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Diet-Quality Indexes Are Associated with a Lower Risk of Cardiovascular, Respiratory, and All-Cause Mortality among Chinese Adults.
J Nutr. 2018 08 01; 148(8):1323-1332.JN

Abstract

Background

Diet-quality indexes have been associated with a lower risk of chronic disease mortality in Western populations, but it is unclear whether these indexes reflect protective dietary patterns in Asian populations.

Objective

We examined the association between Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and Healthy Diet Indicator (HDI) scores and the risk of all-cause cardiovascular disease (CVD), cancer, and respiratory disease mortality.

Methods

We used data from a prospective cohort of 57,078 Singapore Chinese men and women (aged 45-74 y) who were free of cancer and CVD at baseline (1993-1998) and who were followed up through 2014. The diet-quality index scores were calculated on the basis of data from a validated 165-item food-frequency questionnaire. Cox regression models with adjustment for potential confounders including sociodemographic and lifestyle variables, body mass index, and medical history were used to estimate HRs and 95% CIs.

Results

During a total of 981,980 person-years of follow-up, 15,262 deaths (CVD: 4871; respiratory: 2690; and cancer: 5306) occurred. Comparing the highest with the lowest quintiles, the multivariable adjusted HRs (95% CIs) for all-cause mortality were 0.82 (0.78, 0.86) for AHEI-2010, 0.80 (0.76, 0.85) for aMED, 0.80 (0.75, 0.84) for DASH, and 0.88 (0.83, 0.92) for HDI scores (all P-trend < 0.001). Higher diet index scores were associated with a 14-28% lower risk of CVD and respiratory mortality, but only a 5-12% lower risk of cancer mortality. Higher consumption of vegetables, fruit, nuts, and long-chain n-3 (ω-3) fatty acids, lower consumption of red meat, and avoidance of high alcohol consumption were the diet index components associated with a lower risk of mortality.

Conclusion

Adherence to several recommended dietary patterns that emphasize healthy plant-based foods was associated with a substantially lower risk of chronic disease mortality in an Asian population. The Singapore Chinese Health Study was registered at www.clinicaltrials.gov as NCT03356340.

Authors+Show Affiliations

Saw Swee Hock School of Public Health.Saw Swee Hock School of Public Health. Duke-NUS Medical School, Singapore.Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, Pittsburgh, PA. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.Saw Swee Hock School of Public Health. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29982724

Citation

Neelakantan, Nithya, et al. "Diet-Quality Indexes Are Associated With a Lower Risk of Cardiovascular, Respiratory, and All-Cause Mortality Among Chinese Adults." The Journal of Nutrition, vol. 148, no. 8, 2018, pp. 1323-1332.
Neelakantan N, Koh WP, Yuan JM, et al. Diet-Quality Indexes Are Associated with a Lower Risk of Cardiovascular, Respiratory, and All-Cause Mortality among Chinese Adults. J Nutr. 2018;148(8):1323-1332.
Neelakantan, N., Koh, W. P., Yuan, J. M., & van Dam, R. M. (2018). Diet-Quality Indexes Are Associated with a Lower Risk of Cardiovascular, Respiratory, and All-Cause Mortality among Chinese Adults. The Journal of Nutrition, 148(8), 1323-1332. https://doi.org/10.1093/jn/nxy094
Neelakantan N, et al. Diet-Quality Indexes Are Associated With a Lower Risk of Cardiovascular, Respiratory, and All-Cause Mortality Among Chinese Adults. J Nutr. 2018 08 1;148(8):1323-1332. PubMed PMID: 29982724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diet-Quality Indexes Are Associated with a Lower Risk of Cardiovascular, Respiratory, and All-Cause Mortality among Chinese Adults. AU - Neelakantan,Nithya, AU - Koh,Woon-Puay, AU - Yuan,Jian-Min, AU - van Dam,Rob M, PY - 2018/01/02/received PY - 2018/04/13/accepted PY - 2018/7/10/pubmed PY - 2019/5/8/medline PY - 2018/7/9/entrez SP - 1323 EP - 1332 JF - The Journal of nutrition JO - J. Nutr. VL - 148 IS - 8 N2 - Background: Diet-quality indexes have been associated with a lower risk of chronic disease mortality in Western populations, but it is unclear whether these indexes reflect protective dietary patterns in Asian populations. Objective: We examined the association between Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and Healthy Diet Indicator (HDI) scores and the risk of all-cause cardiovascular disease (CVD), cancer, and respiratory disease mortality. Methods: We used data from a prospective cohort of 57,078 Singapore Chinese men and women (aged 45-74 y) who were free of cancer and CVD at baseline (1993-1998) and who were followed up through 2014. The diet-quality index scores were calculated on the basis of data from a validated 165-item food-frequency questionnaire. Cox regression models with adjustment for potential confounders including sociodemographic and lifestyle variables, body mass index, and medical history were used to estimate HRs and 95% CIs. Results: During a total of 981,980 person-years of follow-up, 15,262 deaths (CVD: 4871; respiratory: 2690; and cancer: 5306) occurred. Comparing the highest with the lowest quintiles, the multivariable adjusted HRs (95% CIs) for all-cause mortality were 0.82 (0.78, 0.86) for AHEI-2010, 0.80 (0.76, 0.85) for aMED, 0.80 (0.75, 0.84) for DASH, and 0.88 (0.83, 0.92) for HDI scores (all P-trend < 0.001). Higher diet index scores were associated with a 14-28% lower risk of CVD and respiratory mortality, but only a 5-12% lower risk of cancer mortality. Higher consumption of vegetables, fruit, nuts, and long-chain n-3 (ω-3) fatty acids, lower consumption of red meat, and avoidance of high alcohol consumption were the diet index components associated with a lower risk of mortality. Conclusion: Adherence to several recommended dietary patterns that emphasize healthy plant-based foods was associated with a substantially lower risk of chronic disease mortality in an Asian population. The Singapore Chinese Health Study was registered at www.clinicaltrials.gov as NCT03356340. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/29982724/Diet_Quality_Indexes_Are_Associated_with_a_Lower_Risk_of_Cardiovascular_Respiratory_and_All_Cause_Mortality_among_Chinese_Adults_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.1093/jn/nxy094 DB - PRIME DP - Unbound Medicine ER -