{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T18:02:56Z","timestamp":1783620176503,"version":"3.55.0"},"reference-count":116,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondazione Istituto Danone"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Healthy longevity depends on not only lifespan but also the maintenance of physiological, metabolic, physical, and cognitive functions throughout aging. Identifying early determinants of health is crucial for preventing age-related decline. This narrative review aims to synthesize current evidence on how diet and specific nutrients relate to these early risk factors and indicators of healthy longevity. Methods: A review was performed to identify the links between dietary factors, energy balance, and gut microbiota composition and normal body weight; blood cholesterol, pressure, and glucose; healthy sleep; an active lifestyle; and normal physical function and cognitive performance. Particular attention was given to Mediterranean and other plant-based dietary models as sources of key nutrients. Evidence from observational studies, randomized controlled trials, and meta-analyses was considered. Results: Across all markers, dietary quality and nutrient adequacy emerged as consistent determinants of health outcomes. Key nutrients were associated with favorable cardiometabolic, cognitive, and musculoskeletal functions, such as omega-3 fatty acids, fiber, vitamins D and B, minerals like magnesium and potassium, and polyphenols. Common nutrition gaps included insufficient intake of fiber, unsaturated fats, and micronutrients, which was often linked to a shift toward less plant-based diets. Gut microbiota diversity may mediate several of these associations, influencing metabolism, inflammation, sleep quality, and cognitive performance, although inter-individual variability and causal pathways remain incompletely understood. Conclusions: An integrated dietary approach emphasizing the consumption of whole and plant-rich foods, with moderate amounts of animal foods, supports multiple early markers, risk factors, and indicators of healthy longevity. The modulation of the gut microbiota through plant-based diets and fermented foods represents a promising strategy for maintaining health across aging trajectories.<\/jats:p>","DOI":"10.3390\/nu18111664","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T16:06:08Z","timestamp":1779465968000},"page":"1664","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early Biomarkers, Risk Factors, and Functional Indicators of Healthy Longevity and Their Relationship with Diet"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8298-926X","authenticated-orcid":false,"given":"Daniela","family":"Martini","sequence":"first","affiliation":[{"name":"Division of Human Nutrition, Department of Food, Environmental and Nutritional Sciences (DeFENS), Universit\u00e0 Degli Studi di Milano, 20133 Milano, Italy"},{"name":"Fondazione Istituto Danone, 20159 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8336-4851","authenticated-orcid":false,"given":"Mariangela","family":"Rondanelli","sequence":"additional","affiliation":[{"name":"Fondazione Istituto Danone, 20159 Milano, Italy"},{"name":"Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0475-2712","authenticated-orcid":false,"given":"Lorenzo","family":"Morelli","sequence":"additional","affiliation":[{"name":"Fondazione Istituto Danone, 20159 Milano, Italy"},{"name":"Department for Sustainable Food Process-DiSTAS, Universit\u00e0 Cattolica del Sacro Cuore, 26100 Cremona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Landi","sequence":"additional","affiliation":[{"name":"Fondazione Istituto Danone, 20159 Milano, Italy"},{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1016\/S0140-6736(25)01637-X","article-title":"Burden of 375 Diseases and Injuries, Risk-Attributable Burden of 88 Risk Factors, and Healthy Life Expectancy in 204 Countries and Territories, Including 660 Subnational Locations, 1990\u20132023: A Systematic Analysis for the Global Burden of Disease Study 2023","volume":"406","author":"Hay","year":"2025","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1016\/S0140-6736(19)30041-8","article-title":"Health Effects of Dietary Risks in 195 Countries, 1990\u20132017: A Systematic Analysis for the Global Burden of Disease Study 2017","volume":"393","author":"Afshin","year":"2019","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","article-title":"Worldwide Trends in Underweight and Obesity from 1990 to 2022: A Pooled Analysis of 3663 Population-Representative Studies with 222 Million Children, Adolescents, and Adults","volume":"403","author":"Phelps","year":"2024","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"102848","DOI":"10.1016\/j.eclinm.2024.102848","article-title":"Burden of Disease Attributable to High Body Mass Index: An Analysis of Data from the Global Burden of Disease Study 2021","volume":"76","author":"Zhou","year":"2024","journal-title":"EClinicalMedicine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global Incidence, Prevalence, Years Lived with Disability (YLDs), Disability-Adjusted Life-Years (DALYs), and Healthy Life Expectancy (HALE) for 371 Diseases and Injuries in 204 Countries and Territories and 811 Subnational Locations, 1990\u20132021: A System Analysis for the Global Burden of Disease Study 2021","volume":"403","author":"Ferrari","year":"2024","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.clnu.2025.04.002","article-title":"Burden of Cancer Attributable to High Body Mass Index: A Systematic Analysis of the Global Burden of Disease Study 2021","volume":"48","author":"Figlioli","year":"2025","journal-title":"Clin. 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