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The Alternative Healthy Eating Index and Physical Function Impairment in Men



Physical function is increasingly recognized as integral to healthy aging, in particular as a core component of mobility and independent living in older adults. Thus, it is important to identify strategies for the prevention of physical function decline.


Longitudinal cohort study.

Setting and Participants

A total of 12,658 men from the Health Professionals Follow-Up Study were followed from 2008–2012.


We examined the association between the Alternative Healthy Eating Index-2010 (AHEI), a measure of diet quality combining 11 dietary components (vegetables, fruits, nuts and legumes, red and processed meats, sugar-sweetened beverages and fruit juices, alcohol, whole grains, omega-3 fatty acids, polyunsaturated fatty acids, trans fatty acids, sodium), and impairment in physical function, as measured by the SF-36. Multivariable logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) of impairment in physical function.


In the multivariable-adjusted model, each 10-point increase in total AHEI score was associated with a 10% lower odds of impairment in physical function (OR=0.90, 95% CI: 0.86,0.95), and in the categorical analysis, men with AHEI scores in the top quintile had a 26% lower odds (OR=0.74, 95% CI:0.63,0.86) compared with men in the bottom quintile. For individual AHEI components, higher intake of vegetables (p-trend=0.01), nuts and legumes (p-trend<0.01), polyunsaturated fatty acids (p-trend<0.01) and lower intake of red and processed meats (p-trend=0.03) and sugar-sweetened beverages (p-trend=0.01) were significantly associated with lower odds of physical impairment. For specific foods, higher consumption of lettuce, broccoli, blueberries, peanuts, walnuts and other nuts were associated with lower odds of impairment.


In this large cohort of older men, better overall diet quality was significantly associated with a lower odds of impairment in physical function. Given the value of physical function to healthy aging and quality of life, this may represent a particularly compelling public health rationale for older men to improve their diet.

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Alternative Healthy Eating Index-2010


Body Mass Index


Confidence Interval


Food Frequency Questionnaire


Health Professionals Follow-Up Study


Odds Ratio


Medical Outcomes Short Form-36


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Correspondence to Kaitlin A. Hagan.

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Hagan, K.A., Grodstein, F. The Alternative Healthy Eating Index and Physical Function Impairment in Men. J Nutr Health Aging 23, 459–465 (2019).

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Key words

  • Diet Quality
  • physical function
  • aging
  • longitudinal cohort study
  • epidemiology