Dietary diversity and all-cause mortality among Chinese adults aged 65 or older: A community-based cohort study

To evaluate the association between dietary diversity and all-cause mortality in older adults.

17,949 community-based elderly participants aged ≥65 years in China were included in this cohort study. The baseline consumption frequencies of nine food groups (meat, vegetables, fish, eggs, fruits, legumes, milk, tea, and nuts) were recorded, and the dietary diversity score (0-9) was calculated. Survival status and death date were collected during follow-up. Cox proportional-hazards models were used to assess the association between dietary diversity and all-cause mortality.

We identified 8445 death events over 57,685 person-years of follow-up. Compared with participants in the lowest dietary diversity score group (score 0-1), higher dietary diversity scores were associated with lower mortality risk in univariate models. After adjusting for potential confounders, participants in the higher dietary diversity score group had a 9%-30% lower risk in all-cause mortality (p trend <0.001) compared with those in the lowest dietary diversity score group. The inverse relationship between dietary diversity score and all-cause mortality was also significant in four food groups (vegetables, fish, fruits, and nuts). Similar results were observed in sensitivity analyses.

Our study showed that dietary diversity was inversely associated with all-cause mortality in the Chinese elderly, especially in the oldest old and men. Therefore, increasing dietary diversity may reduce mortality rates in the older population, and tailored interventions for improving dietary diversity are required to benefit health and survival in them.