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

Brook E Harmon; Carol J Boushey; Yurii B Shvetsov; Reynolette Ettienne; Jill Reedy; Lynne R Wilkens; Loic Le Marchand; Brian E Henderson; Laurence N Kolonel

doi:10.3945/ajcn.114.090688

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

Am J Clin Nutr. 2015 Mar;101(3):587-97. doi: 10.3945/ajcn.114.090688. Epub 2015 Jan 7.

Authors

Brook E Harmon¹, Carol J Boushey¹, Yurii B Shvetsov¹, Reynolette Ettienne¹, Jill Reedy¹, Lynne R Wilkens¹, Loic Le Marchand¹, Brian E Henderson¹, Laurence N Kolonel¹

Affiliation

¹ From the Departmental and Institutional Affiliations, Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI (BE Harmon, CJB, YBS, RE, LRW, LLM, and LNK); the Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD (JR); and the University of Southern California, Los Angeles, CA (BE Henderson).

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.

Publication types

Comparative Study
Multicenter Study
Research Support, N.I.H., Extramural

MeSH terms

Aged
Asian
Black or African American
Cardiovascular Diseases / ethnology
Cardiovascular Diseases / mortality
Cardiovascular Diseases / prevention & control*
Cohort Studies
Diet / adverse effects*
Diet / ethnology
Female
Follow-Up Studies
Guidelines as Topic*
Hawaii / epidemiology
Health Promotion*
Hispanic or Latino
Humans
Japan / ethnology
Los Angeles / epidemiology
Male
Middle Aged
Mortality
Native Hawaiian or Other Pacific Islander
Neoplasms / ethnology
Neoplasms / mortality
Neoplasms / prevention & control*
Patient Compliance*
Prospective Studies
White People

Abstract

Publication types

MeSH terms

Grants and funding