Diet quality index + death risk

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Hi All,

http://aje.oupjournals.org/cgi/content/abstract/157/11/980?etoc is my site

to get into the PDF-available paper below not in Medline yet on diet quality

and risk of various mortalities.

It did not sound very persuasive in the statistics. The CR part of CRON

again seems to be more important than the ON component.

Cheers, Al.

Am J Epidemiol 2003; 157:980-988.

Diet Quality Index as a Predictor of Short-term

Mortality in the American Cancer Society Cancer

Prevention Study II Nutrition Cohort

D. Seymour et al and J. Thun

ABSTRACT

The Diet Quality Index (DQI) was developed

to measure overall dietary patterns and to

predict chronic disease risk. This study examined

associations between DQI and short-term

all-cause, all-circulatory-disease, and all-

cancer mortality in the American Cancer Society

Cancer Prevention Study II Nutrition Cohort,

a cohort of US adults aged 50–79 years

enrolled in a prospective study. After 4 years

of follow-up (1992–1996), there were 869

deaths among 63,109 women and 1,736 deaths among

52,724 men. All study participants reported being disease

free at baseline in 1992–1993. In age-adjusted models,

a higher DQI, which was indicative of a poorer quality

diet, was positively related to all-cause and all-circulatory-

disease mortality rates in both women and men

and to cancer mortality in men

only. However, in fully adjusted models,

only circulatory disease mortality was clearly

positively related to DQI and only in

women (medium-low-quality diet vs.

highest-quality diet: rate ratio = 1.86, 95%

confidence interval: 1.19, 2.89). Although

trend tests indicated significant positive

relations between DQI and all-cause mortality,

effects were small (rate ratios 1.31),

and confidence intervals were wide, generally

including 1.0. DQI was unrelated to cancer

mortality. As currently constructed,

the DQI may have limited ability to

predict mortality.

Key Words: cardiovascular diseases; diet; diet

surveys; mortality; neoplasms; nutrition; nutrition

assessment; nutrition surveys

……Significant positive associations were

greatly attenuated when additional covariates

were added. In multivariate-adjusted

models, there was a slightly significant increase

in all-cause mortality (rate ratio = 1.31, 95

percent CI: 1.04, 1.65) and

all-circulatory-disease mortality (rate

ratio = 1.86, 95 percent CI: 1.19, 2.89)

when a medium-low-quality diet was compared

with a high-quality diet for women.

The p value for trend was significant

for both all-cause and all-circulatory-disease

mortality but not for all-cancer mortality,

where again there were no significant

positive associations for women. For men, there

was a weak but nonsignificant positive

association between a low-quality

diet and all-cause mortality (rate ratio

= 1.19, 95 percent CI:

0.94, 1.49). The p value for the

trend test was significant (p = 0.04).

There was no association between diet quality

And all-circulatory-disease or all-cancer

mortality in men.

In multivariate-adjusted models examining

individual components of the DQI (data not

shown), the cholesterol component was

positively associated with all-cause, all-

circulatory-disease, and all-cancer mortality

for both women and men, indicating that a

higher intake of cholesterol was positively

associated with increased mortality. For

women only, the fruit and vegetable

component was positively associated

with all-circulatory-disease mortality

and the calcium component was positively

associated with all-cause mortality,

indicating that lower intakes of fruits

and vegetables and calcium were positively

associated with mortality.

Alan Pater, Ph.D.; Faculty of Medicine; Memorial University; St. 's, NL

A1B 3V6 Canada; Tel. No.: (709) 777-6488; Fax No.: (709) 777-7010; email:

apater@...