If the MAHA crowd is serious about “food is medicine,” it’s time to get specific. A 15-year Swedish study tracking nearly 2,500 older adults found that certain dietary patterns meaningfully slowed the accumulation of chronic diseases, especially those involving the heart and brain. But here’s the catch: not every “healthy” diet worked. This isn’t another moral lecture about carbs or clean eating—it’s a data-backed reminder that evidence, not slogans, should guide both personal health choices and public policy.
SNAC-K is a longitudinal study of Swedish adults designed to study the impact of aging and chronic illness. The research cohort was a randomly sampled subgroup of 2,473 Swedish adults 60 or older evaluated at six-year intervals for over 15 years. The average age was 71, and 61% of the participants were females. The SNAC-K cohort consists of urban, mostly community-dwelling, highly educated, and relatively affluent Swedish older adults; a population with a generally higher diet quality and lower risk of chronic illness, limiting the generalization of the conclusions to other demographics.
Multimorbidity, the presence of two or more chronic illnesses, was the outcome of interest, with the rate of accumulating those illnesses serving as a proxy for aging. Categorizing in this way shifted the focus from a specific disease “burden” to a more general descriptor of overall health. Chronic illnesses were counted in total, and for three specific “organ systems, cardiovascular, neuropsychiatric, and musculoskeletal [1]. Among the study participants, 84% had multimorbidity at baseline.
Four Diets, Four Philosophies
The investigators consider four dietary patterns rather than individual foods or nutrients:
The Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) – a specifically designed diet shown to be protective for dementia, emphasizing minimally processed plant-based foods, and limited consumption of animal products and foods high in saturated fats.
The Alternative Healthy Eating Index (AHEI) – a diet rich in plant-based foods and healthy fats, limiting red and processed meats, sugar-sweetened beverages, and sodium, designed, through a review of relevant scientific literature and discussions with nutrition researchers, to lower the risk of chronic diseases. This is the type of guidance we might expect from the upcoming MAHA commission dietary report.
The Alternative Mediterranean Diet (AMED) – focused on the traditional eating patterns of northwestern Spain and Portugal, emphasizing fresh, whole, and locally sourced, seasonal foods, including vegetables, fruits, fish, and olive oil, while also incorporating carbohydrates like bread, pasta, and potatoes. While similar to the Mediterranean diet, it takes into account cooking methods, a nuanced nod to NOVA’s food classification.
The Empirical Dietary Inflammatory Index (EDII) – distinct from the other three, it assesses diet quality based on its inflammatory potential. It assigns values to food groups based on scientific studies of their pro- or anti-inflammatory effects. Foods like leafy greens, colorful vegetables, whole grains, legumes, fish, poultry, and tea tend to have anti-inflammatory properties. In contrast, processed meats, red meats, refined grains, sugary beverages, and fried foods are associated with promoting inflammation. A positive score suggests a diet that promotes inflammation. Unlike the other three dietary patterns, a higher adherence or score for EDII indicates a less healthy diet.
While these patterns differ in emphasis, their cumulative impact depends on adherence over time. That brings us to a key limitation. The long duration of the study helps capture the cumulative effect of diet; however, the self-reported dietary data were only collected during the first six years of study, limiting the certainty of the study’s conclusions. Apply grains of salt as you wish.
Findings
Each of the three healthier eating patterns slowed the accumulation of chronic illnesses, with the most pronounced effects on cardiovascular and neuropsychiatric diseases. Diet did not influence the development of chronic musculoskeletal disease. After 15 years, participants in the top 10% of adherence to healthy diets had 1–2.5 fewer chronic diseases than those in the bottom 10%, a meaningful difference in long-term health. The disparity between musculoskeletal illness and cardiovascular and neuropsychiatric illness makes sense; a significant component of musculoskeletal disease is trauma-related, while cardiovascular and neuropsychiatric illness have a greater metabolic component amenable to dietary modification.
The inflammatory nature of the diet also mattered, with higher EDII pro-inflammatory scores linked to a faster accumulation of heart and brain-related chronic illnesses. Those with higher EDII scores accumulated more than two additional chronic illnesses compared with lower-scoring participants.
The AHEI diet stood out as the most healthful in this study, likely because it was explicitly designed to predict chronic cardiovascular and neuropsychiatric disease risk and has been tied to reduced risks for dementia, depression, and cardiovascular conditions.
What the Findings Actually Say
Ultimately, the study underscores that diet is amodifiable factor in determining how quickly older adults accumulate chronic diseases, offering important guidance for aging-related dietary recommendations. What does this all mean for aging, public health, and that MAHA commission? Several implications stand out…
Encouraging adherence to healthy dietary patterns, rather than specific foods or nutrients, can be a successful public health strategy.
Dietary guidance, regardless of age, may help reduce the onset and burden of chronic illnesses. However, nutritional interventions are impactful for some, not all, chronic diseases, necessitating a more personalized intervention, treating diets as guidance rather than rules.
Inflammation appears to be an underlying mechanism; therefore, dietary patterns that reduce inflammation may be particularly beneficial. However, we cannot conflate reduced inflammatory markers with desired outcomes. A healthful lifespan has more origins than diet alone.
Paradoxically, improved health span, to the extent that it extends our lifespan, may not yield the economic savings one envisions. Extending life while living with costly chronic illness, while providing an individual benefit, may come with a reduced but still present economic burden.
If diet is a form of medicine, then some prescriptions work far better than others. The more your plate resembles a produce aisle, the more your health will remain stable rather than decline.
Beyond Slogans: The MAHA opportunity
For the MAHA champions of the “food is medicine” mantra, this study underscores a crucial and overdue clarification: not all food-as-medicine claims are created equal, and not all dietary patterns yield equal health benefits. When “food as medicine” is reduced to a slogan, it invites pseudoscientific overreach, from marketing organic cane sugar as a virtuous upgrade over high fructose corn syrup to the ritual shaming of red meat with more zeal than data. However, when grounded in rigorous longitudinal evidence, as this Swedish study offers, diet emerges not as a panacea, but as a powerful, modifiable lever in the trajectory of aging and chronic disease.
That distinction matters. It separates actionable insight from aspirational fluff, and health strategy from wellness theater.
For the free marketers, the path forward doesn’t lie in regulating what Americans put on their plates, but in empowering the public. The real opportunity is in building markets that reward health-promoting innovation and lower the barriers to smarter eating, through pricing, availability, user experience, and consumer trust. The government and private sector can be formidable engines for better health, not by preaching dietary virtue, but through public policy and private innovation, supporting a food ecosystem where healthier choices are easier, tastier, and more affordable.
[1] Cardiovascular diseases – ischemic heart disease, heart failure, atrial fibrillation, cerebrovascular disease, and peripheral vascular disease. Neuropsychiatric diseases – depression and mood diseases, dementia, Parkinson’s disease, epilepsy, and other psychiatric or neurological disorders. Musculoskeletal diseases – dorsopathies, inflammatory arthropathies, osteoarthritis, and osteoporosis, among other musculoskeletal and joint conditions.
Source: Dietary Patterns And Accelerated Multimorbidity In Older Adults Nature Aging DOI: 10.1038/s43587-025-00929-8
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