Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 180, Issue 6, Pages 616-625Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwu173
Keywords
diet; diet quality indices; mortality risk; postmenopausal women; prospective cohort study
Categories
Funding
- Applied Research Program of the National Cancer Institute
- National Heart, Lung, and Blood Institute [HHSN268201100046C, HHSN 268201100001C, HHSN268201100002C, HHSN2682011 00003C, HHSN26820110004C, HHSN271201100004C]
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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.
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