Integrating Sleep, Physical Activity, and Diet Quality to Estimate All-Cause Mortality Risk: A Combined Compositional Clustering and Survival Analysis of the National Health and Nutrition Examination Survey 2005–2006 Cycle

2020 ◽  
Vol 189 (10) ◽  
pp. 1057-1064 ◽  
Author(s):  
Borja del Pozo Cruz ◽  
Duncan E McGregor ◽  
Jesús del Pozo Cruz ◽  
Matthew P Buman ◽  
Javier Palarea-Albaladejo ◽  
...  

Abstract We aimed to compare all-cause mortality risk across clusters of adults ≥50 years of age (n = 1,035) with common lifestyle behaviors patterns, enrolled in the US National Health and Nutrition Examination Survey (2005–2006). Log-ratio coordinates of 24-hour movement pattern and z scores of diet quality were used as input into a model-based clustering analysis. A Cox regression model was fitted to ascertain the all-cause mortality risk associated with each cluster. Participants were clustered into 4 groups: 1) a group characterized by a better physical activity profile and longer sleep duration coupled with an average diet quality (cluster 1); 2) a group with the poorest activity profile and shortest sleep but also the best diet quality (cluster 2); 3) another group featuring lower levels of activity of either intensity and higher levels of sedentary behavior and also a poor diet quality score (cluster 3); and 4) a group with an average diet quality and the best activity profile in the sample (cluster 4). A combination of a poorer diet and activity profile increased the prospective risk of all-cause mortality. Our findings emphasize the importance of considering the combination of diet quality and 24-hour movement patterns when developing interventions to reduce the risk of premature mortality.

2021 ◽  
pp. 1-24
Author(s):  
Bushra Hoque ◽  
Zumin Shi

Abstract Selenium (Se) is a trace mineral that has antioxidant and anti-inflammatory properties. This study aimed to investigate the association between Se intake, diabetes, all-cause and cause-specific mortality in a representative sample of US adults. Data from 18,932 adults who attended the 2003-2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Information on mortality was obtained from the US mortality registry updated to 2015. Multivariable logistic regression and Cox regression were used. Cross-sectionally, Se intake was positively associated with diabetes. Comparing extreme quartiles of Se intake, the odds ratio (OR) for diabetes was 1.44 (95% CI: 1.09–1.89). During a mean of 6.6 years follow-up, there were 1627 death (312 CVD, 386 cancer). High intake of Se was associated with a lower risk of all-cause mortality. When comparing the highest with the lowest quartiles of Se intake, the hazard ratios (HRs) for all-cause, CVD mortality, cancer mortality and other mortality were: 0.77 (95% CI 0.59-1.01), 0.62 (95% CI, 0.35-1.13), 1.42 (95% CI, 0.78-2.58) and 0.60 (95% CI,0.40-0.80), respectively. The inverse association between Se intake and all-cause mortality was only found among white participants. In conclusion, Se intake was positively associated with diabetes but inversely associated with all-cause mortality. There was no interaction between Se intake and diabetes in relation to all-cause mortality.


2021 ◽  
Vol 8 ◽  
Author(s):  
Shuo Sun ◽  
Xiao-cong Liu ◽  
Guo-dong He ◽  
Kenneth Lo ◽  
Ying-qing Feng ◽  
...  

Purpose: The aim was to explore the association of normal range SBP with cardiovascular and all-cause mortality in older adults without hypertension.Methods: Participants aged ≥ 65 years without hypertension and those had an SBP level between 90 and 129 mmHg were included from the National Health and Nutrition Examination Survey (1999–2014). SBP was categorized into: 90–99, 100–109, 110–119, and 120–129 mmHg. Multivariate Cox regression was performed with hazard ratio (HR) and 95% confidence interval (CI).Results: Of the 1,074 participants, 584 were men (54.38%). Compared with participants with SBP level ranged 110 to 119 mmHg, the HRs for all-cause mortality risk was 1.83 (95% CI: 1.04, 3.23) for SBP level ranged 90 to 99 mm Hg, 0.87 (95% CI: 0.54, 1.41) for SBP level ranged 100 to 109 mmHg, and 1.30 (95% CI: 0.96, 1.75) for SBP level ranged 120 to 129 mmHg (P for trend = 0.448), and the HR for cardiovascular mortality risk was 3.30 (95% CI: 0.87, 12.54) for SBP level ranged 90 to 99 mmHg, 0.35(95% CI: 0.08, 1.56) for SBP level ranged 100 to 109 mmHg, and 1.75 (95% CI: 0.78, 3.94) for SBP level ranged 120 to 129 mm Hg (P for trend = 0.349) after confounders were adjusted.Conclusion: These were a nonlinear association of normal range SBP level with all-cause and cardiovascular death in older adults.


Author(s):  
Anna E Clarke ◽  
Valerie Carson ◽  
Jean-Philippe Chaput ◽  
Rachel C Colley ◽  
Karen C Roberts ◽  
...  

This study determined if meeting the Canadian 24-Hour Movement Guidelines recommendations are associated with all-cause mortality. Participants were 3,471 adults from the 2005-2006 U.S. National Health and Nutrition Examination Survey followed for mortality over 11 years. They were classified as meeting or not meeting recommendations for sleep duration, sedentary behaviour, and moderate-to-vigorous physical activity (MVPA). A total of 63.8%, 35.3%, and 41.5% of participants met recommendations for sleep, sedentary behavior, and physical activity while 12.3% met all three recommendations. The hazard ratio (HR) for all-cause mortality in participants meeting the recommendations relative to those not meeting the recommendations were 0.91 (0.72, 1.16) for sleep, 0.92 (0.61, 1.40) for sedentary behavior, and 0.42 (0.24, 0.74) for MVPA. The HR for meeting none, any one, any two, and all three recommendations were 1.00, 0.86 (0.65, 1.14), 0.49 (0.28, 0.86), and 0.72 (0.34, 1.50). When the cut-point used to denote acceptable sedentary time was changed from ≤8 to ≤10 hours/day, the HR for meeting none, any one, any two, and all three recommendations were 1.00, 0.83 (0.59, 1.15), 0.57 (0.34, 0.96), and 0.43 (0.20, 0.93). These findings provide some support for the ability of the 24-hour movement guidelines to predict mortality risk. NOVELTY - The 24-Hour Movement Guidelines provide recommendations for sleep, sedentary behavior, and physical activity. - The findings of this study provide some support of the ability of these new guidelines to predict mortality risk.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Molly Jung ◽  
Robert C Kaplan ◽  
Yasmin Mossavar-Rahmani ◽  
Shankar Viswanathan ◽  
Judith Wylie-Rosett ◽  
...  

Objectives: To better understand the relationship between added sugars intake and diet quality, and to estimate associations between added sugars intake with all-cause mortality Methods: National Health and Nutrition Examination Survey III data were linked to mortality data (1988-2006), among 13,902 US adults between ages 18-74 yr having energy intake within 500-3500calories for women and 800-4000 calories for men, no history of a heart attack, stroke, or congestive heart failure. Usual intake of added sugars and energy were estimated using the NCI method and categorized into gender-specific quartiles. Diet quality was assessed using the Healthy Eating Index 2005 score (HEI-2005). Associations between added sugars intake and mortality were estimated using Cox proportional hazards regression adjusting for age, race/ethnicity, body mass index (BMI), and usual total energy intake after testing for multiplicative interaction by each of these covariates. Results: Mean intake of added sugar was 17.2 (95% Confidence Interval (CI) 16.8, 17.6) teaspoons (tsp) in women and 25.0 (95% CI 24.4, 25.7) tsp in men. Higher usual intake of added sugars was associated with being younger, a current smoker, and having between 12 and 15 years of education among both men and women. Higher usual intake of added sugars was related to a lower HEI score in women versus a higher HEI score in men (Quartile (Q) 4 for HEI =61.62 versus Q1=64.73 in women, p=0.0002; (Q4=62.71 vs. Q1=60.07 in men, p=0.0209). Higher HEI scores for the grain, fruit, vegetable, meat, and variety components were related to lower intake of added sugars; whereas, the fats, cholesterol, and sodium components of the HEI were related to higher intake of added sugars in men and women. During a median follow-up period of 14 years, a total of 1,889 deaths were recorded. After multivariable adjustment, higher added sugars intake was not associated with increased all-cause mortality (hazard ratio (HR) 95% CI of Q4 vs Q1, 1.08 (0.77, 1.52)). Interpretation: Epidemiological studies suggested that higher sugars intake is associated with an increased risk of obesity and cardiovascular diseases (CVD). These findings indicate higher intake of added sugars is associated with lower diet quality in women, but not men. Added sugars intake was not significantly associated with all-cause mortality in this representative sample of the US population.


2021 ◽  
pp. 1-11
Author(s):  
Selma Gicevic ◽  
Emin Tahirovic ◽  
Sabri Bromage ◽  
Walter Willett

Abstract Objective: We assessed the ability of the Prime Diet Quality Score (PDQS) to predict mortality in the US population and compared its predictiveness with that of the Healthy Eating Index-2015 (HEI-2015). Design: PDQS and HEI-2015 scores were derived using two 24-h recalls and converted to quintiles. Mortality data were obtained from the 2015 Public-Use Linked Mortality File. Associations between diet quality and all-cause mortality were evaluated using multivariable Cox proportional hazards models, and predictive performance of the two metrics was compared using a Wald test of equality of coefficients with both scores in a single model. Finally, we evaluated associations between individual metric components and mortality. Setting: A prospective analysis of the US National Health and Nutrition Examination Survey (NHANES) data. Participants: Five-thousand five hundred and twenty-five participants from three survey cycles (2003–2008) in the NHANES aged 40 years and over. Results: Over the 51 248 person-years of follow-up (mean: 9·2 years), 767 deaths were recorded. In multivariable models, hazard ratios between the highest and lowest quintiles of diet quality scores were 0·70 (95 % CI 0·51, 0·96, Ptrend = 0·03) for the PDQS and 0·77 (95 % CI 0·57, 1·03, Ptrend = 0·20) for the HEI-2015. The PDQS and HEI-2015 were similarly good predictors of total mortality (Pdifference = 0·88). Conclusion: Among US adults, better diet quality measured by the PDQS was associated with reduced risk of all-cause mortality. Given that the PDQS is simpler to calculate than the HEI-2015, it should be evaluated further for use as a diet quality metric globally.


2021 ◽  
pp. 1-29
Author(s):  
Zach Conrad ◽  
Sarah Reinhardt ◽  
Rebecca Boehm ◽  
Acree McDowell

Abstract Objectives: To evaluate the association between diet quality and cost for foods purchased for consumption at home and away from home. Design: Cross-sectional analysis. Multivariable linear regression models evaluated the association between diet quality and cost for all food, food at home, and food away from home. Setting: Daily food intake data from the National Health and Nutrition Examination Survey (2005-2016). Food prices were derived using data from multiple, publicly available databases. Diet quality was assessed using the Healthy Eating Index-2015 and the Alternative Healthy Eating Index-2010. Participants: 30,564 individuals ≥20 y with complete and reliable dietary data. Results: Mean per capita daily diet cost was $14.19 (95% CI: $13.91-14.48), including $6.92 ($6.73-7.10) for food consumed at home and $7.28 ($7.05-7.50) for food consumed away from home. Diet quality was higher for food at home compared to food away from home (P<0.001). Higher diet quality was associated with higher food costs overall, at home, and away from home (P<0.001 for all comparisons). Conclusions: These findings demonstrate that higher diet quality is associated with higher costs for all food, food consumed at home, and food consumed away from home. This research provides policymakers, public health professionals, and clinicians with information needed to support healthy eating habits. These findings are particularly relevant to contemporary health and economic concerns that have worsened because of the COVID-19 pandemic.


Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2952
Author(s):  
Yong Zhu ◽  
Neha Jain ◽  
Vipra Vanage ◽  
Norton Holschuh ◽  
Anne Hermetet Agler ◽  
...  

This study examined differences in dietary intake between ready-to-eat cereal eaters and non-eaters in adults from the United States. Participants (n = 5163) from the National Health and Nutrition Examination Survey 2015–2016 were included. One-day dietary recall was used to define ready-to-eat cereal consumption status and estimate dietary intake in eaters and non-eaters. Data from Food Patterns Equivalent Database 2015–2016 were used to compare intakes of food groups by consumption status. Diet quality was assessed by Healthy Eating Index 2015. Nineteen percent of US adults were ready-to-eat cereal eaters; they had a similar level of energy intake as non-eaters, but they had significantly higher intake of dietary fiber, and several vitamins and minerals, such as calcium, iron, magnesium, potassium, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, and vitamin D. They were also more likely to meet nutrient recommendations. Compared to non-eaters, ready-to-eat cereal eaters had the same level of added sugar intake but they had significantly higher intake of whole grains, total fruits, and dairy products. The diet quality of ready-to-eat cereal eaters was significantly higher than that of non-eaters. The study supports that ready-to-eat cereal eaters have better dietary intake with a healthier dietary pattern than non-eaters in the United States.


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