Dietary behavior patterns and short-term pace of aging-evidence from a Chinese cohort

Unhealthy dietary behaviors have been associated with increased risks of mortality and chronic diseases, yet mortality is a distal endpoint that requires long-term follow-up and is therefore poorly suited for short-term evaluation. Aging, which lies upstream of mortality and is modifiable by lifestyle factors, may serve as a meaningful early intermediate outcome. However, evidence linking dietary behavior patterns to short-term changes in the pace of biological aging remains limited. Therefore, we conducted this study to examine the associations between dietary behavior patterns and short-term changes in the pace of biological aging in a Chinese adult population, and to assess whether these associations vary by follow-up duration and chronological age.

In a longitudinal cohort from two health management centers in China, dietary behavior patterns were identified using data-driven clustering approaches and categorized into low-, moderate-, and high-risk groups. Changes in biological age, estimated from multi-system biomarkers, were used to quantify short-term aging pace. Associations over 12- and 24-month follow-up periods were assessed using weighted longitudinal models.

Among 71,579 participants in the longitudinal cohort, higher-risk dietary behavior patterns were associated with greater increases in biological age over 12 months. When dietary behavior pattern was modeled as an ordinal exposure, each per-level increase in dietary risk was associated with a 0.017-year higher change in biological age at 12 months (95% CI: 0.003, 0.030). In contrast, no statistically significant associations were observed at 24 months. Associations were generally consistent across chronological age groups. Exploratory analyses of individual behavioral dimensions showed similar short-term patterns.

Adverse dietary behavior patterns were associated with modest but detectable short-term acceleration in biological aging, with attenuation over time. These findings support the use of short-term biological aging measures as intermediate outcomes for evaluating early physiological responses to dietary behaviors.