Angela D Liese1, Edwina Wambogo2, Jennifer L Lerman2, Carol J Boushey3, Marian L Neuhouser4, Song Wang5, Brook E Harmon6, Lesley F Tinker4. 1. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. 2. Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, US Department of Health and Human Services, Bethesda, MD, USA. 3. Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA. 4. Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 5. Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, USA. 6. Nutrition and Health Care Management, Appalachian State University, Boone, NC, USA.
Abstract
BACKGROUND: It is currently unknown if within high-quality dietary intake there exist distinct dietary patterns associated with health benefits that are identifiable with multidimensional dietary pattern analyses. The purpose of this study was to identify specific dietary patterns and groups therein and their associations with all-cause, CVD, and cancer mortality. METHODS: We conducted sex-specific k-means cluster analyses within Healthy Eating Index 2015 (HEI-2015) quintile 5 in 3 US cohorts [NIH-American Association of Retired Persons Diet and Health Study (AARP), the Multiethnic Cohort (MEC), Women's Health Initiative Observational Study (WHI OS)], clusters ranging from n = 1190 to n = 12,007. Characterizations incorporated HEI-2015 overall and component-specific percentage adherence goals, using untruncated and truncated radar graphs and shape analyses. Using cohort- and sex-specific Cox proportional hazards models, associations of quintile 5 clusters with all-cause, cardiovascular disease (CVD), and cancer mortality were evaluated relative to quintile 1. RESULTS: In each cohort sex-specific sample, 3 identified clusters included 16%-62% of participants, providing evidence for variation within high-quality dietary intake. Clusters revealed commonalities in total fruits and whole fruits intakes that exceeded goals and high sodium intake. Dairy and whole grain intakes oftentimes fell below goal. Some clusters were in addition characterized by total vegetables, greens & beans, and seafood & plant protein intakes exceeding goals. All high-quality dietary patterns were associated with a multivariable-adjusted significant 15%-26% lower risk of all-cause death than diet intake in quintile 1 (except for cluster 2 in WHI OS), and with a 16%-25% lower risk of CVD mortality in the AARP and MEC cohorts. Cancer mortality results were inconsistent. CONCLUSIONS: Multiple ways to achieve a high-quality diet were identified and significant associations with lower all-cause and CVD mortality were seen in some cohorts.
BACKGROUND: It is currently unknown if within high-quality dietary intake there exist distinct dietary patterns associated with health benefits that are identifiable with multidimensional dietary pattern analyses. The purpose of this study was to identify specific dietary patterns and groups therein and their associations with all-cause, CVD, and cancer mortality. METHODS: We conducted sex-specific k-means cluster analyses within Healthy Eating Index 2015 (HEI-2015) quintile 5 in 3 US cohorts [NIH-American Association of Retired Persons Diet and Health Study (AARP), the Multiethnic Cohort (MEC), Women's Health Initiative Observational Study (WHI OS)], clusters ranging from n = 1190 to n = 12,007. Characterizations incorporated HEI-2015 overall and component-specific percentage adherence goals, using untruncated and truncated radar graphs and shape analyses. Using cohort- and sex-specific Cox proportional hazards models, associations of quintile 5 clusters with all-cause, cardiovascular disease (CVD), and cancer mortality were evaluated relative to quintile 1. RESULTS: In each cohort sex-specific sample, 3 identified clusters included 16%-62% of participants, providing evidence for variation within high-quality dietary intake. Clusters revealed commonalities in total fruits and whole fruits intakes that exceeded goals and high sodium intake. Dairy and whole grain intakes oftentimes fell below goal. Some clusters were in addition characterized by total vegetables, greens & beans, and seafood & plant protein intakes exceeding goals. All high-quality dietary patterns were associated with a multivariable-adjusted significant 15%-26% lower risk of all-cause death than diet intake in quintile 1 (except for cluster 2 in WHI OS), and with a 16%-25% lower risk of CVD mortality in the AARP and MEC cohorts. Cancer mortality results were inconsistent. CONCLUSIONS: Multiple ways to achieve a high-quality diet were identified and significant associations with lower all-cause and CVD mortality were seen in some cohorts.
Authors: Frances E Thompson; Amy F Subar; Charles C Brown; Albert F Smith; Carolyn O Sharbaugh; Jared B Jobe; Beth Mittl; James T Gibson; Regina G Ziegler Journal: J Am Diet Assoc Date: 2002-02
Authors: Angela D Liese; Susan M Krebs-Smith; Amy F Subar; Stephanie M George; Brook E Harmon; Marian L Neuhouser; Carol J Boushey; TusaRebecca E Schap; Jill Reedy Journal: J Nutr Date: 2015-01-21 Impact factor: 4.798
Authors: Jill Reedy; Jennifer L Lerman; Susan M Krebs-Smith; Sharon I Kirkpatrick; TusaRebecca E Pannucci; Magdalena M Wilson; Amy F Subar; Lisa L Kahle; Janet A Tooze Journal: J Acad Nutr Diet Date: 2018-09 Impact factor: 4.910
Authors: Susan M Krebs-Smith; TusaRebecca E Pannucci; Amy F Subar; Sharon I Kirkpatrick; Jennifer L Lerman; Janet A Tooze; Magdalena M Wilson; Jill Reedy Journal: J Acad Nutr Diet Date: 2018-09 Impact factor: 4.910
Authors: Jill Reedy; Susan M Krebs-Smith; Paige E Miller; Angela D Liese; Lisa L Kahle; Yikyung Park; Amy F Subar Journal: J Nutr Date: 2014-02-26 Impact factor: 4.798