As I was reading down in the LIFO (last in first out) pile of medical journals that bury my desk I came to this article from last Summer that demonstrates that improved diet quality was consistently associated with decreased risk of death.(1)
Using the 47,994 women in the Nurses’ Health Study, of which my wife is a subject, and the 25,745 men in the Health Professionals study, of which my father was a subject, they assessed changes in diet quality over time starting in 1986 and calculated the correlation with total and cause-specific mortality. Diet quality was determined using 3 scoring methods – the Alternative Healthy Eating Index, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score, from questionnaires administered to the participants every 4 years. Basically all these diets stress whole grains, vegetables, fruit and n-3 fatty acids (fish) – the things your mother has been telling you forever.
A 20-percentile higher “diet quality” increase was associated with about 10% less dying overall and even bigger decreases in cardiovascular mortality specifically. Improvements in mortality risk were seen even if the dietary improvements came later in the lives of these worthy subjects. Eating bad conversely was associated with more dying.
In general, participants with consistently high quality diets at baseline and 12 years later were older, had lower BMI, were less likely to be current smokers, and were more physically active than those with a poor quality diets over this period. Those factors were adjusted for in analysis but it is probable that people who do what their mothers tell them to are different in many other ways that cannot be totally adjusted for. Notably there is no mention of weight change in any of this. Eating good is not about losing weight.
Another article in this same issue of the New England Journal of Medicine (2) laments the public distrust of science. While overall trust of science among the public seems to be high and steady over time, hot button political issues seem to be polarized because when people are faced with contradiction to their political belief they don’t change their minds, instead they ridicule science. A Harvard psychologist , Daniel Gilbert, is quoted as saying. “only by being in the business of constantly changing our minds are we getting closer and closer to truth.”
Nutrition science has the most ammunition for this distrust. It is so hard to properly study something that everybody does a lot of – eating; so that most nutrition science is only observational like this report about good eating.
I intend to cut out and frame this editorial about science. “Just as Winston Churchill observed that democracy is the worst form of government except for all the others, Gilbert notes that science is the worst way to find truth – except for every other option.”
John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- firstname.lastname@example.org or phone-354-6605.
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