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Background <p>Diet quality may influence the progression from health to chronic disease, multimorbidity, and death, but current evidence is limited.</p> Methods <p>We aimed to assess the association between diet quality and the risk of transitioning among four health states using multi-state models: from a healthy (disease-free) state to developing one predefined chronic disease, to multimorbidity and lastly, to death. A total of 84,293 healthy individuals (40–70 years) from the UK Biobank were included and diet quality was assessed through four separate exposures using well-established scores: the Alternate Mediterranean Diet Index (aMED), the Dietary Approaches to Stop Hypertension (DASH), the Alternative Healthy Eating Index 2010 (AHEI-2010), and the healthful Plant-based Diet Index (hPDI).</p> Results <p>Over 11.2 years follow-up, 22,723 participants developed one predefined chronic disease and 4368 progressed to multimorbidity. A total of 2886 deaths occurred: 770 after multimorbidity, 1512 after one chronic condition, and 604 among participants who did not develop any of the diseases under study. Higher adherence to aMED, DASH, and AHEI-2010 was associated with a reduced risk of developing one chronic disease [HR (95% CI) for highest vs. lowest tertile: 0.92 (0.89, 0.95), 0.94 (0.91, 0.98), and 0.92 (0.89, 0.95)]. aMED was also associated with lower risk of death without any disease [HR: 0.72 (0.56, 0.92)]. aMED and DASH were associated with lower risk of progression to multimorbidity [HRs: 0.92 (0.86, 0.98) and 0.90 (0.83, 0.98)]. aMED and hPDI were associated with lower risk of death after a first disease [HRs: 0.89 (0.79, 1.00) and 0.87 (0.77, 0.98)]. All scores except hPDI were associated with a reduced risk of death after multimorbidity [0.76 (0.61, 0.95) for aMED, 0.71 (0.59, 0.86) for DASH, and 0.80 (0.65, 0.97) for AHEI-2010].</p> Conclusions <p>Our findings indicate that greater adherence to healthy dietary patterns was associated with a reduced risk of progression towards one predefined chronic condition, multimorbidity and death, highlighting their potential protective role in long-term health.</p>

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Diet quality and progression from health to chronic disease, multimorbidity and mortality in the UK Biobank

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月3日

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  • Aitana Vázquez-Fernández,
  • Humberto Yévenes-Briones,
  • Alberto Lana,
  • Ana Baylin,
  • Francisco Félix Caballero,
  • Esther Lopez-Garcia

摘要

Background

Diet quality may influence the progression from health to chronic disease, multimorbidity, and death, but current evidence is limited.

Methods

We aimed to assess the association between diet quality and the risk of transitioning among four health states using multi-state models: from a healthy (disease-free) state to developing one predefined chronic disease, to multimorbidity and lastly, to death. A total of 84,293 healthy individuals (40–70 years) from the UK Biobank were included and diet quality was assessed through four separate exposures using well-established scores: the Alternate Mediterranean Diet Index (aMED), the Dietary Approaches to Stop Hypertension (DASH), the Alternative Healthy Eating Index 2010 (AHEI-2010), and the healthful Plant-based Diet Index (hPDI).

Results

Over 11.2 years follow-up, 22,723 participants developed one predefined chronic disease and 4368 progressed to multimorbidity. A total of 2886 deaths occurred: 770 after multimorbidity, 1512 after one chronic condition, and 604 among participants who did not develop any of the diseases under study. Higher adherence to aMED, DASH, and AHEI-2010 was associated with a reduced risk of developing one chronic disease [HR (95% CI) for highest vs. lowest tertile: 0.92 (0.89, 0.95), 0.94 (0.91, 0.98), and 0.92 (0.89, 0.95)]. aMED was also associated with lower risk of death without any disease [HR: 0.72 (0.56, 0.92)]. aMED and DASH were associated with lower risk of progression to multimorbidity [HRs: 0.92 (0.86, 0.98) and 0.90 (0.83, 0.98)]. aMED and hPDI were associated with lower risk of death after a first disease [HRs: 0.89 (0.79, 1.00) and 0.87 (0.77, 0.98)]. All scores except hPDI were associated with a reduced risk of death after multimorbidity [0.76 (0.61, 0.95) for aMED, 0.71 (0.59, 0.86) for DASH, and 0.80 (0.65, 0.97) for AHEI-2010].

Conclusions

Our findings indicate that greater adherence to healthy dietary patterns was associated with a reduced risk of progression towards one predefined chronic condition, multimorbidity and death, highlighting their potential protective role in long-term health.