Nithya Neelakantan1, Woon-Puay Koh1,2, Jian-Min Yuan3,4, Rob M van Dam1,5,6. 1. Saw Swee Hock School of Public Health. 2. Duke-NUS Medical School, Singapore. 3. Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, Pittsburgh, PA. 4. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. 5. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore. 6. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA.
Abstract
Background: Diet-quality indexes have been associated with a lower risk of chronic disease mortality in Western populations, but it is unclear whether these indexes reflect protective dietary patterns in Asian populations. Objective: We examined the association between Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and Healthy Diet Indicator (HDI) scores and the risk of all-cause cardiovascular disease (CVD), cancer, and respiratory disease mortality. Methods: We used data from a prospective cohort of 57,078 Singapore Chinese men and women (aged 45-74 y) who were free of cancer and CVD at baseline (1993-1998) and who were followed up through 2014. The diet-quality index scores were calculated on the basis of data from a validated 165-item food-frequency questionnaire. Cox regression models with adjustment for potential confounders including sociodemographic and lifestyle variables, body mass index, and medical history were used to estimate HRs and 95% CIs. Results: During a total of 981,980 person-years of follow-up, 15,262 deaths (CVD: 4871; respiratory: 2690; and cancer: 5306) occurred. Comparing the highest with the lowest quintiles, the multivariable adjusted HRs (95% CIs) for all-cause mortality were 0.82 (0.78, 0.86) for AHEI-2010, 0.80 (0.76, 0.85) for aMED, 0.80 (0.75, 0.84) for DASH, and 0.88 (0.83, 0.92) for HDI scores (all P-trend < 0.001). Higher diet index scores were associated with a 14-28% lower risk of CVD and respiratory mortality, but only a 5-12% lower risk of cancer mortality. Higher consumption of vegetables, fruit, nuts, and long-chain n-3 (ω-3) fatty acids, lower consumption of red meat, and avoidance of high alcohol consumption were the diet index components associated with a lower risk of mortality. Conclusion: Adherence to several recommended dietary patterns that emphasize healthy plant-based foods was associated with a substantially lower risk of chronic disease mortality in an Asian population. The Singapore Chinese Health Study was registered at www.clinicaltrials.gov as NCT03356340.
Background: Diet-quality indexes have been associated with a lower risk of chronic disease mortality in Western populations, but it is unclear whether these indexes reflect protective dietary patterns in Asian populations. Objective: We examined the association between Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and Healthy Diet Indicator (HDI) scores and the risk of all-cause cardiovascular disease (CVD), cancer, and respiratory disease mortality. Methods: We used data from a prospective cohort of 57,078 Singapore Chinese men and women (aged 45-74 y) who were free of cancer and CVD at baseline (1993-1998) and who were followed up through 2014. The diet-quality index scores were calculated on the basis of data from a validated 165-item food-frequency questionnaire. Cox regression models with adjustment for potential confounders including sociodemographic and lifestyle variables, body mass index, and medical history were used to estimate HRs and 95% CIs. Results: During a total of 981,980 person-years of follow-up, 15,262 deaths (CVD: 4871; respiratory: 2690; and cancer: 5306) occurred. Comparing the highest with the lowest quintiles, the multivariable adjusted HRs (95% CIs) for all-cause mortality were 0.82 (0.78, 0.86) for AHEI-2010, 0.80 (0.76, 0.85) for aMED, 0.80 (0.75, 0.84) for DASH, and 0.88 (0.83, 0.92) for HDI scores (all P-trend < 0.001). Higher diet index scores were associated with a 14-28% lower risk of CVD and respiratory mortality, but only a 5-12% lower risk of cancer mortality. Higher consumption of vegetables, fruit, nuts, and long-chain n-3 (ω-3) fatty acids, lower consumption of red meat, and avoidance of high alcohol consumption were the diet index components associated with a lower risk of mortality. Conclusion: Adherence to several recommended dietary patterns that emphasize healthy plant-based foods was associated with a substantially lower risk of chronic disease mortality in an Asian population. The Singapore Chinese Health Study was registered at www.clinicaltrials.gov as NCT03356340.
Authors: Teresa T Fung; Frank B Hu; Marjorie L McCullough; P K Newby; Walter C Willett; Michelle D Holmes Journal: J Nutr Date: 2006-02 Impact factor: 4.798
Authors: Nicole Jankovic; Anouk Geelen; Martinette T Streppel; Lisette C P G M de Groot; Philippos Orfanos; Edith H van den Hooven; Hynek Pikhart; Paolo Boffetta; Antonia Trichopoulou; Martin Bobak; H B Bueno-de-Mesquita; Frank Kee; Oscar H Franco; Yikyung Park; Göran Hallmans; Anne Tjønneland; Anne M May; Andrzej Pajak; Sofia Malyutina; Růžena Kubinova; Pilar Amiano; Ellen Kampman; Edith J Feskens Journal: Am J Epidemiol Date: 2014-10-15 Impact factor: 4.897
Authors: Nicole Jankovic; Anouk Geelen; Martinette T Streppel; Lisette Cpgm de Groot; Jessica C Kiefte-de Jong; Philippos Orfanos; Christina Bamia; Antonia Trichopoulou; Paolo Boffetta; Martin Bobak; Hynek Pikhart; Frank Kee; Mark G O'Doherty; Genevieve Buckland; Jayne Woodside; Oscar H Franco; M Arfan Ikram; Ellen A Struijk; Andrzej Pajak; Sofia Malyutina; Růžena Kubinova; Maria Wennberg; Yikyung Park; H Bas Bueno-de-Mesquita; Ellen Kampman; Edith J Feskens Journal: Am J Clin Nutr Date: 2015-09-09 Impact factor: 7.045
Authors: Raphaëlle Varraso; Stephanie E Chiuve; Teresa T Fung; R Graham Barr; Frank B Hu; Walter C Willett; Carlos A Camargo Journal: BMJ Date: 2015-02-03
Authors: Jowy Yi Hoong Seah; Gibson Ming Wei Gay; Jin Su; E-Shyong Tai; Jian-Min Yuan; Woon-Puay Koh; Choon Nam Ong; Rob M van Dam Journal: Nutrients Date: 2017-01-31 Impact factor: 5.717
Authors: Anne E Cust; Ben J Smith; Josephine Chau; Hidde P van der Ploeg; Christine M Friedenreich; Bruce K Armstrong; Adrian Bauman Journal: Int J Behav Nutr Phys Act Date: 2008-06-02 Impact factor: 6.457