Patterns of Recommended Dietary Behaviors Predict Subsequent Risk of Mortality in a Large Cohort of Men and Women in the United States
- 1 July 2009
- journal article
- Published by Elsevier BV in Journal of Nutrition
- Vol. 139 (7), 1374-1380
- https://doi.org/10.3945/jn.109.104505
Abstract
Recommendations for intake of fruits and vegetables, whole grains, lean meats, and low-fat dairy form the underpinning of dietary guidance for health promotion. We examined the association of a summary index of food consumption behaviors compatible with the spirit of prevailing dietary guidance and mortality. We used data from the NIH-American Association of Retired Persons cohort (n = 350,886), aged 50–71 y and disease free at baseline in 1995–1996, to examine the association of a dietary behavior score (DBS) with mortality after 10.5 y of follow-up (deaths, n = 29,838). The DBS included 6 equally weighted components derived from responses to questions on usual dietary behaviors related to consumption of fruits, vegetables, low-fat dairy, whole grains, lean meat and poultry, and discretionary fat. The covariate-adjusted association of DBS and mortality from all causes, cancer, and coronary heart disease was examined using Cox proportional hazards regression methods. Compared with those in the lowest one-fifth of DBS, the multivariate-adjusted relative risk of mortality in the highest one-fifth of the DBS was 0.75 (95% CI, 0.70–0.80) in women and 0.79 (95% CI, 0.75–0.83) in men (P-trend < 0.0001). The inverse association of DBS and mortality was significant in both genders in nearly all categories of covariates. Similar trends were observed for DBS associations with mortality from cancer and heart disease. Nearly 12% of the covariate-adjusted population risk of mortality was attributable to nonconformity with dietary recommendations. Adoption of recommended dietary behaviors was associated with lower mortality in both men and women independent of other lifestyle risk factors.Keywords
This publication has 33 references indexed in Scilit:
- Performance of a food-frequency questionnaire in the US NIH–AARP (National Institutes of Health–American Association of Retired Persons) Diet and Health StudyPublic Health Nutrition, 2008
- Secular trends in the association of socio-economic position with self-reported dietary attributes and biomarkers in the US population: National Health and Nutrition Examination Survey (NHANES) 1971–1975 to NHANES 1999–2002Public Health Nutrition, 2007
- Estimation of attributable number of deaths and standard errors from simple and complex sampled cohortsStatistics in Medicine, 2006
- Is It Time to Abandon the Food Frequency Questionnaire?Cancer Epidemiology, Biomarkers & Prevention, 2005
- Les déterminants de la saine alimentation au Canada: Aperçu et synthèseCanadian Journal of Public Health, 2005
- Cognitive research enhances accuracy of food frequency questionnaire reports: results of an experimental validation studyJournal of the American Dietetic Association, 2002
- Food Frequency Dietary Assessment: How Bad Is Good Enough?American Journal of Epidemiology, 2001
- Accuracy of on-line databases in determining vital statusJournal of Clinical Epidemiology, 2001
- Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in womenThe American Journal of Clinical Nutrition, 2000
- Dietary diversity and subsequent cause-specific mortality in the NHANES I epidemiologic follow-up study.Journal of the American College of Nutrition, 1995