The best and worst foods for longevity, according to research

How foods affect mortality risk

Foods that lower mortality risk

• Whole grains:
  • -25% (3 servings/day, optimal) 
  • -17% (3 servings/day, optimal)
  • -17% (high vs low intake)
  • -16% (high vs low intake)
  • -12% (daily vs/ non-daily intake)
• Vegetables:
  • -32% (3+ servings/day vs low)
  • -25% (6 servings/day, optimal)
  • -25% (3 servings/day, optimal)
  • -16% (high vs low intake)
  • -11% (3 servings/day, optimal)
  • -4% per serving
• Olive Oil:
  • -26% (high vs low consumption)
  • -23% (2 tbsp per day vs none)
• Nuts:
  • -22% (1 serving/day, optimal)
  • -17% (1 serving/day, optimal)
• Fruits:
  
  • -19% (6 servings/day, optimal)
  • -17% (3 servings/day, optimal)
  • -16% (3 servings/day, optimal)
  • -10% (2.5 servings/day, optimal)
• Legumes:
  • -16% (3 servings/day, optimal)
  • -10% (high vs low intake)
• Fish:
  • -11% (at 2+ servings/week) 
  • -10% (at 2 servings/day)
  • -8% (high vs low intake)
  • -5% (one serving/day)
  • 0% (high vs low intake)

Foods that do not affect mortality risk

• Yogurt:
  • -2% (1 serving/day, optimal)
  • 0% (1 serving/day)
• Dairy:
  • 0% 
  • 0% (<4 servings)
  • +15% (4+ servings) 
• Cheese:
  • 0% (high vs low intake)
  • 0% (one serving/day)
• Milk: 0%
• Butter:
  • 0%
  • +1% (each tablespoon per day)
• Salt: 
  • 0% (< 2,645mg or > 4,945mg/day detrimental)
  • 0% (high vs low intake)
  • 0% (high vs low intake)
• Sugar: 
  • 0%
  • 0%
  • 0% (optimal intake is >5% of calories but <20%)
  • sugar-sweetened solid foods reduce mortality risk but sugar-sweetened beverages increase risk
• Refined grains:
  • 0%
  • 0%
• Potatoes:
  • -22% (high vs low intake)
  • 0% (high vs low intake)
  • 0% (high vs low intake)
  • 0% (high vs low intake, large study)
• Poultry:
  • -7% (each daily serving)
  • 0%
  • 0%

Foods that increase mortality risk

• Sugar sweetened beverages:
  • +7% (each daily serving)
  • +19% (high vs low intake)
• Fried food:
  • +7% (fried fish, 1+ serving week) 
  • +8% (each daily serving)
  • +27 (fried potatoes, high vs low intake)
  • +126% (fried potatoes, >2 times a week)
• Red meat:
  • +10% (each daily serving)
  • +14% (2 servings/day vs 0.25)
  • +14% (high vs low intake)
  • +26% (high vs low intake)
  • +29% (high vs low intake)
• Eggs:
  • 0% (high vs low intake)
  • +8% (each 1/2 egg per day)
  • +15% (each daily serving)
  • +23% (>6 eggs per week)
• Processed meat:
  • +23% (high vs low intake) 
  • +23% (each daily serving)
  • +44% (2 servings/day vs 0.25)

Related: What thin people eat, according to research

Specific vegetables and mortality risk

• Non-potato vegetables: -16% (each daily serving)
• Raw vegetables:
  • -16% (high vs low intake)
  • -12% (high vs low intake)
• Cruciferous vegetables: -13% (high vs low intake)
• Salad: -13% (each daily serving)
• Green leafy vegetables: -8% (high vs low intake)
• Cooked vegetables:
  • -7% (high vs low intake)

Specific fruits and mortality risk

• Fresh fruit:
  • -21% (daily vs non-daily)
  • -4% (each daily serving)
• Apples/pears: -20% (high vs low intake)
• Citrus: -10% (high vs low intake)
• Berries: -8% (high vs low intake)
• Canned fruit:
  • +13% (high vs low intake)
  • +17% (each daily serving)

Specific grains and mortality risk

• All bread: -23% (high vs low intake)
• Whole grain breakfast cereal: -21% (high vs low intake)
• Whole grain bread: -19% (high vs low intake)
• All breakfast cereal:
  • -15% (high vs no intake)
  • -13% (high vs low intake)

Specific nuts and mortality risk

• Tree nuts: -20% (high vs low intake)
• Peanuts: -15% (high vs low intake)
• Peanut butter: -11% (high vs low intake)

General diets and mortality

Optimal diet reduces mortality risk by 56%; poor diet increases risk by 50% (meta-analysis)

The aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages, with risk of all-cause mortality. Results: With increasing intake (for each daily serving) of whole grains (RR risk ratio: 0.92), vegetables (RR: 0.96), fruits (RR: 0.94), nuts (RR: 0.76), and fish (RR: 0.93), the risk of all-cause mortality decreased; higher intake of red meat (RR: 1.10) and processed meat (RR: 1.23) was associated with an increased risk of all-cause mortality in a linear dose-response meta-analysis. Optimal consumption of risk-decreasing foods results in a 56% reduction of all-cause mortality, whereas consumption of risk-increasing foods is associated with a 2-fold increased risk of all-cause mortality.

https://academic.oup.com/ajcn/article/105/6/1462/4569801

High consumption of fruit/vegetables, low consumption of meat reduce mortality (meta-analysis)

Regarding Mediterranean diet components, relatively stronger and statistically significant inverse associations were highlighted for moderate/none-excessive alcohol consumption (0·86) and for above/below-the-median consumptions of fruit (0·88) and vegetables (0·94), whereas a positive association was apparent for above/below-the-median intake of meat (1·07). Our meta-analyses confirm the inverse association of Mediterranean diet with mortality and highlight the dietary components that influence mostly this association.

https://pubmed.ncbi.nlm.nih.gov/30401007-mediterranean-diet-and-its-components-in-relation-to-all-cause-mortality-meta-analysis/

Replacing carbs with meat increases mortality risk by 18%; Replacing carbs with plants decreases it by 18% (n=432,179)

In the ARIC cohort, after multivariable adjustment, there was a U-shaped association between the percentage of energy consumed from carbohydrate (mean 48·9%) and mortality: a percentage of 50-55% energy from carbohydrate was associated with the lowest risk of mortality. In the meta-analysis of all cohorts (432,179 participants), both low carbohydrate consumption (<40%) and high carbohydrate consumption (>70%) conferred greater mortality risk than did moderate intake, which was consistent with a U-shaped association (pooled hazard ratio 1.20 for low carbohydrate consumption; 1.23 for high carbohydrate consumption). However, results varied by the source of macronutrients: mortality increased when carbohydrates were exchanged for animal-derived fat or protein (1.18) and mortality decreased when the substitutions were plant-based (0.82).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339822/

Vegan and vegetarian diets do not decrease overall mortality risk (meta-analysis)

Aim of this study was to clarify the association between vegetarian, vegan diets, risk factors for chronic diseases, risk of all-cause mortality, incidence, and mortality from cardio-cerebrovascular diseases, total cancer and specific type of cancer, through meta-analysis. Results: Eighty-six cross-sectional and 10 cohort prospective studies were included. The analysis showed a significant reduced risk of incidence and/or mortality from ischemic heart disease (RR 0.75) and incidence of total cancer (RR 0.92) but not of total cardiovascular and cerebrovascular diseases, all-cause mortality and mortality from cancer. The analysis conducted among vegans reported significant association with the risk of incidence from total cancer (RR 0.85), despite obtained only in a limited number of studies.

https://pubmed.ncbi.nlm.nih.gov/26853923-vegetarian-vegan-diets-and-multiple-health-outcomes-a-systematic-review-with-meta-analysis-of-observational-studies/

Vegetarian diets only associated with longevity among seventh day adventists (meta-analysis)

We searched for comparative studies that evaluated clinical outcomes associated with vegetarian diet as compared to non-vegetarian controls or the general population. Eight studies met the inclusion criteria with 183,321 participants (n=183,321). In all instances, we found that seventh day adventist studies showed greater effect size as compared to non-seventh day adventist studies: death (RR 0.68 vs RR 1.04 (not significant)), ischaemic heart disease (RR 0.60 vs RR 0.84). Sex specific analyses showed that heart disease was significantly reduced in both genders but risk of death and cerebrovascular disease was only significantly reduced in men. Conclusions: Data from observational studies indicates that there is modest cardiovascular benefit, but no clear reduction in overall mortality associated with a vegetarian diet. This evidence of benefit is driven mainly by studies in seventh day adventists, whereas the effect of vegetarian diet in other cohorts remains unproven.

https://pubmed.ncbi.nlm.nih.gov/25149402-vegetarian-diet-seventh-day-adventists-and-risk-of-cardiovascular-mortality-a-systematic-review-and-meta-analysis/

Among health conscious individuals, vegetarians do not live longer (n=10771)

Results: 2064 (19%) subjects smoked, 4627 (43%) were vegetarian, 6699 (62%) ate wholemeal bread daily, 2948 (27%) ate bran cereals daily, 4091 (38%) ate nuts or dried fruit daily, 8304 (77%) ate fresh fruit daily, and 4105 (38%) ate raw salad daily. After a mean of 16.8 years follow up there were 1343 deaths before age 80. Overall the cohort had a mortality about half that of the general population. Within the cohort, daily consumption of fresh fruit was associated with significantly reduced mortality from all causes combined (0.79). Conclusions: In this cohort of health conscious individuals, daily consumption of fresh fruit is associated with a reduced mortality from all causes combined.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2352199/

Milk, cheese, and butter do not increase mortality risk; meat does (meta-analysis)

We identified 26 publications with individual dietary data and all-cause, total cancer, or cardiovascular mortality as endpoints. Pooled relative risk estimates demonstrated that high intakes of milk, cheese, yogurt, and butter were not associated with a significantly increased risk of mortality compared with low intakes. High intakes of meat and processed meat were significantly associated with an increased risk of mortality.

https://pubmed.ncbi.nlm.nih.gov/23865702-food-sources-of-saturated-fat-and-the-association-with-mortality-a-meta-analysis/

Foods common in Mediterranean diet reduce risk of mortality (n=23349)

Controlling for potential confounders, higher adherence to a Mediterranean diet was associated with a statistically significant reduction in total mortality. The contributions of the individual components of the Mediterranean diet to this association were moderate ethanol consumption 23.5%, low consumption of meat and meat products 16.6%, high vegetable consumption 16.2%, high fruit and nut consumption 11.2%, high monounsaturated to saturated lipid ratio 10.6%, and high legume consumption 9.7%. The contributions of high cereal consumption and low dairy consumption were minimal, whereas high fish and seafood consumption was associated with a non-significant increase in mortality ratio.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272659/

Fish and olive oil may reduce mortality risk while meat increases risk (n=8937)

The risk of death was significantly lower among subjects with the highest fruit and vegetable consumption (at least one fruit and one vegetable, cooked or raw, per day versus less than one fruit and one vegetable, cooked or raw, per day (hazard ratio 0·90) and with regular fish consumption (more than twice a week versus less than twice per week) (hazard ratio 0·89). The benefit of olive oil use was found only in women (moderate olive oil use: hazard ratio 0·80; intensive use: hazard ratio 0·72). Conversely, daily meat (including poulty) consumption increased the mortality risk (HR 1·12). No association was found between risk of death and diet diversity and use of various fats. These findings suggest that fruits/vegetables, olive oil and regular fish consumptions have a beneficial effect on the risk of death, independently of the socio-demographic features and the number of medical conditions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666086/

Fruits and veggies

Benefits to fruits and veggies maxes out at 5 servings combined, lowering mortality risk 26% (meta-analysis)

Sixteen prospective cohort studies were eligible in this meta-analysis. During follow-up periods ranging from 4.6 to 26 years there were 56,423 deaths among 833,234 participants. Higher consumption of fruit and vegetables was significantly associated with a lower risk of all cause mortality. Pooled hazard ratios of all cause mortality were 0.95 for an increment of one serving a day of fruit and vegetables, 0.94 for fruit, and 0.95 for vegetables. There was a threshold around five servings of fruit and vegetables a day, after which the risk of all cause mortality did not reduce further. Compared with people who had no daily consumption of fruit and vegetables, the estimated hazard ratios of all cause mortality were 0.92 for one serving/day of fruit and vegetables, 0.85 for two servings/day, 0.79 for three servings/day, 0.76 for four servings/day, 0.74 for five servings/day, and 0.74 for six or more servings/day. A lower risk of all cause mortality was observed in association with higher fruit consumption at about two servings a day (hazard ratio 0.83) and vegetable consumption at about three servings a day (0.75).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4115152/#!po=27.5000

Eating a combined 8 servings per day of fruits and vegetables reduces mortality risk 31% (meta-analysis)

95 studies were included. For fruits and vegetables combined, the summary risk ratio per 200 g/day was 0.90 for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day. Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality. The summary risk ratio was 0.85 for fruits, and 0.87 for vegetables. There was evidence of nonlinearity for fruits and vegetables, fruits, and vegetables, respectively, with stronger reductions in risk at lower levels of intake. There were 31%, 19% and 25% reductions in the relative risk with intakes of 800 g/day for fruits and vegetables combined, and at 600 g/day for fruits, and for vegetables, respectively.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5837313/

Combined fruit/veggie intake of 3 to 4 servings reduces mortality risk 22%; no benefit to more servings (n=135335)

Overall, combined mean fruit, vegetable and legume intake was 3.91 (SD 2.77) servings per day. The hazard ratio for total mortality was lowest for three to four servings per day (0.78) compared with the reference group, with no further apparent decrease in hazard ratio with higher consumption. When examined separately, fruit intake was associated with lower risk of cardiovascular, non-cardiovascular, and total mortality, while legume intake was inversely associated with non-cardiovascular death and total mortality (in fully adjusted models). For vegetables, raw vegetable intake was strongly associated with a lower risk of total mortality, whereas cooked vegetable intake showed a modest benefit against mortality.

https://pubmed.ncbi.nlm.nih.gov/28864331-fruit-vegetable-and-legume-intake-and-cardiovascular-disease-and-deaths-in-18-countries-pure-a-prospective-cohort-study/

Vegetables better for longevity than fruit (n=65226)

Fruit and vegetable consumption was associated with decreased all-cause mortality (adjusted hazard ratio for 7+ portions 0.67, reference category <1 portion). This association was more pronounced when excluding deaths within a year of baseline (0.58). Fruit and vegetable consumption was associated with reduced cancer (0.75) and cardiovascular mortality (0.69). Vegetables may have a stronger association with mortality than fruit (hazard ratio for 2 to 3 portions 0.81 and 0.90, respectively). In the fully adjusted model, there appeared to be a threshold for increasing survival with consumption of three to less than four portions of fruit daily (HR 0.84). The effect of vegetable consumption was greater, HR for three+ portions daily 0.68. Consumption of vegetables (0.85 per portion) or salad (0.87 per portion) were most protective, while frozen/canned fruit consumption was apparently associated with increased mortality (1.17 per portion). Conclusions: A robust inverse association exists between fruit and vegetable consumption and mortality, with benefits seen in up to 7+ portions daily.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145465/

Raw vegetables may promote longevity more than cooked vegetables (n=451,151)

Nuts

Nuts reduce mortality risk 19%; peanut butter and tree nuts both effective (meta-analysis)

Twenty studies were included in the meta-analysis. The summary risk ratio for high versus low intake was 0.81. The summary risk ratio was 0.78 per one serving per day. There was evidence of a nonlinear association between nut consumption and all-cause mortality, with a steeper reduction in risk at lower intakes, and no further reduction in risk above 15–20 grams per day. The summary risk ratio for high versus low intake of tree nuts was 0.80, that of peanuts was 0.85, and that of peanut butter was 0.89, and the respective summary risk ratios per 10 grams/day increase in intake were 0.82, 0.77, and 0.94, respectively.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137221/

Olive oil

High consumption of olive oil reduces mortality risk by 23% (meta-analysis)

Following subgroup analyses, significant associations could only be found between higher intakes of olive oil and reduced risk of all-cause mortality (RR: 0.77), cardiovascular events (RR: 0.72), and stroke (RR: 0.60), respectively. Subgroup analysis for mono-unsaturated fatty acids (of mixed animal and plant origin) did not reveal any significant risk reduction for all-cause mortality.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198773/

2 tbsp of olive oil per day reduces mortality risk 26% (n=40622)

A total of 40,622 participants (62% female) aged 29-69 y were recruited from 5 Spanish regions in 1992-1996. The association between olive oil (analyzed as a categorical and continuous variable) and overall and cause-specific mortality (CVD, cancer, and other causes) was analyzed. Results: In comparison with nonconsumers, the highest quartile of olive oil consumption was associated with a 26% reduction in risk of overall mortality and a 44% reduction in CVD mortality. For each increase in olive oil of 10 g · 2000 kcal, there was a 7% decreased risk of overall mortality and a 13% decreased risk of CVD mortality. No significant association was observed between olive oil and cancer mortality.

https://academic.oup.com/ajcn/article/96/1/142/4571420

Grains

High intake of whole grains reduces mortality risk 18% (meta-analysis)

45 studies were included. The pooled relative risk for high versus low intake was 0.82. Although steeper reductions in risk were observed at lower intakes, there was a clear dose-response relation, and the lowest risk was observed at 225 g/day. Intakes of specific types of whole grains including whole grain bread, whole grain breakfast cereals, and added bran, as well as total bread and total breakfast cereals were also associated with reduced risks of cardiovascular disease and/or all cause mortality, but there was little evidence of an association with refined grains, white rice, total rice, or total grains. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4908315/

3 servings of whole grains daily reduces mortality risk 17% (meta-analysis)

Twenty prospective cohort studies were included in the systematic review: 9 studies reported total whole-grain intake and 11 others reported specific whole-grain food intake. A greater intake of both total whole grains and specific whole-grain foods was significantly associated with a lower risk of all-cause mortality in the meta-analysis. The pooled risk ratio for all-cause mortality for an increase of 3 servings total whole grains/d (90 g/d) was 0.83.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5105035/

Those consuming the most whole grains enjoy 16% lower risk of mortality (meta-analysis)

We included 19 cohort studies, with 1,041,692 participants. We observed an inverse relationship of whole grain intake with risk of total, cardiovascular disease and cancer mortality. The pooled risk ratio was 0.84 for total mortality, 0.83 for CVD mortality and 0.94 for cancer mortality, comparing the highest intake of whole grain with the lowest category. For dose-response analysis, we found a nonlinear relationship of whole grain intake with risk of total, cardiovascular and cancer mortality. Each 28 g/d intake of whole grains was associated with a 9% (pooled risk ratio: 0.91) lower risk for total mortality.

https://pubmed.ncbi.nlm.nih.gov/29091078-association-of-whole-grain-intake-with-all-cause-cardiovascular-and-cancer-mortality-a-systematic-review-and-dose-response-meta-analysis-from-prospective-cohort-studies/

Those consuming highest ratio of whole grains/refined enjoy 17% lower risk of death (n=11040)

After multivariate adjustment in proportional hazards regression, women who consumed on average 1.9 g refined grain fiber/2,000 kcal and 4.7 g whole grain fiber/2,000 kcal had a 17% lower mortality rate (RR=0.83, 95% CI=0.73-0.94) than women who consumed predominantly refined grain fiber: 4.5 g/2,000 kcal, but only 1.3 g whole grain fiber/2,000 kcal.

https://pubmed.ncbi.nlm.nih.gov/10875605-fiber-from-whole-grains-but-not-refined-grains-is-inversely-associated-with-all-cause-mortality-in-older-women-the-iowa-womens-health-study/

Cereal reduces mortality risk 15% (n=367442)

Consumption of ready to eat cereal was significantly associated with reduced risk of mortality from all-cause mortality. In multivariate models, compared to nonconsumers of ready to eat cereal, those in the highest intake of ready to eat cereal had a 15% lower risk of all-cause mortality. Within ready to eat consumers, total fiber intakes were associated with reduced risk of mortality from all-cause mortality. Conclusions: Consumption of ready to eat cereal was associated with reduced risk of all-cause mortality. This association may be mediated via greater fiber intake.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325722/

Meat

Red meat and processed meat increases risk of mortality by 14% and 22%; no effect of white meat (meta-analysis)

In the meta-analysis combining the risk estimates for the highest v. the lowest consumption category, the consumption of processed meat but not of total, red and white meats was found to be positively associated with all-cause mortality (risk ratio 1.22). For red meat consumption, the heterogeneity remained when each study was excluded one by one, and a positive association was confirmed (risk ratio 1.14) when an Asian study was excluded. For white meat consumption, between-study heterogeneity decreased when a large American study was excluded, but no association with all-cause mortality was observed.

The dose–response analysis showed that the risk ratio for a 50 g/d increase in processed meat intake was 1.25. A positive association was found between red meat consumption and mortality risk in both men (risk ratio 1.21) and women (risk ratio 1.14).

Fried food

Fried food increases mortality risk 8% through heart disease, not cancer (n=106,966)

For total fried food consumption, when comparing at least one serving per day with no consumption, the multivariable adjusted hazard ratio was 1.08  for all cause mortality. When comparing at least one serving per week of fried chicken with no consumption, the hazard ratio was 1.13 for all cause mortality and 1.12 for cardiovascular mortality. For fried fish/shellfish, the corresponding hazard ratios were 1.07 for all cause mortality and 1.13 for cardiovascular mortality. Total or individual fried food consumption was not generally associated with cancer mortality.

https://pubmed.ncbi.nlm.nih.gov/30674467-association-of-fried-food-consumption-with-all-cause-cardiovascular-and-cancer-mortality-prospective-cohort-study/

Fried potatoes increase mortality risk 126%; unfried white potatoes do not increase risk (n=4400)

Of the 4400 participants, 2551 (57.9%) were women with a mean ± SD age of 61.3 ± 9.2 y. During the 8-y follow-up, 236 participants died. After adjustment for 14 potential baseline confounders, and taking those with the lowest consumption of potatoes as the reference group, participants with the highest consumption of potatoes did not show an increased risk of overall mortality. However, subgroup analyses indicated that participants who consumed fried potatoes 2-3 times/wk (HR: 1.95) and ≥3 times/wk (HR: 2.26) were at an increased risk of mortality. The consumption of unfried white potatoes was not associated with an increased mortality risk.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486204/