This study investigates gender differences in trajectories of support from close relationships among adults in the transition from middle to old age, taking into account stability and change in the identity of the closest persons. Multi-level modelling was used to estimate gendered age-trajectories in three dimensions of support: emotional support, practical support and negative encounters, which were repeatedly measured over ten years amongst 6,718 Whitehall II participants. Men were more likely than women to nominate their partner as their closest person throughout follow-up; whereas women drew support from a wider range of sources. Gender differences were only evident in age-related trajectories of emotional support, and were contingent on stability and change in the closest relationships. Men reported increased emotional support from closest relationships with age, except for those who transitioned out of a partnership. For women, emotional support was stable among those whose closest person remained consistent, but decreased among those who changed their closest person. Further, emotional support increased with age for all married men, which was only the case for married women who nominated their partner as their closest person. Our analysis highlights gender-specific trajectories of perceived support from adults’ closest relationships in late life, and indicate more pronounced socio-emotional selectivity in older men than women.

Higher variety of recommended foods, identified arbitrarily based on dietary guidelines, has been associated with better health status. Nutrient profiling is designed to identify objectively, based on nutrient content, healthier foods whose consumption should be encouraged. The objective was to assess the prospective associations between total food variety (food variety score, FVS) and variety from selected recommended and non-recommended foods (RFV and NRFV, respectively) and risk of chronic disease and mortality. In 1991–3, 7251 participants of the Whitehall II study completed a 127-item FFQ. The FVS was defined as the number of foods consumed more than once a week. (N)RFV(Ofcom) and (N)RFV(SAIN,LIM) were similarly derived selecting healthier (or less healthier) foods as defined by the UK Ofcom and French SAIN,LIM nutrient profile models, respectively. Multi-adjusted Cox regressions were fitted with incident CHD, diabetes, CVD, cancer and all-cause mortality (318, 754, 137, 251 and 524 events, respectively – median follow-up time 17 years). RFV and NRFV scores were mutually adjusted. The FVS (fourth v. first quartile) was associated with a 39 and 26 % reduction of prospective CHD and all-cause mortality risk, respectively. The RFV(Ofcom) (third v. first quartile) was associated with a 27 and 35 % reduction of all-cause mortality and cancer mortality risk, respectively; similar associations were suggested, but not significant for the RFV(SAIN,LIM). No prospective associations were observed with NRFV scores. The results strengthen the rationale to promote total food variety and variety from healthy foods. Nutrient profiling can help in identifying those foods whose consumption should be encouraged.

Few prospective studies have examined the effects of different types of dairy food on the risks of type 2 diabetes, CHD and mortality. We examined whether intakes of total dairy, high-fat dairy, low-fat dairy, milk and fermented dairy products were related to these outcomes in the Whitehall II prospective cohort study. At baseline, dairy consumption was assessed by FFQ among 4526 subjects (72 % men) with a mean age 56 (sd 6) years. Death certificates and medical records were used to ascertain CHD mortality and non-fatal myocardial infarction. Incident diabetes was detected by the oral glucose tolerance test or self-report. Incidence data were analysed using Cox proportional hazards models, adjusted for lifestyle and dietary factors. During approximately 10 years of follow-up, 273 diabetes, 323 CHD and 237 all-cause mortality cases occurred. In multivariable models, intakes of total dairy and types of dairy products were not significantly associated with incident diabetes or CHD (all P values for trend >0·1). Fermented dairy products was inversely associated with overall mortality (hazard ratios approximately 0·7 in the middle and highest tertiles; P for trend < 0·01) but not with incident CHD or diabetes (P>0·3). In conclusion, intakes of total dairy and types of dairy products showed no consistent relationship with incident diabetes, CHD or all-cause mortality.

Analysis of the epidemiological effects of overall dietary patterns offers an alternative approach to the investigation of the role of diet in CHD. We analysed the role of blood lipid-related dietary patterns using a two-step method to confirm the prospective association of dietary pattern with incident CHD. Analysis is based on 7314 participants of the Whitehall II study. Dietary intake was measured using a 127-item FFQ. Reduced rank regression (RRR) was used to derive dietary pattern scores using baseline serum total and HDL-cholesterol, and TAG levels as dependent variables. Cox proportional hazard regression was used to confirm the association between dietary patterns and incident CHD (n 243) over 15 years of follow-up. Increased CHD risk (hazard ratio (HR) for top quartile: 2·01 (95 % CI 1·41, 2·85) adjusted for age, sex, ethnicity and energy misreporting) was observed with a diet characterised by high consumption of white bread, fried potatoes, sugar in tea and coffee, burgers and sausages, soft drinks, and low consumption of French dressing and vegetables. The diet–CHD relationship was attenuated after adjustment for employment grade and health behaviours (HR for top quartile: 1·81; 95 % CI 1·26, 2·62), and further adjustment for blood pressure and BMI (HR for top quartile: 1·57; 95 % CI 1·08, 2·27). Dietary patterns are associated with serum lipids and predict CHD risk after adjustment for confounders. RRR identifies dietary patterns using prior knowledge and focuses on the pathways through which diet may influence disease. The present study adds to the evidence that diet is an important risk factor for CHD.

At least fourteen cohort studies have documented an inverse association between coffee consumption and risk of type 2 diabetes. We examined the prospective association between coffee and tea consumption and the risk of type 2 diabetes mellitus among British men (n 4055) and women (n 1768) from the Whitehall II cohort. During 11·7 years follow-up there were a total of 387 incident cases of diabetes confirmed by self-report of doctor's diagnosis or glucose tolerance tests. Despite an inverse association between coffee intake and 2 h post-load glucose concentration at the baseline assessment, combined caffeinated and decaffeinated coffee (hazard ratio (HR) 0·80; 95 % CI 0·54, 1·18) or only decaffeinated coffee intake (HR 0·65; 95 % CI 0·36, 1·16) was not significantly associated with diabetes risk at follow-up after adjustment for possible confounders. There was an association between tea intake and diabetes (HR 0·66; 95 % CI 0·61, 1·22; P < 0·05) after adjustment for age, gender, ethnicity and social status, which was not robust to further adjustments. There was, however, an association between combined intake of tea and coffee (two or more cups per day of both beverage) and diabetes (HR 0·68; 95 % CI 0·46, 0·99; P < 0·05) after full adjustment. In conclusion, relatively moderate intake (more than three cups per day) of coffee and tea were not prospectively associated with incidence of type 2 diabetes although there was evidence of a combined effect. The limited range of exposure and beverage consumption according to socio-economic class may explain these conflicting findings.

Our aim was to investigate how socio-demographic factors influence trends and age-related trajectories of fish consumption. We examined consumption of total, fried and recommended fish (white and oily fish, and shellfish) in the Whitehall II study over 11 years in participants aged 39–59 years at phase 3. The cohort included 8358 British civil servants who completed a FFQ at phase 3 (1991–3), phase 5 (1997–9, n 5430) and phase 7 (2002–4, n 5692). Occupational grade, ethnicity, marital and retirement status were collected at each phase. To analyse changes in age-related trends of fish intake over time according to socio-demographic characteristics, we applied a random mixed-effect model. Over the follow-up a significant increase in consumption of ‘recommended’ (mean: 1·85 to 2·22 portions/week) and total fish (mean: 2·32 to 2·65 portions/week) and a decreasing trend in fried-fish intake (mean: 0·47 to 0·43 portions/week) was observed. Recommended, fried and total fish consumption differed by occupational status, ethnicity, marital status and sex. The trend of age-related fish intake diverged significantly by ethnicity. In South Asian participants (n 432), slope of recommended-fish consumption was significantly higher compared with white participants (0·077 v. 0·025 portions/week per year). For black participants (n 275) slope of fried-fish intake was significantly higher compared with white participants (0·0052 v. − 0·0025 portions/week per year). In terms of public health, our descriptive and analytical work allows detailed understanding of the impact of socio-demographic factors on fish intake and its age-related trends. Such information is valuable for food policies that seek to promote health equity.