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However, the extent to which adherence to different so-called healthy diets overlaps, whether these dietary patterns are equally beneficial, and whether they are associated with similar DNA methylation profiles, remains unclear. Therefore, we investigate the overlap in adherence to ten diet quality scores, and examine the associations of these scores with both biological aging markers and DNA methylation profiles. We use data from the Rhineland Study, a large population-based cohort, and validated our findings using corresponding data from the EPIC-Potsdam cohort. Here, we show minimal overlap of participants classified in the highest quartile (top 25%) of adherence across different diet quality scores. Adherence to a healthy dietary pattern is associated with reduced epigenetic aging, although associations differed in magnitude across diet quality scores. Different dietary patterns are associated with distinct methylation profiles, which however largely converged onto the same biological pathways. Our findings suggest that general adherence to a healthy dietary pattern could promote health through similar epigenetic mechanisms, despite variations in dietary composition.<\/jats:p>","DOI":"10.1038\/s41467-026-77064-4","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T14:33:58Z","timestamp":1788014038000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between diet quality, epigenetic aging and epigenome in two population-based cohorts"],"prefix":"10.1038","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5659-1864","authenticated-orcid":false,"given":"Juliana F.","family":"Tavares","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6732-7433","authenticated-orcid":false,"given":"Dan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Talevi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3975-5596","authenticated-orcid":false,"given":"Fabian","family":"Eichelmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Jannasch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0830-5277","authenticated-orcid":false,"given":"Matthias B.","family":"Schulze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6184-458X","authenticated-orcid":false,"given":"N. 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