There’s a lot of dietary advice out there, but the science that links food and health isn’t always clear-cut. A new study on the topic is one of the most comprehensive to date and has identified four eating patterns associated with lower mortality risk.

Analyzing the eating patterns of 119,315 people over 36 years, researchers compared those patterns with four sets of recognized healthy dietary regimes: the Healthy Eating Index, the Alternate Mediterranean Diet, the Healthful Plant-based Diet Index, and the Alternate Healthy Eating Index.

Sticking closely to at least one of these patterns reduced the risk of premature death by any cause and cardiovascular disease, cancer, and respiratory disease, the study showed. While the diets differ, they all include whole grains, fruits, vegetables, nuts, and legumes.

That matches the official Dietary Guidelines for Americans (DGAs), the researchers note – guidelines that recommend multiple healthy eating patterns to suit individual preferences, cultures, and health needs and offer a host of tips on eating in a way that doesn’t harm our bodies.

“The Dietary Guidelines for Americans are intended to provide science-based dietary advice that promotes good health and reduces major chronic diseases,” says Frank Hu, a nutritional epidemiologist from the Harvard TH Chan School of Public Health in Massachusetts.

“Thus, it is critical to examine the associations between DGAs-recommended dietary patterns and long-term health outcomes, especially mortality.”

The Healthy Eating Index, for example, provides recommended amounts across all the main food groups, including fruits, vegetables, and dairy. The Alternate Mediterranean Diet score is comprehensive, taking in data on fruits, fish, nuts, alcohol, and more.

Then there’s the Healthful Plant-based Diet Index, which ranks healthy plant-based foods (like vegetables and whole grains) against unhealthy plant-based foods (such as refined grains and high-sugar foods) and animal-based foods.

Finally, the Alternate Healthy Eating Index takes in everything from vegetables to sugary drinks, mainly how this links with chronic disease.

As per the results from this latest study, it’s an excellent idea to start following at least one of these approaches.

“It is important to evaluate adherence to DGAs-recommended eating patterns and health outcomes, including mortality, so that timely updates can be made,” says Hu.

While the research can’t definitively say that these specific dietary habits are causing longer life – and it relies on self-reported data rather than anything scientifically logged – the association is clear enough to demonstrate the health benefits of eating well.

As noted by the Dietary Guidelines for Americans, 6 in 10 adults in the US are living with at least one chronic disease related to their diet. Meanwhile, adherence to these guidelines hasn’t improved much over recent years.

There is no shortage of studies looking at diet and health, though recommendations can vary depending on age and how we’re built. Legumes, whole grains, and vegetables are often recommended, while fish, eggs, and dairy are typically best eaten in moderation, according to experts.

What’s clear is how important it is to commit to a healthy diet throughout our lives if we want those lives to last as long as possible. That’s part of the job of the Dietary Guidelines for Americans, which are due to be updated in the near future.

“Our findings will be valuable for the 2025-2030 Dietary Guidelines Advisory Committee, which is being formed to evaluate current evidence surrounding different eating patterns and health outcomes,” says Hu.

The research has been published in JAMA Internal Medicine.

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