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Health

These healthy diets were associated with lower risk of death, according to a study of 119,000 people across four decades

Eat healthy, live longer.

That’s the takeaway from a major study published this month in JAMA Internal Medicine. Scientists led by a team from the Harvard TH Chan School of Public Health found that people who most closely adhered to at least one of four healthy eating patterns were less likely to die from cardiovascular disease, cancer or respiratory disease compared with people who did not adhere as closely to these diets. They were also less likely to die of any cause.

“These findings support the recommendations of Dietary Guidelines for Americans that multiple healthy eating patterns can be adapted to individual food traditions and preferences,” the researchers concluded, adding that the results were consistent across different racial and ethnic groups. The eating habits and mortality rates of more than 75,000 women from 1984 to 2020 over 44,000 men from 1986 to 2020 were included in the study.

The four diets studied were the Healthy Eating Index, the Alternate Mediterranean Diet, the Healthful Plant-Based Diet Index and the Alternate Healthy Eating Index. All four share some components, including whole grains, fruits, vegetables, nuts and legumes. But there are also differences: For instance, the Alternate Mediterranean Diet encourages fish consumption, and the Healthful Plant-Based Diet Index discourages eating meat.

The Alternate Mediterranean Diet is adapted from the original Mediterranean Diet, which includes olive oil (which is rich in omega-3 fatty acids), fruits, nuts, cereals, vegetables, legumes and fish. It allows for moderate consumption of alcohol and dairy products but low consumption of sweets and only the occasional serving of red meat. The alternate version, meanwhile, cuts out dairy entirely, only includes whole grains and uses the same alcohol-intake guideline for men and women, JAMA says.

The world’s ‘best diets’ overlap with study results

The Mediterranean Diet consistently ranks No. 1 in the US News and World Report’s Best Diets ranking, which looks at seven criteria: short-term weight loss, long-term weight loss, effectiveness in preventing cardiovascular disease, effectiveness in preventing diabetes, ease of compliance, nutritional completeness and health risks. The 2023 list ranks the top three diets as the Mediterranean Diet, the DASH Diet and the Flexitarian Diet.

The DASH (Dietary Approaches to Stop Hypertension) Diet recommends fruits, vegetables, nuts, whole grains, poultry, fish and low-fat dairy products and restricts salt, red meat, sweets and sugar-sweetened beverages. The Flexitarian Diet is similar to the other diets in that it’s mainly vegetarian, but it allows the occasional serving of meat or fish. All three diets are associated with improved metabolic health, lower blood pressure and reduced risk of Type 2 diabetes.

Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health and co-author of the latest study, said it’s critical to examine the associations between the US government’s Dietary Guidelines for Americans and long-term health. “Our findings will be valuable for the 2025-2030 Dietary Guidelines Advisory Committee, which is being formed to evaluate current evidence surrounding different eating patterns and health outcomes,” he said.

Reducing salt intake is a good place to start. In 2021, the Food and Drug Administration issued new guidance for restaurants and food manufacturers to, over a two-and-a-half-year period, voluntarily reduce the amount of sodium in their food to help consumers stay under a limit of 3,000 milligrams per day — still higher than the recommended daily allowance. Americans consume around 3,400 milligrams of sodium per day, on average, but the Centers for Disease Control and Prevention recommends that people consume less than 2,300 milligrams each day.

Related: Eating 400 calories a day from these foods could raise your dementia risk by over 20%

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Health

10 medical tests every older adult should get

Maintaining your physical fitness and mental well-being is crucial to living a longer and happy life.

There are about two dozen tests or screenings older adults can get to help ensure optimal health and wellness, based on recommendations from the US Preventive Services Task Force, an independent panel of experts in primary care and prevention, and on Medicare’s coverage of preventive health service .

Of course, exactly which tests you need depends on a variety of factors, including your age, weight, sex, family history and risk factors, as well as on your doctor’s recommendations.

The Affordable Care Act mandates preventive care with no cost-sharing, so in 2011, Medicare began offering a variety of free preventive-health services. Some services may need to be ordered during an annual wellness visit in order to be covered; otherwise, you may need to cover the costs out of pocket or with private insurance.

“People are living into their 90s, independently and in the community, and loving it. But in order to get there, you’ve got to do this stuff,” said Richard Besdine, a professor of medicine and public health at Brown University. “Not all of these are fatal diseases, but they can take the fun out of life. And what’s the point of that?”

Besdine said a Mediterranean-style diet and daily exercise are at the top of the list of the most important habits for aging well. Adequate sleep is also crucial, as are quitting smoking and limiting alcohol.

Mental health is equally important. Many older adults face depression, loneliness and isolation amid life changes such as the loss of a spouse. Ask a doctor for a depression screening if you or a loved one are showing any signs of depression.

And keep up with vaccines, such as those for COVID-19, shingles and the flu. Also consider getting the pneumococcal polysaccharide vaccine (PPSV23), which helps protect against meningitis and bloodstream infections, and the pneumococcal conjugate vaccine (PCV13), which protects against pneumonia.

Here’s a rundown of routine tests you should get as an older adult:

eye testing
Eye health may decline gradually as people get older, but the changes may not be noticeable right away. Poor eyesight can affect your ability to drive, get around the house and perform daily tasks. Also, as you age, the risk for eye problems such as cataracts and glaucoma increases.

In addition, recent research has found that up to 100,000 US dementia cases could have potentially been prevented with improved eye care.

According to a study published this year in JAMA Neurology, one of the top things you can do to help reduce your risk for Alzheimer’s and related dementias is to get vision problems corrected with the help of eye exams, eyeglasses and cataract surgery.

Researchers found that about 1.8% of US dementia cases were associated with visual impairment and projected that by 2050, that total would rise to around 250,000 cases. The investigators also found that incidence of impaired vision in older adults was higher for Hispanic people, at 11%, compared with 8.3% on average for Black and non-Hispanic white people.

Last year, a study published in the British Journal of Ophthalmology also suggested that certain eye conditions including age-related macular degeneration, cataracts and diabetes-related eye disease may be associated with an increased risk of dementia.

“Avoiding dementia is the No. 1 job of physicians and patients,” Besdine said. “Do everything you can to maintain your mental and physical health.”

Hearing exam
While we’re talking about dementia, get your hearing tested — and get a hearing aid if you need one.

If you have hearing loss, you have a greater chance of developing dementia, according to a 2020 Lancet commission report that listed hearing loss as one of the top risk factors for dementia.

People with moderate hearing loss were twice as likely to experience cognitive decline as their peers, while those with severe hearing loss faced five times the risk, research has found.

In the US, hearing aids are now available over the counter — and they cost just hundreds of dollars, rather than the several thousands that prescription devices can cost. The White House estimated that people could save nearly $3,000 by buying over-the-counter devices.

Also read: ‘It democratizes what you get’: Hearing aids are now available over the counter — what you need to know

Walmart WMT,
+0.84%,
Walgreen WBA,
-1.12%,
CVS CVS,
+1.54%
and Best Buy BBY,
+1.53%
are among the national retailers that now sell hearing aids.

Dental examination
Gum disease increases the risk of a heart attack. That alone should get you to the dentist, but gum health can also be a good barometer of your overall health. Your teeth, gums, mouth and throat need to be checked by a dentist, ideally twice a year. Medicare does not cover dental checkups, however, so private insurance or out-of-pocket payments are necessary.

Blood-pressure screening
High blood pressure, or hypertension, is common; more than half of the adults in the US have it. As you age, your arteries change and become stiffer. Left untreated, hypertension can lead to strokes, heart attacks and heart disease.

Diabetes screening
After age 65, both men and women should be screened for diabetes regularly. The American Diabetes Association recommends that a fasting blood-sugar test be done at least once every three years in order catch diabetes early and manage it so it doesn’t become a life-threatening disorder.

Breast cancer screening
The Mayo Clinic supports screening for breast cancer beginning at age 40. Women up to age 75 should get a mammogram every one to two years, depending on their risk factors. Risk factors include having started menstruation before age 12, a family history of breast cancer, dense breasts and genetic mutations. After age 75, women should discuss the need for continued breast-cancer screening with their doctor.

Osteoporosis screening
As you age, your bones become thinner, which can make you more susceptible to fractures or breaks, especially in the hips and spine. All women older than 64 should get a bone-density scan at least once a year. Men over 70 should also consider getting screened for osteoporosis, especially if the condition runs in their family.

prostate cancer
Prostate cancer is a common disease among men, especially those over the age of 65. Doctors can check for prostate cancer with a physical examination and a blood test. Some signs of prostate cancer include difficulty urinating, unexplained weight loss or blood in the urine.

Colon-cancer screening
Colorectal cancer is more common among older adults, with an average age at diagnosis of 68 for men and 72 for women. If you experience changes in bowel habits, abdominal pain or bleeding, see your doctor.

The US Preventive Services Task Force recommends that adults age 45 to 75 be screened for colorectal cancer. Types of screening include stool tests, flexible sigmoidoscopy, colonoscopy and CT colonography (virtual colonoscopy). Adults ages 76 to 85 should talk to their doctor about whether they should continue to get screened.

skin review
The American Cancer Society recommends regular screening for skin cancer. Be sure to ask your doctor to check your skin if you have any unusual moles or skin changes or if you’re at high risk with a history of skin cancer, have close relatives with skin cancer or have a weakened immune system.

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