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PubMed2005

Prospective study of dietary patterns and persistent cough with phlegm among Chinese Singaporeans.

RATIONALE: Using principal components analysis to examine dietary patterns complements the evaluation of individual food and nutrient intake in relation to health outcomes, but has not yet been applied to nonmalignant respiratory disease or symptoms. OBJECTIVE: To examine the relation between patterns of dietary intake at baseline and new onset of persistent cough with phlegm in a population-based cohort of Singapore Chinese. METHODS: A 165-item validated food frequency questionnaire was administered in-person at baseline in 1993. We identified 623 cases of incident cough with phlegm among 52,325 subjects by telephone interview from 1999 through 2004. We identified two distinct food patterns: a "meat-dim sum" pattern characterized by pork and chicken dim sum foods and noodle dishes, and a "vegetable-fruit-soy" pattern characterized by vegetables, fruit, and soyfood items. MAIN RESULTS: The meat-dim sum pattern was positively associated with new-onset cough with phlegm (odds ratio, 1.43; 95% confidence interval, 1.08, 1.89; comparing fourth to first quartile, p for trend = 0.02), after adjustment for age, sex, total energy intake, smoking, education, and nonstarch polysaccharide intake, a protective factor for cough with phlegm in this cohort. Weaker associations were seen for more chronic symptoms and for incident asthma. A weak inverse association for the vegetable-fruit-soy pattern disappeared after adjustment for nonstarch polysaccharide intake. CONCLUSION: A diet rich in meats, sodium, and refined carbohydrates may increase risk of developing cough with phlegm, independently of the apparent beneficial effects of a diet high in fiber in this Singapore Chinese cohort.

Aged↗
PubMed1999

[Dietary pattern of adolescents in Guipuzcoa].

OBJECTIVE: Multiple international studies demonstrate an imbalance in the dietary pattern of adolescents resulting in a nutritional intake that is inadequate to guarantee the biochemical basis of genetic expression, health and development of the person. PATIENTS AND METHODS: A 24 hour survey (five days, weekly, holidays and seasonal rotation) in reference to RDA was given to a population of 2,407 adolescents between 14 and 16 years of age. The population included 1,232 girls (51.2%) and 1,175 boys (48.8%). The sample was determined by simple aleatory sampling (margin of error lower than 2%, level of trust 95%) which was followed by descriptive and analytic statistical processing of the data. RESULTS: There is an excessive intake of lipids, saturated fats and cholesterol in both sexes. The caloric contribution in the form of complex carbohydrates and fiber is insufficient. The average intake of nutrients is sufficient, except for vitamins A and B6, folate, calcium, magnesium and zinc in both sexes and phosphorous and iron in girls. The dietary models of boys and girls present significant differences in nutrients. CONCLUSIONS: The dietary pattern moves away from the balance of the Mediterranean diet and it is characterized by an excessive intake of meat, fats, sugars and candies, refined products and alcohol, as well as an insufficient intake of fruits, fresh vegetables, whole cereals, fish and low-fat dairy products. This results in an excessive intake of saturated fats and cholesterol, as well as an insufficient average intake of vitamins A and B6, folate, calcium, magnesium, zinc and iron.

Adolescent↗
PubMed1995

Dietary patterns and cardiovascular risk factors in elderly men: the Zutphen Elderly Study.

BACKGROUND: We investigated whether dietary patterns were associated with cardiovascular risk factors in 518 elderly men (70-89 years), using data from the 30-year follow-up survey of the Zutphen Study. METHODS: Dietary intake was estimated by cross-check dietary history. We used cluster analysis to aggregate individuals into four groups, characterized by high alcohol intake, high meat consumption, healthy dietary pattern, and high intake of refined sugars. RESULTS: In the alcohol cluster socioeconomic status was higher (P < 0.05) than in the meat cluster. High density lipoprotein (HDL)-cholesterol was 0.15-0.23 mmol/l higher (P < 0.05) in the alcohol cluster compared to the other clusters. Furthermore, in the meat cluster HDL-cholesterol was 0.08 mmol/l higher than in the refined sugars cluster (P < 0.05). Total serum cholesterol was 0.26 mmol/l higher in the meat cluster compared to the healthy diet cluster (95% CI: -0.17, 0.69). The prevalence of hypertension was almost 10% higher in alcohol cluster compared to the other three clusters (95% CI: -3, 23). The percentage of non-smokers was highest in the healthy diet cluster. These results were irrespective of potential confounders, such as age, body mass index, socioeconomic status, smoking, and being on a prescribed diet. CONCLUSIONS: The effects of moderate alcohol intake on cardiovascular risk factors are confirmed in elderly men. Furthermore, a healthy diet is associated with more favourable levels of cardiovascular risk factors at old age.

Aged↗
PubMed2000

[The relationship between dental fluorosis and dietary pattern among Tibetan children in natural protective areas of Mount Qomolangma].

OBJECTIVE: To study the relationship between dietary pattern and dental fluorosis among Tibetan children in natural protective areas of Mount Qomolangma. METHODS: Environmental fluorine levels, dietary pattern and occurrence of dental fluorosis among children in Xieger town, Dingri County and Zhangmu town, Nielamu County, were studied. RESULTS: The total fluorine intake in children was 8.039 mg in Xieger town and the prevalence rate of dental fluorosis was 75.93%. The total fluorine intake and morbidity of dental fluorosis are 2.797 mg and 25.86% respectively in Zhangmu town. CONCLUSION: It suggested that fluorosis of children is related to total fluoride intake.

Adolescent↗
PubMed1999

Differences in fat-related dietary patterns between black, Hispanic and White women: results from the Women's Health Trial Feasibility Study in Minority Populations.

OBJECTIVE: This report examines how sources of fat and patterns of fat-related dietary habits differed between black, Hispanic and white women participating in a randomized trial of a low-fat diet intervention. DESIGN: The intervention consisted of group sessions, which met weekly for 6 weeks, biweekly for 6 weeks and monthly for 9 months, and included didactic nutrition education and activities to provide motivation for sustained dietary change. Outcomes included total fat and fat from nine food groups from a food frequency questionnaire (FFQ), and a summary scale and five subscales that measure fat-related dietary habits. SETTING/SUBJECTS: Data are from 1702 post-menopausal women, recruited from clinical centres in Atlanta, Birmingham and Miami, with dietary assessments at baseline and 6 months post-randomization. RESULTS: Total fat intake was similar across race/ethnic groups at baseline, yet there were many differences in sources of fat and fat-related dietary habits. For example, blacks consumed less fat from dairy foods and more fat from meats than whites. Effects of the intervention on total fat intake or the summary fat-related dietary habits scale did not differ across race/ethnicity groups. There were, however, many differences in how the intervention affected sources of fat and fat-related dietary habits. For example, the intervention effect for added fats (e.g. butter and salad dressings) was -8.9 g for blacks and -12.0 g for whites (P<0.05). The intervention effect for adopting low-fat meat purchasing and preparation methods was larger for blacks than whites, and the intervention effect for replacing high-fat foods with fruits and vegetables was larger for Hispanics than whites. CONCLUSIONS: This study demonstrates that, if properly designed, a single nutrition intervention programme can work well even in groups with culturally diverse dietary patterns.

Black or African American↗
PubMed2002

Dietary patterns and risk of hypertension, type 2 diabetes mellitus, and coronary heart disease.

Dietary pattern analysis, which reflects the complexity of dietary intake, has recently received considerable attention by nutritional epidemiologists. Two general approaches have been used to define these summary variables in observational studies. The so-called a posteriori approach builds on statistical exploratory methods, whereas the so-called a priori approach focuses on the construction of pattern variables that reflect hypothesis-oriented patterns based on available scientific evidence for specific diseases. Several studies, both observational and clinical, suggest that these measures of overall diet predict disease risk, and that its application might be especially valuable in the development of food-based dietary guidelines. In this review, we describe different patterning approaches and the available evidence regarding the relationships between dietary patterns and risk of hypertension, type 2 diabetes mellitus, and coronary heart disease.

Coronary Disease↗
PubMed1987

Dietary patterns and metabolic control in diabetic diets: a prospective study of 51 outpatient men on unmeasured and exchange diets.

In a prospective, single blind study, 51 adult diabetic, male outpatients at or below ideal body weight (IBW), all but four of whom were insulin-treated, were randomly assigned to a calorically defined exchange diet (EXCH) or an unmeasured diet avoiding refined sugars (UNMEAS). Fasting chemistries, weights and 48-hr dietary recalls were obtained every 3 months for 3 years. There was no difference between groups in mean body weight, mean caloric intake, percentages of carbohydrate or fat intake, day to day consistency of caloric intake, or fasting chemistries. The patients whose actual weight tended to be less than IBW consumed more calories than their theoretical calculated needs (p = 0.002) without effect on glycemic control or stability of weight. Patients with low carbohydrate intake (less than 30%) had significantly higher triglyceride levels (p = 0.015). Otherwise, variations in dietary patterns were not reflected in fasting clinical chemistries. Individual fasting serum glucose levels were not related to consistency of carbohydrate intake, caloric distribution throughout the day or composition of diets. These results suggest that actual dietary patterns of subjects following exchange diabetic diets with precise caloric prescriptions are similar to those resulting from unmeasured diets with restriction of simple sugars. Other than correlation between carbohydrate intake and triglycerides, there was no detectable effect of variations in dietary patterns upon conventional chemical metabolic levels.

Adult↗
PubMed1998

Dietary pattern, nutrient intake and growth of adolescent school girls in urban Bangladesh.

OBJECTIVE: To investigate the dietary pattern and nutritional status of adolescent girls attending schools in Dhaka city and to examine the association with various social factors. DESIGN: Cross-sectional study. SETTING: Girls high schools in Dhaka city. SUBJECTS: A total of 384 girls, aged from 10 to 16 years, who were students of classes VI to IX of 12 girls high schools in Dhaka city were selected by systematic random sampling. Nutrient intake was assessed using the 24-h recall method and the usual pattern of food intake was examined using a 7-day food frequency questionnaire. RESULTS: The prevalence of undernutrition among the participants assessed as stunting was 10% overall with younger girls being less stunted (2%) than older girls (16%), whereas 16% were thin with relatively more of the younger girls (21%) being thin than of the older girls (12%). Based on the usual pattern of food intake, a substantial proportion of the girls did not consume eggs (26%), milk (35%) or dark green leafy vegetables (20%). By comparison, larger proportions consumed meat (50%) and fish (65%) at least four times a week. For the intake of energy and protein, only 9 and 17% of the girls, respectively, met the recommended daily allowance (RDA). For nearly 77% of the girls, the intake of fat was less than the recommendation. Intakes less than the RDA were found for iron (77% of the girls), calcium (79%), vitamin A (62%), vitamin C (67%), and riboflavin (96%). Based on the food consumption data, cereals were the major source of energy (57%), thiamin (67%), niacin (63%) and iron (37%). Animal sources supplied 50% of dietary protein. Cooking fats were the principal source of fat (67%) in the diet. Milk was the major contributor for riboflavin and preformed vitamin A (retinol). Leafy vegetables and fruits were the main sources of provitamin A (carotenes). The girls from families with less educated parents were more likely to be thin and short for their age. Those girls from families with lower incomes and less educated parents had a dietary pattern which tended to be poor with regard to egg, milk, meat and fruit, with lower intakes of protein, fat and riboflavin. CONCLUSION: The findings indicate that the diets of these girls tended to be inadequate both for macronutrients and micronutrients, with significant health implications. There was also a relationship between the family income and the education of the parents with the nutritional status of the girls.

Adolescent↗
PubMed2003

[The dietary patterns and nutritional status of adult Yi people in Liangshan autonomous region].

This study was undertaken to know about the dietary pattern and nutrition status of adult Yi people in Liangshan autonomous region so that to provide evidence to ameliorate and promote the health and prevent nutrition-related diseases. 220 families, 468 inhabitants aged from 18 to 60, were sampled for the survey by a multistage, stratified, random, cluster process. Questionnaire-survey and measurement of height and weight were executed on the spot. Between rural and urban Yi inhabitants, there were differences in income, dietary pattern and eating habit. Compared with RNIs, dietary nutrients intakes of adult Yi people were irrational and differences lay between rural and urban. For urban inhabitants, the prevalence of overweight and obesity was 188%, and the prevalence of emaciation was 4.7%; while for rural inhabitants, the prevalence of emaciation was 9.8%, but no prevalence of overweight and obesity. There was obvious imbalance in energy and nutrients intakes of rural and urban adult Yi people in Liangshan. Emaciation, overweight and obesity prevalence was different between these two subgroups of population.

Adolescent↗
PubMed2007

Dietary patterns and diabetes incidence in the Melbourne Collaborative Cohort Study.

The authors investigated the association of dietary patterns and type 2 diabetes in a 4-year prospective study of 36,787 adults in the Melbourne Collaborative Cohort Study (1990-1994). A total of 31,641 (86%) participants completed follow-up, and 365 cases were identified. Four factors with eigenvalues of greater than 2 were identified using the principal factor method with 124 foods/beverages, followed by orthogonal rotation. Variables with factor loadings having absolute values of 0.3 or greater were used in interpreting the factors. Odds ratios for diabetes incidence across quintiles of factor scores were computed by use of logistic regression, adjusting for age, energy intake, family history of diabetes, country of birth, and other factor scores. Factor 1, characterized by olive oil, salad vegetables, and legumes and by avoidance of sweet bakery items, margarine, and tea, was associated with country of birth but not with diabetes. Factor 2, characterized by salad and cooked vegetables, was inversely associated with diabetes. Factor 3, characterized by meats and fatty foods, was associated with increased diabetes risk. A range of fruits loaded strongly on factor 4, which showed little association with diabetes. Avoidance of a dietary pattern including meats and fatty foods, as well as adherence to a pattern including salad and cooked vegetables, is recommended.

Adult↗
PubMedDate not supplied

Dietary patterns of adults in Québec and their nutritional adequacy.

The purpose of this study was to identify dietary patterns among adults in Québec and to determine their relationship to nutritional adequacy of the diet. We used 24-hour food recall data on 2,104 adults from the Québec nutrition survey (1990). Nutritional adequacy was assessed based on the 1990 Nutrition Recommendations for Canadians; dietary patterns were assessed via a factor analysis of the 30 food groups consumed. The three major patterns identified ('high-energy density', 'traditional' and 'health-conscious') explained 18% of the variation in food intake. Only the 'health-conscious' pattern correlated positively with the four chosen indicators of nutritional adequacy. Generally, men scored positively on the 'high-energy density' and the 'traditional' pattern whereas women scored positively on the 'health-conscious' pattern. Aside from sex, scoring was most related to age and education. The use of these patterns to define and target nutrition interventions should be tested in the aim of improving the effectiveness of health promotion.

Adult↗
PubMed1997

Dietary pattern and 20 year mortality in elderly men in Finland, Italy, and The Netherlands: longitudinal cohort study.

OBJECTIVE: To investigate the association of dietary pattern and mortality in international data. DESIGN: Cohort study with 20 years' follow up of mortality. SETTING: Five cohorts in Finland, the Netherlands, and Italy. SUBJECTS: Population based random sample of 3045 men aged 50-70 years in 1970. MAIN OUTCOME MEASURES: Food intake was estimated using a cross check dietary history. In this dietary survey method, the usual food consumption pattern in the 6-12 months is estimated. A healthy diet indicator was calculated for the dietary pattern, using the World Health Organisation's guidelines for the prevention of chronic diseases. Vital status was verified after 20 years of follow up, and death rates were calculated. RESULTS: Dietary intake varied greatly in 1970 between the three countries. In Finland and the Netherlands the intake of saturated fatty acids and cholesterol was high and the intake of alcohol was low; in Italy the opposite was observed. In total 1796 men (59%) died during 20 years of follow up. The healthy diet indicator was inversely associated with mortality (P for trend < 0.05). After adjustment for age, smoking, and alcohol consumption, the relative risk in the group with the healthiest diet indicator compared with the group with the least healthy was 0.87 (95% confidence interval 0.77 to 0.98). Estimated relative risks were essentially similar within each country. CONCLUSIONS: Dietary intake of men aged 50-70 is associated with a 20 year, all cause mortality in different cultures. The healthy diet indicator is useful in evaluating the relation of mortality to dietary patterns.

Aged↗
PubMed2003

Dietary patterns and changes in body mass index and waist circumference in adults.

BACKGROUND: Obesity has increased > 20% in the past decade in the United States, and more than one-half of US adults are overweight or obese. OBJECTIVE: Our objective was to further elucidate the nutritional etiology of changes in body mass index (BMI; in kg/m(2)) and waist circumference by dietary intake pattern. We hypothesized that a healthy dietary pattern would lead to smaller changes in BMI and waist circumference than would other dietary patterns. DESIGN: Subjects were 459 healthy men and women participating in the ongoing Baltimore Longitudinal Study of Aging. Diet was assessed with the use of 7-d dietary records, from which 41 food groups were created and entered into a cluster analysis. RESULTS: Five dietary patterns were derived (healthy, white bread, alcohol, sweets, and meat and potatoes). The mean annual change in BMI was 0.30 +/- 0.06 for subjects in the meat-and-potatoes cluster and 0.05 +/- 0.06 for those in the healthy cluster (P < 0.01). The mean annual change in waist circumference was more than 3 times as great for subjects in the white-bread cluster (1.32 +/- 0.29 cm) as for those in the healthy cluster (0.43 +/- 0.27 cm) (P < 0.05). CONCLUSIONS: Consuming a diet high in fruit, vegetables, reduced-fat dairy, and whole grains and low in red and processed meat, fast food, and soda was associated with smaller gains in BMI and waist circumference. Because foods are not consumed in isolation, dietary pattern research based on natural eating behavior may be useful in understanding dietary causes of obesity and in helping individuals trying to control their weight.

Adult↗
PubMed2005

Anthropometric characteristics, dietary patterns and risk of type 2 diabetes mellitus in Vietnam.

OBJECTIVE: To determine the impact of anthropometric characteristics and dietary patterns on Type 2 diabetes mellitus in Vietnam. METHODS: Data from 144 subjects (9m/39f newly diagnosed diabetics; 18m/78f control subjects) were analyzed in this case-control study. Height, weight, waist and hip circumferences and percent body fat were measured. Dietary intakes were assessed by 24-hour recall on three non-consecutive weekdays. Fasting blood samples were collected for the analysis of plasma glucose, fructosamine, protein and lipid concentrations. RESULTS: Although the body mass index (BMI, kg/m(2)) was similar between diabetic and control subjects, diabetic subjects had significantly greater percent body fat (31.1 +/- 5.8% vs. 27.7 +/- 6.2%) and waist-hip ratios (WHR, 0.91 +/- 0.07 vs. 0.86 +/- 0.08). Diabetic subjects had higher intakes of protein (p < 0.01), especially animal protein (p < 0.001), and consumed more meat (p < 0.01) than control subjects. Percent body fat and WHR were positively associated with diabetes (odds ratios [OR] 1.53 [95%CI 1.29-1.79] and 1.09 [95% CI 0.89-1.58], respectively) as were protein intake (OR 1.21 [95% CI 1.12-1.31]) and animal protein intake (OR 1.18 [95% CI 1.10-1.26]). CONCLUSIONS: This study indicates that percent body fat and WHR are risk factors associated with diabetes even when the BMI is normal. Evolving dietary patterns with increasingly more protein and meat consumption may also contribute to the deterioration of glucose metabolism among Vietnamese people.

Adipose Tissue↗
PubMed2005

A homocysteine metabolism-related dietary pattern and the risk of coronary heart disease in two independent German study populations.

A biomarker profile of high folate and vitamin B-12 and low plasma homocysteine concentrations reduces the risk of coronary heart disease (CHD) and may be linked to diet. The objectives of the present study were to identify a food pattern related to these biomarkers and to examine its association with CHD risk. Dietary patterns related to biomarker plasma concentrations were constructed from data obtained in the Coronary Risk Factors for Atherosclerosis in Women (CORA) Study (200 cases; 255 controls) using the reduced rank regression statistical method. Risks for CHD with relation to the identified pattern were estimated in the CORA study and in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study with 157 cases of incident myocardial infarction among 26,795 participants. In these 2 German study populations, whole-grain bread, fresh fruit, olive oil, mushrooms, cruciferous vegetables, wine, and nuts contributed the most positively and fried potatoes the most negatively to a dietary pattern that was directly associated with both plasma folate and vitamin B-12 concentrations, but inversely with plasma homocysteine. Multivariate-adjusted relative risks for CHD across increasing quintiles of the food pattern score were 1.0, 0.55, 0.52, 0.58, 0.39 (P for trend = 0.05) in the case-control sample and 1.0, 0.95, 0.75, 0.56, 0.72 (P for trend = 0.041) in the prospective study. The combination of a high intake of whole-grain bread, fresh fruit, olive oil, mushrooms, cruciferous vegetables, wine, and nuts with a low intake of fried potatoes was associated with a favorable biomarker profile of homocysteine metabolism and reduced risk of CHD.

Aged↗
PubMed2002

Dietary patterns and nutrient intakes of 7-year-old children taking part in an atherosclerosis prevention project in Finland.

OBJECTIVE: To evaluate the dietary patterns of 7-year-old children participating in an atherosclerosis prevention project and the relationship of those dietary patterns to nutrient intakes and serum cholesterol values. DESIGN: In the randomized, prospective Special Turku Coronary Risk Factor Intervention Project (STRIP) 1,062 children were randomly assigned to an intervention group (n=540; low-saturated fat, low-cholesterol diet) or to a control group (n=522; unrestricted diet) at 7 months of age. SUBJECTS/SETTINGS: The intervention families received, at 6-month intervals, individualized counseling that focused on the known environmental atherosclerosis risk factors and aimed at reducing children's saturated fat and cholesterol intake. Nutrition counseling was targeted at the child but, because of the young age of the children, was given to the parents. When children were 7 years old, food and nutrient intakes of 307 intervention and 323 control children were studied using 4-day food records. STATISTICAL ANALYSES PERFORMED: K-means cluster analysis was used to classify children into 4 groups on the basis of similarity of food intake. Differences in nutrient intakes and serum lipid concentrations between children in the 4 food intake clusters were evaluated using Tukey's multiple comparison test. RESULTS: Intervention children dominated the bread, skim milk, and margarine cluster and the cereals, rice, and pasta cluster whereas the 1.5%-fat milk and butter cluster included mainly control children. Saturated fat intake was nearest to the recommendations, that is 11.7% and 11.9% of energy, in the bread, skim milk, and margarine cluster and the cereals, rice, and pasta cluster, respectively. Children in the bread, skim milk, and margarine cluster had 20% to 27% higher fiber intakes (P<.001) whereas children in the sugar and sweets cluster had markedly higher sugar intakes than children in other clusters (P<.001). Serum cholesterol concentrations were lower in those clusters with high dietary ratios of polyunsaturated to saturated fat. CONCLUSION: Detailed and repeated dietary counseling of parents, starting when children are aged 7 months, that aims at decreasing children's exposure to known nutrition risk factors for coronary heart disease modifies children's food patterns and nutrient intakes toward expected values.

Arteriosclerosis↗
PubMed2004

Dietary patterns and risk of colon cancer and adenoma in a cohort of men (United States).

BACKGROUND: Examining the effects of dietary patterns on cancer risk may provide insights beyond the assessment of individual foods or nutrients. DESIGN: In the health professionals follow-up cohort, associations between the 'prudent' and the 'western' dietary pattern and risk of colon cancer and adenomas were examined in 561 colon cancer cases and 1207 distal colon adenoma cases. RESULTS: Higher prudent pattern scores were only weakly and non-significantly associated with decreased risk of colon cancer or distal colon adenoma (highest versus lowest quintile: colon cancer: multivariate adjusted relative risk (RR) = 0.84 (95% confidence interval (CI) = 0.64-1.10); p(trend) = 0.37; distal adenoma: multivariate odds ratio (OR) = 0.88 (95% CI = 0.73-1.08); p(trend) = 0.12). Our findings suggest a moderately increased risk of colon cancer and distal adenoma with higher western pattern scores (colon cancer: RR = 1.27 (95% CI = 0.96-1.69), p(trend) = 0.05; distal adenoma: OR = 1.28 (95% CI = 1.05-1.56), p(trend) = 0.01). Adding body mass index, which is positively related to western pattern and thus may be considered an intermediate endpoint between western pattern and colon cancer, attenuated associations somewhat but not substantially. CONCLUSION: Our data do not provide evidence for an appreciable inverse association between higher prudent pattern scores and risk of colon cancer or distal colon adenomas, but do support a moderate positive association between higher western pattern scores and risk of colon cancer or distal colon adenomas.

Adenoma↗
PubMed2004

Dietary patterns predict mortality in a national cohort: the National Health Interview Surveys, 1987 and 1992.

We examined the association of mortality and dietary patterns using data from the National Health Interview Surveys of 1987 and 1992 (n = 10,084), aged >/=45 y at baseline (with 2287 deaths due to all causes over 5.9 median years of follow-up). The approximately 60-item FFQ administered at baseline was examined for mentions of foods and dietary behaviors recommended in current dietary guidance (fruits, vegetables, lean poultry and alternates, low-fat dairy, and whole grains), and the resulting patterns were expressed as follows: 1) a Recommended Foods and Behavior Score (RFBS), 2) factor scores from factor analysis, and 3) clusters from cluster analysis. The multivariate-adjusted relative risk (RR) of mortality for each of the 3 types of dietary patterns was examined using Cox proportional hazards regression analysis. In men, RR of all-cause mortality was 0.72 (95% CI: 0.56, 0.92, P for trend < 0.001) for RFBS, and 0.74 (95% CI: 0.57, 0.95, P for trend = 0.002) for the fruit-vegetable-whole grain factor score when comparing extreme quartiles. Membership in 1 of the 4 clusters also was associated with lower risk in men (RR = 0.82, 95% CI: 0.66, 1.01). For women, the RFBS was a modest inverse predictor of mortality after multivariate adjustment (RR = 0.80, 95% CI: 0.61, 1.04, P for trend = 0.04), but estimates for factor and cluster patterns were attenuated. The population-attributable fraction due to diet was 0.16 in men and 0.09 in women. Dietary patterns characterized by compliance with prevailing food-based dietary guidance were associated with a lower risk of all-cause mortality.

Aged↗