Anti-inflammatory diet, physical activity, and risk of all-cause mortality in older adults: a prospective cohort study

Abstract

Background Anti-inflammatory dietary patterns are associated with a lower risk of several chronic diseases, but their association with all-cause mortality in Chinese older adults is unknown. In this first study of a Chinese population, we investigated this association and its joint effects with physical activity, to inform strategies for healthy longevity. Methods This analysis included 6,468 participants aged ≥65 years from the Chinese Longitudinal Healthy Longevity Survey. Anti-inflammatory diet was assessed using the anti-inflammatory diet index (AIDI), which was derived from data collected via a simplified food frequency questionnaire. Physical activity was assessed by a self-reported questionnaire. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results During a median follow-up of 7 years, 4,117 deaths occurred. After multivariable adjustment, compared with participants in the lowest tertile of the AIDI, those in the highest tertile had a lower risk of all-cause mortality (HR = 0.85; 95%CI: 0.77-0.94). Each one standard deviation increase in the AIDI was associated with a 8% lower risk of mortality. Joint analyses further showed that a high AIDI combined with regular exercise, or with high leisure activity, was associated with a significantly lower mortality risk. Conclusions Adherence to an anti-inflammatory diet was associated with reduced mortality risk in Chinese older adults. The findings underscore the value of integrating both dietary and physical activity strategies to promote healthy longevity.