scholarly journals Adherence to the Healthy Eating Index–2015 and Other Dietary Patterns May Reduce Risk of Cardiovascular Disease, Cardiovascular Mortality, and All-Cause Mortality

2019 ◽  
Vol 150 (2) ◽  
pp. 312-321 ◽  
Author(s):  
Emily A Hu ◽  
Lyn M Steffen ◽  
Josef Coresh ◽  
Lawrence J Appel ◽  
Casey M Rebholz
Keyword(s):  
Cardiovascular Disease ◽  
Healthy Eating ◽  
Lower Risk ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Mortality Data ◽  
Dietary Intakes ◽  
All Cause Mortality ◽  
Dietary Guidelines For Americans ◽  
Cvd Mortality

ABSTRACT Background The Healthy Eating Index–2015 (HEI-2015) score measures adherence to recommendations from the 2015–2020 Dietary Guidelines for Americans. The HEI-2015 was altered from the HEI-2010 by reclassifying sources of dietary protein and replacing the empty calories component with 2 new components: saturated fats and added sugars. Objectives Our aim was to assess whether the HEI-2015 score, along with 3 other previously defined indices, were associated with incident cardiovascular disease (CVD), CVD mortality, and all-cause mortality. Methods We conducted a prospective analysis of 12,413 participants aged 45–64 y (56% women) from the Atherosclerosis Risk in Communities (ARIC) Study. The HEI-2015, Alternative Healthy Eating Index–2010 (AHEI-2010), alternate Mediterranean (aMed) diet, and Dietary Approaches to Stop Hypertension Trial (DASH) scores were computed using the average dietary intakes of Visits 1 (1987–1989) and 3 (1993–1995). Incident CVD, CVD mortality, and all-cause mortality data were ascertained from baseline through 31 December, 2017. We used Cox proportional hazards models to estimate HRs and 95% CIs. Results There were 4509 cases of incident CVD, 1722 cases of CVD mortality, and 5747 cases of all-cause mortality over a median of 24–25 y of follow-up. Compared with participants in the lowest quintile of HEI-2015, participants in the highest quintile had a 16% lower risk of incident CVD (HR: 0.84; 95% CI: 0.76–0.93; P-trend < 0.001), 32% lower risk of CVD mortality (HR: 0.68; 95% CI: 0.58–0.80; P-trend < 0.001), and 18% lower risk of all-cause mortality (HR: 0.82; 95% CI: 0.75–0.89; P-trend < 0.001) after adjusting for demographic and lifestyle covariates. There were similar protective associations for AHEI-2010, aMed, and DASH scores, and no significant interactions by race. Conclusions Higher adherence to the 2015–2020 Dietary Guidelines for Americans was associated with lower risks of incident CVD, CVD mortality, and all-cause mortality among US adults.

scholarly journals Diet Quality in Association with All-Cause, Cardiovascular, and Cancer Mortality Among US Adults: NHANES 1999–2010 (OR14-04-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jiaqi Wang ◽  
Danielle Haslam ◽  
Mengyuan Ruan ◽  
Fan Chen ◽  
Mengxi Du ◽  
...  
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Cancer Mortality ◽  
Lower Risk ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Mortality Data ◽  
Eating Pattern ◽  
All Cause Mortality ◽  
Risk Of Cancer

Abstract Objectives The 2015 Dietary Guidelines for Americans (DGA) recommend a healthy eating pattern for chronic disease prevention. This study aimed to prospectively evaluate diet quality by adherence to the 2015 DGA in association with mortality outcomes among a representative sample of US adults. Methods Using dietary data collected by 24-hour diet recalls among 29,098 US adults aged 20+ years from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2010, we estimated adherence to the 2015 DGA using the Healthy Eating Index-2015 (HEI-2015). Mortality from all cause, cardiovascular diseases (CVD), and cancer were obtained from linkage to the National Death Index Mortality data. Cox proportional-hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after multivariable adjustments. Results The mean (SE) of total HEI-2015 was 50.1 (0.2). During a median follow-up of 6.2 years, 2861 total deaths occurred, including 726 CVD and 671 cancer deaths. Compared to individuals in the lowest quartile of HEI-2015, those in the highest quartile had a 16% lower risk of all-cause mortality (Q4 vs. Q1: HR = 0.84; 95% CI: 0.72–0.90; P-trend = 0.04) and a 31% lower risk of cancer mortality (Q4 vs. Q1: HR = 0.69; 95% CI: 0.50–0.95; P-trend = 0.06). The lower all-cause and cancer mortality among those with higher HEI-2015 scores was confined to individuals with comorbidity conditions at baseline (all-cause mortality: Q4 vs. Q1: HR = 0.79; 95% CI: 0.67–0.94; p-trend = 0.005; cancer mortality: Q4 vs. Q1: HR = 0.46; 95% CI: 0.30–0.69; p-trend = 0.001), former smokers (all-cause mortality: Q4 vs. Q1: HR = 0.65; 95% CI: 0.49–0.88; p-trend = 0.006; cancer mortality: Q4 vs. Q1: HR = 0.47; 95% CI: 0.29–0.74; p-trend = 0.005), and those with a body mass index of 18.5–25 kg/m2 (all-cause mortality: Q4 vs. Q1: HR = 0.60; 95% CI: 0.46–0.79; p-trend < 0.001; cancer mortality: Q4 vs. Q1: HR = 0.40; 95% CI: 0.22–0.70; p-trend = 0.001). Similar associations were found between men and women. No significant associations were observed between HEI-2015 and CVD mortality. Conclusions Better adherence to the 2015 Dietary Guidelines of Americans is associated with lower all-cause and cancer mortality among US adults. Funding Sources National Institute of Health/National Institute of Minority Health and Health Disparities. Supporting Tables, Images and/or Graphs    

scholarly journals Dietary Patterns and Risk of Chronic Kidney Disease Progression and All-Cause Mortality: Findings from the CRIC study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1415-1415
Author(s):  
Emily Hu ◽  
Josef Coresh ◽  
Cheryl Anderson ◽  
Lawrence Appel ◽  
Morgan Grams ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Healthy Eating ◽  
Dietary Patterns ◽  
Lower Risk ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Ckd Progression ◽  
Adjusted Risk ◽  
All Cause Mortality

Abstract Objectives Current dietary guidelines recommend that chronic kidney disease (CKD) patients reduce intake of individual nutrients, such as sodium, potassium, phosphorus, and protein. This approach can be difficult for patients to implement and ignores important nutrient interactions. Our objective was to define the association of healthy dietary patterns with risk of CKD progression and all-cause mortality among people with CKD. Methods We analyzed data from 2403 participants aged 21–74 years with an estimated glomerular filtration rate (eGFR) of 20–70 mL/min/1.73 m2 and dietary data in the Chronic Renal Insufficiency Cohort (CRIC) study. Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean diet (aMed), and Dietary Approaches to Stop Hypertension (DASH) diet scores were calculated using data collected from food frequency questionnaires. We analyzed the association between these dietary patterns and two main outcomes: 1) CKD progression defined as ≥50% eGFR decline, kidney transplantation, or dialysis, and 2) all-cause mortality. Cox proportional hazards regression models adjusted for demographic, lifestyle, and clinical covariates were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results There were 855 cases of CKD progression and 773 deaths over a maximum of 14 years. Compared with participants with the lowest adherence, the most highly adherent tertile of AHEI-2010, aMed, and DASH had lower adjusted risk of CKD progression with the strongest association for aMed (HR: 0.75, 95% CI: 0.62–0.90). Nuts and legumes were independently associated with lower risk of CKD progression. Compared with participants with the lowest adherence, the highest adherence tertiles for all four scores had a 24–31% lower adjusted risk of all-cause mortality. Conclusions Greater adherence to a healthy dietary pattern is associated with a lower risk of CKD progression and all-cause mortality among people with CKD. Guidance to adopt healthy dietary patterns should be incorporated into guidelines for individuals with CKD. Funding Sources NIH (NHLBI, NIDDK).

scholarly journals Diet Indices Reflecting Changes to Dietary Guidelines for Americans from 1990 to 2015 Are More Strongly Associated with Risk of Coronary Heart Disease

2019 ◽  
Author(s):  
Casey M Rebholz ◽  
Hyunju Kim ◽  
Jiantao Ma ◽  
Paul F Jacques ◽  
Daniel Levy ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Healthy Eating ◽  
Diet Quality ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Disease Outcomes ◽  
Dietary Guidelines For Americans

Abstract Background The Dietary Guidelines for Americans (DGAs) provide dietary recommendations for the general population with the intent of preventing chronic disease such as cardiovascular disease. An evaluation of whether updated versions of the DGAs accomplish this goal is lacking. Objective The objective of this project was to determine whether updates to DGAs over time, reflected in subsequent versions of diet quality indices, strengthened the associations between diet quality and risk of cardiovascular disease outcomes. Methods Dietary data collected using a food frequency questionnaire in the Framingham Heart Study Offspring cohort was used to assess adherence to sequential versions of the Healthy Eating Index (1990, 2005, 2010, and 2015) and Alternative Healthy Eating Index (2000 and 2010) (N = 3,267). We conducted prospective analyses using Cox regression to estimate the association between diet indices and incident cardiovascular disease outcomes. Results Among the 3,267 study participants, 54% were female, mean age was 55 years, and mean body mass index was 27 kg/m2. There were a total of 544 events for the composite outcome of cardiovascular diseases (324 coronary heart disease events, 153 stroke events, and 187 heart failure events). Adherence to any dietary index was inversely associated with risk of cardiovascular disease, coronary heart disease, and heart failure, but not stroke. Compared to HEI-1990, scores for the more recent diet indices were more strongly associated with coronary heart disease risk, but not cardiovascular disease, heart failure, or stroke. Conclusions More recent iterations of diet indices, reflecting updates to the DGAs over time, are more strongly associated with risk of incident coronary heart disease than the original diet index (HEI-1990).

scholarly journals Adherence to the Chinese or American Dietary Guidelines is Associated with a Lower Risk of Primary Liver Cancer in China: A Case-Control Study

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1113 ◽  
Author(s):  
Pei-Yan Chen ◽  
Ai-Ping Fang ◽  
Xiao-Yan Wang ◽  
Qiu-Ye Lan ◽  
Gong-Cheng Liao ◽  
...  
Keyword(s):  
Liver Cancer ◽  
Healthy Eating ◽  
Lower Risk ◽  
Primary Liver Cancer ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Dietary Quality ◽  
Logistic Regression Models ◽  
Dietary Guidelines For Americans ◽  
Control Study

Adherence to healthy dietary guidelines has been related to a lower risk of several cancers, but its role in primary liver cancer (PLC) has not been fully investigated, especially among Eastern populations. This study enrolled 720 PLC patients and 720 healthy controls who were frequency-matched by age and sex between September 2013 and October 2017 in South China. Dietary quality was assessed by the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index 2015 (HEI-2015), which manifests as scores of adhering to the 2016 Dietary Guidelines for Chinese and adhering to the 2015–2020 Dietary Guidelines for Americans, respectively. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models, adjusting for potential confounders. Higher scores in both the CHEI and HEI-2015 were associated with a lower risk of PLC (per 5-points increment of the total scores: OR: 0.43, 95% CI: 0.38–0.50 for CHEI; OR: 0.47, 95% CI: 0.40–0.55 for HEI-2015). The protective associations persisted significantly in the stratified analyses by sex, smoker status, alcohol consumption, HBV infection, and histological types of PLC, without statistical evidence for heterogeneity (p-interaction > 0.05). Closer adherence to the most recent dietary guidelines for Chinese or Americans may protect against PLC.

scholarly journals Dose–Response Relation between Tea Consumption and Risk of Cardiovascular Disease and All-Cause Mortality: A Systematic Review and Meta-Analysis of Population-Based Studies

2020 ◽  
Vol 11 (4) ◽  
pp. 790-814 ◽  
Author(s):  
Mei Chung ◽  
Naisi Zhao ◽  
Deena Wang ◽  
Marissa Shams-White ◽  
Micaela Karlsen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Lower Risk ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Tea Consumption ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cvd Mortality

ABSTRACT Tea flavonoids have been suggested to offer potential benefits to cardiovascular health. This review synthesized the evidence on the relation between tea consumption and risks of cardiovascular disease (CVD) and all-cause mortality among generally healthy adults. PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Food Science and Technology Abstracts, and Ovid CAB Abstract databases were searched to identify English-language publications through 1 November 2019, including randomized trials, prospective cohort studies, and nested case-control (or case-cohort) studies with data on tea consumption and risk of incident cardiovascular events (cardiac or peripheral vascular events), stroke events (including mortality), CVD-specific mortality, or all-cause mortality. Data from 39 prospective cohort publications were synthesized. Linear meta-regression showed that each cup (236.6 mL)  increase in daily tea consumption (estimated 280 mg  and 338 mg  total flavonoids/d for black and green tea, respectively) was associated with an average 4% lower risk of CVD mortality, a 2% lower risk of CVD events, a 4% lower risk of stroke, and a 1.5% lower risk of all-cause mortality. Subgroup meta-analysis results showed that the magnitude of association was larger in elderly individuals for both CVD mortality (n = 4; pooled adjusted RR: 0.89; 95% CI: 0.83, 0.96; P = 0.001), with large heterogeneity (I2 = 72.4%), and all-cause mortality (n = 3; pooled adjusted RR: 0.92; 95% CI: 0.90, 0.94; P &lt; 0.0001; I2 = 0.3%). Generally, studies with higher risk of bias appeared to show larger magnitudes of associations than studies with lower risk of bias. Strength of evidence was rated as low and moderate (depending on study population age group) for CVD-specific mortality outcome and was rated as low for CVD events, stroke, and all-cause mortality outcomes. Daily tea intake as part of a healthy habitual dietary pattern may be associated with lower risks of CVD and all-cause mortality among adults.

scholarly journals Legume Consumption and All-Cause and Cardiovascular Disease Mortality

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Hua Li ◽  
Jinmeng Li ◽  
Yegen Shen ◽  
Jie Wang ◽  
Depu Zhou
Keyword(s):  
Cardiovascular Disease ◽  
Lower Risk ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Protective Effects ◽  
Prospective Cohort Studies ◽  
Relative Risks ◽  
Disease Mortality ◽  
All Cause Mortality ◽  
Cvd Mortality

Background. Legume consumption is suggested to have protective effects against cardiovascular disease (CVD) mortality in the general population, but the results have been equivocal. We conducted a meta-analysis of prospective cohort studies to assess the association between legume consumption and risk of CVD mortality and all-cause mortality. Methods and Results. Medline (via Ovid) and EMBASE (via Ovid) databases were searched through April 2017 to identify eligible studies. The two authors independently extracted the data and the adjusted relative risks (RRs) and 95% confidence intervals (CIs) were pooled by using a random-effects model. A total of 6 studies were identified, including the sizes of participants ranging from 23,601 to 59,485 with a sum of 21,8997. Comparing the highest category with the lowest, the pooled RR (95% CI) was 0.96 (0.86–1.06) for CVD mortality and 0.93 (0.87–0.99) for all-cause mortality. Conclusions. Results from the current study show that high legume intakes are associated with lower risk of all-cause mortality. In consideration of the small number of studies, the evidence for assessing relationship between legumes intake and risk of all-cause mortality remains inclusive and warrants further study in the future. Further, consuming legumes does not increase the risk of CVD mortality.

scholarly journals Adherence to dietary guidelines and 15-year risk of all-cause mortality

2012 ◽  
Vol 109 (3) ◽  
pp. 547-555 ◽  
Author(s):  
Joanna Russell ◽  
Victoria Flood ◽  
Elena Rochtchina ◽  
Bamini Gopinath ◽  
Margaret Allman-Farinelli ◽  
...  
Keyword(s):  
Diet Quality ◽  
Population Based ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Mortality Data ◽  
Food Groups ◽  
Multiple Data ◽  
All Cause Mortality ◽  
The Relationship ◽  
Reduced Risk

Past investigation of diet in relation to disease or mortality has tended to focus on individual nutrients. However, there has been a recent shift to now focus on overall patterns of food intake. The present study aims to investigate the relationship between diet quality reflecting adherence to dietary guidelines and mortality in a sample of older Australians, and to report on the relationship between core food groups and diet quality. This was a population-based cohort study of persons aged 49 years or older at baseline, living in two postcode areas west of Sydney, Australia. Baseline dietary data were collected during 1992–4, from 2897 people using a 145-item Willett-derived FFQ. A modified version of the Healthy Eating Index for Australians was developed to determine diet quality scores. The Australian National Death Index provided 15-year mortality data using multiple data linkage steps. Hazard risk (HR) ratios and 95 % CI for mortality were assessed for diet quality. Subjects in quintile 5 (highest) of the Total Diet Score had a 21 % reduced risk of all-cause mortality (HR 0·79, 95 % CI 0·63, 0·98, Ptrend= 0·04) compared with those in quintile 1 (lowest) after multivariate adjustment. The present study provides longitudinal support for a reduced risk of all-cause mortality in an older population who have greater compliance with published dietary guidelines.

scholarly journals Greater Adherence to Dietary Guidelines were Associated with Lower Risk of Cardiovascular Diseases in Chinese Patients with Type 2 Diabetes: A Case-Control Study

2020 ◽  
Author(s):  
Shang-Ling Wu ◽  
Yan-Bin Ye ◽  
Long-Yun Peng ◽  
Yu-Ming Chen ◽  
Fang-Fang Zeng ◽  
...  
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Lower Risk ◽  
Case Control Study ◽  
Case Control ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Chinese Patients ◽  
Control Study

Abstract Background The evidence regarding the impact of the healthy eating index on the risk of cardiovascular events among patients with type 2 diabetes (T2D) is limited. To examine the associations of adherence to the Chinese and American dietary guidelines and the risk of cardiovascular disease (CVD) among Chinese individuals with T2D. Methods This 1:1 matched case-control study included 419 enrolled pairs hospital-based CVD cases and controls who were matched by age and sex, in Guangdong province, China, all of whom had T2D. A structured questionnaire and a 79-item food-frequency questionnaire was used to collect general information and dietary intake information. Diet quality scores were calculated according to the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index-2015 (HEI-2015). Results After adjustment for various confounding factors, the higher diet quality scores on the CHEI and HEI-2015 showed a significant association with a lower risk of CVD. The odds ratios (95% confidence interval) per 5-score increment were 0.88(0.83,0.92) in the CHEI and 0.80(0.74,0.88) in the HEI-2015, respectively. In stratified analyses, the protective associations remained significant in the subgroups of sex, smoking status, tea-drinking, hypertension state, dyslipidemia state, BMI, and T2D duration, but not among the drinkers in CHEI. Conclusion Greater adherence to the most recent Chinese or American dietary guidelines were associated with a lower risk of CVD incidents among Chinese patients with T2D.

scholarly journals Adherence to the Healthy Eating Index-2015 (HEI-2015), Cognitive Function, and Incident Dementia in the Atherosclerosis Risk in Communities (ARIC) Study (OR32-01-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Emily Hu ◽  
Aozhou Wu ◽  
Jennifer Dearborn ◽  
Rebecca Gottesman ◽  
Lyn Steffen ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Lower Risk ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Word Fluency ◽  
Atherosclerosis Risk In Communities ◽  
Incident Dementia ◽  
Symbol Substitution ◽  
Dietary Guidelines For Americans ◽  
Aric Study

Abstract Objectives The Healthy Eating Index-2015 (HEI-2015) score was created to measure adherence to the 2015–2020 Dietary Guidelines for Americans. It remains undetermined whether adherence to the newly released guidelines is associated with improved cognitive function or reduced incident dementia. Methods We assessed the diet of 13,632 participants from the Atherosclerosis Risk in Communities (ARIC) study who were recruited from 1987–1989 and calculated their HEI-2015 scores (0–100) using responses to food frequency questionnaires. Baseline cognitive function was assessed using the Delayed Word Recall, Digit Symbol Substitution, and Word Fluency Tests. We used linear regression models to assess the cross-sectional association of adherence to HEI-2015 and standardized cognitive test scores. Incident dementia was ascertained through the end of 2017. Dementia status at the ARIC Neurocognitive Study visits (2011–13, 2016–17) was determined by detailed neurocognitive battery, informant interviews, and adjudicated review as well as through dementia screening by phone interview and informant review, or by ICD-9 dementia code for a hospitalization or death. We used Cox proportional hazards regression models adjusted for demographic, lifestyle, genetic, and clinical covariates to estimate the association between HEI-2015 score and risk of incident dementia. Results Compared to participants in the lowest quintile of HEI-2015 score, participants in the highest quintile scored higher on the Digit Symbol Substitution Test (β: 0.07, 95% CI: 0.03 to 0.11, P for trend < 0.001), Word Fluency Test (β: 0.07, 95% CI: 0.02 to 0.12, P for trend < 0.001) and global cognitive score (β: 0.05, 95% CI: 0.01 to 0.10, P for trend = 0.003) (Table). In total, there were 2354 cases of incident dementia over a median follow-up of 25 years. Compared to participants in the lowest quintile, participants in other quintiles had a lower risk of incident dementia after adjusting for covariates. Participants in the highest quintile had a 19% lower risk of dementia compared to those in the lowest (HR: 0.81, 95% CI: 0.71–0.93, P for trend = 0.01). Conclusions Higher adherence to the 2015–2020 Dietary Guidelines for Americans was associated with higher baseline cognitive function and lower risk of incident dementia. Funding Sources NHLBI, NIDDK, NIA, NINDS, NIH, HHS. Supporting Tables, Images and/or Graphs

Association between serum 25-hydroxyvitamin D concentrations and mortality among adults with prediabetes

2021 ◽  
Author(s):  
Qi Lu ◽  
Zhenzhen Wan ◽  
Jingyu Guo ◽  
Liegang Liu ◽  
An Pan ◽  
...  
Keyword(s):  
Lower Risk ◽  
Elevated Serum ◽  
Density Lipoprotein ◽  
Mortality Data ◽  
Hydroxyvitamin D ◽  
Reactive Protein ◽  
All Cause Mortality ◽  
25 Hydroxyvitamin D ◽  
Sufficient Vitamin ◽  
Cvd Mortality

Abstract Objectives To investigate the association of circulating 25-hydroxyvitamin D [25(OH)D] levels with mortality among adults with prediabetes. Methods This retrospective cohort study included 15195 adults with prediabetes (aged ≥20 years) from the National Health and Nutrition Examination Survey (NHANES) III and NHANES 2001-2014. Mortality from all causes, cardiovascular disease (CVD), and cancer was linked to National Death Index mortality data. Results The median (interquartile range) concentration of serum 25(OH)D was 60.5 (45.3, 77.4) nmol/L, and only 23.1% had sufficient vitamin D (≥75 nmol/L). Elevated serum 25(OH)D concentrations were significantly associated with lower levels of insulin, HOMA-IR, triglyceride, and C-reactive protein, and higher levels of high-density lipoprotein at baseline (all Ptrend&lt;0.05). During a median follow up of 10.7 years, 3765 deaths (including 1080 CVD deaths and 863 cancer deaths) were identified. Compared with participants with 25(OH)D &lt;30 nmol/L, the multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for participants with 25(OH)D ≥75 nmol/L were 0.66 (0.53, 0.82) for all-cause mortality (Ptrend&lt;0.001), 0.66 (0.48, 0.89) for CVD mortality (Ptrend=0.001), and 0.82 (0.49, 1.35) for cancer mortality (Ptrend=0.32). For per unit increment in ln-transformed 25(OH)D, there was a 27% lower risk of all-cause mortality and a 34% lower risk of CVD mortality (both P&lt;0.01). Conclusions These findings suggested that higher serum 25(OH)D concentrations were associated with lower all-cause and CVD mortality among individuals with prediabetes.

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