High-Quality Carbohydrates in Midlife Linked to Healthier Aging in Women
For every 10% increase in energy from high-quality carbohydrates, the odds of healthy aging rose by 31%, according to an analysis of data from the Nurse's Health Study.
A diet rich in high-quality carbohydrates and dietary fiber in midlife was associated with a 6% to 37% greater likelihood of healthy aging in women, according to a study published in JAMA Network Open. The 32-year prospective analysis of 47,513 participants in the Nurses’ Health Study (NHS) found that women with higher intakes of whole grains, fruits, vegetables, legumes, and dietary fiber had significantly greater odds of reaching age 70 or older in good health—defined as being free of major chronic diseases, physical disability, memory impairment, and depression.1
Courtesy of Tufts School of Medicine
Refined carbohydrate consumption, on the other hand, reduced the likelihood of reaching older age in good health by approximately 13%. Higher intake of refined carbohydrates was associated with lower odds of healthy aging (OR, 0.87; 95% CI, 0.80–0.95 per 10% increase in energy intake), while higher glycemic index and a greater carbohydrate-to-fiber ratio were also linked to unfavorable outcomes, according to the study.1
“We’ve all heard that different carbohydrates can affect health differently, whether for weight, energy, or blood sugar levels. But rather than just look at the immediate effects of these macronutrients, we wanted to understand what they might mean for good health 30 years later,” Andres V. Ardisson Korat, ScD, a scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, said in a press release. “Our findings suggest that carbohydrate quality may be an important factor in healthy aging.”2
Ardisson Korat and colleagues evaluated dietary data from food frequency questionnaires collected from NHS participants in 1984 and 1986, when participants were on average 48.5 years old. Researchers categorized carbohydrate intake into total, refined, and high-quality carbohydrates, and also assessed glycemic index (GI), glycemic load (GL), and sources of dietary fiber. Healthy aging outcomes were measured between 2014 and 2016, defined as survival to at least age 70 without any of 11 major chronic diseases (Figure), along with intact cognitive and physical function and good mental health.
Findings
Only 7.8% of women in the cohort met this definition of healthy aging. Still, midlife intake of high-quality carbohydrates—specifically those from whole grains, fruits, vegetables, and legumes—was consistently linked to higher odds of aging well. For every 10% increase in energy from high-quality carbohydrates, the odds of healthy aging rose by 31% (OR, 1.31; 95% CI, 1.22–1.41). Korat et al reported that carbohydrates from individual sources also contributed: for example, fruit-derived carbohydrates were associated with a 22% increase (OR, 1.22; 95% CI, 1.15–1.28 per 5% energy increment), and vegetable-derived carbohydrates were associated with a 37% increase (OR, 1.37; 95% CI, 1.20–1.57 per 5% energy increment).
Total dietary fiber intake was another strong predictor of healthy aging, researchers found. Per one standard deviation (SD) increase in fiber intake, the odds of healthy aging rose by 17% (OR, 1.17; 95% CI, 1.13–1.22). Fruit fiber showed a 14% increase (OR, 1.14; 95% CI, 1.10–1.19), while vegetable and cereal fibers were linked to 11% (OR, 1.11; 95% CI, 1.07–1.15) and 7% (OR, 1.07; 95% CI, 1.03–1.11) greater odds, respectively.
Refined carbohydrate intake showed a consistent negative association across most domains of healthy aging, including chronic disease risk and physical function. Carbohydrates from starchy vegetables such as potatoes, corn, and yams were also inversely associated with healthy aging (OR, 0.90; 95% CI, 0.82–0.99 per 5% energy increment).
Glycemic effects of carbohydrates were also examined. Higher glycemic index was associated with 24% lower odds of healthy aging (OR, 0.76; 95% CI, 0.67–0.87), and a higher carbohydrate-to-fiber ratio corresponded to 29% lower odds (OR, 0.71; 95% CI, 0.62–0.81). Glycemic load, on the other hand, showed a modest positive association, which was attenuated after adjusting for dietary fiber intake.
Importantly, the researchers modeled isocaloric substitutions to evaluate the impact of replacing other macronutrients with high-quality carbohydrates. Replacing 5% of energy from refined carbohydrates, animal protein, total fat, or trans fats with high-quality carbohydrates improved the odds of healthy aging by 8% to 16% (ORs ranging from 1.08 to 1.16). “These findings suggest that intakes of dietary fiber, high-quality, and refined carbohydrates may be important determinants of overall health status in older adulthood,” the authors wrote.
The strength of the associations remained robust even after adjusting for numerous covariates including body mass index, physical activity, alcohol intake, smoking, and total energy intake. Additional analyses confirmed that the benefits of high-quality carbohydrate intake were particularly evident among women with higher fiber consumption and lower dietary GI in midlife.
Among the study’s limitations, the authors note the homogeneity of the study cohort, ie, White female nurses, which limits generalizability of the findings to other populations. They call for future research to replicate the findings in more diverse cohorts.
“Studies are starting to find an association between food choices in midlife and quality of life in later years,” Addison Korat said. “The more we can understand about healthy aging, the more science can help people live healthier for longer.”
References
1. Ardisson Korat AV, Duscova E, Shea MK, et al. Dietary carbohydrate intake, carbohydrate quality, and health aging in women.JAMA Netw Open. 2025;8(5):e2511056. doi:10.1001/jamanetworkopen.2025.11056
2. LaPoint L. In healthy aging, carb quality counts. TuftsNow. May 16, 2025. https://now.tufts.edu/2025/05/16/healthy-aging-carb-quality-counts
