Associations of key diet-quality indexes with mortality in the Multiethnic Cohort: the Dietary Patterns Methods Project234

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ABSTRACT

Background: Healthy dietary patterns have been linked positively with health and longevity. However, prospective studies in diverse populations in the United States addressing dietary patterns and mortality are limited.

Objective: We assessed the ability of the following 4 diet-quality indexes [the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the alternate Mediterranean diet score (aMED), and the Dietary Approaches to Stop Hypertension (DASH)] to predict the reduction in risk of mortality from all causes, cardiovascular disease (CVD), and cancer.

Design: White, African American, Native Hawaiian, Japanese American, and Latino adults (n = 215,782) from the Multiethnic Cohort completed a quantitative food-frequency questionnaire. Scores for each dietary index were computed and divided into quintiles for men and women. Mortality was documented over 13–18 y of follow-up. HRs and 95% CIs were computed by using adjusted Cox models.

Results: High HEI-2010, AHEI-2010, aMED, and DASH scores were all inversely associated with risk of mortality from all causes, CVD, and cancer in both men and women (P-trend < 0.0001 for all models). For men, the HEI-2010 was consistently associated with a reduction in risk of mortality for all causes (HR: 0.75; 95% CI: 0.71, 0.79), CVD (HR: 0.74; 95% CI: 0.69, 0.81), and cancer (HR: 0.76; 95% CI: 0.70, 0.83) when lowest and highest quintiles were compared. In women, the AHEI and aMED showed large reductions for all-cause mortality (HR: 0.78; 95% CI: 0.74, 0.82), the AHEI showed large reductions for CVD (HR: 0.76; 95% CI: 0.69, 0.83), and the aMED showed large reductions for cancer (HR: 0.84; 95% CI: 0.76, 0. 92).

Conclusion: These results, in a US multiethnic population, suggest that consuming a dietary pattern that achieves a high diet-quality index score is associated with lower risk of mortality from all causes, CVD, and cancer in adult men and women.

Keywords

dietary indexes
epidemiology
multiethnic
risk factors
survival

ABBREVIATIONS

AHEI-2010
Alternate Healthy Eating Index-2010
aMED
alternate Mediterranean diet score
CVD
cardiovascular disease
DASH
Dietary Approaches to Stop Hypertension
DPMP
Dietary Patterns Methods Project
HEI-2010
Healthy Eating Index-2010
MEC
Multiethnic Cohort
MPED
MyPyramid Equivalents Database
QFFQ
quantitative food-frequency questionnaire
Qx1
baseline questionnaire
SSB
sugar-sweetened beverage

Cited by (0)

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Supported by the National Cancer Institute (NCI) (HHSN261201200423P) and in part by the NIH/NCI (P30 CA071789). The Multiethnic Cohort Study is supported by the NIH/NCI (4R37 CA 54281). BE Harmon and RE were recipients of the postdoctoral fellowship R25 CA 90956.

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Supplemental Tables 1–10 and Supplemental Figure 1 are available from the “Supplemental data” link in the online posting of the article and from the same link in the online table of contents at http://ajcn.nutrition.org.

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Present address for RE: Department of Human Nutrition, Food and Animal Sciences, University of Hawaii, 1955 East West Road, Honolulu, HI 96822.

Copyright © 2015 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.