Diet Quality and Long-Term Absolute Risks for Incident Cardiovascular Disease and Mortality - 19/04/21
, Hongyan Ning, MD, MS b, Linda Van Horn, PhD b, Mercedes R. Carnethon, PhD b, John T. Wilkins, MD, MS b, Donald M. Lloyd-Jones, MD, ScM b, Norrina B. Allen, PhD bAbstract |
Background |
Long-term absolute risks for cardiovascular disease and mortality and cardiovascular disease-free survival according to diet quality at different adult ages are unclear.
Methods |
Data from 6 prospective cohorts collected in 1985-2016 were analyzed (n = 29,497). Baseline diet quality was assessed by alternate Healthy Eating Index 2010 (aHEI-2010), alternate Mediterranean (aMED) diet score, and Dietary Approaches to Stop Hypertension (DASH) score. Absolute risks were estimated using modified Kaplan-Meier analysis and cardiovascular disease-free survival using Irwin's restricted mean. Analyses were stratified by sex and baseline age: young (20-39 years), middle-aged (40-59), and older (60-79).
Results |
Comparing participants in the lowest quintile with those in the highest quintile of aHEI-2010 score, the 40-year risks for incident cardiovascular disease were 14.3% (95% confidence interval [CI]: 10.0-18.6) compared to 5.9% (3.0-8.9) in young men, 8.8% (4.3-13.3) compared to 3.0% (1.6-4.4) in young women, 39.6% (36.1-43.2) compared to 30.8% (26.2-35.3) in middle-aged men, and 32.9% (28.0-37.8) compared to 19.5% (16.6-22.4) in middle-aged women. For older adults, the 30-year risks for incident cardiovascular disease were 54.7% (49.3-60.2) compared to 49.7% (44.5-55.0) in men and 48.3% (44.0-52.5) compared to 42.4% (38.2-46.7) in women. Similar inverse associations were identified for all-cause mortality. Compared with participants in the lowest quintile of aHEI-2010 score, those in the highest quintile had ~0.5-2.2 years of longer cardiovascular disease-free survival. Results based on DASH score, but not aMED score, were similar to results based on aHEI-2010 score.
Conclusions |
Consuming a higher quality diet was associated with lower long-term absolute risks for cardiovascular disease and mortality and longer cardiovascular disease-free survival, regardless of sex or age at dietary assessment.
Le texte complet de cet article est disponible en PDF.Keywords : Absolute risk, Cardiovascular disease, Diet quality, Mortality, Public health nutrition, Survival time
Plan
| Funding: This study was partly supported by a postdoctoral fellowship to VWZ from the American Heart Association Strategically Focused Research Networks (14SFRN20480260). The Lifetime Risk Pooling Project was supported by the National Institutes of Health/National Heart, Lung, and Blood Institute (R21 HL085375) and by the Northwestern University Feinberg School of Medicine. The funders of this study had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication. |
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| Conflicts of Interest: JTW reports receiving consulting fees from NGM Biopharmaceuticals (Modest). VWZ, HN, LVH, MRC, DML-J, NBA report none. |
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| Authorship: All authors had access to the data and a role in writing this manuscript. |
Vol 134 - N° 4
P. 490 - avril 2021 Retour au numéro
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