Association of Changes in Diet Quality with Total and Cause-Specific Mortality

作者：Sotos-Prieto, Mercedes^*; Bhupathiraju, Shilpa N.; Mattei, Josiemer; Fung, Teresa T.; Li, Yanping; Pan, An; Willett, Walter C.; Rimm, Eric B.; Hu, Frank B.^*

来源：New England Journal of Medicine, 2017, 377(2): 143-153.

DOI：10.1056/NEJMoa1613502

• CORONARY-HEART-DISEASE
• HEALTHY EATING INDEX
• ALL-CAUSE MORTALITY
• CARDIOVASCULAR-DISEASE
• MEDITERRANEAN DIET
• POSTMENOPAUSAL WOMEN
• ALCOHOL-CONSUMPTION
• PRIMARY PREVENTION
• RISK
• ADHERENCE

BACKGROUND @@@ Few studies have evaluated the relationship between changes in diet quality over time and the risk of death. @@@ METHODS @@@ We used Cox proportional-hazards models to calculate adjusted hazard ratios for total and cause-specific mortality among 47,994 women in the Nurses' Health Study and 25,745 men in the Health Professionals Follow-up Study from 1998 through 2010. Changes in diet quality over the preceding 12 years (1986-1998) were assessed with the use of the Alternate Healthy Eating Index-2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score. @@@ RESULTS @@@ The pooled hazard ratios for all-cause mortality among participants who had the greatest improvement in diet quality (13 to 33% improvement), as compared with those who had a relatively stable diet quality (0 to 3% improvement), in the 12-year period were the following: 0.91 (95% confidence interval [CI], 0.85 to 0.97) according to changes in the Alternate Healthy Eating Index score, 0.84 (95 CI%, 0.78 to 0.91) according to changes in the Alternate Mediterranean Diet score, and 0.89 (95% CI, 0.84 to 0.95) according to changes in the DASH score. A 20-percentile increase in diet scores (indicating an improved quality of diet) was significantly associated with a reduction in total mortality of 8 to 17% with the use of the three diet indexes and a 7 to 15% reduction in the risk of death from cardiovascular disease with the use of the Alternate Healthy Eating Index and Alternate Mediterranean Diet. Among participants who maintained a high-quality diet over a 12-year period, the risk of death from any cause was significantly lower - by 14% (95% CI, 8 to 19) when assessed with the Alternate Healthy Eating Index score, 11% (95% CI, 5 to 18) when assessed with the Alternate Mediterranean Diet score, and 9% (95% CI, 2 to 15) when assessed with the DASH score - than the risk among participants with consistently low diet scores over time. @@@ CONCLUSIONS @@@ Improved diet quality over 12 years was consistently associated with a decreased risk of death. (Funded by the National Institutes of Health.)

• 出版日期2017-7-13
• 单位华中科技大学