A recent study asked the question whether diet could affect the onset of multimorbidity, and in particular, the researchers monitored how fast chronic conditions accumulated in an aging population depending on diet.
Diet was assessed using two sets of diet quality indices: (1) MIND, AHEI, AMED/MEDAS represent “healthy” eating patterns (Mediterranean-leaning; whole plant foods, fish, olive oil), while penalizing sugar, red/processed meats, trans fat, and sodium. (2) EDII/EDIP/IDI are inflammatory potential indices (higher = more inflammatory), They quantify a diet’s inflammatory load based on its association with biomarkers such as CRP and IL-6, which are linked to atherosclerosis, cardiovascular disease, type 2 diabetes, obesity, chronic kidney disease, cancer, and dementia.
The study was performed in Sweden (a relatively affluent European population) with 2,473 adults ≥60 years, and multimorbidity was tracked for 15 years with follow-ups every 6 years, or every 3 years for those ≥78. MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay), AHEI (Alternate Healthy Eating Index), AMED (Alternate Mediterranean Diet), and EDII (Empirical Dietary Inflammatory Index) were assessed via a 98-item questionnaire.
The primary outcome was the annual rate of chronic disease accumulation (total count, i.e. multimorbidity), which was grouped into cardiovascular, neuropsychiatric, and musculoskeletal systems. Linear mixed models estimated the interaction of diet score in standard deviation (SD) units relative to the excess yearly change in chronic disease count. The models were adjusted for sociodemographics, lifestyle, and energy intake.
The key findings described the relationship between diet score and the number of chronic conditions. More specifically, for total multimorbidity, per one standard deviation (1-SD) higher adherence to diet (95% confidence interval (CI) in parentheses):
- MIND: β = −0.049 (95% CI −0.065 to −0.032)
- AHEI: β = −0.051 (−0.068 to −0.035)
- AMED: β = −0.031 (−0.048 to −0.014)
- EDII: β = +0.053 (0.035 to 0.071)
Beta (β) is the slope of the linear relationship between diet index and chronic disease accumulation rate with a negative slope indicating a negative correlation, i.e. higher index corresponds to less disease accumulation. For the inflammation index (EDII), a higher score correlates with more chronic disease.
Breaking down the data according to physiologic systems showed similar patterns for cardiovascular and neuropsychiatric diseases with the overall results, but no association for musculoskeletal diseases.
To put the numbers more concretely, one can look at the number of disease as a function of time (Figure 1 shows MIND). The absolute differences after 15 years in the 90th percentile adherence group versus the 10th percentile adherence conveyed how many fewer chronic diseases with higher adherence to diet based on diet indices (number fewer of diseases in parentheses): AHEI (−2.54), MIND (−2.01), AMED (−1.10); more with higher EDII (+2.13). Two fewer chronic conditions is medically significant.
Notably these results were consistent with previous work. Cai et al. (2025) demonstrated that lower-inflammation diets (measured by IDI/EDIP) associate with lower hazard of incident multimorbidity and smaller annual increases in disease count, with effects most pronounced beyond age 60 and small but meaningful extensions in disease-free survival time. Similarly, Duarte Junior et al. (2025) found that higher AHEI/MEDAS scores relate to fewer conditions at baseline and a slower longitudinal increase thereafter (β ≈ −0.16 for change over time across categories).
These complementary results help to allay some concerns over possible caveats and limitations of the Swedish study, which include the fact that the diet index data were self-reported via questionnaire and potential bias such as reverse causality, i.e. chronic conditions could affect diet choices. On the other hand, strengths of the study were the long 15-year follow-up and repeated diet measures.
In summary, higher diet quality (MIND, AHEI, AMED) was linked to a slower expansion of multimorbidity in older adults, whereas a more inflammatory diet (EDII) was linked to a faster expansion. This supports diet quality as a modifiable risk factor for multimorbidity progression -- relevant for guidelines, public health strategies, and clinical counseling in aging populations.
From a practical standpoint, turning high MIND/AHEI/AMED scores into shopping and cooking means centering meals on leafy and cruciferous vegetables (e.g. broccoli), berries and other fruit, legumes, intact whole grains, nuts/seeds, olive oil, and regular fish, while minimizing sugar-sweetened beverages, refined grains, ultra-processed snacks, deep-fried foods, and processed/red meats. Diet-quality checklists can help, as well as periodic monitoring of physiologic biomarkers (e.g. CRP for inflammation) and general health conditions such as blood sugar levels, obesity, etc.
Figure 1. Chronic disease accumulation (y-axis) as a function of time (follow-up years, x-axis). Three groups are defined based on adherence to healthy diet as measured by MIND index: (1) 10th percentile adherence (red solid), (2) median adherence (orange dashed), and (3) 90th percentile adherence (blue dashed dot). The slopes indicate the rate of chronic disease accumulation with the fastest rate being associated with the poorest adherence to a healthy diet (red), while the slowest rate is associated with the strictest adherence (blue). After 15 years, the difference between the red and blue lines was about 2.5 chronic diseases (from Abbad-Gomez et al. Nature Aging, 2025).
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