Abstract
The impact of lifestyle factors on biological aging is typically assessed one time at enrollment in epidemiological studies, with few studies examining their impact over time. In this prospective study with 143,823 individuals from the Taiwan MJ cohort, we investigate the association between healthy lifestyle scores (HLS) and annualized changes in biological age (ΔMDAge/year), replicated with Phenotypic Age and UK Biobank data. Compared to individuals with HLS of 0, increasing HLS was associated with decreased level of ΔMDAge/year, with the adjusted betas (95%CI) were -0.19 (-0.30 to -0.08), -0.23 (-0.33 to -0.12), -0.29 (-0.39 to -0.18), -0.34 (-0.45 to -0.24), and -0.38 (-0.49 to -0.28) for HLS of 1, 2, 3, 4, and 5, respectively. Those results were also replicated in the UK Biobank. Individuals with accelerated aging at baseline and higher HLS exhibited lower odds ratio of persistent aging acceleration. Moreover, those with a higher HLS and decreased ΔMDAge/year had a 49% reduction in all-cause mortality risk. About 5.05% of the association between HLS and mortality was mediated by ΔMDAge/year. These findings demonstrate that a healthier lifestyle profile is associated with attenuated aging acceleration, potential reversal of accelerated aging status, and reduced mortality risk.