Nutrition as the key to healthy aging

A healthy lifestyle is an important pillar for a long and vital life. Nutrition in particular plays a central role in healthy aging, a process in which one grows older while maintaining good physical and mental health. Worldwide, the number of older people is steadily increasing, and with that aging also comes the challenge of preventing chronic diseases and loss of function[1][2]. In this article we discuss what science so far knows about nutrition and healthy aging. We look at proven insights, likely associations, and areas where uncertainty still exists. We also translate this knowledge into practical recommendations for a broad audience, in clear language and with scientific nuance.

What does "healthy aging" mean?

Healthy aging, in English often healthy aging mentioned, goes beyond simply reaching an advanced age. It refers to aging without serious chronic diseases and while maintaining physical, mental, and cognitive functions[3][4]. A person who ages healthily, for example, remains active into old age, mentally sharp, and free of conditions such as heart disease, diabetes, or dementia. Long-term research shows that only a minority of people achieve this ideal scenario; in one large study only ~9% met the criteria for healthy aging up to age 70[5]. Yet studies show that lifestyle factors, and especially nutrition, can significantly increase the chances of this[4][6].

Scientific definition: Healthy aging is often measured as reaching a certain age (e.g., 70 or 75 years) without chronic disease and while maintaining good cognitive and physical health[3]. This concept is gaining attention as the World Health Organization calls not only to fight disease, but also to support the functional capacities of older adults[2]. In other words, the focus is on healthspan (healthy years of life) rather than only lifespan. Nutrition is one of the most important modifiable factors in this.

Dietary patterns and life expectancy

The overall dietary pattern is more important than one superfood. Researchers emphasize that no single food determines the aging process, but rather the overall dietary pattern over the years[7]. A healthy diet is characterized by plenty of plant-based foods (vegetables, fruit, whole grains, legumes, nuts), healthy protein sources and fats, and little ultra-processed products, sugar, and unhealthy fats[4][8]. Various traditional and modern dietary patterns meet these principles and are consistently associated with lower mortality and fewer diseases later in life[9][6]. Below we discuss some of these patterns.

The Mediterranean and similar diets

One of the most studied dietary patterns for a long and healthy life is the Mediterranean diet. This diet, traditionally typical of countries around the Mediterranean Sea, emphasizes plenty of vegetables, fruit, olive oil (healthy fats), whole grains, legumes, nuts, and regular fish, with moderate amounts of red meat and dairy. Large observational studies consistently associate high adherence to the Mediterranean diet with a lower risk of cardiovascular disease, certain cancers, cognitive decline, and overall mortality[10][9]. For example, a 2025 meta-analysis found that people who most closely followed a Mediterranean eating pattern had a ~18% lower risk of cognitive decline and dementia compared with people who followed this pattern little[10].

Moreover, there is also causal evidence from randomized research. The famous PREDIMED study from Spain compared a Mediterranean diet (supplemented with extra virgin olive oil or nuts) with a control diet in people at increased heart risk. After several years, the Mediterranean diet group was ~30% less often affected by serious cardiovascular disease compared with the control group[11]. This result underscores that this diet is not only associated with better health, but can actually help prevent heart disease (Estruch et al., 2018). Other variants, such as the similar DASH diet (developed to prevent high blood pressure) and the Nordic diet (with lots of berries, fish, and rapeseed oil) show similar benefits for heart health and mortality[9].

Blue Zones and traditional diets: Interestingly, in so-called Blue Zones, regions in the world with an exceptionally high number of centenarians, such as Okinawa (Japan) and Sardinia (Italy), the local dietary patterns strikingly align with the principles mentioned above. The traditional Okinawan diet, for example, is very low in calories but rich in nutrients and antioxidants, with lots of vegetables (especially sweet potatoes), soy/legumes and fish, and little meat, dairy, and processed food[12]. This diet has a low glycemic load and is seen as a factor contributing to the exceptional longevity of the Okinawans[12] (Willcox et al., 2009). Although genetics and lifestyle as a whole of course also play a role, these traditional diets illustrate that high-quality nutrition can go hand in hand with healthy aging.

Plant-forward: predominantly plant-based with room for fish and dairy

A common thread in all these successful eating patterns is the emphasis on plant-based foods, combined with modest portions of healthy animal products. Recent large-scale research in the US supported this balance: those who consistently followed one of several healthy dietary patterns in midlife, such as the Alternative Healthy Eating Index (AHEI), the Mediterranean diet, or a fully plant-based index diet, later had a significantly greater chance of aging in good health[13][4]. In this study with over 100,000 participants over ~30 years, the AHEI score in particular proved strongly predictive: the highest scorers had nearly twice the chance of healthy aging compared with the lowest scorers[13]. What these dietary patterns have in common is lots of vegetables, fruit, whole grains, nuts, legumes and unsaturated fats (such as from fish and plant oils) and little red and processed meat, salt, sugar-sweetened beverages and trans fats[4]. The researchers’ conclusion was clear: dietary patterns rich in plant-based foods, with moderate amounts of healthy animal products, are most conducive to healthy aging[4].

Such a flexible, predominantly plant-based approach is also reflected in the latest dietary guidelines. Professor Frank Hu (Harvard) emphasizes that there is no one-size-fits-all diet for a long life, but that flexibility within healthy basic principles is important[7]. “Ultimately, it’s about the overall dietary pattern,” says Hu. Unsaturated fats (such as in olive oil and avocado) are beneficial and are associated with lower mortality, while saturated fats from, for example, red meat contribute to a higher risk of death[14][15]. Hu also points to the role of polyphenols, antioxidants in plant-based foods such as berries, leafy greens and even coffee and tea. Coffee, a rich source of polyphenols, has been associated with lower risks of type 2 diabetes, heart disease, some cancers and overall mortality[16]. Green tea probably shows similar benefits, although additional research is still needed[16]. The common thread is that a mainly plant-based diet with whole grains, vegetables/fruit and healthy fats contributes to a lower risk of the most important age-related diseases.

Nutrition and chronic diseases later in life

Healthy aging goes hand in hand with preventing or delaying chronic diseases such as cardiovascular disease, type 2 diabetes, certain cancers and dementia. Nutrition is one of the most decisive lifestyle factors for the risk of these conditions, right after smoking and physical inactivity[17][18]. Below we discuss what science says about diet and some important age-related diseases.

Cardiovascular disease and nutrition

Cardiovascular diseases (such as heart attacks and strokes) are among the leading causes of death worldwide. Both observational studies and interventions show that a healthy dietary pattern significantly reduces the risk of cardiovascular disease. An analysis of three large U.S. cohort studies (with more than 30 years of follow-up) found that people who adhered most closely to various healthy eating patterns consistently had a lower risk of cardiovascular disease[19]. The risk reduction was dose-dependent: the higher the diet quality, the smaller the chance of, for example, a heart attack or stroke[19]. This finding applied to multiple dietary patterns (including Mediterranean, plant-based, DASH and AHEI), indicating that it is mainly the shared characteristics of these diets that are protective[20][9]. Namely: lots of plant-based foods, fish, nuts; little salt, saturated fat, and unprocessed meat.

The evidence from intervention studies is also strong. As mentioned earlier, a Mediterranean diet in the PREDIMED trial reduced the risk of heart disease by ~30% compared with a low-fat (and relatively processed) dietary pattern[11]. Nut consumption has also been linked in various studies to better heart health; nuts provide unsaturated fats, magnesium, and other micronutrients that favorably affect cholesterol and inflammation[21][22]. In short, nutrition can function as medicine for the heart: a healthy diet can slow atherosclerosis (hardening of the arteries) and even partially reverse it, while an unhealthy dietary pattern (lots of salt, trans fat, sugar) actually accelerates the process.

Nutrition and type 2 diabetes

Type 2 diabetes is another common age-related condition that is strongly influenced by diet. Overweight and insulin resistance are important risk factors for diabetes, and diet plays a direct role in this. A dietary pattern rich in fiber (whole grains, legumes), unsaturated fats, and low in rapidly absorbed sugars improves insulin sensitivity and helps keep weight under control. This significantly reduces the chance of diabetes. Studies show, for example, that people who eat a lot of whole grains, vegetables, and fruit have up to 30–40% lower risk of diabetes than people who consume a lot of red meat, sugar-sweetened drinks, and refined grains[23][9].

Insulin regulation and aging: An interesting nuance is the role of insulin itself in aging. Insulin is the hormone that regulates blood sugar, but it also influences cell growth and metabolic pathways associated with aging. With aging, insulin resistance often occurs; body cells respond less well to insulin, causing the pancreas to produce more insulin. This phenomenon (reduced insulin sensitivity, increased insulin production) is seen as a typical hallmark of aging[24]. It leads to higher blood sugar levels and thus an increased risk of diabetes, but also to damaging effects on tissues. At the same time, too much insulin activity is also not good: chronically high insulin levels can actually accelerate aging via excessive stimulation of growth pathways[24]. Scientists therefore call insulin a “double-edged sword” in aging (Kolb et al., 2023). The core message is that stability of blood sugar and insulin regulation is important. A healthy diet helps by avoiding large blood sugar spikes and improving insulin sensitivity, for example by eating fewer fast carbohydrates and more fiber and healthy fats. In addition, a healthy weight (prevention of obesity) keeps insulin sensitivity higher[25][6].

Cognitive health and nutrition

Many people fear memory loss or dementia as they age. There is growing evidence that nutrition also affects brain health. Observational studies suggest that those who eat according to a healthy dietary pattern, especially the Mediterranean or the specific MIND diet, have a lower risk of cognitive decline and Alzheimer’s disease[10][26]. The MIND diet is a combination of the Mediterranean and DASH diets, with extra emphasis on foods that may protect the brain (such as leafy greens, berries, nuts, and olive oil), and restrictions on, for example, butter, red meat, and sugar[27][28]. A 2025 meta-analysis confirmed that high adherence to the Mediterranean diet is associated with a clearly lower risk of dementia[10]. Other plant-based nutrients, such as the aforementioned polyphenols in berries and green tea, are associated with slowed cognitive decline thanks to their anti-inflammatory and antioxidant effects[16].

Nuance, evidence from trials is limited: Despite these hopeful associations, we must add a scientific nuance: hard causality has not yet been conclusively proven. Recently, the first large dietary intervention aimed at cognition was completed, an RCT in which older adults without dementia followed the MIND diet for three years. The results were somewhat disappointing: after 3 years there was no significant difference in memory and thinking functions between the MIND diet group and the control group (which also received dietary advice)[29]. In other words, strictly following the MIND diet did not measurably slow cognitive decline in this study any more than general health counseling (Barnes et al., 2023). This does not mean that nutrition plays no role; the follow-up may have been too short or the control group too well informed. It does show that nutrition alone may not be sufficient to prevent dementia, or that effects only become visible over the longer term. Scientists continue to investigate this; in any case, the advice remains to eat healthily for your heart and weight, because what is good for the heart and blood vessels is generally also good for the brain.

Muscle maintenance, proteins, and nutrition

A well-known problem with aging is loss of muscle mass and strength, also called sarcopenia. Nutrition, especially sufficient protein intake, and physical activity are crucial to preserve muscle tissue later in life. Proteins provide the building blocks (amino acids) for muscle repair and growth. Older adults often have a lower anabolic response to protein (also called anabolic resistance), which means they need slightly more protein to achieve the same muscle effect as younger people. Guidelines therefore often recommend ~1.0 to 1.2 grams of protein per kilogram of body weight per day for people aged 65 and over, higher than the 0.8 g/kg/day for younger adults.

Research supports the importance of protein in combination with exercise. In a Dutch study, fit older adults received a protein supplement daily for 12 weeks (in addition to their normal diet) while training for a walking marathon. The group with extra protein increased more in muscle mass than the placebo group[30], and their fat mass also decreased slightly[31]. This shows that extra protein in physically active older adults can have a positive effect on body composition (Ten Haaf et al., 2019).

Still, more is not always better: new review studies show nuance. A large umbrella analysis of existing studies (meta-analyses) found that in healthy older people, additional protein intake generally gave no significant improvement in muscle mass, muscle strength, or walking performance[32][33]. In other words, an average healthy older adult who already eats enough protein does not suddenly build more muscle by taking even more protein. However, subgroups did benefit: in particular, older adults with a chronic condition or undernutrition benefit from supplemental proteins, especially if this is accompanied by exercise therapy[32][33]. Also in recovering patients (e.g., older adults with a hip fracture), protein supplementation reduced the number of medical complications[32]. The authors' conclusion (Obasi et al., 2025) was that routine protein supplementation is not necessary for all fit older adults, but targeted use in vulnerable groups can be useful.

Quality and timing: In addition to the amount of protein, the distribution throughout the day and the protein source also play a role. For older adults, it is recommended to spread protein intake (at each meal ~20-30 g protein) rather than a lot at once, because the body can reach a maximum of muscle protein synthesis per eating occasion. As for sources, both animal (meat, fish, dairy, eggs) and plant proteins (legumes, tofu, nuts) provide important amino acids. A mix is fine, although animal proteins often contain a complete amino acid profile and leucine, which is a strong trigger for muscle building. Plant sources can compensate for this, however, through volume and combination (e.g., grains + legumes together for all amino acids).

Avoid extremes: Interestingly, both too little and too much protein can be unhealthy in the long term. In mice, it has been shown that an extremely low-protein diet (only 1% of calories from protein) leads to reduced appetite and weight loss due to changes in the hypothalamus that suppress the feeling of hunger[34]. These mice mainly lost fat mass, but such undernutrition is of course undesirable and can lead to loss of muscle tissue and vitality (Wu et al., 2021). On the other hand, some population studies suggest that a very high-protein diet in middle age correlates with higher mortality, possibly because excessive protein (especially from red meat) stimulates growth pathways that accelerate aging[35][36]. However, this effect seems to depend on age: in those over 65, a slightly higher protein intake is actually associated with better survival, probably because preserving muscle mass then weighs more heavily and the growth pathways are less sensitive[37][38]. The current thinking is therefore balance: enough protein to counteract muscle loss, but no excesses and preferably more plant-based than animal proteins. Such a balanced approach also aligns with the aforementioned dietary patterns that support healthy aging.

Calorie intake, fasting, and metabolic health

Besides what we eat, is also how much and when what we eat is relevant to aging. Calorie restriction, eating slightly below expended calories for a long time without malnutrition, has proven in animal studies to be the most consistent way to extend lifespan. In organisms from worms and fruit flies to mice, consuming ~20-30% fewer calories often significantly extends lifespan and improves health later in life[39][40]. Calorie restriction activates cellular defense mechanisms: it increases the efficiency of cell repair, stimulates autophagy (clearance of damaged cellular components), and shifts metabolic pathways toward maintenance rather than growth[41][42]. These processes are accompanied by lower insulin and IGF-1 levels, less inflammation and oxidative stress, factors associated with slower aging.

In humans, long-term calorie restriction is difficult as a lifestyle intervention, but there are indications that eating moderately less throughout adult life benefits health later in life. For example: populations that naturally have a slightly lower calorie intake (such as the aforementioned Okinawans, who traditionally ate ~15% fewer calories than the Japanese average) show fewer lifestyle diseases and higher life expectancy[43][44]. The principle hara hachi bu, eating until you are ~80% full, is culturally passed down in Okinawa and could contribute to their low obesity and diabetes rates.

Intermittent fasting (periodically eating nothing or very little for longer periods, for example 16 hours fasting/8-hour eating window per day, or a 5:2 schedule per week) is an approach that seems to mimic some benefits of calorie restriction, without having to eat less all the time. Animal research shows that intermittent fasting can extend lifespan and improves aging markers in, among others, mice and fruit flies[45]. In humans, intermittent fasting has been associated with improved insulin sensitivity, lower inflammatory markers, and improvement in cardiovascular risk factors. However, hard data on effects on lifespan in humans are still lacking (those studies take decades). Still, gerontologists consider fasting regimens promising for healthspan. It is thought that the metabolic switch that occurs during fasting (from burning sugar to burning fat, production of ketones) triggers beneficial stress responses similar to calorie restriction[45][46].

It is important to note that such strategies are not suitable for everyone; older adults, for example, should be cautious with fasting due to the risk of malnutrition or dizziness. The rule always applies: consult a doctor or dietitian before introducing major dietary restrictions. But the insights from this field of research do teach us something universal: excess (in caloric terms) accelerates aging, while moderation and periods of nutrient scarcity activate defense mechanisms. A practically applicable message from this is: avoid chronic overconsumption (prevent obesity) and do not view a little hunger now and then as unhealthy, but as a potentially useful signal for the body. Of course always within limits; malnutrition or deficiencies must be avoided at all times.

What do we know for sure, what is plausible, what is uncertain?

Based on decades of research, we can draw a number of solid conclusions about nutrition and healthy aging:

• Undisputedly beneficial: Diets rich in plant-based foods (vegetables, fruit, legumes, nuts, whole grains) and healthy fats (such as in olive oil and fish) contribute to lower risks of heart disease, stroke, type 2 diabetes, and probably also certain cancers[9]. This translates into a higher chance of living longer in good health[4][9]. This finding is consistent across many cohort studies worldwide. In addition, we know that avoiding overweight and maintaining a stable energy balance from midlife onward is very important; obesity in middle age clearly increases the risk of premature chronic diseases and functional decline. Maintaining a healthy weight appears to be just as crucial as following a high-quality diet[25][6].

• Plausible/strong evidence but not yet complete consensus: The Mediterranean diet is widely recognized as an example of an eating pattern that promotes healthy aging (strong evidence from epidemiology and some RCTs). The MIND diet is promising for brain health (good epidemiological support), but the first RCT showed no significant effect, so there is still debate about whether longer or earlier intervention is needed. Intermittent fasting and periodic calorie restriction have proven promising in animal studies and short-term human studies for metabolic health, but whether they actually extend lifespan in humans or slow aging remains to be seen. Still, researchers consider it plausible that periods of eating less have positive health effects, partly given the mechanistic overlap with proven pathways (such as improved insulin sensitivity, activation of cellular repair processes)[42]. Furthermore, there is strongly suggestive evidence that excessive consumption of red and processed meat and of ultra-processed foods contributes to higher mortality and disease burden; this association is consistent, although it is based on observational data and is partly also a marker of an overall unhealthy Western eating pattern[4][23]. But based on this, it is recommended to limit these products.

• Should people at an older age eat relatively more protein than at a younger age for maximum health? The data on this are mixed: some experts argue for higher protein intake to combat sarcopenia, while others warn that too high an intake (especially from animal sources) may pose other risks. The dose effect of protein on mortality seems to differ before and after about 65 years, which requires further study[35][37]. Finally, the concept of “precision nutrition” is on the rise: can we personalize diets based on someone’s genetics or metabolism to influence aging? This is still in the research phase.

Conclusion: nutrition as a building block of a long and vital life

The current state of science teaches us that a holistic, healthy way of eating is one of the most powerful tools for healthy aging. There is no magic elixir or superfood that stops aging, but a pattern of varied, predominantly plant-based, unprocessed, and moderate eating offers the best chance of a long life in good health. In practice, this means: plenty of vegetables and fruit, sufficient protein (especially from plant sources and fish), lots of fiber from whole-grain products, regular nuts and healthy oils, and sparing use of salt, sugar, and red/processed meat. Such diets, whether called Mediterranean, Okinawan, plant-based, or otherwise, share the same core principles, and these are repeatedly associated with a lower disease burden and mortality[9].

In addition to nutrition, other lifestyle factors are of course also important: not smoking, getting enough exercise, sufficient sleep, and social connectedness all contribute to healthy aging. For example, one calculation showed that people who both ate healthily and had other favorable habits could gain as much as 8 to 10 additional disease-free years of life[6]. Nutrition therefore forms an integral part of that broader lifestyle package.

Finally: while science is increasingly unraveling the link between diet and aging, the message for the public fortunately remains simple. Choose pure, unprocessed foods as much as possible, eat a varied diet and in moderation, and enjoy meals rich in nutrients. This classic advice is now supported by modern research down to the level of genes and cells: our dietary choices influence hormones, inflammation levels, cell renewal, and many processes that determine how we age[9][49]. Those who invest in healthy nutrition are investing in the foundations of a vital old age. And it is never too late (or too early) to start; every improvement in eating patterns can increase the health gains. As the saying goes: "let food be your medicine", especially when it comes to extending the healthy years of our lives.

Reference list (APA):

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·         Estruch, R., Sala-Vila, A., Ros, E., et al. (2018). Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. New England Journal of Medicine, 378(25), e34. DOI: 10.1056/NEJMoa1800389

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·         Obasi, A. A., Gordon, A. L., Smith, K., et al. (2025). Effects of supplemental protein in older people: an overview of meta-analyses. Age and Ageing, 54(12), afaf351. DOI: 10.1093/ageing/afaf351

·         Shan, Z., Li, Y., Baden, M. Y., et al. (2020). Association between healthy eating patterns and risk of cardiovascular disease. JAMA Internal Medicine, 180(8), 1090-1100. DOI: 10.1001/jamainternmed.2020.2176

·         Ten Haaf, D. S. M., Eijsvogels, T. M. H., Bongers, C. C. W. G., et al. (2019). Protein supplementation improves lean body mass in physically active older adults: a randomized placebo-controlled trial. Journal of Cachexia, Sarcopenia and Muscle, 10(2), 298–310. DOI: 10.1002/jcsm.12390

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·         Willcox, D. C., Scapagnini, G., & Willcox, B. J. (2009). The Okinawan diet: health implications of a low-calorie, nutrient-dense, antioxidant-rich dietary pattern low in glycemic load. Journal of the American College of Nutrition, 28(suppl), 500S–516S. DOI: 10.1080/07315724.2009.10718117

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