Do you know the most popular diets that impact longevity?

Highlights:

• There are many factors that play a role in what diet is going to be optimal for longevity for individuals such as health status, body type, or even budget.
• The most extensively studied longevity-promoting diets are the Mediterranean diet, plant-based diets, the Okinawa diet, and the DASH diet.
• The most notable longevity-promoting eating patterns come from the Blue Zones and nutritional research expands on them.
• There are certain criteria for rating longevity-friendly diets such as impact on disease risk and how well a diet fits longevity-promoting eating patterns.

Introduction

There are a lot of popular dietary approaches that promise benefits to health and longevity. It can be hard for health practitioners and nutritionists to evaluate each and formulate a recommendation. In this article, we will go over what constitutes a longevity-promoting eating pattern and what criteria can be used to rate diets in relation to longevity. We will also analyze several popular diets using this approach as a jumping-off point.

“One Size doesn’t fit all”

It is important to note that we are not trying to establish the best diet for longevity or even create a definitive list. There is no single best diet for every client to follow forever. Many factors play a role in what diet is going to be optimal, and even these factors change throughout life.

• Health status
• Body type
• Lifestyle
• Athletic goals
• Food preferences and tradition
• Food availability
• Time availability
• Cooking experience
• Budget

We rate diets based on the best available understanding of longevity and nutrition in general terms. Specific recommendations have to be made concerning each client’s situation; the number one diet on this list may not be the winner for everyone.

Longevity-promoting eating patterns

The best place to look for these patterns might be in Blue Zones, places where people live exceptionally long and healthy lives compared to the rest of the world (1). This gives us a starting point but not the whole picture. Thankfully, there has been a recent shift in nutrition research from single nutrients to overall dietary patterns. This allowed researchers to identify key eating patterns that are associated with a reduction in the incidence of chronic diseases and enable older adults to live a long-lasting and healthier life (2). Here is a list of the most notable patterns:

• A high proportion of foods derived from plants and whole grains to ensure high fiber, mineral, vitamin, and phytonutrient intake.
• Moderate protein consumption, primarily plant-based, except for fish.
• Use of monounsaturated and polyunsaturated fats.
• Inclusion of spices and herbs that have antioxidant and anti-inflammatory effects.
• Alcohol consumption in moderation or none at all.
• An infrequent or no consumption of red and processed meat.
• No consumption of processed and ultra-processed foods
• Sparing use of sugar.

Criteria for rating longevity-friendly diets

While the composition of a diet gives us a good idea of whether it might be worth recommending, we should always consider research looking at outcomes related to disease and mortality. If available, studies describing how a given diet affects the development of frailty and aging are very valuable too. A good longevity diet should receive a high rating in the following three criteria:

• How well a diet fits longevity-promoting eating patterns
• What the impact on disease risk is
• What the impact on aging processes is

This way of thinking can be used for any diet your clients might be interested in. This article will apply it to several of the most popular diets.

Mediterranean diet

The Mediterranean diet is known for its high intake of fresh, unprocessed plant-based foods and olive oil. It includes plenty of fish and moderate amounts of wine and limits junk food. It aligns with what we consider longevity-promoting eating patterns near perfectly. From this perspective, we have every reason to believe the Mediterranean diet is healthy and likely to improve lifespan.

The Mediterranean diet is also among the most well-researched ones. We know it reduces the risk of cardiovascular diseases, type 2 diabetes, and neurodegenerative diseases even in places outside the Mediterranean region (3).

The above-mentioned reduced disease risk is already a significant benefit to longevity. Research also describes how the Mediterranean diet can positively impact cellular and molecular hallmarks of aging (5). It is also known that greater adherence to this diet is linked to a significantly lower frailty risk in old age (6).

Based on all three criteria, the Mediterranean diet appears to be an excellent choice for longevity and is worth considering for any client.

Plant-based diets

Several types of plant-based diets differ in how strictly they limit animal-based foods. The vegan diet eliminates animal-based foods completely, which poses a risk for deficiencies in vitamin B12 and D, long-chain omega-3 fatty acids, iron, calcium, and zinc that need to be addressed with supplementation. The vegetarian diet is less risky in this regard, thanks to the inclusion of dairy and eggs. There are also the pescetarian and flexitarian variants, including fish, seafood, and even limited amounts of meat. These resemble the longevity-promoting eating patterns best and are at much less of a need for supplementation.

Plant-based diets have been extensively studied and consistently connected with a lower risk of chronic disease, mainly cancer and ischemic heart disease (7). It is important to note that the quality of a plant-based diet affects the benefit, and unhealthful plant-based diets have even been shown to increase the risk of disease (8).

Plant-based diets may also confer a direct benefit for longevity through plant protein. Plant protein sources are typically low in several amino acids. A reduced intake of these amino acids has been shown to activate longevity-promoting pathways (9). Plant-based diets have the potential to be an excellent longevity option for any client. It is crucial that the diet is well-formulated and supplements are used to account for an increased risk of certain nutritional deficits.

Okinawa diet

Okinawa Island is one of the Blue Zones, making its traditional diet appealing for longevity. The Okinawa diet, closely related to the Japanese diet, is mostly composed of unprocessed plant-based foods. It features a wide variety of fruits, vegetables, and herbs while keeping added sugar and fat intake very low.

Research shows that Okinawans have a much lower rate of coronary heart disease compared to the US (10). They also suffer from only a fraction of some types of cancer, dementia, and other chronic diseases. People in Okinawa also have a tradition of only eating till 80% full. This practice helps them restrict energy intake. Calorie restriction has been shown to be very effective at extending lifespan in a variety of model organisms and may be effective in humans too.

Overall, the Okinawa diet matches longevity-promoting eating patterns well, and people following it are healthy into their 90s and even 100s. The concern is that as the traditional diet meets the modern food environment and conveniences, the health benefits Okinawans enjoy seem to disappear too slowly (11).

DASH diet

The DASH diet has originally been developed as a strategy to reduce high blood pressure. Patients are told to reduce sodium intake and encouraged to eat nutritious, minimally processed foods such as whole grains, cereals, fruits, and vegetables. Those put on the DASH diet would also be instructed to avoid highly processed foods, fatty meats, full-fat dairy, and sugar-sweetened beverages.

Research shows that the diet is very effective at reducing blood pressure. It also suggests that DASH can be suitable for weight loss and minimize the risk of kidney damage, osteoporosis, cancer, cardiovascular disease, and diabetes (12).

Overall, the DASH diet can be a good choice for longevity, but the sodium restrictions can be relatively restrictive in day-to-day life. Clients that are not dealing with hypertension might have little reason to choose the DASH diet over other diets higher on this list.

Keto diet

The ketogenic diet focuses mainly on severe carbohydrate restriction while keeping a moderate protein and high fat intake in order to achieve a state of ketosis. It does not specifically define which foods to eat and avoid, but nearly all processed food with added sugar, most fruits, and starchy foods such as potatoes, rice, corn, or wheat have to be avoided to meet the carbohydrate limits. Because of these restrictions, the keto diet is often high in animal-based foods and low in plant-based ones. This poses several risks, such as excess saturated fat intake, low fiber intake, and a higher risk for micronutrient deficiencies. A ketogenic diet is unlikely to fit the outlined longevity-promoting eating patterns.

Research suggests that the keto diet is effective for weight loss, treating type 2 diabetes, and even managing some neurodegenerative diseases such as epilepsy (13). The keto diet has also been shown to extend lifespan in rats significantly, and it is hypothesized that it could beneficially influence aging pathways (14). We do not currently have evidence showing this in humans.

The ketogenic diet is very restrictive, which makes it socially isolating and challenging to follow long-term. It also requires close professional guidance to avoid nutritional problems. As much as it might hold potential in benefiting longevity, it would be hard to recommend it above the others on the list.

Conclusion

It is necessary for nutritionists and health coaches to be able to decide the best-suited diet for their clients interested in longevity. How well a given diet fits longevity-promoting eating patterns and what research says about the effects of the diet on disease risk and the aging process are the key criteria. While we have to acknowledge that no single diet will fit every client, we can identify several that should be high on the list for most. The Mediterranean, plant-based, or Okinawa diet are great examples.

References

1. Buettner D, Skemp S. Blue Zones: Lessons From the World's Longest Lived. American journal of lifestyle medicine 2016;10(5):318-21. 10.1177/1559827616637066
2. Dominguez LJ, Veronese N, Baiamonte E, Guarrera M, Parisi A, Ruffolo C, Tagliaferri F, Barbagallo M. Healthy Aging and Dietary Patterns. Nutrients 2022;14(4):889. 10.3390/nu14040889
3. Aridi YS, Walker JL, Roura E, Wright ORL. Adherence to the Mediterranean Diet and Chronic Disease in Australia: National Nutrition and Physical Activity Survey Analysis. Nutrients 2020;12(5):E1251. 10.3390/nu12051251
4. Shannon OM, Ashor AW, Scialo F, Saretzki G, Martin-Ruiz C, Lara J, Matu J, Griffiths A, Robinson N, Lillà L, Stevenson E, Stephan BCM, Minihane AM, Siervo M, Mathers JC. Mediterranean diet and the hallmarks of ageing. European journal of clinical nutrition 2021;75(8):1176-92. 10.1038/s41430-020-00841-x
5. Capurso C, Bellanti F, Lo Buglio A, Vendemiale G. The Mediterranean Diet Slows Down the Progression of Aging and Helps to Prevent the Onset of Frailty: A Narrative Review. Nutrients 2019;12(1):E35. 10.3390/nu12010035
6. Palacios OM, Maki KC. Vegetarian diet patterns and chronic disease risk: what we know and what we don’t. Nutrition Today. 2019 Jul 1;54(4):132-40.
7. Megu Y Baden, Gang Liu, Ambika Satija, Yanping Li, Qi Sun, Teresa T Fung, et al. Changes in Plant-Based Diet Quality and Total and Cause-Specific Mortality. Circulation. 2019 Sep 17;140(12):979-991. doi: 10.1161/CIRCULATIONAHA.119.041014.
8. Julieanna Hever, Raymond J Cronise. Plant-based nutrition for healthcare professionals: implementing diet as a primary modality in the prevention and treatment of chronic disease. Journal of Geriatric Cardiology (2017) 14: 355368
9. D Craig Willcox, Bradley J Willcox, Hidemi Todoriki, Makoto Suzuki. The Okinawan diet: health implications of a low-calorie, nutrient-dense, antioxidant-rich dietary pattern low in glycemic load. J Am Coll Nutr. 2009 Aug;28 Suppl:500S-516S. doi: 10.1080/07315724.2009.10718117.
10. Natalia S. Gavrilova, Leonid A. Gavrilov. Comments on Dietary Restriction, Okinawa Diet and Longevity. Gerontology. 2012 Apr; 58(3): 221–223. Published online 2011 Aug 31. doi: 10.1159/000329894
11. Suri S, Kumar V, Kumar S, Goyal A, Tanwar B, Kaur J, Kaur J. DASH Dietary Pattern: A Treatment for Non-communicable Diseases. Current hypertension reviews 2020;16(2):108-14. 10.2174/1573402115666191007144608
12. Crosby L, Davis B, Joshi S, Jardine M, Paul J, Neola M, Barnard ND. Ketogenic Diets and Chronic Disease: Weighing the Benefits Against the Risks. Frontiers in nutrition 2021;8:702802. 10.3389/fnut.2021.702802
13. Roberts, Megan N et al. "A Ketogenic Diet Extends Longevity and Healthspan in Adult Mice." Cell metabolism vol. 26,3 (2017): 539-546.e5.

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