Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Dietary patterns, assessed from a weighed food record, and survival among elderly participants from the United Kingdom

European Journal of Clinical Nutrition volume 64, pages 853–861 (2010)Cite this article

Subjects

Abstract

Background/Objectives:

There is variability in the association between dietary intake and health outcomes across different countries, especially among the elderly. We used the gold standard dietary assessment method, a weighed food record, to examine the association between dietary pattern and mortality in a representative sample of community dwelling participants from Great Britain aged 65 years and older.

Subjects/Methods:

Dietary intake was recorded at baseline in 1017 elderly participants (520 men, 497 women, mean age 76.3±7.4 years). Exploratory factor analysis was performed to examine dietary patterns and participants were followed up over an average of 9.2 years for mortality.

Results:

The factor analysis revealed four interpretable principal components accounting for approximately 9.8% of the total variance, with similar patterns across sex. A ‘Mediterranean-style’ dietary pattern explained the greatest proportion of the variance (3.7%), followed by ‘health-aware’ (2.2%), ‘traditional’ (2.0%) and ‘sweet and fat’ (1.9%) factors. There were a total of 683 deaths through follow-up. After adjustment for potential confounders, only the Mediterranean-style dietary pattern remained associated with mortality (highest vs lowest tertile; hazard ratio=0.82, 95% CI, 0.68–1.00). The benefits of the Mediterranean-style diet were only observed among women (hazard ratio=0.71, 95% CI 0.52–0.96) although in men the traditional diet was a risk factor for mortality (hazard ratio=1.30, 95% CI 1.00–1.71).

Conclusions:

Using a gold standard approach, our results confirm previous evidence that dietary patterns are important in longevity among the elderly.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  • Bamia C, Orfanos P, Ferrari P, Overvad K, Hundborg HH, Tjønneland A et al. (2005). Dietary patterns among older Europeans: the EPIC-Elderly study. Br J Nutr 94, 100–113.

    Article  CAS  Google Scholar 

  • Bamia C, Trichopoulos D, Ferrari P, Overvad K, Bjerregaard L, Tjønneland A et al. (2007). Dietary patterns and survival of older Europeans: the EPIC-Elderly Study (European Prospective Investigation into Cancer and Nutrition). Public Health Nutr 10, 590–598.

    Article  Google Scholar 

  • Bates CJ, Walmsley CM, Prentice A, Finch S (1999). Use of medicines by older people in a large British national survey, and their relation to vitamin status indices. Pub Health Nutr 2, 15–22.

    CAS  Google Scholar 

  • Brunner EJ, Mosdøl A, Witte DR, Martikainen P, Stafford M, Shipley MJ et al. (2008). Dietary patterns and 15-y risks of major coronary events, diabetes, and mortality. Am J Clin Nutr 87, 1414–1421.

    Article  CAS  Google Scholar 

  • Christensen K, Doblhammer G, Rau R, Vaupel JW (2009). Ageing populations: the challenges ahead. Lancet 374, 1196–1208.

    Article  Google Scholar 

  • Cox BD, Whichelow MJ, Prevost AT (2000). Seasonal consumption of salad vegetables and fresh fruit in relation to the development of cardiovascular disease and cancer. Public Health Nutr 3, 19–29.

    Article  CAS  Google Scholar 

  • Department of Health (1991). Dietary reference values for food energy and nutrients for the United Kingdom. Report of the panel on dietary reference values of the committee on medical aspects of food policy. HMSO: London.

  • Fargnoli JL, Fung TT, Olenczuk DM, Chamberland JP, Hu FB, Mantzoros CS (2008). Adherence to healthy eating patterns is associated with higher circulating total and high-molecular-weight adiponectin and lower resistin concentrations in women from the Nurses’ Health Study. Am J Clin Nutr 88, 1213–1224.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Finch S (1998). National diet and nutrition survey people aged 65 years or over. Volume 1 Report of the Diet and Nutrition Survey. The Stationery Office: London.

    Google Scholar 

  • Fung TT, Chiuve SE, McCullough ML, Rexrode KM, Logroscino G, Hu FB (2008). Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med 168, 713–720.

    Article  Google Scholar 

  • Hamer M, Mishra GD (2009). Dietary patterns and cardiovascular risk markers in the UK Low Income Diet and Nutrition Survey. Nutr Metab Cardiovasc Dis, e-pub ahead of print 17 August 2009.

  • Heidemann C, Hoffmann K, Spranger J, Klipstein-Grobusch K, Möhlig M, Pfeiffer AF et al. (2005). A dietary pattern protective against type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)—Potsdam Study cohort. Diabetologia 48, 1126–1134.

    Article  CAS  Google Scholar 

  • Hoffmann K, Boeing H, Boffetta P, Nagel G, Orfanos P, Ferrari P (2005). Comparison of two statistical approaches to predict all-cause mortality by dietary patterns in German elderly subjects. Br J Nutr 93, 709–716.

    Article  CAS  Google Scholar 

  • Hu FB, Rimm EB, Stampfer MJ, Ascherio A, Spiegelman D, Willett WC (2000). Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr 72, 912–921.

    Article  CAS  Google Scholar 

  • Khani BR, Ye W, Terry P, Wolk A (2004). Reproducibility and validity of major dietary patterns among Swedish women assessed with a food-frequency questionnaire. J Nutr 134, 1541–1545.

    Article  CAS  Google Scholar 

  • Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menotti A et al. (2004). Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. JAMA 292, 1433–1439.

    Article  Google Scholar 

  • Lopez-Garcia E, Schulze MB, Fung TT, Meigs JB, Rifai N, Manson JE et al. (2004). Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 80, 1029–1035.

    Article  CAS  Google Scholar 

  • Masala G, Ceroti M, Pala V, Krogh V, Vineis P, Sacerdote C et al. (2007). A dietary pattern rich in olive oil and raw vegetables is associated with lower mortality in Italian elderly subjects. Br J Nutr 98, 406–415.

    Article  CAS  Google Scholar 

  • McCann SE, Marshall JR, Brasure JR, Graham S, Freudenheim JL (2001). Analysis of patterns of food intake in nutritional epidemiology: food classification in principle components analysis and the subsequent impact on estimates for endometrial cancer. Public Health Nutr 4, 989–997.

    CAS  PubMed  Google Scholar 

  • McNaughton SA, Mishra GD, Stephen AM, Wadsworth MEJ (2007). Dietary patterns throughout adult life are associated with body mass index, waist circumference, blood pressure and red cell folate. J Nutr 137, 99–105.

    Article  CAS  Google Scholar 

  • Mishra GD, McNaughton SA, Bramwell G, Wadsworth MEJ (2006). Longitudinal changes in dietary patterns during adult life. Br J Nutr 96, 735–744.

    CAS  PubMed  Google Scholar 

  • Mishra GD, Prynne CJ, Paul AA, Greenberg DC, Bolton-Smith C (2004). The impact of inter-generational social and regional circumstances on dietary intake patterns of British adults: results from the 1946 British Birth Cohort. Public Health Nutr 7, 737–744.

    Article  CAS  Google Scholar 

  • Myint PK, Welch AA, Bingham SA, Surtees PG, Wainwright NW (2007). Fruit and vegetable consumption and self-reported functional health in men and women in the European Prospective study into Cancer-Norfolk (EPIC-Norfolk): a population-based cross-sectional study. Public Health Nutr 10, 34–41.

    Article  Google Scholar 

  • Nettleton JA, Polak JF, Tracy R, Burke GL, Jacobs Jr DR (2009). Dietary patterns and incident cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr 90, 647–654.

    Article  CAS  Google Scholar 

  • Nettleton JA, Steffen LM, Mayer-Davis EJ, Jenny NS, Jiang R, Herrington DM et al. (2006). Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr 83, 1369–1379.

    Article  CAS  Google Scholar 

  • Newby PK, Muller D, Hallfrisch J, Andres R, Tucker KL (2004). Food patterns measured by factor analysis and anthropometric changes in adults. Am J Clin Nutr 80, 504–513.

    Article  CAS  Google Scholar 

  • Pala V, Sieri S, Masala G, Palli D, Panico S, Vineis P (2006). Associations between dietary pattern and lifestyle, anthropometry and other health indicators in the elderly participants of the EPIC-Italy cohort. Nutr Metab Cardiovasc Dis 16, 186–201.

    Article  Google Scholar 

  • Pryer JA, Cook A, Shetty P (2001a). Identification of groups who report similar patterns of diet among a representative national sample of British adults aged 65 years of age or more. Public Health Nutr 4, 787–795.

    Article  CAS  Google Scholar 

  • Pryer JA, Nichols R, Elliott P, Thakrar B, Brunner E, Marmot M (2001b). Dietary patterns among a national random sample of British adults. J Epidemiol Comm Health 55, 29–37.

    Article  CAS  Google Scholar 

  • Schulz M, Hoffmann K, Weikert C, Nöthlings U, Schulze MB, Boeing H (2008). Identification of a dietary pattern characterized by high-fat food choices associated with increased risk of breast cancer: the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Br J Nutr 100, 942–946.

    Article  CAS  Google Scholar 

  • Trichopoulou A, Orfanos P, Norat T, Bueno-de-Mesquita B, Ocké MC, Peeters PH et al. (2005). Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ 330, 991.

    Article  Google Scholar 

  • van Dam RM, Rimm EB, Willett WC, Stampfer MJ, Hu FB (2002). Dietary patterns and risk for type 2 diabetes mellitus in U.S. men. Ann Intern Med 136, 201–209.

    Article  Google Scholar 

  • Waijers PM, Ocké MC, van Rossum CT, Peeters PH, Bamia C, Chloptsios Y et al. (2006). Dietary patterns and survival in older Dutch women. Am J Clin Nutr 83, 1170–1176.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We are indebted to Claire Deverill and Marie Sanchez (NatCen) for assistance in obtaining the mortality data. The survey was commissioned jointly by the Department of Health and the Ministry of Agriculture, Fisheries and Food, whose survey responsibility has since been transferred to the Food Standards Agency. It was carried out by the National Centre for Social Research (NatCen), formerly Social and Community Planning Research (SCPR) in conjunction with the Micronutrient Status Laboratory of the MRC Dunn Nutrition Unit, now part of MRC Human Nutrition Research. The survey data sets were obtained from the survey commissioners, the University of Essex Data Archive and the Social Survey Division of the Office for National Statistics, and funding was also provided by The Medical Research Council. The funders have not influenced this research or its publication. SAM was supported by a National Health and Medical Research Council Public Health Postdoctoral Research Fellowship.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Public Health, University College London, London, UK

    M Hamer & G D Mishra

  2. Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Victoria, Australia

    S A McNaughton

  3. MRC Human Nutrition Research, Cambridge, UK

    C J Bates

Authors
  1. M Hamer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S A McNaughton
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C J Bates
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G D Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Hamer.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Contributors: MH, CJB, GDM had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors contributed to the concept and design of study, drafting and critical revision of the article.

Appendices

Appendix A

Spearman's rank correlation coefficients between dietary pattern score and blood nutrient biomarkers.

Table A1

Table 4 Table a1
Full size table

Appendix B

Original food and drink categories

Table A2

Table 5 Table a2
Full size table

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hamer, M., McNaughton, S., Bates, C. et al. Dietary patterns, assessed from a weighed food record, and survival among elderly participants from the United Kingdom. Eur J Clin Nutr 64, 853–861 (2010). https://doi.org/10.1038/ejcn.2010.93

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2010.93

Keywords

This article is cited by

Search

Advanced search

Quick links