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.
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.
['George|Stephanie M|SM|', 'Ballard-Barbash|Rachel|R|', 'Manson|JoAnn E|JE|', 'Reedy|Jill|J|', 'Shikany|James M|JM|', 'Subar|Amy F|AF|', 'Tinker|Lesley F|LF|', 'Vitolins|Mara|M|', 'Neuhouser|Marian L|ML|']
D002318:Cardiovascular Diseases D002908:Chronic Disease D015331:Cohort Studies D004032:Diet D038441:Diet, Mediterranean D004522:Educational Status D005247:Feeding Behavior D005260:Female D015438:Health Behavior D006801:Humans D006973:Hypertension D015994:Incidence D008875:Middle Aged D015233:Models, Statistical D015999:Multivariate Analysis D009369:Neoplasms D018673:Nutrition Policy D011159:Population Surveillance D017698:Postmenopause D016016:Proportional Hazards Models D011446:Prospective Studies D012307:Risk Factors D011795:Surveys and Questionnaires D016019:Survival Analysis D016387:Women's Health
diet mortality risk postmenopausal women prospective cohort study diet quality indices