Nutrition Examination Surveys.

This secondary analysis of survey data examined mediating-moderating effects of allostatic load score (calculated using the Rodriquez method) on the association between nutrient-based Dietary Approaches to Stop Hypertension (DASH) diet score (Mellen Index) and the all-cause and cause-specific mortality risks among 11,630 adults ≥ 30 years of age from the 2001-2010 National Health and Nutrition Examination Surveys with no history of cardiovascular disease or cancer at baseline, and who were followed-up for ~9.35 years. Multivariable models were adjusted for demographic, socioeconomic, lifestyle, and health characteristics. All-cause, cardiovascular disease, and cancer-specific mortality rates were estimated at 6.5%, 1.1%, and 1.9%, respectively. The median DASH total score was 3.0 (range: 1-8) (with 78.3% scoring < 4.5), whereas the median allostatic load score was 3 (range: 0-9). The DASH diet, fiber, and magnesium were negatively correlated with allostatic load, whereas allostatic load predicted higher all-cause mortality, irrespective of the DASH diet. Whereas protein was protective, potassium increased all-cause mortality risk, irrespective of allostatic load. Potassium was protective against cardiovascular disease-specific mortality but was a risk factor for cancer-specific mortality. Although no moderating effects were observed, mediation by the allostatic load on cardiovascular disease-specific mortality was observed for DASH total score and selected component scores. Direct (but not indirect) effects of DASH through the allostatic load were observed for all-cause mortality, and no direct or indirect effects were observed for cancer-specific mortality. From a public health standpoint, the allostatic load may be a surrogate for the preventive effects of the DASH diet and its components on cardiovascular disease-specific mortality risk.