Dietary pattern and 20 year mortality in elderly men in Finland, Italy, and the Netherlands: longitudinal cohort study

Huijbregts, P.P.C.W.; Feskens, Edith J. M.; Rásänen, Leena; Fidanza, F; Nissinen, Aulikki; Menotti, Alessandro; Kromhout, Daan

doi:10.1136/bmj.315.7099.13

Cited by 343 publications

(314 citation statements)

References 22 publications

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“…The QFFQ was completed for foods eaten over the previous 30 d. The food intake was coded according to the South African Food Composition Database System of the South African Medical Research Council and then used to calculate the nutrient and food group intakes (23)(24)(25) . Table 1 presents the components and cut-off points of the HDI (13) and the Deficiency Score/Excess Score by Thiele et al (12) , which were used in the present study. The score by Thiele et al suggested using up to thirty nutrients in a Deficiency Score to identify a preferable diet quality and using six nutrients in an Excess Score to identify a nonpreferable diet quality.…”

Section: Methodsmentioning

confidence: 99%

The use of predefined diet quality scores in the context of CVD risk during urbanization in the South African Prospective Urban and Rural Epidemiological (PURE) study

Dolman

Wentzel-Viljoen

Jerling

et al. 2013

Public Health Nutr.

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Objective: Urbanization is generally associated with increased CVD risk and accompanying dietary changes. Little is known regarding the association between increased CVD risk and dietary changes using approaches such as diet quality. The relevance of predefined diet quality scores (DQS) in non-Western developing countries has not yet been established. Design: The association between dietary intakes and CVD risk factors was investigated using two DQS, adapted to the black South African diet. Dietary intake data were collected using a quantitative FFQ. CVD risk was determined by analysing known CVD risk factors. Setting: Urban and rural areas in North West Province, South Africa. Subjects: Apparently healthy volunteers from the South African Prospective Urban and Rural Epidemiological (PURE) study population (n 1710). Results: CVD risk factors were significantly increased in the urban participants, especially women. Urban men and women had significantly higher intakes of both macro-and micronutrients with macronutrient intakes well within the recommended CVD guidelines. While micronutrient intakes were generally higher in the urban groups than in the rural groups, intakes of selected micronutrients were low in both groups. Both DQS indicated improved diet quality in the urban groups and good agreement was shown between the scores, although they seemed to measure different aspects of diet quality. Conclusions: The apparent paradox between improved diet quality and increased CVD risk in the urban groups can be explained when interpreting the cut-offs used in the scores against the absolute intakes of individual nutrients. Predefined DQS as well as current guidelines for CVD prevention should be interpreted with caution in non-Western developing countries.

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Section: Methodsmentioning

confidence: 99%

The use of predefined diet quality scores in the context of CVD risk during urbanization in the South African Prospective Urban and Rural Epidemiological (PURE) study

Dolman

Wentzel-Viljoen

Jerling

et al. 2013

Public Health Nutr.

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“…Several studies (8)(9)(10)(11)(12)(13)(14)(15), have evaluated the effect of different dietary patterns as defined by healthy a priori scores and certain health outcomes, including total mortality (12)(13)(14)(15). Most of them have reported an inverse association between adherence to healthy dietary patterns defined a priori and overall mortality.…”

Section: Introductionmentioning

confidence: 99%

Dietary Patterns and Total Mortality in a Mediterranean Cohort: The SUN Project

Zazpe¹,

Sánchez‐Tainta²,

Toledo³

et al. 2014

Journal of the Academy of Nutrition and Dietetics

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Background: Different dietary patterns have been associated with several health outcomes, including morbidity and mortality. There is little evidence on the association between empirically-derived dietary patterns and all cause mortality in Southern European populations.Objective: the aim of this study was to prospectively evaluate the association between an empirically-derived dietary pattern and all-cause mortality.Design: The SUN Project is an ongoing, multipurpose, prospective and dynamic Spanish cohort.Participants/setting: a prospective cohort of 16,008 middle-aged Spanish adults. All of them were former university graduates (alumni) (59.6 percent women, mean age: 38 years). Usual diet was assessed at baseline with a validated semiquantitative foodfrequency questionnaire.Main outcome measures: Deaths were confirmed by review of medical records and of the National Death Index.Statistical analyses performed: Dietary patterns were ascertained through a factor (principal component) analysis based on 30 predefined food groups. Participants were classified according to tertiles of adherence to the three main dietary patterns identified with factor analysis. Cox regression models were fitted to estimate multivariableadjusted hazard ratios (HR) and 95% confidence intervals (CI) for mortality.Results: Three major dietary patterns were identified: they were labelled Western dietary pattern (WDP) (rich in red and processed meat, potatoes and fast food), Mediterranean dietary pattern (MDP) (rich in vegetables, fish and seafood, fruits, and olive oil) and Alcoholic beverages dietary pattern (ABDP). During follow-up, 148 deaths were reported (mean age at death: 54.5 years). After adjustment for potential confounders, the lowest risk of all-cause mortality was found in the tertile of highest adherence to the MDP (adjusted HR for third vs. first tertile: 0.53; 95% CI: 0.34-0.84) (p for trend <0.01). The WDP and ABDP showed no significant association with mortality.Conclusions: Greater adherence to an empirically-derived dietary pattern approaching the traditional Mediterranean diet was associated with a reduction in the risk of allcause mortality among middle-aged Mediterranean adults.

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“…Further, focusing on specific dietary components does not take into account the existence of non-nutrient bioactive substances that may impact on disease risk (Randall et al, 1990). In a practical sense, the examination of dietary patterns is important, since it may more readily enable the identification of those groups in the population at greatest risk of diet-related morbidity and mortality (Huijbregts et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Dietary patterns of Australian adults and their association with socioeconomic status: results from the 1995 National Nutrition Survey

et al. 2002

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Objective: To describe dietary patterns among men and women in the Australian population, and to explore how these varied according to socioeconomic status (SES). Design: A cross-sectional self-report population survey, the 1995 Australian National Nutrition Survey (NNS), was used. Setting: Private dwelling sample, covering urban and rural areas across Australia. Subjects: Data provided by 6680 adults aged 18 -64 who participated in the NNS were used in the analyses. Methods: Factor analyses were used to analyse data from a Food Frequency Questionnaire (FFQ) completed by participants. Associations between SES and dietary pattens were assessed using ANOVA. Results: Separate factor analyses of the FFQ data for men and women revealed 15 factors, accounting for approximately 50% of the variance in both men's and women's dietary patterns. Several gender and SES differences in food patterns were observed. Lower SES males more frequently consumed 'tropical fruits', 'protein foods', and 'offal and canned fish', while high SES males more often ate 'breakfast cereals' and 'wholemeal bread'. Lower SES females more often ate 'traditional vegetables', 'meat dishes' and 'pasta, rice and other mixed foods', while high SES females more frequently ate 'ethnic vegetables' and 'breakfast cereal=muesli'. Conclusions: These findings contribute to a better understanding of the dietary patterns that underscore gender-specific SES differences in nutrient intakes. Analyses of the type employed in this study will facilitate the development of interventions aimed at modifying overall eating patterns, rather than specific components of the diet.

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Dietary pattern and 20 year mortality in elderly men in Finland, Italy, and the Netherlands: longitudinal cohort study

Abstract: Dietary intake of men aged 50-70 is associated with a 20 year, all cause mortality in different cultures. The healthy diet indicator is useful in evaluating the relation of mortality to dietary patterns.

Cited by 343 publications

References 22 publications

The use of predefined diet quality scores in the context of CVD risk during urbanization in the South African Prospective Urban and Rural Epidemiological (PURE) study

The use of predefined diet quality scores in the context of CVD risk during urbanization in the South African Prospective Urban and Rural Epidemiological (PURE) study

Dietary Patterns and Total Mortality in a Mediterranean Cohort: The SUN Project

Dietary patterns of Australian adults and their association with socioeconomic status: results from the 1995 National Nutrition Survey

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