scholarly journals Diet quality and risk and severity of COVID-19: a prospective cohort study

Gut ◽  
2021 ◽  
Vol 70 (11) ◽  
pp. 2096-2104 ◽  
Author(s):  
Jordi Merino ◽  
Amit D Joshi ◽  
Long H Nguyen ◽  
Emily R Leeming ◽  
Mohsen Mazidi ◽  
...  
Keyword(s):  
Diet Quality ◽  
Lower Risk ◽  
Socioeconomic Deprivation ◽  
Healthy Plant ◽  
Unhealthy Lifestyle ◽  
Cox Models ◽  
Plant Foods ◽  
High Deprivation ◽  
Diet Score

ObjectivePoor metabolic health and unhealthy lifestyle factors have been associated with risk and severity of COVID-19, but data for diet are lacking. We aimed to investigate the association of diet quality with risk and severity of COVID-19 and its interaction with socioeconomic deprivation.DesignWe used data from 592 571 participants of the smartphone-based COVID-19 Symptom Study. Diet information was collected for the prepandemic period using a short food frequency questionnaire, and diet quality was assessed using a healthful Plant-Based Diet Score, which emphasises healthy plant foods such as fruits or vegetables. Multivariable Cox models were fitted to calculate HRs and 95% CIs for COVID-19 risk and severity defined using a validated symptom-based algorithm or hospitalisation with oxygen support, respectively.ResultsOver 3 886 274 person-months of follow-up, 31 815 COVID-19 cases were documented. Compared with individuals in the lowest quartile of the diet score, high diet quality was associated with lower risk of COVID-19 (HR 0.91; 95% CI 0.88 to 0.94) and severe COVID-19 (HR 0.59; 95% CI 0.47 to 0.74). The joint association of low diet quality and increased deprivation on COVID-19 risk was higher than the sum of the risk associated with each factor alone (Pinteraction=0.005). The corresponding absolute excess rate per 10 000 person/months for lowest vs highest quartile of diet score was 22.5 (95% CI 18.8 to 26.3) among persons living in areas with low deprivation and 40.8 (95% CI 31.7 to 49.8) among persons living in areas with high deprivation.ConclusionsA diet characterised by healthy plant-based foods was associated with lower risk and severity of COVID-19. This association may be particularly evident among individuals living in areas with higher socioeconomic deprivation.

scholarly journals Diet quality and risk and severity of COVID-19: a prospective cohort study

2021 ◽  
Author(s):  
Jordi Merino ◽  
Amit D Joshi ◽  
Long Nguyen ◽  
Emily Leeming ◽  
David Alden Drew ◽  
...  
Keyword(s):  
Diet Quality ◽  
Lower Risk ◽  
Socioeconomic Deprivation ◽  
Healthy Plant ◽  
Cox Models ◽  
Plant Foods ◽  
Hazard Ratios ◽  
High Deprivation ◽  
Diet Score

Objective: Poor metabolic health and certain lifestyle factors have been associated with risk and severity of coronavirus disease 2019 (COVID-19), but data for diet are lacking. We aimed to investigate the association of diet quality with risk and severity of COVID-19 and its intersection with socioeconomic deprivation. Design: We used data from 592,571 participants of the smartphone-based COVID Symptom Study. Diet quality was assessed using a healthful plant-based diet score, which emphasizes healthy plant foods such as fruits or vegetables. Multivariable Cox models were fitted to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for COVID-19 risk and severity defined using a validated symptom-based algorithm or hospitalization with oxygen support, respectively. Results: Over 3,886,274 person-months of follow-up, 31,815 COVID-19 cases were documented. Compared with individuals in the lowest quartile of the diet score, high diet quality was associated with lower risk of COVID-19 (HR, 0.91; 95% CI, 0.88-0.94) and severe COVID-19 (HR, 0.59; 95% CI, 0.47-0.74). The joint association of low diet quality and increased deprivation on COVID-19 risk was higher than the sum of the risk associated with each factor alone (Pinteraction=0.005). The corresponding absolute excess rate for lowest vs highest quartile of diet score was 22.5 (95% CI, 18.8-26.3) and 40.8 (95% CI, 31.7-49.8; 10,000 person-months) among persons living in areas with low and high deprivation, respectively. Conclusions: A dietary pattern characterized by healthy plant-based foods was associated with lower risk and severity of COVID-19. These association may be particularly evident among individuals living in areas with higher socioeconomic deprivation.

Abstract 13676: Association of Plant-centered Diet Intake With Cardiovascular Disease and All-cause Mortality: Findings From the Coronary Artery Risk Development in Young Adults Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yuni Choi ◽  
Nicole Larson ◽  
Lyn M Steffen ◽  
Pamela J SCHREINER ◽  
Daniel D Gallaher ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Diet Quality ◽  
Lower Risk ◽  
Multivariable Analysis ◽  
Parental History ◽  
Plant Foods ◽  
All Cause Mortality

Introduction: There is growing data regarding the potential for plant-centered diets to reduce risk for cardiovascular disease (CVD) and mortality. However, additional investigation is needed to strengthen and address inconsistencies in the existing evidence base. We examined the association between cumulative consumption of a plant-centered diet and a shift toward a more plant-centered diet and onset of CVD and all-cause mortality. Hypothesis: Nutritionally-rich plant-centered diets will be related to decreased risk of CVD and mortality. Methods: We included 4,926 black and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, ages 18-30 years and free of CVD at baseline (1985-1986, exam year [Y0]) and followed until 2018. Diet was assessed through an interviewer-administered diet history at Y0, Y7, and Y20. A Priori Diet Quality Score (APDQS) was used to assess plant-centered diet quality, and high index scores were characterized by higher consumption of nutritionally-rich plant foods with limited consumption of meats and less healthful plant foods. Proportional hazards regression estimated the association of time-varying APDQS, which were cumulatively averaged over follow-up and 13-year change in APDQS (Y7-Y20) with CVD and all-cause mortality. The model was adjusted for sociodemographic factors, energy intake, parental history of CVD, smoking, and physical activity. Results: We documented 289 new CVD cases and 445 all-cause deaths during the median 32-years of follow up. In multivariable analysis, the highest quintile of cumulative APDQS was associated with a 52% lower risk of CVD (hazard ratio [HR]: 0.48, 95% CI: 0.28-0.81) compared with the lowest quintile of cumulative APDQS. Increased APDQS over 13 years was related to a 62% lower subsequent 12-year risk of CVD (95% CI: 0.18-0.78) when comparing extreme quintiles. The association for all-cause mortality was only apparent among high educational groups. Conclusions: Following a plant-centered, high-quality diet staring from young adulthood was associated with a lower risk of developing CVD and death by middle age. Our findings support the concept that a plant-centered diet may help prevent early CVD and death.

scholarly journals MIND diet and the risk of dementia: a population-based study

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Tosca O. E. de Crom ◽  
Sanne S. Mooldijk ◽  
M. Kamran Ikram ◽  
M. Arfan Ikram ◽  
Trudy Voortman
Keyword(s):  
Lower Risk ◽  
Population Based ◽  
Reverse Causality ◽  
Cox Models ◽  
The Mind ◽  
Residual Confounding ◽  
Diet Score ◽  
Insight Into ◽  
Mind Diet

Abstract Background Adherence to the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet has been linked to a decreased risk of dementia, but reverse causality and residual confounding by lifestyle may partly account for this link. We aimed to address these issues by studying the associations over cumulative time periods, which may provide insight into possible reverse causality, and by using both historical and more contemporary dietary data as this could give insight into confounding since historical data may be less affected by lifestyle factors. Methods In the population-based Rotterdam Study, dietary intake was assessed using validated food frequency questionnaires in 5375 participants between 1989 and 1993 (baseline I) and in a largely non-overlapping sample in 2861 participants between 2009 and 2013 (baseline II). We calculated the MIND diet score and studied its association with the risk of all-cause dementia, using Cox models. Incident all-cause dementia was recorded until 2018. Results During a mean follow-up of 15.6 years from baseline I, 1188 participants developed dementia. A higher MIND diet score at baseline I was associated with a lower risk of dementia over the first 7 years of follow-up (hazard ratio (HR) [95% confidence interval (CI)] per standard deviation (SD) increase, 0.85 [0.74, 0.98]), but associations disappeared over longer follow-up intervals. The mean follow-up from baseline II was 5.9 years during which 248 participants developed dementia. A higher MIND diet score at baseline II was associated with a lower risk of dementia over every follow-up interval, but associations slightly attenuated over time (HR [95% CI] for 7 years follow-up per SD increase, 0.76 [0.66, 0.87]). The MIND diet score at baseline II was more strongly associated with the risk of dementia than the MIND diet score at baseline I. Conclusion Better adherence to the MIND diet is associated with a decreased risk of dementia within the first years of follow-up, but this may in part be explained by reverse causality and residual confounding by lifestyle. Further research is needed to unravel to which extent the MIND diet may affect the risk of dementia.

scholarly journals Adherence to Healthy Diet and Risk and Severity of SARS-CoV-2 Infections: A Community Survey Study Within the COVID Symptom Study Application

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 237-237
Author(s):  
Jordi Merino ◽  
Amit Joshi ◽  
Long Nguyen ◽  
Mohsen Mazidi ◽  
Mark Graham ◽  
...  
Keyword(s):  
Diet Quality ◽  
Severe Case ◽  
Smartphone Application ◽  
Socioeconomic Deprivation ◽  
Healthy Diet ◽  
Survey Study ◽  
Cox Models ◽  
Health And Social Care ◽  
Reduced Risk

Abstract Objectives To examine the association of adherence to a healthy diet with risk and severity of SARS-CoV-2 infections. Methods We included participants from the COVID Symptom Study smartphone application enrolled in March 2020 from the UK and the US who provided information about their sociodemographic characteristics and risk factors for COVID-19 at baseline, and subsequently reported any symptoms they were experiencing over follow-up. We administered a supplementary diet and lifestyle survey between August and September 2020 to ascertain diet quality before the pandemic using a validated 35-item short food frequency questionnaire. We defined incident predicted cases of COVID-19 over follow-up using a validated symptom-based model and a severe case of COVID-19 as a report of hospitalization with requirement of oxygen support. We used Cox models to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for predicted COVID-19 and severe COVID-19 after adjusting for potential sociodemographic and behavioral confounders. Results Over 4,044,344 person-months of follow-up, we recorded 33,360 incident COVID-19 cases. Compared with individuals in the lowest quartile of the diet quality score, high diet quality was associated with a reduced risk of predicted COVID-19 (adjusted HR 0.94, 95% CI 0.91 to 0.97) and reduced risk of severe COVID-19 (adjusted HR 0.80, 95% CI 0.65 to 0.99). We found evidence of significant interactions between diet quality and socioeconomic status on COVID-19 risk, in which the attributable risk proportion of the joint effect due to the interaction was 30% (95% CI 2.8 to 57.2). Among participants with higher levels of socioeconomic deprivation, COVID-19 incidence rate per 1,000 person-months was 7.5% for those with low diet quality (95% CI 7.1 to 7.8) compared with 5.5% for those with a high diet quality (95% CI 5.2 to 5.9). Conclusions These findings suggest that adherence to a healthy diet is associated with lower risk of COVID-19 infection and severity. The apparent beneficial association of a high-quality diet may be particularly evident among individuals with a higher levels of socioeconomic deprivation. Funding Sources Zoe Global, UK Government Department of Health and Social Care, Wellcome Trust, Massachusetts Consortium on Pathogen Readiness

scholarly journals Plant‐Centered Diet and Risk of Incident Cardiovascular Disease During Young to Middle Adulthood

2021 ◽  
Author(s):  
Yuni Choi ◽  
Nicole Larson ◽  
Lyn M. Steffen ◽  
Pamela J. Schreiner ◽  
Daniel D. Gallaher ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Diet Quality ◽  
Lower Risk ◽  
Proportional Hazards ◽  
A Priori ◽  
Meat Products ◽  
Hazard Ratio ◽  
Healthy Plant ◽  
Time Varying ◽  
Plant Foods

Background The association between diets that focus on plant foods and restrict animal products and cardiovascular disease (CVD) is inconclusive. We investigated whether cumulative intake of a plant‐centered diet and shifting toward such a diet are associated with incident CVD. Methods and Results Participants were 4946 adults in the CARDIA (Coronary Artery Risk Development in Young Adults) prospective study. They were initially 18 to 30 years old and free of CVD (1985–1986, exam year [year 0]) and followed until 2018. Diet was assessed by an interviewer‐administered, validated diet history. Plant‐centered diet quality was assessed using the A Priori Diet Quality Score (APDQS), in which higher scores indicate higher consumption of nutritionally rich plant foods and limited consumption of high‐fat meat products and less healthy plant foods. Proportional hazards models estimated hazard ratios of CVD associated with both time‐varying average APDQS and a 13‐year change in APDQS score (difference between the year 7 and year 20 assessments). During the 32‐year follow‐up, 289 incident CVD cases were identified. Both long‐term consumption and a change toward such a diet were associated with a lower risk of CVD. Multivariable‐adjusted hazard ratio was 0.48 (95% CI, 0.28–0.81) when comparing the highest quintile of the time‐varying average ADPQS with lowest quintiles. The 13‐year change in APDQS was associated with a lower subsequent risk of CVD, with a hazard ratio of 0.39 (95% CI, 0.19–0.81) comparing the extreme quintiles. Similarly, strong inverse associations were found for coronary heart disease and hypertension‐related CVD with either the time‐varying average or change APDQS. Conclusions Consumption of a plant‐centered, high‐quality diet starting in young adulthood is associated with a lower risk of CVD by middle age.

scholarly journals Changes in Plant-Based Diet Quality and Total and Cause-Specific Mortality

Circulation ◽  
2019 ◽  
Vol 140 (12) ◽  
pp. 979-991 ◽  
Author(s):  
Megu Y. Baden ◽  
Gang Liu ◽  
Ambika Satija ◽  
Yanping Li ◽  
Qi Sun ◽  
...  
Keyword(s):  
Diet Quality ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Environmental Benefits ◽  
Health Study ◽  
Specific Mortality ◽  
Cvd Mortality

Background: Plant-based diets have been associated with lower risk of type 2 diabetes mellitus and cardiovascular disease (CVD) and are recommended for both health and environmental benefits. However, the association between changes in plant-based diet quality and mortality remains unclear. Methods: We investigated the associations between 12-year changes (from 1986 to 1998) in plant-based diet quality assessed by 3 plant-based diet indices (score range, 18–90)—an overall plant-based diet index (PDI), a healthful PDI, and an unhealthful PDI—and subsequent total and cause-specific mortality (1998–2014). Participants were 49 407 women in the Nurses’ Health Study (NHS) and 25 907 men in the Health Professionals Follow-Up Study (HPFS) who were free from CVD and cancer in 1998. Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% CIs. Results: We documented 10 686 deaths including 2046 CVD deaths and 3091 cancer deaths in the NHS over 725 316 person-years of follow-up and 6490 deaths including 1872 CVD deaths and 1772 cancer deaths in the HPFS over 371 322 person-years of follow-up. Compared with participants whose indices remained stable, among those with the greatest increases in diet scores (highest quintile), the pooled multivariable-adjusted HRs for total mortality were 0.95 (95% CI, 0.90–1.00) for PDI, 0.90 (95% CI, 0.85–0.95) for healthful PDI, and 1.12 (95% CI, 1.07–1.18) for unhealthful PDI. Among participants with the greatest decrease (lowest quintile), the multivariable-adjusted HRs were 1.09 (95% CI, 1.04–1.15) for PDI, 1.10 (95% CI, 1.05–1.15) for healthful PDI, and 0.93 (95% CI, 0.88–0.98) for unhealthful PDI. For CVD mortality, the risk associated with a 10-point increase in each PDI was 7% lower (95% CI, 1–12%) for PDI, 9% lower (95% CI, 4–14%) for healthful PDI, and 8% higher (95% CI, 2–14%) for unhealthful PDI. There were no consistent associations between changes in plant-based diet indices and cancer mortality. Conclusions: Improving plant-based diet quality over a 12-year period was associated with a lower risk of total and CVD mortality, whereas increased consumption of an unhealthful plant-based diet was associated with a higher risk of total and CVD mortality.

Abstract P215: Plasma and Dietary Linoleic Acid and Diabetes Incidence After Myocardial Infarction

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Marjolein C Harbers ◽  
Kamalita Pertiwi ◽  
Sabita S Soedamah-Muthu ◽  
Janette de Goede ◽  
Famke J Mölenberg ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Fatty Acids ◽  
Linoleic Acid ◽  
Lower Risk ◽  
Plasma Cholesterol ◽  
Dietary Factors ◽  
Diabetes Incidence ◽  
Cox Models ◽  
Total Fatty Acids

Background: Plasma linoleic acid (C18:2n-6, LA) has been associated with a lower risk of type 2 diabetes mellitus (T2DM) in prospective cohort studies, but associations of dietary LA with T2DM risk are inconsistent. Objective: To study both plasma and dietary LA in relation to incident T2DM in post-myocardial infarction (MI) patients who received state-of-the-art drug treatment. Methods: We included 3,377 patients (80% male) from the Alpha Omega Cohort aged 60-80 y who had an MI <10 y before study enrollment and who were initially free of T2DM. At baseline, LA was measured in plasma cholesterol esters as a proportion of total fatty acids. Dietary LA intake was estimated from a validated 203-item food-frequency questionnaire that had been specifically designed for measuring fatty acid intake. Incident T2DM was ascertained through self-reported physician diagnosis and medication use. HRs for incident T2DM in quintiles of plasma LA and dietary LA were obtained from multivariable Cox models that included age, sex, lifestyle and dietary factors. For dietary LA, we used a substitution model in which LA was iso-calorically replaced with the sum of saturated plus trans fatty acids. Results: From the lowest to the highest quintile, dietary LA ranged from 3.5 to 8.8 percent of energy and the proportion of plasma LA ranged from 43.7 to 56.3%. Plasma and dietary LA were weakly correlated (Spearman r = 0.14, P <.0001). During a median follow-up of 3.4 years, 171 cases of T2DM occurred. Plasma LA was associated with a significantly lower risk of T2DM (HR Q5vsQ1 : 0.45; 95% CI: 0.27 - 0.76; P for trend = 0.002). Dietary LA was not associated with T2DM risk (HR Q5vsQ1: 0.97; 95% CI: 0.53 - 1.76; P for trend = 0.85). Conclusion: Plasma LA but not dietary LA was associated with lower T2DM risk in post-MI patients. The utility of plasma LA as a biomarker of dietary LA warrants further investigation.

Abstract P516: A Traditional Mexican Diet Score is Not Associated With Increased Risk of Hypertension and is Comparable to Other Diet Scores Among U.S. Adults of Mexican Heritage in the Hispanic Community Health Study/Study of Latinos Cohort

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Martha Tamez ◽  
Eric Rimm ◽  
Bernard Rosner ◽  
Daniela Sotres-Alvarez ◽  
Martha L Daviglus ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diet Quality ◽  
Regression Models ◽  
Health Study ◽  
Hypertension Risk ◽  
Hispanic Community ◽  
Mexican Heritage ◽  
Unit Increase ◽  
Diet Score

Introduction: Little is known about whether prevailing diet quality scores apply to Hispanics/Latinos when assessing hypertension risk or if a diet score applied to a traditional diet would be more relevant. Objective: To compare a traditional Mexican diet score (tMexS) against three prevailing diet quality scores (Mediterranean Diet Score [MeDS], Alternate Healthy Eating Index-2010 [AHEI-2010], and Dietary Approaches to Stop Hypertension [DASH]) in association with risk of hypertension and change in systolic and diastolic blood pressure (BP) in adults of Mexican heritage in the U.S. Methods: Data were analyzed from 3,542 U.S. adults of Mexican heritage in the multicenter population-based Hispanic Community Health Study/Study of Latinos (HCHS/SOL) cohort with baseline (2008-2011) and follow-up (2014-2017) visits, and without CVD and hypertension at baseline. Diet quality scores were calculated from the average of two 24-h recalls. Higher scores of MeDS, AHEI-2010, and DASH indicate a healthier diet, while a higher tMexS indicates a more traditional Mexican diet. Hypertension was defined as an average of ≥140 systolic or ≥90 mmHg diastolic BP from triplicate measurements, or self-reported use of antihypertensive medications. Logistic regression models tested the association of four dietary scores with incident hypertension, and linear regression models tested the association of dietary scores and changes in systolic and diastolic BP by hypertension status. Multivariable models with complex survey procedures were adjusted for confounders, and the final model included all dietary scores simultaneously. Results: After an average 6y of follow-up, there were 553 incident cases of hypertension. Mean (±SE) total score was 5.8 ± 0.05 for tMexS (range: 0-12), 5.3 ± 0.04 for MeDS (range: 0-9), 51.4 ± 0.19 for AHEI-2010 (range: 0-110), and 48.5 ± 0.22 for DASH (range: 0-90). The tMexS, MeDS, and DASH were not associated with risk of hypertension. A 10-unit increase in the AHEI-2010 was associated with a lower risk of hypertension (OR: 0.77; 95% CI: 0.60, 0.98). Among normotensive adults, diastolic BP decreased by 0.24 ± 0.11 mmHg per one-unit increase in tMexS (p-value=0.02). No significant changes were noted for systolic BP nor among adults with hypertension. Conclusions: In this prospective cohort, the AHEI-2010, but not DASH, MeDS, or tMexS, was associated with lower hypertension risk among U.S. adults of Mexican heritage, while the tMexS reduced diastolic BP among normotensive adults. To decrease hypertension risk, adults of Mexican heritage should adhere to AHEI-2010 dietary recommendations, while consuming traditional Mexican foods for modest benefits on blood pressure.

scholarly journals A Plant-Centered Diet and Onset of Chronic Kidney Disease in 20 Years of Follow-Up: Findings from the Coronary Artery Risk Development in Young Adults (CARDIA) Cohort

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1388-1388
Author(s):  
Yuni Choi ◽  
David Jacobs ◽  
Haitao Chu ◽  
Daniel Duprez ◽  
Daniel Gallaher ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Diet Quality ◽  
Lower Risk ◽  
Multivariable Analysis ◽  
High Quality ◽  
Quality Diet

Abstract Objectives Chronic kidney disease (CKD) is an increasing health problem in young adults and may be associated with dietary patterns. We examined the association of a plant-centered diet with incident moderate-to-very high risk CKD in young adults who were initially free of CKD. Methods We followed 3026 community-based participants (Black and White men and women) from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort (1985–86 to 2015–16). Diet was assessed by an interviewer-administered diet history at exam years (Y) 0, 7, and 20. Higher plant-centered diet quality was judged by higher cumulative average value of the A Priori Diet Quality Score (APDQS, range 0–132), a hypothesis-driven index based on 46 food groups. A higher APDQS is characterized by high consumption of nutritionally rich plant foods and limited meat, added sugars, and other less nutritious foods. Kidney status, assessed at 5-year intervals from Y10 to Y30, was based on estimated glomerular filtration rate (eGFR) using CKD-EPI creatinine equation and spot urine albumin-to-creatinine ratio (ACR). CKD diagnosis included new onset of micro- or macro-albuminuria (ACR ≥30 mg/g), eGFR &lt;60 mL/min/1.73m,2, or (hospitalized or fatal) end stage renal disease. Prevalent CKD cases throughout Y10 were excluded. Proportional hazards regression estimated the association of time-varying cumulative average APDQS with incident CKD, adjusted for age, sex, race, education, energy intake, % energy from protein, physical activity, and smoking. Results Mean Y10 age was 35.1 y (±3.6 y) and mean cumulative average APDQS was 65.0 (±11.4). We identified 358 incident CKD cases (59 of whom were severe cases) during mean follow-up of 17.7 years (±4.4) after Y10. Eating a plant-centered, high quality diet was associated with a lower risk of incident CKD. In multivariable analysis, participants in the highest quintile of the APDQS had 37% (95% confidence interval: 0.41–0.97) lower risk of CKD as compared with those in the lowest quintile of the APDQS. For each 11-point increment in APDQS, there was 15% lower risk of CKD (0.74–0.97). The association remained similar after further adjustment for prevalent cases of hypertension and diabetes. Conclusions A plant-centered, high quality diet was associated with a lower risk of developing CKD. Funding Sources CARDIA and MnDRIVE (University of Minnesota).

scholarly journals Dietary pattern in midlife and cognitive impairment in late life: a prospective study in Chinese adults

2019 ◽  
Vol 110 (4) ◽  
pp. 912-920 ◽  
Author(s):  
Jing Wu ◽  
Xingyue Song ◽  
Guo-Chong Chen ◽  
Nithya Neelakantan ◽  
Rob M van Dam ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Diet Quality ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Lower Risk ◽  
Late Life ◽  
Chinese Adults ◽  
The Third

ABSTRACT Background Prospective studies linking dietary pattern and cognitive function in the elderly are limited in Asian populations. Objective We examined the associations between various healthful dietary patterns and risk of cognitive impairment in Chinese adults. Methods We used data from the Singapore Chinese Health Study of 16,948 men and women who were aged 45–74 y at baseline (1993–1998) and reinterviewed at the third follow-up visit (2014–2016), ∼20 y later. Diet quality at baseline was assessed according to the alternate Mediterranean diet (aMED), the Dietary Approaches to Stop Hypertension (DASH) diet, the alternative Healthy Eating Index (AHEI)-2010, overall plant-based diet index (PDI), and healthful plant-based diet index (hPDI). Cognitive function was evaluated using a Singapore-modified Mini-Mental State Examination during the third follow-up visit when subjects were aged 61–96 y. Multivariable logistic regression models were used to compute ORs and 95% CIs associated with the risk of cognitive impairment defined using education-specific cut-offs. Results Cognitive impairment was present in 2443 (14.4%) participants. The OR (95% CI) for cognitive impairment comparing the highest with the lowest quartile of diet quality scores was 0.67 (0.59, 0.77) for aMED, 0.71 (0.62, 0.81) for DASH, 0.75 (0.66, 0.85) for AHEI-2010, 0.82 (0.71, 0.94) for PDI, and 0.78 (0.68, 0.90) for hPDI (all P values for trend &lt;0.001). Each SD increment in different diet quality scores was associated with 7–16% lower risk of cognitive impairment. Conclusions These results provide evidence that adherence to healthy dietary patterns in midlife is associated with a lower risk of cognitive impairment in late life in Chinese adults.

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