Abstract
BACKGROUND/OBJECTIVES: There is variability in the association between dietary intake and health outcomes across different countries, especially among the elderly. We used the gold standard dietary assessment method, a weighed food record, to examine the association between dietary pattern and mortality in a representative sample of community dwelling participants from Great Britain aged 65 years and older. SUBJECTS/METHODS: Dietary intake was recorded at baseline in 1017 elderly participants (520 men, 497 women, mean age 76.3+/-7.4 years). Exploratory factor analysis was performed to examine dietary patterns and participants were followed up over an average of 9.2 years for mortality. RESULTS: The factor analysis revealed four interpretable principal components accounting for approximately 9.8% of the total variance, with similar patterns across sex. A 'Mediterranean-style' dietary pattern explained the greatest proportion of the variance (3.7%), followed by 'health-aware' (2.2%), 'traditional' (2.0%) and 'sweet and fat' (1.9%) factors. There were a total of 683 deaths through follow-up. After adjustment for potential confounders, only the Mediterranean-style dietary pattern remained associated with mortality (highest vs lowest tertile; hazard ratio=0.82, 95% CI, 0.68-1.00). The benefits of the Mediterranean-style diet were only observed among women (hazard ratio=0.71, 95% CI 0.52-0.96) although in men the traditional diet was a risk factor for mortality (hazard ratio=1.30, 95% CI 1.00-1.71). CONCLUSIONS: Using a gold standard approach, our results confirm previous evidence that dietary patterns are important in longevity among the elderly.