Dietary Patterns Are Associated with Cardiovascular and Cancer Mortality among Swiss Adults in a Census-Linked Cohort

Abstract

Defining dietary guidelines requires a quantitative assessment of the influence of diet on the development of diseases. The aim of the study was to investigate how dietary patterns were associated with mortality in a general population sample of Switzerland. We included 15,936 participants from two population-based studies (National Research Program 1A (NRP1A) and Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA)—1977 to 1993) who fully answered a simplified 24-h dietary recall. Mortality data were available through anonymous record linkage with the Swiss National Cohort (follow-up of up to 37.9 years). Multiple correspondence analysis and hierarchical clustering were used to define data-driven qualitative dietary patterns. Mortality hazard ratios were calculated for all-cause, cancer and cardiovascular mortality using Cox regression. Two patterns were characterized by a low dietary variety (“Sausage and Vegetables”, “Meat and Salad”), two by a higher variety (“Traditional”, “High-fiber foods”) and one by a high fish intake (“Fish”). Males with unhealthy lifestyle (smokers, low physical activity and high alcohol intake) were overrepresented in the low-variety patterns and underrepresented in the high-variety and “Fish” patterns. In multivariable-adjusted models, the “Fish” (hazard ratio = 0.82, 95% CI (0.68–0.99)) and “High-fiber foods” (0.85 (0.72–1.00)) patterns were associated with lower cancer mortality. In men, the “Fish” (0.73 (0.55–0.97)) and “Traditional” (0.76 (0.59–0.98)) patterns were associated with lower cardiovascular mortality. In summary, our results support the notion that dietary patterns affect mortality and that these patterns strongly cluster with other health determinants.

Cultural Differences in Diet and Determinants of Diet Quality in Switzerland: Results from the National Nutrition Survey menuCH

“…In the current study, 11 out of 12 potential determinants of diet quality were found to be significantly associated with one or both diet quality scores. As already reported from many previous studies [13,15,24,25,28,42,45], a higher diet quality was observed for females and older participants. The weak significant association between sex and MDS in the present study was most likely due to the use of sex-specific medians in the calculation of the score.…”

“…In Switzerland, the effects of sociodemographic and lifestyle factors on diet quality have been investigated in different studies [20,24,25,26,27,28,29,30]. However, since no nutrition survey existed in Switzerland until 2015, most of these results relied on undetailed dietary data or were derived from a single city or region [20,24,25,26,28,29,30]. To fill this gap, the first Swiss National Nutrition Survey menuCH was recently conducted with the aim to assess the dietary habits in a representative sample of the Swiss population [27,31].…”

Is a Consumer Perception of Salt Modification a Sensory or a Behavioural Phenomenon? Insights from a Bread Study

“…Our results show that the "salt adherent" cluster members are notably heavier in habit of adding additional salt at the table, but they are also highly aware of their excessive salt use and significantly less attentive in limiting their salt consumption. Studies suggest that general changes in dietary habits are needed for an effective decrease in salt content to affect NCD risks [90][91][92]. A survey by Mørk et al [74] showed that consumers who have already changed their dietary salt intake or intend to do so are also more willing to purchase salt-reduced food products.…”

Combining Recent Nutritional Data with Prospective Cohorts to Quantify the Impact of Modern Dietary Patterns on Disability–Adjusted Life Years: A Feasibility Study

“…In most longitudinal studies, however, dietary assessment occurs once at study entry (i.e., potentially decades before the end of the study); thus, the DALYs-dietary patterns association calculated based on this information reflects the impact of "old" dietary habits on morbidity and mortality [9]. Although this information is extremely valuable from a public health perspective, the impact of currently consumed diets on DALYs may be more relevant to improve and dynamically adapt nutritional guidelines.…”

“…To overcome this limitation, we combined two chronologically distinct data sources in order to calculate the association between dietary patterns currently consumed and DALYs from NCDs. In this method, a recent cross-sectional study was first used to characterize the currently consumed dietary patterns [11][12][13], whereas a prospective cohort study was used to quantify the dietary patterns-DALYs association for individuals who consumed a diet similar to the modern dietary patterns [9]. This approach extends previous work on the estimation of DALYs in cohort studies to the calculation of the association between current dietary patterns and DALYs.…”