Associations of key diet-quality indexes with mortality in the Multiethnic Cohort: the Dietary Patterns Methods Project

ABSTRACT Background Epidemiological data on the role of overall dietary patterns in nonalcoholic fatty liver disease (NAFLD) are limited, especially from population-based prospective studies. Objectives We investigated the associations between dietary patterns assessed by predefined diet quality indexes (DQIs) and NAFLD risk by cirrhosis status in African Americans, Japanese Americans, Latinos, Native Hawaiians, and whites from the Multiethnic Cohort (MEC). Methods A nested case-control analysis was conducted within the MEC. NAFLD cases were identified by linkage to 1999–2016 Medicare claims. Four DQIs—Healthy Eating Index (HEI)-2015, Alternative Healthy Eating Index-2010, alternate Mediterranean diet score, and Dietary Approaches to Stop Hypertension (DASH) score—were calculated from a validated FFQ administered at baseline. Conditional logistic regression was used to estimate the ORs and 95% CIs with adjustment for multiple covariates. Results Analyses included 2959 NAFLD cases (509 with cirrhosis; 2450 without cirrhosis) and 29,292 matched controls. Higher scores for HEI-2015 (i.e., highest compared with lowest quintile OR: 0.83; 95% CI: 0.73, 0.94; P for trend = 0.002) and DASH (OR: 0.78; 95% CI: 0.69, 0.89; P for trend < 0.001), reflecting favorable adherence to a healthful diet, were inversely associated with NAFLD risk. Whereas there were no differences by sex or race/ethnicity, the inverse association was stronger for NAFLD with cirrhosis than for NAFLD without cirrhosis (P for heterogeneity = 0.03 for HEI-2015 and 0.05 for DASH). Conclusions Higher HEI-2015 and DASH scores were inversely associated with NAFLD risk in this ethnically diverse population. The findings suggest that having better diet quality may reduce NAFLD risk with more benefit to NAFLD with cirrhosis.

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Among 4 Diet Quality Indexes, Only the Alternate Mediterranean Diet Score Is Associated with Better Colorectal Cancer Survival and Only in African American Women in the Multiethnic Cohort

Journal of Nutrition ◽

10.3945/jn.116.234237 ◽

2016 ◽

Vol 146 (9) ◽

pp. 1746-1755 ◽

Cited By ~ 30

Author(s):

Simone Jacobs ◽

Brook E Harmon ◽

Nicholas J Ollberding ◽

Lynne R Wilkens ◽

Kristine R Monroe ◽

...

Keyword(s):

Colorectal Cancer ◽

African American ◽

African American Women ◽

Mediterranean Diet ◽

Diet Quality ◽

Cancer Survival ◽

Mediterranean Diet Score ◽

Multiethnic Cohort ◽

Diet Score ◽

Quality Indexes

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High-Quality Diets Associate With Reduced Risk of Colorectal Cancer: Analyses of Diet Quality Indexes in the Multiethnic Cohort

Gastroenterology ◽

10.1053/j.gastro.2017.04.004 ◽

2017 ◽

Vol 153 (2) ◽

pp. 386-394.e2 ◽

Cited By ~ 49

Author(s):

Song-Yi Park ◽

Carol J. Boushey ◽

Lynne R. Wilkens ◽

Christopher A. Haiman ◽

Loïc Le Marchand

Keyword(s):

Colorectal Cancer ◽

Diet Quality ◽

High Quality ◽

Multiethnic Cohort ◽

Quality Indexes ◽

Reduced Risk

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The Role of Diet in Prognosis among Cancer Survivors: A systematic Review and Meta-Analysis of Dietary Patterns and Diet Interventions

10.20944/preprints202112.0278.v1 ◽

2021 ◽

Author(s):

Carlota Castro-Espin ◽

Antonio Agudo

Keyword(s):

Breast Cancer ◽

Cohort Studies ◽

Cancer Survivors ◽

Diet Quality ◽

Dietary Patterns ◽

Prospective Cohort ◽

Breast Cancer Survivors ◽

Meta Analysis ◽

Cancer Prognosis ◽

Prospective Cohort Studies

Cancer survival continues to improve in high-income countries, partly explained by advances in screening and treatment. Previous studies have mainly examined the relationship between individual dietary components and cancer prognosis in tumours with good therapeutic response (breast, colon and prostate cancers). The aim of this review was to assess qualitatively (and quantitatively where appropriate) the associations of dietary patterns and cancer prognosis from published prospective cohort studies, as well as the effect of diet interventions by means of randomized controlled trials (RCT). A systematic search was conducted in PubMed, and a total of 35 prospective cohort studies and 14 RCT published between 2011 and 2021 were selected. Better overall diet quality was associated with improved survival among breast and colorectal cancer survivors; adherence to the Mediterranean diet was associated to lower risk of mortality in colorectal and prostate cancer survivors. A meta-analysis using a random-effects model showed that higher versus lower diet quality was associated with a 23% reduction in overall mortality in breast cancer survivors. There was evidence that dietary interventions, generally combined with physical activity, improved overall quality of life, though most studies were in breast cancer survivors. Further cohort and intervention studies in other cancers are needed to make more specific recommendations.

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Diet Quality Indexes, Arterial Stiffness and Endothelial Function in Healthy Young Adults

The FASEB Journal ◽

10.1096/fasebj.2021.35.s1.02136 ◽

2021 ◽

Vol 35 (S1) ◽

Author(s):

Andrea Lobene ◽

Katarina Smiljanec ◽

Mararena Ramos‐Gonzalez ◽

Shannon Lennon

Keyword(s):

Young Adults ◽

Arterial Stiffness ◽

Endothelial Function ◽

Diet Quality ◽

Quality Indexes

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Empirically Derived Dietary Patterns in UK Adults Are Associated with Sociodemographic Characteristics, Lifestyle, and Diet Quality

Nutrients ◽

10.3390/nu10020177 ◽

2018 ◽

Vol 10 (2) ◽

pp. 177 ◽

Cited By ~ 14

Author(s):

Katharine Roberts ◽

Janet Cade ◽

Jeremy Dawson ◽

Michelle Holdsworth

Keyword(s):

Diet Quality ◽

Dietary Patterns ◽

Sociodemographic Characteristics

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Low diet quality and the risk of stroke mortality: the multiethnic cohort study

European Journal of Clinical Nutrition ◽

10.1038/s41430-018-0103-4 ◽

2018 ◽

Vol 72 (7) ◽

pp. 1035-1045 ◽

Cited By ~ 8

Author(s):

Annette Aigner ◽

Heiko Becher ◽

Simone Jacobs ◽

Lynne R. Wilkens ◽

Carol J. Boushey ◽

...

Keyword(s):

Cohort Study ◽

Diet Quality ◽

Stroke Mortality ◽

Multiethnic Cohort

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Diet Quality and All-Cause and Cancer-Specific Mortality in Older Adults with Invasive Cancer: The Multiethnic Cohort Study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa046_055 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 555-555

Author(s):

Song-Yi Park ◽

Yurii Shvetsov ◽

Minji Kang ◽

V Wendy Setiawan ◽

Carol Boushey ◽

...

Keyword(s):

Older Adults ◽

Diet Quality ◽

Cancer Mortality ◽

Healthy Eating Index ◽

Invasive Cancer ◽

Japanese American ◽

Multiethnic Cohort ◽

Specific Mortality ◽

Cancer Specific Mortality

Abstract Objectives We examined the association of postdiagnostic diet quality with all-cause and cancer-specific mortality in older adults diagnosed with invasive cancer, in comparison with those without invasive cancer, in the Multiethnic Cohort. Methods Data were from 66,374 African American, Native Hawaiian, Japanese American, Latino, and White men and women, who had no prevalent cancer, heart disease, or stroke at baseline (1993–1996, 45–75 years) and completed a quantitative food frequency questionnaire at both baseline and 10-year follow-up (2003–2007). Overall diet quality was measured by the Healthy Eating Index (HEI)-2015, the Alternative HEI-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED), and the Dietary Approaches to Stop Hypertension (DASH) scores. Invasive cancer cases between the baseline and 10-year surveys and deaths after the 10 year survey were identified through linkage to cancer registries and to state death files and the National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated in multivariate Cox models for the dietary indexes at 10-year follow-up with subsequent mortality. Results Age-adjusted mean scores of the 4 dietary indexes at baseline (prediagnosis) and 10-year follow-up (postdiagnosis) were similar or slightly lower in participants with cancer (n = 5998), compared to those without cancer (n = 60,376). Among participants with cancer (71.5 ± 8.0 years), 2006 all-cause and 1005 cancer-specific deaths were identified during a mean follow-up of 8 years after the 10-year survey. Postdiagnostic scores from all 4 indexes were associated with lower risk of all-cause and cancer mortality: for the highest vs. lowest quartiles, HR (95% CI) for all-cause mortality was 0.72 (0.62–0.82) for HEI-2015, 0.84 (0.73–0.96) for AHEI-2010, 0.74 (0.63–0.86) for aMED, and 0.76 (0.66–0.87) for DASH. The corresponding HRs (95% CIs) for cancer mortality were 0.81 (0.66–0.99), 0.81 (0.66–0.99), 0.72 (0.58–0.89), and 0.79 (0.65–0.97). These HRs were similar to those for participants without cancer. Conclusions Postdiagnostic high-quality diet was related to lower all-cause and cancer mortality in older adults with invasive cancer, with risk reduction comparable to that among participants without cancer. Funding Sources National Cancer Institute.

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Sociodemographic, Lifestyle, Environmental and Pregnancy-Related Determinants of Dietary Patterns during Pregnancy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16050754 ◽

2019 ◽

Vol 16 (5) ◽

pp. 754 ◽

Cited By ~ 12

Author(s):

Ewelina Wesołowska ◽

Agnieszka Jankowska ◽

Elżbieta Trafalska ◽

Paweł Kałużny ◽

Mariusz Grzesiak ◽

...

Keyword(s):

Diet Quality ◽

Dietary Patterns ◽

Dietary Pattern ◽

Whole Grains ◽

Processed Meat ◽

Small Cities ◽

Western Dietary Pattern ◽

Mother And Child ◽

Specific Factors

Background: Characterization of dietary patterns represents a valid and meaningful measure of overall diet quality and nutrient intake. The study aims at evaluating the sociodemographic, lifestyle, environmental, and pregnancy-related determinants of maternal dietary patterns during pregnancy. Methods: The analysis was conducted on a group of pregnant women from the Polish Mother and Child Cohort (REPRO_PL). During the second trimester of pregnancy, 1306 women filled in a modified version of the validated food frequency questionnaire (FFQ). Dietary patterns were estimated using an exploratory factor analysis. Potential dietary determinants were assessed via a questionnaire or biomarker measurements (saliva cotinine level). Results: Two dietary patterns were identified. The Prudent dietary pattern was characterized by high consumption of fruit, vegetables, legumes, whole grains, poultry, and low-fat dairy products, while the Western dietary pattern included high intake of refined grains, processed meat, potatoes, and very low intake of whole grains. Clear sociodemographic, environmental, lifestyle, and pregnancy-related determinants of diet quality were established. Older age (β = 0.2; p < 0.01), higher educational level (β = 0.3; p < 0.01), and socioeconomic status (SES) (β = 0.2; p < 0.01), overweight/obesity before (β = 0.3; p < 0.01), as well as physical activity during pregnancy (β = 0.2; p = 0.01) were positive determinants of a healthier diet (increasing Prudent–Western difference in dietary pattern scores). On the other hand, parity (β = −0.2; p = 0.04) and living in small cities (β = −0.3; p = 0.02) were significantly related to a rather Western dietary pattern. Conclusions: The current study presents evidence on specific factors influencing dietary patterns. They need to be accounted for in educational programs and interventions focused on healthy diet recommendations during pregnancy.

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