Diet quality and multimorbidity in older adults: a prospective cohort study

Background The role of diet quality in the accumulation of multiple chronic conditions is mostly unknown. This study examined diet quality in association with the number of chronic conditions and the rate of multimorbidity development among community-dwelling older adults. Methods We used data from 2784 adults aged ≥65 years from the Seniors-ENRICA 2 cohort. Diet quality was assessed at baseline (2015–2017) with the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Mediterranean Diet Adherence Screener (MEDAS). Information on medical diagnoses was obtained from electronic clinical records up to 2021. Results Higher adherence to the AHEI-2010 was associated with a lower number of total chronic conditions [β (95% CI) quartile 4 vs. 1: -0.57 (-0.86, 0.27), P trend <0.001] and cardiometabolic conditions [-0.30 (-0.44, -0.17), P trend <0.001] at baseline, while higher adherence to the MEDAS was associated with lower number of total chronic conditions [-0.30 (-0.58, -0.02), P trend =0.01] and neuropsychiatric and neurodegenerative conditions [-0.09 (-0.17, -0.01), P trend =0.01]. After a median follow-up of 5.2 years (range: 0.1–6.1 years) higher adherence to the AHEI-2010 was associated with a lower increase in chronic conditions [β (95% confidence interval) quartile 4 vs. 1: -0.16 (-0.30, -0.01), P trend =0.04] and with lower rate of chronic disease accumulation. Conclusion Higher diet quality, as measured by the AHEI-2010, was associated with a lower number of chronic health conditions and a lower rate of multimorbidity development over time.