Adult height, dietary patterns, and healthy aging

Abstract

Background: Adult height has shown directionally diverse associations with several age-related disorders, including cardiovascular disease, cancer, decline in cognitive function, and mortality.Objective: We investigated the associations of adult height with healthy aging measured by a full spectrum of health outcomes, including incidence of chronic diseases, memory, physical functioning, and mental health, among populations who have survived to older age, and whether lifestyle factors modified such relations.Design: We included 52,135 women (mean age: 44.2 y) from the Nurses' Health Study without chronic diseases in 1980 and whose health status was available in 2012. Healthy aging was defined as being free of 11 major chronic diseases and having no reported impairment of subjective memory, physical impairment, or mental health limitations.Results: Of all eligible study participants, 6877 (13.2%) were classified as healthy agers. After adjustment for demographic and lifestyle factors, we observed an 8% (95% CI: 6%, 11%) decrease in the odds of healthy aging per SD (0.062 m) increase in height. Compared with the lowest category of height (≤1.57 m), the OR of achieving healthy aging in the highest category (≥1.70 m) was 0.80 (95% CI: 0.73, 0.87; P-trend < 0.001). In addition, we found a significant interaction of height with a prudent dietary pattern in relation to healthy aging (P-interaction = 0.005), and among the individual dietary factors characterizing the prudent dietary pattern, fruit and vegetable intake showed the strongest effect modification (P-interaction = 0.01). The association of greater height with reduced odds of healthy aging appeared to be more evident among women with higher adherence to the prudent dietary pattern rich in vegetable and fruit intake.Conclusions: Greater height was associated with a modest decrease in the likelihood of healthy aging. A prudent diet rich in fruit and vegetables might modify the relation.

Keywords: adult height; dietary pattern; fruit and vegetables; healthy aging; lifestyle.

FIGURE 1

ORs (95% CIs) of healthy aging according to joint categories of height and prudent dietary pattern score. The analysis included 5844 healthy agers and 38,281 usual agers. The logistic regression model was adjusted for the following: age (years); ethnicity (white: yes or no); education (registered nurse, bachelor, or graduate); marriage status (married, widowed, or separated/divorced); menopausal status (pre- or postmenopausal; never, past, or current menopausal hormone use); smoking status (never smoked; pack-years: 1.0–9.9, 10.0–24.9, 25.0–44.9, or ≥45.0); alcohol intake (0, 0.1–4.9, 5.0–14.9, 15.0–19.9, 20.0–29.9, or ≥30.0 g/d); physical activity (0, 0.01–0.9, 1.0–3.5, 3.6–5.9, or ≥6.0 h/wk); BMI (kg/m²: <23.0, 23.0–24.9, 25.0–26.9, 27.0–28.9, 29.0–30.9, 31.0–32.9, 33.0–34.9, 35.0–36.9, 37.0–38.9, 39.0–40.9, 41.0–42.9, 43.0–44.9, or ≥45.0); family history of myocardial infarction, cancer, or diabetes (yes or no); baseline history of hypertension or hypercholesterolemia (yes or no); aspirin use (yes or no); multivitamin use (yes or no); and total energy intake (quintiles). Q, quintile.

FIGURE 2

ORs (95% CIs) of healthy aging according to joint categories of height and dietary intake of fruit and vegetables. The analysis included 5844 healthy agers and 38,281 usual agers. The logistic regression model was adjusted for the following: age (years); ethnicity (white: yes or no); education (registered nurse, bachelor, or graduate); marriage status (married, widowed, or separated/divorced); menopausal status (pre- or postmenopausal; never, past, or current menopausal hormone use); smoking status (never smoked; pack-years: 1.0–9.9, 10.0–24.9, 25.0–44.9, or ≥45.0); alcohol intake (0, 0.1–4.9, 5.0–14.9, 15.0–19.9, 20.0–29.9, or ≥30.0 g/d); physical activity (0, 0.01–0.9, 1.0–3.5, 3.6–6.0, or ≥6.0 h/wk); BMI (kg/m²: <23.0, 23.0–24.9, 25.0–26.9, 27.0–28.9, 29.0–30.9, 31.0–32.9, 33.0–34.9, 35.0–36.9, 37.0–38.9, 39.0–40.9, 41.0–42.9, 43.0–44.9, or ≥45.0); family history of myocardial infarction, cancer, or diabetes (yes or no); baseline history of hypertension or hypercholesterolemia (yes or no); aspirin use (yes or no); multivitamin use (yes or no); total energy intake (quintiles); and modified Alternate Healthy Eating Index score (excluding fruit and vegetables; quintiles). Q, quintile.