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Comparing indices of diet quality with chronic disease mortality risk in postmenopausal women in the Women's Health Initiative Observational Study: evidence to inform national dietary guidance.
Am J Epidemiol 2014; 180(6):616-25AJ

Abstract

Poor diet quality is thought to be a leading risk factor for years of life lost. We examined how scores on 4 commonly used diet quality indices-the Healthy Eating Index 2010 (HEI), the Alternative Healthy Eating Index 2010 (AHEI), the Alternate Mediterranean Diet (aMED), and the Dietary Approaches to Stop Hypertension (DASH)-are related to the risks of death from all causes, cardiovascular disease (CVD), and cancer among postmenopausal women. Our prospective cohort study included 63,805 participants in the Women's Health Initiative Observational Study (from 1993-2010) who completed a food frequency questionnaire at enrollment. Cox proportional hazards models were fit using person-years as the underlying time metric. We estimated multivariate hazard ratios and 95% confidence intervals for death associated with increasing quintiles of diet quality index scores. During 12.9 years of follow-up, 5,692 deaths occurred, including 1,483 from CVD and 2,384 from cancer. Across indices and after adjustment for multiple covariates, having better diet quality (as assessed by HEI, AHEI, aMED, and DASH scores) was associated with statistically significant 18%-26% lower all-cause and CVD mortality risk. Higher HEI, aMED, and DASH (but not AHEI) scores were associated with a statistically significant 20%-23% lower risk of cancer death. These results suggest that postmenopausal women consuming a diet in line with a priori diet quality indices have a lower risk of death from chronic disease.

Authors

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Pub Type(s)

Comparative Study
Evaluation Studies
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Validation Studies

Language

eng

PubMed ID

25035143

Citation

George, Stephanie M., et al. "Comparing Indices of Diet Quality With Chronic Disease Mortality Risk in Postmenopausal Women in the Women's Health Initiative Observational Study: Evidence to Inform National Dietary Guidance." American Journal of Epidemiology, vol. 180, no. 6, 2014, pp. 616-25.
George SM, Ballard-Barbash R, Manson JE, et al. Comparing indices of diet quality with chronic disease mortality risk in postmenopausal women in the Women's Health Initiative Observational Study: evidence to inform national dietary guidance. Am J Epidemiol. 2014;180(6):616-25.
George, S. M., Ballard-Barbash, R., Manson, J. E., Reedy, J., Shikany, J. M., Subar, A. F., ... Neuhouser, M. L. (2014). Comparing indices of diet quality with chronic disease mortality risk in postmenopausal women in the Women's Health Initiative Observational Study: evidence to inform national dietary guidance. American Journal of Epidemiology, 180(6), pp. 616-25. doi:10.1093/aje/kwu173.
George SM, et al. Comparing Indices of Diet Quality With Chronic Disease Mortality Risk in Postmenopausal Women in the Women's Health Initiative Observational Study: Evidence to Inform National Dietary Guidance. Am J Epidemiol. 2014 Sep 15;180(6):616-25. PubMed PMID: 25035143.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparing indices of diet quality with chronic disease mortality risk in postmenopausal women in the Women's Health Initiative Observational Study: evidence to inform national dietary guidance. AU - George,Stephanie M, AU - Ballard-Barbash,Rachel, AU - Manson,JoAnn E, AU - Reedy,Jill, AU - Shikany,James M, AU - Subar,Amy F, AU - Tinker,Lesley F, AU - Vitolins,Mara, AU - Neuhouser,Marian L, Y1 - 2014/07/17/ PY - 2014/7/19/entrez PY - 2014/7/19/pubmed PY - 2014/10/30/medline KW - diet KW - diet quality indices KW - mortality risk KW - postmenopausal women KW - prospective cohort study SP - 616 EP - 25 JF - American journal of epidemiology JO - Am. J. Epidemiol. VL - 180 IS - 6 N2 - Poor diet quality is thought to be a leading risk factor for years of life lost. We examined how scores on 4 commonly used diet quality indices-the Healthy Eating Index 2010 (HEI), the Alternative Healthy Eating Index 2010 (AHEI), the Alternate Mediterranean Diet (aMED), and the Dietary Approaches to Stop Hypertension (DASH)-are related to the risks of death from all causes, cardiovascular disease (CVD), and cancer among postmenopausal women. Our prospective cohort study included 63,805 participants in the Women's Health Initiative Observational Study (from 1993-2010) who completed a food frequency questionnaire at enrollment. Cox proportional hazards models were fit using person-years as the underlying time metric. We estimated multivariate hazard ratios and 95% confidence intervals for death associated with increasing quintiles of diet quality index scores. During 12.9 years of follow-up, 5,692 deaths occurred, including 1,483 from CVD and 2,384 from cancer. Across indices and after adjustment for multiple covariates, having better diet quality (as assessed by HEI, AHEI, aMED, and DASH scores) was associated with statistically significant 18%-26% lower all-cause and CVD mortality risk. Higher HEI, aMED, and DASH (but not AHEI) scores were associated with a statistically significant 20%-23% lower risk of cancer death. These results suggest that postmenopausal women consuming a diet in line with a priori diet quality indices have a lower risk of death from chronic disease. SN - 1476-6256 UR - https://www.unboundmedicine.com/medline/citation/25035143/Comparing_indices_of_diet_quality_with_chronic_disease_mortality_risk_in_postmenopausal_women_in_the_Women's_Health_Initiative_Observational_Study:_evidence_to_inform_national_dietary_guidance_ L2 - https://academic.oup.com/aje/article-lookup/doi/10.1093/aje/kwu173 DB - PRIME DP - Unbound Medicine ER -