Diet and weight in midlife affect your odds of healthy aging

People who gain excess weight from their 20s onwards have less healthy hearts by the time they are in their 60s. That’s according to a new study published in the European Heart Journal, which was led by Professor Alun Hughes from University College London.

“We know that being overweight is associated with poorer heart health, but we know little about the long-term relationship between being overweight over the adult life course and subsequent heart health,” Hughes said. “We wanted to look at whether being overweight at earlier stages of adult life showed lasting associations with poorer heart health irrespective of people’s weight in later life.”

Researchers examined data on 1690 people who are part of the British Medical Research Council National Survey of Health and Development Birth Cohort. Throughout their adult lives, these people had their body mass index (BMI) and waist-to-hip ratio measured. They were also given echocardiograms, where ultrasound is used to investigate the structure and function of the heart. The researchers were particularly interested in a measurement called the left ventricular mass, because when this is higher than expected, it indicates a larger amount of heart tissue and an increased risk of death from heart disease.

The data showed that people whose BMI was elevated at any time from age 20 onwards had higher left ventricular mass in their 60s, even when researchers took account of people’s BMI in their 60s. For example, in an average 43-year-old, a five-unit higher BMI corresponded with a 15% or 27-gram increase in left ventricular mass.

“This suggests that weight gain, even at a young age, leads to heart damage over and above the effects of being overweight in later life,” Hughes said.

“Maintaining a healthy weight is likely to be important for people even in early adulthood and if we want to improve heart health in the long term, we need to prevent weight gain in people of all ages.”

The researchers caution that the study included mostly white European people, so it may not apply to the global population. It also cannot prove incontrovertibly that earlier weight gain causes heart damage — only that the two are closely linked.

“It also does not tell us how the two are linked, but if being overweight has effects on the heart that are irreversible or only partially reversible then we might expect to see heart damage that accumulates and worsens throughout life,” Hughes said.

“If we want to improve heart health in the long term, we need to prevent weight gain in people of all ages.”

The research was announced just weeks after a separate study, presented at NUTRITION 2024 by Harvard University’s Dr Anne-Julie Tessier, revealed the importance of diet in midlife, finding that people who followed a healthy diet from their 40s onward were 43–84% more likely to be well-functioning physically and mentally at age 70 compared with those who did not.

Researchers analysed data from over 106,000 people going back to 1986. Participants were at least 39 years old and free of chronic diseases at the start of the study and provided information about their diet via questionnaires every four years. As of 2016, nearly half of the study participants had died and only 9.2% survived to age 70 or older while maintaining freedom from chronic diseases and good physical, cognitive and mental health.

The researchers compared rates of healthy aging among people in the highest versus lowest quintiles for adherence to each of eight healthy dietary patterns that have been defined by previous scientific studies. The strongest correlation was seen with the alternative healthy eating index, a pattern that reflects close adherence to the Dietary Guidelines for Americans. Participants in the top quintile for this dietary pattern were 84% more likely to achieve healthy aging than those in the bottom quintile.

Strong correlations were also found for the empirical dietary index for hyperinsulinemia diet (associated with a 78% greater likelihood of healthy aging), planetary health diet (68%), alternative Mediterranean diet (67%), dietary approaches to stop hypertension (DASH) diet (66%), the Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet (59%) and empirical dietary inflammatory pattern (58%). A somewhat more modest association was found for the healthful plant-based diet (43%).

“A finding that stood out was the association between the planetary health diet and healthy aging,” Tessier said. “This diet is based on the EAT-Lancet Commission’s report, which emphasises fruits, vegetables, whole grains, plant proteins and healthy fats from sustainable sources.”

Tessier noted that each of the healthy dietary patterns was linked with healthy aging as a whole, as well as with individual components of healthy aging including physical health, cognitive functioning and mental health. The ties between diet and healthy aging remained strong even when the researchers accounted for physical activity and other factors that are known to impact health.

Tessier added that dietary guidelines have traditionally focused on preventing chronic diseases like heart disease, but this study provides evidence for dietary recommendations to promote overall healthy aging as a long-term goal. Given the study’s focus on dietary patterns in middle age, Tessier said that future research could help to elucidate the potential impacts of switching to a healthier dietary pattern later in life.

Image credit: iStock.com/Vadym Petrochenko