Association between a Planetary Health Diet and changes in intrinsic capacity in older adults: the Seniors-ENRICA cohorts

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BACKGROUND: The Planetary Health Diet (PHD) benefits health and the environment. However, its impact on healthy ageing, estimated by intrinsic capacity (IC), remains unexplored. OBJECTIVE: To examine the association between adherence to a PHD Index (PHDI) and changes in IC in older adults. METHODS: Data were collected from 2519 adults aged ≥60y from the Seniors-ENRICA-1 (2012-15) and 3273 aged ≥65y from the Seniors-ENRICA-2 (2017-19) Spanish cohorts. Food consumption was collected with a dietary history, and the PHDI was based on 15 food groups. IC was measured across six domains: cognition, psychology, vitality, hearing, vision and locomotion (ranged: 0-18, lower score equals better IC). Adjusted multinomial logistic regressions were used, and data from both cohorts were pooled. RESULTS: Over a 2.6-year median follow-up, IC worsened for 32.0% of participants, improved for 27.7% and remained stable for 40.3%. Participants in the highest vs lowest tertile of adherence to the PHDI were more likely to improve vs worsen IC [relative risk ratio (RRR) 1.36; 95% confidence interval (95% CI) 1.05-1.77; P-trend = .021]. Higher PHDI scores were significantly associated with improvement vs worsening in the hearing domain (RRR 1.37; 95% CI 1.04-1.82; P-trend = .025). Higher adherence to PHDI's recommendations regarding nuts (RRR 1.05; 95% CI 1.01-1.09) and starchy vegetables (RRR 1.09; 95% CI 1.01-1.17) were independently associated with improvement vs worsening IC. CONCLUSION: In these older-adult cohorts, higher adherence to the PHDI was associated with improvement in overall IC and in its hearing domain. Adherence to nuts and starchy vegetables recommendations was particularly beneficial.