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Adherence to the Eatwell Guide and associations with markers of physical function: a prospective analysis within the UK Biobank cohort

Lookup NU author(s): Fiona Malcomson, Kirstie CroninORCiD, Dr Oliver ShannonORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© The Author(s) 2026.The Eatwell Guide represents the UK’s principal healthy eating model and understanding whether adherence to UK dietary recommendations can attenuate age-related functional decline is essential to inform healthy ageing strategies. In up to 157,457 participants from the UK Biobank, we explored cross-sectional and prospective associations between adherence to the Eatwell Guide and markers of physical function (grip strength, fat-free mass percentage, self-reported walking pace, and falls). Eatwell Guide adherence scores were derived from 24-h dietary recall data (Oxford WebQ), and quantified using a graded, food-based scoring system. Differences between population subgroups including by age, sex, physical activity, and protein intake level were explored. Higher Eatwell Guide adherence was cross-sectionally associated with higher grip strength, greater fat-free mass percentage, higher odds of brisk walking pace, and lower odds of falls (all p < 0.001). Prospectively, greater adherence was associated with attenuated fat-free mass decline (β = 0.02, SE = 0.001, p < 0.001) and slower grip strength decline (β = 0.01, SE = 0.002, p < 0.01). For walking pace, the positive cross-sectional association attenuated over follow-up (EWG × time interaction OR = 0.998, 95% CI 0.997–0.999, p = 0.002), whereas the protective association with falls remained stable over time (OR = 1.000, 95% CI 0.998–1.000, p = 0.89). Higher Eatwell Guide adherence was associated with preserved muscle mass, modest attenuation of grip strength decline over time, and a reduced risk of falls, supporting its relevance for musculoskeletal health and physical function in aging populations.

Publication metadata

Author(s): Griffiths A, Gregory S, Malcomson FC, Cronin K, Matu J, Ells L, Shannon OM

Publication type: Article

Publication status: Published

Journal: GeroScience

Year: 2026

Pages: epub ahead of print

Online publication date: 16/07/2026

Acceptance date: 08/07/2026

Date deposited: 03/08/2026

ISSN (print): 2509-2715

ISSN (electronic): 2509-2723

Publisher: Springer Science

URL: https://doi.org/10.1007/s11357-026-02414-5

DOI: 10.1007/s11357-026-02414-5

Data Access Statement: Data used for this study were obtained from the UK Biobank and are subject to access restrictions.

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