Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in women.

BACKGROUND Little is known about the overall health effects of adherence to the Dietary Guidelines for Americans. The healthy eating index (HEI), developed at the US Department of Agriculture, measures how well Americans' diets conform to these guidelines. OBJECTIVE We tested whether the HEI (scores range from 0 to 100; 100 is best) calculated from food-frequency questionnaires (HEI-f) would predict risk of major chronic disease in women. DESIGN A total of 67272 US female nurses who were free of major disease completed detailed questionnaires on diet and chronic disease risk factors in 1984 and repeatedly over 12 y. Major chronic disease was defined as fatal or nonfatal cardiovascular disease (myocardial infarction or stroke, n = 1365), fatal or nonfatal cancer (n = 5216), or other nontraumatic deaths (n = 496), whichever came first. We also examined cardiovascular disease and cancer as separate outcomes. RESULTS After adjustment for smoking and other risk factors, the HEI-f score was not associated with risk of overall major chronic disease in women [relative risk (RR) = 0.97; 95% CI: 0.89, 1.06 comparing the highest with the lowest quintile of HEI-f score]. Being in the highest HEI-f quintile was associated with a 14% reduction in cardiovascular disease risk (RR = 0.86; 95% CI: 0.72, 1. 03) and was not associated with lower cancer risk (RR = 1.02; 95% CI: 0.93, 1.12). CONCLUSION These data suggest that adherence to the 1995 Dietary Guidelines for Americans, as measured by the HEI-f, will have limited benefit in preventing major chronic disease in women.

[1]  John D. Potter,et al.  Food, nutrition and the prevention of cancer : a global perspective , 2001 .

[2]  B. Graubard,et al.  A prospective study of diet quality and mortality in women. , 2000, JAMA.

[3]  K. Williams,et al.  Atherosclerosis--an inflammatory disease. , 1999, The New England journal of medicine.

[4]  J. Manson,et al.  Dietary intake of α-linolenic acid and risk of fatal ischemic heart disease among women , 1999 .

[5]  D Spiegelman,et al.  Dietary fat and coronary heart disease: a comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements. , 1999, American journal of epidemiology.

[6]  L. Appel,et al.  Effects of dietary patterns on blood pressure: subgroup analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized clinical trial. , 1999, Archives of internal medicine.

[7]  J. Manson,et al.  Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study , 1998, BMJ.

[8]  S. L. Murphy,et al.  Deaths: final data for 1996. , 1998, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[9]  A. Folsom,et al.  Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women: the Iowa Women's Health Study. , 1998, The American journal of clinical nutrition.

[10]  J. Variyam,et al.  USDA's Healthy Eating Index and Nutrition Information , 1998 .

[11]  E. Rimm,et al.  Associations of plasma carotenoid concentrations and dietary intake of specific carotenoids in samples of two prospective cohort studies using a new carotenoid database. , 1998, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[12]  J. Manson,et al.  Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. , 1998, JAMA.

[13]  W. Willett,et al.  Should a low-fat, high-carbohydrate diet be recommended for everyone? Beyond low-fat diets. , 1997, The New England journal of medicine.

[14]  E. Feskens,et al.  Dietary pattern and 20 year mortality in elderly men in Finland, Italy, and the Netherlands: longitudinal cohort study , 1997, BMJ.

[15]  Cliff B. Jones,et al.  Effects of low-fat, high-carbohydrate diets on risk factors for ischemic heart disease in postmenopausal women. , 1997, The American journal of clinical nutrition.

[16]  G A Colditz,et al.  Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. , 1997, JAMA.

[17]  M. Schroll,et al.  Diet and mortality in a cohort of elderly people in a north European community. , 1997, International journal of epidemiology.

[18]  S. Hoerr,et al.  The Healthy Eating Index needs further work. , 1996, Journal of the American Dietetic Association.

[19]  A. Kant,et al.  Indexes of overall diet quality: a review. , 1996, Journal of the American Dietetic Association.

[20]  E. Kennedy,et al.  The 1995 dietary guidelines for Americans: an overview. , 1996, Journal of the American Dietetic Association.

[21]  E. Rimm,et al.  Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. , 1996, JAMA.

[22]  G A Colditz,et al.  Intake of carotenoids and retinol in relation to risk of prostate cancer. , 1995, Journal of the National Cancer Institute.

[23]  L. Lipworth,et al.  Diet and overall survival in elderly people , 1995, BMJ.

[24]  B. Schneeman,et al.  Use of the Food Guide Pyramid and US Dietary Guidelines to improve dietary intake and reduce cardiovascular risk in active-duty Air Force members. , 1995, Journal of the American Dietetic Association.

[25]  S. Carlson,et al.  The Healthy Eating Index: design and applications. , 1995, Journal of the American Dietetic Association.

[26]  J. Muthukannan,et al.  The Food Guide Pyramid , 1995 .

[27]  C. Davis,et al.  Essential fatty acids and USDA's Food Guide Pyramid. , 1995, The American journal of clinical nutrition.

[28]  R. Ziegler,et al.  Dietary diversity and subsequent cause-specific mortality in the NHANES I epidemiologic follow-up study. , 1995, Journal of the American College of Nutrition.

[29]  R. Lerman,et al.  Role of essential fatty acids: dangers in the US Department of Agriculture dietary recommendations ("pyramid") and in low-fat diets. , 1994, The American journal of clinical nutrition.

[30]  E. Rimm,et al.  Intake of fat, meat, and fiber in relation to risk of colon cancer in men. , 1994, Cancer research.

[31]  L. Kolonel,et al.  Animal Fat Consumption and Prostate Cancer: A Prospective Study in Hawaii , 1994, Epidemiology.

[32]  W. Willett,et al.  Diet and health: what should we eat? , 1994, Science.

[33]  E. Rimm,et al.  A prospective study of dietary fat and risk of prostate cancer. , 1993, Journal of the National Cancer Institute.

[34]  D Feskanich,et al.  Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire. , 1993, Journal of the American Dietetic Association.

[35]  J. Manson,et al.  Vitamin E consumption and the risk of coronary disease in women. , 1993, The New England journal of medicine.

[36]  J. Manson,et al.  Intake of trans fatty acids and risk of coronary heart disease among women , 1993, The Lancet.

[37]  R. Mensink,et al.  Effect of dietary fatty acids on serum lipids and lipoproteins. A meta-analysis of 27 trials. , 1992, Arteriosclerosis and thrombosis : a journal of vascular biology.

[38]  T. Dolecek,et al.  Epidemiological Evidence of Relationships between Dietary Polyunsaturated Fatty Acids and Mortality in the Multiple Risk Factor Intervention Trial , 1992, Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine.

[39]  G A Colditz,et al.  Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. , 1992, American journal of epidemiology.

[40]  E. Rimm,et al.  Comparison of measures of fatty acid intake by subcutaneous fat aspirate, food frequency questionnaire, and diet records in a free-living population of US men. , 1992, American journal of epidemiology.

[41]  F. Sacks,et al.  More on chewing the fat. The good fat and the good cholesterol. , 1991, The New England journal of medicine.

[42]  G A Colditz,et al.  Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women. , 1990, The New England journal of medicine.

[43]  R B D'Agostino,et al.  Relation of pooled logistic regression to time dependent Cox regression analysis: the Framingham Heart Study. , 1990, Statistics in medicine.

[44]  G A Colditz,et al.  Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. , 1989, International journal of epidemiology.

[45]  J. Vandenbroucke,et al.  Scoring of prudent dietary habits and its relation to 25-year survival. , 1987, Journal of the American Dietetic Association.

[46]  W. Catalona,et al.  Diagnosis, staging, and surgical treatment of prostatic carcinoma. , 1987, Archives of internal medicine.

[47]  M. Katan,et al.  EFFECT OF MONOUNSATURATED FATTY ACIDS VERSUS COMPLEX CARBOHYDRATES ON HIGH-DENSITY LIPOPROTEINS IN HEALTHY MEN AND WOMEN , 1987, The Lancet.

[48]  G. Reaven.  Looking at the world through LDL-cholesterol-colored glasses. , 1986, The Journal of nutrition.

[49]  W. Willett,et al.  Reproducibility and validity of a semiquantitative food frequency questionnaire. , 1985, American journal of epidemiology.

[50]  W. Willett,et al.  Test of the National Death Index. , 1984, American journal of epidemiology.

[51]  T. Wolever,et al.  Glycemic index of foods: a physiological basis for carbohydrate exchange. , 1981, The American journal of clinical nutrition.

[52]  F. D. Weinfeld,et al.  The National Survey of Stroke. Clinical findings. , 1981, Stroke.

[53]  Joanne R. Lupton,et al.  Nutrition and Your Health Dietary Guidelines for Americans , 1980, Journal of the American Dietetic Association.

[54]  M. Posada de la Paz,et al.  CLINICAL FINDINGS , 1978, WHO regional publications. European series.

[55]  H. Blackburn,et al.  Cardiovascular survey methods. , 1969, Monograph series. World Health Organization.

[56]  Nathan Mantel,et al.  Chi-square tests with one degree of freedom , 1963 .

[57]  D. Feskanich,et al.  Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in men. , 2000, The American journal of clinical nutrition.

[58]  Ames,et al.  Cohort studies of fat intake and the risk of breast cancer--a pooled analysis. , 2000 .

[59]  J. Witteman,et al.  Low Circulating Folate and Vitamin B 6 Concentrations Risk Factors for Stroke, Peripheral Vascular Disease, and Coronary Artery Disease , 1998 .

[60]  D. Hegsted.  Dietary fat intake and the risk of coronary heart disease in women. , 1998, The New England journal of medicine.

[61]  R B D'Agostino,et al.  Comparison of baseline and repeated measure covariate techniques in the Framingham Heart Study. , 1988, Statistics in medicine.

[62]  L. Watson,et al.  Case-control study of dietary etiological factors: the Melbourne Colorectal Cancer Study. , 1987, Nutrition and cancer.

[63]  R. L. Rizek,et al.  Continuing survey of food intakes by individuals , 1985 .

[64]  F. D. Weinfeld,et al.  National survey of stroke. , 1979, Transactions of the American Neurological Association.

[65]  Catherine F. Adams,et al.  Nutritive value of American foods in common units , 1975 .

[66]  M. Graffar.  [Modern epidemiology]. , 1971, Bruxelles medical.