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Live longer by following any of four healthy eating patterns

As a family nurse practitioner, I get many questions from patients who want to know how to protect their health and live longer. You likely are interested in the same. You may be considering purchasing supplements offered on this website. While some supplements may be helpful, please don’t ignore everything else you put in your body.

In this blog post, we will explore why a holistic approach to diet is an essential component to optimizing your health and longevity. Keep reading to discover exciting and recent evidence that by following any of four different healthy eating patterns you can increase your chances of a long life.

Four different healthy eating patterns lead to a longer life 🙌

Over 30 years ago, more than 100,000 healthcare professionals were recruited for two long-term cohort studies. The Nurse’s Health Study followed over 75,000 women, while the Health Professionals Follow-Up Study followed over 44,000 men. These professionals, who had no reported heart disease, cancer, or diabetes at the study origin, were given a carefully validated survey every two-four years to determine their dietary habits. These studies ran from the mid-1980s until 2020.

Not all studies are the same. Studies that span many years and include large numbers of people from many different ethnic backgrounds can offer unique insights into the long-term effects of health behaviors. The authors of this study wrote, “Strengths of the present study include a direct comparison of multiple dietary patterns, long-term and repeated measures of diet, multiple racial and ethnic groups, and observed associations between dietary quality scores and respiratory and neurological disease mortality” (Shan et al, 2023).

The only reported limitations of the study were that the diet was self-reported (although this is the only feasible way to do a study with thousands of participants over many decades). It also mainly focused on health professionals, who may have different health habits than other population segments. Finally, it focused on the whole diet rather than individual food components, so these results inform us about patterns of eating rather than individual nutrients.

What did researchers conclude? The results of this study, published January 2023, found a significantly lower risk of death from all causes (including heart disease, cancer, and respiratory diseases like COPD) for adherents of four different healthy food patterns.

So, what are the four healthy eating patterns?

  1. The Healthy Eating Index aligns with the Dietary Guidelines for Americans. It has categories of foods that people should make sure to eat enough of—fruits, vegetables (including green vegetables and beans), whole grains, dairy, proteins (especially from seafood and plants), and healthy fats. It also has categories of foods that should only be eaten in moderationrefined grains such as white bread, sodium (table salt), added sugars, and saturated fats (such as butter and margarine).
  2. The Alternate Healthy Eating Index is a modification to the pattern above, emphasizing specific foods that Harvard University researchers believe help prevent chronic diseases. This pattern emphasizes more servings of fruits and vegetables and recommends against consuming red or processed meat and sugar-sweetened beverages.
  3. The Mediterranean Diet emphasizes a high intake of fruits, vegetables, whole grains, legumes, and olive oil, a moderate intake of fish and poultry, and a low intake of red meat and dairy products. It allows for some red wine consumption.
  4. The Healthful Plant-Based Diet is based primarily on plant foods, with a focus on whole grains, fruits, vegetables, legumes, and nuts. It also emphasizes avoiding processed foods and all animal products (including fish) and considers tea and coffee intake positive.

How do these eating patterns differ?

The Mediterranean diet recommends moderate fish and poultry intake and allows for some red wine. In contrast, the Healthful Plant Based Diet does not include any meat, does not include alcohol in its recommendations, and considers coffee and tea positive. The Alternate Healthy Eating Index recommends against any red or processed meat, but the Healthy Eating Index 2015 does not explicitly target these meat categories.

What do all of these patterns have in common?

All recommend eating more plant-based foods: fruits, vegetables, whole grains, legumes, and nuts. All recommend limiting red and processed meat, sugar, and sodium. The best thing about these similarities is that they show that a wide range of cultural and personal eating patterns support longevity.

How can you start eating for a long life today?

  • Eat as many foods as possible that come from the ground and are minimally processed (wash the dirt off your carrots before you eat them, though! 😄 )
  • Reread the first point! These good foods include fruits, vegetables, beans, and nuts (the unprocessed kind, not honey-roasted peanuts).
  • If you eat meat, try to eat fish and chicken more than red meat or processed meat.
  • Limit the amount of added sugar you consume.
  • Limit your alcohol intake. If you choose to drink alcohol, consider red wine.
  • All fat isn’t the same. Good fats include olive oil, canola oil, avocados, peanut oil, and most nuts.

A diet rich in fruits, vegetables, whole grains, lean protein, and healthy fats will provide a much wider variety of nutrients than any supplement can. Conversely, a diet high in sugar and saturated fats can increase the risk of chronic diseases such as heart disease and diabetes, regardless of the supplements you take. While supplements may be a helpful addition to a healthy diet, they cannot replace the essential nutrients our bodies need. A holistic approach to diet—whichever of the healthy eating patterns you choose—is crucial to remaining healthy and living longer.

Go deeper:

Read the original study here. (Detailed information about the four eating patterns can be read in the supplemental content section.)


1. Food and Nutrition Service. (N.D.). How the HEI Is Scored.

2. McCullough, M., & Willett, W. (2006). Evaluating adherence to recommended diets in adults: The Alternate Healthy Eating Index. Public Health Nutrition, 9(1a), 152-157. doi:10.1079/PHN2005938

3. Satija, A., Bhupathiraju, S. N., Spiegelman, D., Chiuve, S. E., Manson, J. E., Willett, W., Rexrode, K. M., Rimm, E. B., & Hu, F. B. (2017). Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults. Journal of the American College of Cardiology, 70(4), 411–422.

4. Shan Z, Wang F, Li Y, et al. (2023, January 9). Healthy Eating Patterns and Risk of Total and Cause-Specific Mortality. JAMA Intern Med. Published online January 09, 2023. doi:10.1001/jamainternmed.2022.6117

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