What question did this study set out to answer?

To determine how various dietary patterns affect mortality and life expectancy based on frailty status.

April 24, 2026The journal of nutrition health & aging0 citationsOpen Access

Association of dietary patterns with mortality and life expectancy by frailty status: Evidence from the UK Biobank

WKWeizheng KongQingdao University XHXiaolin HuQingdao University KZKai ZhangQingdao University

Key Points

To determine how various dietary patterns affect mortality and life expectancy based on frailty status.
Included 208,379 participants from the UK Biobank
Dietary intake assessed through 24-hour dietary recall
Used Cox proportional hazards models to analyze mortality and life expectancy
High adherence to healthy dietary patterns significantly reduced all-cause mortality (HR 0.76–0.88)
Longest life expectancy gains observed in frail individuals (up to 5.57 years)
Results consistent across all frailty statuses with women having higher overall life expectancy.

Abstract

Whether healthy dietary patterns can reduce mortality and extend life expectancy across different frailty status remains unclear. We aimed to investigate the associations of four dietary patterns with mortality and life expectancy both in the overall population and by frail status. We included 208,379 participants from the UK Biobank. Dietary intake was collected by the 24-h dietary recall assessments. Dietary patterns were assessed using previously established indices: alternative Mediterranean Diet (aMED), Dietary Approaches to Stop Hypertension (DASH), Plant-based Diet Index (PDI), and Planetary Health Diet Index (PHDI). Frailty status was defined by Fried’s phenotype and classified into robust, prefrailty, and frailty. Cox proportional hazards models and flexible parametric survival models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between dietary patterns and mortality and life expectancy. After a median follow-up of 13.42 years, 12,571 deaths occurred. Participants with the highest adherence to a healthy pattern exhibited reduced all-cause mortality (HR ranged from 0.76 to 0.88) and longer life expectancy (years of life gained ranged from 1.84 to 3.16). The protective effects were consistent across different frailty status, and a more substantial prolongation of life was observed in frail individuals. Taking aMED as an example, the HRs and 95% CIs of mortality for the highest tertile of adherence versus the lowest were 0.80 (0.75–0.86) in robust individuals, 0.76 (0.70–0.82) in pre-frail individuals, and 0.65 (0.50–0.86) in frail individuals, and life expectancy gains were 2.45 (2.03–2.87), 3.27 (2.72–3.82), and 5.57 (3.19–7.95) years, respectively. Women had a higher overall life expectancy than men, whereas men showed greater life expectancy gains from dietary adherence. Higher adherence to aMED, DASH, PDI, and PHDI could reduce all-cause mortality and extend life expectancy regardless of frailty status.

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