Modifiable lifestyle factors and aging

Principal Investigator

Name
Yikyung Park

Degrees
Sc.D

Institution
Washington University in St. Louis

Position Title
Professor

Email
parky@wudosis.wustl.edu

About this CDAS Project

Study
PLCO (Learn more about this study)

Project ID
PLCO-2031

Initial CDAS Request Approval
Mar 16, 2026

Title
Modifiable lifestyle factors and aging

Summary
Chronological age - the simple passage of time- is a major risk factor for cancer, chronic diseases, and mortality. However, it fails to explain substantial interindividual variability in health outcomes and is not a reliable surrogate for biological or functional age and overall healthspan. Although the assessment of biological age has become an area of growing interest, no universally accepted operational definition of biological age currently exists. Moreover, existing epigenetic biological clocks are not practical to use in large observational studies. Nonetheless, there is a broad consensus that aging phenotypes exist and can be characterized using multidimensional health parameters. A body of literature showed that frailty and geriatric assessments, typically derived from self-reported physical, functional, and psychosocial status and comorbidities, predicted aging-related health conditions and mortality. In our previous work, we employed a deficit accumulation index (DAI) as a proxy measure for premature aging. The DAI showed strong correlations with mortality and biological aging markers.

Aging is influenced by genetic and environmental factors, such as diet and physical activity. Emerging evidence suggests that diet and physical activity play important roles in maintaining physical function and muscle strength while reducing frailty and mortality risk. A diet rich in fruits, vegetables, whole grains, and fish or seafood, but low in meat, such as the Mediterranean diet, was associated with longer telomeres, suggesting the beneficial effect of a healthy diet on aging. Limited evidence also suggests that physical activity is associated with a lower risk of premature aging, whereas sedentary behaviors increase the risk. However, the effects of diet and physical activity on aging and the aging trajectories remain largely unknown. Therefore, we propose to examine whether diet and physical activity, and sedentary behaviors are associated with the DAI in the PLCO study.

Aims

Exposures to be examined are food groups (e.g., fruit, vegetables, whole grains, red meat), nutrients (e.g., sugar, protein, alcohol), dietary patterns (e.g., Mediterranean diet), physical activity, and sedentary behaviors. The outcome, DAI, will be estimated using self-reported health and behavior items from the Supplemental Questionnaire and the Brief Survey. We will internally validate the DAI by examining its relation with mortality.

Specifically, we aim to:
- Examine the association between a Deficit Accumulation Index (DAI) and mortality
- Examine the associations between diet – food groups, nutrients, and dietary patterns - and DAI
- Examine the associations between physical activity, sedentary behaviors and DAI

Collaborators

Yikyung Park Washington University in St. Louis
Zhaoming Wang University of South Florida