Cited by 466Nutritional Studies and DietNutrition, Genetics, and DiseaseCardiovascular Health and Risk Factors

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Association of Changes in Diet Quality with Total and Cause-Specific Mortality

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Sotos-Prieto, Mercedes, Bhupathiraju, Shilpa N., Mattei, Josiemer, Fung, Teresa T., Li, Yanping, Pan, An, Willett, Walter C., Rimm, Eric B., Hu, Frank B.·2017·New England Journal of Medicine

DOI 10.1056/nejmoa1613502PMC PMC5589446

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Abstract

BACKGROUND: Few studies have evaluated the relationship between changes in diet quality over time and the risk of death. METHODS: We used Cox proportional-hazards models to calculate adjusted hazard ratios for total and cause-specific mortality among 47,994 women in the Nurses' Health Study and 25,745 men in the Health Professionals Follow-up Study from 1998 through 2010. Changes in diet quality over the preceding 12 years (1986-1998) were assessed with the use of the Alternate Healthy Eating Index-2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score. RESULTS: The pooled hazard ratios for all-cause mortality among participants who had the greatest improvement in diet quality (13 to 33% improvement), as compared with those who had a relatively stable diet quality (0 to 3% improvement), in the 12-year period were the following: 0.91 (95% confidence interval [CI], 0.85 to 0.97) according to changes in the Alternate Healthy Eating Index score, 0.84 (95 CI%, 0.78 to 0.91) according to changes in the Alternate Mediterranean Diet score, and 0.89 (95% CI, 0.84 to 0.95) according to changes in the DASH score. A 20-percentile increase in diet scores (indicating an improved quality of diet) was significantly associated with a reduction in total mortality of 8 to 17% with the use of the three diet indexes and a 7 to 15% reduction in the risk of death from cardiovascular disease with the use of the Alternate Healthy Eating Index and Alternate Mediterranean Diet. Among participants who maintained a high-quality diet over a 12-year period, the risk of death from any cause was significantly lower - by 14% (95% CI, 8 to 19) when assessed with the Alternate Healthy Eating Index score, 11% (95% CI, 5 to 18) when assessed with the Alternate Mediterranean Diet score, and 9% (95% CI, 2 to 15) when assessed with the DASH score - than the risk among participants with consistently low diet scores over time. CONCLUSIONS: Improved diet quality over 12 years was consistently associated with a decreased risk of death. (Funded by the National Institutes of Health.).

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RETRACTED: Primary Prevention of Cardiovascular Disease with a Mediterranean Diet
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The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study
Adawi, M., Damiani, G. B., Bragazzi, N. L., Bridgewood, C., Pacifico, A., Conic, R. R. Z., Morrone, A., Malagoli, P., Pigatto, P. D. M., Amital, H., et al. (2019) · Nutrients · doi:10.3390/nu11030601 · Cited by 90
“Dietary habits have been found to have a significant impact on human health, affecting the risk for hypertension and cardiovascular diseases, as well as influencing the risk of developing malignant conditions and impacting on mortality [12].”
Background
Association between the Mediterranean lifestyle, metabolic syndrome and mortality: a whole-country cohort in Spain
Sotos‐Prieto, M., Ortolá, R., Ruiz‐Canela, M., García‐Esquinas, E., Martínez‐Gómez, D., López‐García, E., Martínez‐González, M. Á., & Rodríguez‐Artalejo, F. (2021) · Cardiovascular Diabetology · doi:10.1186/s12933-020-01195-1 · Cited by 91
Dietary and Lifestyle-Centered Approach in Gout Care and Prevention
Yokose, C., McCormick, N., & Choi, H. K. (2021) · Current Rheumatology Reports · doi:10.1007/s11926-021-01020-y · Cited by 98
Whole Blood DNA Methylation Signatures of Diet Are Associated With Cardiovascular Disease Risk Factors and All-Cause Mortality
Ma, J., Rebholz, C. M., Braun, K. V. E., Reynolds, L. M., Aslibekyan, S. W., Xia, R., Biligowda, N., Huan, T., Liu, C., Mendelson, M., et al. (2020) · Circulation Genomic and Precision Medicine · doi:10.1161/circgen.119.002766 · Cited by 89
Planetary health diet and cardiovascular disease: results from three large prospective cohort studies in the USA
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Metabolic syndrome and cancer: “The common soil hypothesis”
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Evaluation of the Validity and Reliability of the Chinese Healthy Eating Index
Yuan, Y., Li, F., Wu, H., Wang, Y.-C., Chen, J., He, G., Li, S., & Chen, B. (2018) · Nutrients · doi:10.3390/nu10020114 · Cited by 81
“Studies have proved that high-quality diets are associated with a reduction in the risk of various health outcomes, including cardiovascular diseases, cancer, type 2 diabetes mellitus, and all-cause mortality [3,4].”
Background
Method for the Development of WISH, a Globally Applicable Index for Healthy Diets from Sustainable Food Systems
Trijsburg, L. E., Talsma, E. F., Crispim, S. P., Garrett, J., Kennedy, G., de Vries, J. H. M., & Brouwer, I. D. (2020) · Nutrients · doi:10.3390/nu13010093 · Cited by 87
“Another approach, which is used for many national food based dietary guidelines (FBDG) often take into account the current dietary pattern and recognize that even small deviations towards a healthy dietary pattern can lead to positive health outcomes [28,29].”
Background
Dietary patterns, dietary nutrients and cardiovascular disease
Nestel, P. J., & Mori, T. A. (2022) · Reviews in Cardiovascular Medicine · doi:10.31083/j.rcm2301017 · Cited by 95
“The US Nurses’ Health Study (47,994 women) and the Health Professionals Follow-up Study (25,745 men) reported significantly lower CVD event rates over 12-years [17].”
Background
Overweight, Obesity, and CVD Risk: a Focus on Visceral/Ectopic Fat
Chartrand, D. J., Murphy-Després, A., Alméras, N., Lemieux, I., Larose, É., & Després, J. (2022) · Current Atherosclerosis Reports · doi:10.1007/s11883-022-00996-x · Cited by 87
Effects of Diet and Sodium Reduction on Cardiac Injury, Strain, and Inflammation
Juraschek, S. P., Kovell, L. C., Appel, L. J., Miller, E. R., Sacks, F. M., Chang, A. R., Christenson, R. H., Rebuck, H., & Mukamal, K. J. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.03.320 · Cited by 78
Recommendation-based dietary indexes and risk of colorectal cancer in the Nurses’ Health Study and Health Professionals Follow-up Study
Petimar, J., Smith‐Warner, S. A., Fung, T. T., ROSNER, B. A., Chan, A. T., Hu, F. B., Giovannucci, E. L., & Tabung, F. K. (2018) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqy171 · Cited by 76
Health Center–Based Community-Supported Agriculture: An RCT
Berkowitz, S. A., O’Neill, J., Sayer, E., Shahid, N. N., Petrie, M., Schouboe, S., Saraceno, M., & Bellin, R. (2019) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2019.07.015 · Cited by 74
Adherence to the Dietary Approaches to Stop Hypertension Diet and Hyperuricemia: A Cross‐Sectional Study
Gao, Y., Cui, L., Sun, Y., Yang, W., Wang, J., Wu, S., & Gao, X. (2020) · Arthritis Care & Research · doi:10.1002/acr.24150 · Cited by 72
“Higher diet quality has been reported to be associated with better health status and lower mortality rate (15).”
Background
Comparing the Recommended Eating Patterns of the EAT-Lancet Commission and Dietary Guidelines for Americans: Implications for Sustainable Nutrition
Blackstone, N. T., & Conrad, Z. (2020) · Current Developments in Nutrition · doi:10.1093/cdn/nzaa015 · Cited by 71
“The “small changes” approach (15–17) recognizes that even moderate dietary shifts can lead to positive health outcomes (18), so individuals should strive to make incremental dietary improvements that can be more easily adopted and sustained, rather than making more extensive changes all at once (15–17).”
Background
Gut Microbiota and Salivary Diagnostics: The Mouth Is Salivating to Tell Us Something
Kodukula, K., Faller, D. V., Harpp, D. N., Kanara, I., Pernokas, J., Pernokas, M., Powers, W. R., Soukos, N. S., Steliou, K., & Moos, W. H. (2017) · BioResearch open access · doi:10.1089/biores.2017.0020 · Cited by 70
Perspective: Beyond the Mediterranean Diet—Exploring Latin American, Asian, and African Heritage Diets as Cultural Models of Healthy Eating
LeBlanc, K., Baer-Sinnott, S., Lancaster, K. J., Campos, H., Lau, K. H. K., Tucker, K. L., Kushi, L. H., & Willett, W. C. (2024) · Advances in Nutrition · doi:10.1016/j.advnut.2024.100221 · Cited by 75
“These scores predict mortality and a wide variety of other health outcomes across different cultures [84,85], although studies among populations of Asia, Africa, and Latin America remain limited.”
Association of Changes in Cardiovascular Health Metrics and Risk of Subsequent Cardiovascular Disease and Mortality
Gaye, B., Tajeu, G. S., Vasan, R. S., Lassale, C. M., Allen, N. B., Singh‐Manoux, A., & Jouven, X. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.120.017458 · Cited by 66
The influence of sleep health on dietary intake: a systematic review and meta‐analysis of intervention studies
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Estimating the effect of nutritional interventions using observational data: the American Heart Association’s 2020 Dietary Goals and mortality
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Poor appetite and overeating reported by adults in Australia during the coronavirus-19 disease pandemic: a population-based study
Owen, A., Tran, T. D., Hammarberg, K., Kirkman, M., & Fisher, J. (2020) · Public Health Nutrition · doi:10.1017/s1368980020003833 · Cited by 66
Diet quality trends among adults with diabetes by socioeconomic status in the U.S.: 1999–2014
Orr, C. J., Keyserling, T. C., Ammerman, A. S., & Berkowitz, S. A. (2019) · BMC Endocrine Disorders · doi:10.1186/s12902-019-0382-3 · Cited by 68
“The HEI 2010 has been validated in previous research [14] and shown to be associated with diabetes prevalence [15], glycemic control [7], and with risk for a variety of other common chronic diseases [15, 16].”
Method
Effects of the Modified DASH Diet on Adults With Elevated Blood Pressure or Hypertension: A Systematic Review and Meta-Analysis
Guo, R., Li, N., Yang, R., Liao, X.-Y., Zhang, Y., Zhu, B.-F., Zhao, Q., Chen, L., Zhang, Y.-G., & Lei, Y. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.725020 · Cited by 62
“Exclusion criteria were as follows: (1) study design: case reports, case series, observational studies, and animal research; (2) participants: individuals <18 years of age, pregnant women, and acute patients; (3) comparison: other different routes of modified DASH diet; (4) outcomes: outcomes with insufficient data, s…”
BackgroundMethod
Three decades of the Mediterranean diet pyramid: A narrative review of its history, evolution, and advances
Hu, F. B., Drescher, G., Trichopoulou, A., Willett, W. C., & Martínez‐González, M. Á. (2025) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2025.04.036 · Cited by 64
“with an 8 – 17% lower risk of mortality for every 20-percentile increase in diet quality scores [28].”
The Association of Energy and Macronutrient Intake at Dinner Versus Breakfast With Disease-Specific and All-Cause Mortality Among People With Diabetes: The U.S. National Health and Nutrition Examination Survey, 2003–2014
Han, T., Gao, J., Wang, L., Li, C., Qi, L., Sun, C., & Li, Y. (2020) · Diabetes Care · doi:10.2337/dc19-2289 · Cited by 60
“The most important finding of this study was that higher intake of energy at dinner than breakfast was significantly associated with diabetes and CVD mortality, and this association was independent of a series of traditional dietary risk factors, in particular, breakfast skipping anddiet quality (27,28).”
Background
Dietary protein intake in midlife in relation to healthy aging – results from the prospective Nurses’ Health Study cohort
Korat, A. V. A., Shea, M. K., Jacques, P. F., Sebastiani, P., Wang, M., Eliassen, A. H., Willett, W. C., & Sun, Q. (2024) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.11.010 · Cited by 66
“Diet is an important modi ﬁ able factor of several chronic diseases [3,4], frailty [5], premature death [6], and successful or healthy aging [7,8], which are relevant to this vulnerable population.”
Background
What Are the Most Effective Behavioural Strategies in Changing Postpartum Women’s Physical Activity and Healthy Eating Behaviours? A Systematic Review and Meta-Analysis
Lim, S., Hill, B., Pirotta, S., O’Reilly, S., & Moran, L. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9010237 · Cited by 58
“However, improved diet quality independent of weight changes could improve total and cause-specific mortality [53], and considering the high risk of weight gain in this population [54], a modest energy restriction to prevent further weight gain could support chronic diseases prevention [55].”
Background
Association between improved adherence to the Japanese diet and incident functional disability in older people: The Ohsaki Cohort 2006 Study
Matsuyama, S., Zhang, S., Tomata, Y., Abe, S., Tanji, F., Sugawara, Y., & Tsuji, I. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2019.10.008 · Cited by 56
Association of dietary diversity changes and mortality among older people: A prospective cohort study
Liu, D., Zhang, X., Li, Z., Zhang, Y., Lv, Y., Wang, Z., Shen, D., Chen, P., Zhong, W.-F., Huang, Q., et al. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.04.012 · Cited by 57
Unhealthy Lifestyle, Genetics and Risk of Cardiovascular Disease and Mortality in 76,958 Individuals from the UK Biobank Cohort Study
Livingstone, K. M., Abbott, G., Ward, J., & Bowe, S. J. (2021) · Nutrients · doi:10.3390/nu13124283 · Cited by 63
Diet quality indices, genetic risk and risk of cardiovascular disease and mortality: a longitudinal analysis of 77 004 UK Biobank participants
Livingstone, K. M., Abbott, G., Bowe, S. J., Ward, J., Milte, C. M., & McNaughton, S. A. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-045362 · Cited by 55
Calories Purchased by Hospital Employees After Implementation of a Cafeteria Traffic Light–Labeling and Choice Architecture Program
Thorndike, A. N., Gelsomin, E. D., McCurley, J. L., & Levy, D. E. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.6789 · Cited by 57
A Coaching Program to Improve Dietary Intake of Patients with CKD
Kelly, J. T., Conley, M. M., Hoffmann, T., Craig, J. C., Tong, A., Reidlinger, D. P., Reeves, M. M., Howard, K., Krishnasamy, R., Kurtkoti, J., et al. (2020) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.12341019 · Cited by 56
Social norm nudges in shopping trolleys to promote vegetable purchases: A quasi-experimental study in a supermarket in a deprived urban area in the Netherlands
Huitink, M., Poelman, M. P., van den Eynde, E., Seidell, J. C., & Dijkstra, S. C. (2020) · Appetite · doi:10.1016/j.appet.2020.104655 · Cited by 56
Association between dietary carbohydrate quality and the prevalence of obesity and hypertension
Kim, D.-Y., Kim, S. H., & Lim, H. (2018) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12559 · Cited by 59
“A 12-year follow-up study suggested that an improved diet was associated with a decreased risk of death from cardiovascular disease related to metabolic disorders ((4)).”
Validity and Reproducibility of a Semiquantitative Food Frequency Questionnaire for Measuring Intakes of Foods and Food Groups
Gu, X., Wang, D. D., Sampson, L., Barnett, J. B., Rimm, E. B., Stampfer, M. J., Djoussé, L., ROSNER, B. A., & Willett, W. C. (2023) · American Journal of Epidemiology · doi:10.1093/aje/kwad170 · Cited by 52
Impact of Genes and Environment on Obesity and Cardiovascular Disease
Heianza, Y., & Qi, L. (2018) · Endocrinology · doi:10.1210/en.2018-00591 · Cited by 54
Strong inverse associations of Mediterranean diet, physical activity and their combination with cardiovascular disease: The Seguimiento Universidad de Navarra (SUN) cohort
Álvarez‐Álvarez, I., de Rojas, J. P., Fernández‐Montero, A., Zazpe, I., Ruiz‐Canela, M., Hidalgo-Santamaría, M., Bes‐Rastrollo, M., & Martínez‐González, M. Á. (2018) · European Journal of Preventive Cardiology · doi:10.1177/2047487318783263 · Cited by 53
Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial
Weber, B., Bersch-Ferreira, Â. C., Torreglosa, C. R., Marcadenti, A., Lara, E. S., da Silva, J. T., Costa, R. P., Santos, R. H. N., Berwanger, O. B., Bosquetti, R., et al. (2019) · American Heart Journal · doi:10.1016/j.ahj.2019.06.010 · Cited by 53
Diet quality as a predictor of cardiometabolic disease–free life expectancy: the Whitehall II cohort study
Lagström, H., Stenholm, S., Akbaraly, T. N., Pentti, J., Vahtera, J., Mika Kivimaki, B., & Head, J. A. (2019) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqz329 · Cited by 57
Changes in Overall Diet Quality in Relation to Survival in Postmenopausal Women with Breast Cancer: Results from the Women’s Health Initiative
Sun, Y., Bao, W., Liu, B., Caan, B. J., Lane, D. S., Millen, A. E., Simon, M. S., Thomson, C. A., Tinker, L. F., Horn, L. V., et al. (2018) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2018.03.017 · Cited by 49
Lifestyle management to prevent atherosclerotic cardiovascular disease: evidence and challenges
Trier, T. J. V., Mohammadnia, N., Snaterse, M., Peters, R. J. G., Jorstad, H. T., & Bax, W. A. (2021) · Netherlands Heart Journal · doi:10.1007/s12471-021-01642-y · Cited by 56
“On the other hand, in a recent large prospective study, adherence to a DASH-style diet was significantly associated only with all-cause mortality but not cardiovascular mortality [43].”
Result
Increased Adherence to a Mediterranean Diet Is Associated With Reduced Low-Grade Inflammation after a 12.7-Year Period: Results From the Moli-sani Study
Bonaccio, M., Costanzo, S., Castelnuovo, A. F. D., Gialluisi, A., Ruggiero, E., Curtis, A. D., Persichillo, M., Cerletti, C., Donati, M. B., de Gaetano, G., et al. (2022) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2022.12.005 · Cited by 53
Diet quality and its association with nonalcoholic fatty liver disease and all‐cause and cause‐specific mortality
Yoo, E. R., Kim, D., Vazquez‐Montesino, L. M., Escober, J. A., Li, A. A., Tighe, S. P., Fernandes, C. T., Cholankeril, G. T., & Ahmed, A. (2020) · Liver International · doi:10.1111/liv.14374 · Cited by 48
Plant‐Centered Diet and Risk of Incident Cardiovascular Disease During Young to Middle Adulthood
Choi, Y., Larson, N., Steffen, L. M., Schreiner, P. J., Gallaher, D. D., Duprez, D. A., Shikany, J. M., Rana, J. S., & Jacobs, D. R. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.120.020718 · Cited by 49
Associations of combined healthy lifestyles with cancer morbidity and mortality among individuals with diabetes: results from five cohort studies in the USA, the UK and China
Zhang, Y., Pan, X., Lu, Q., Wang, Y.-X., Geng, T., Zhou, Y., Liao, L. M., Tu, Z., Chen, J., Xia, P., et al. (2022) · Diabetologia · doi:10.1007/s00125-022-05754-x · Cited by 48
“Such methods were widely used in previous pooling projects [25, 26].”
Method
Mediterranean Diet Adherence and Risk of All-Cause Mortality in Women
Ahmad, S., Moorthy, M. V., Lee, I.-M. M., Ridker, P. M., Manson, J. E., Buring, J. E., Demler, O., & Mora, S. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.14322 · Cited by 55
Sleep and Dietary Patterns in Pregnancy: Findings from the GUSTO Cohort
van Lee, L., Chia, A., Loy, S. L., Colega, M., Tham, E. K. H., Cai, S., Yap, F. K. P., Godfrey, K. M., Teoh, O. H., Goh, D. Y. T., et al. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14111409 · Cited by 45
“Furthermore, even moderate changes in diet quality have been shown to decrease the risk of death meaningfully [39].”
Background
Associations of dairy product consumption with mortality in the European Prospective Investigation into Cancer and Nutrition (EPIC)–Italy cohort
Pala, V. M., Sieri, S., Chiodini, P., Masala, G., Palli, D., Mattiello, A., Panico, S., Tumino, R., Frasca, G., Fasanelli, F., et al. (2019) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqz183 · Cited by 44
“A healthy diet is associated with decreased risk of death (1).”
Background
Mediating-Moderating Effect of Allostatic Load on the Association between Dietary Approaches to Stop Hypertension Diet and All-Cause and Cause-Specific Mortality: 2001–2010 National Health and Nutrition Examination Surveys
Beydoun, H. A., Huang, S., Beydoun, M. A., Hossain, S. A., & Zonderman, A. B. (2019) · Nutrients · doi:10.3390/nu11102311 · Cited by 44
“Broadly speaking, the DASH dietary pattern has been linked to reductions of 8–22% in all-cause mortality, 19–28% in cardiovascular disease-specific mortality and 11–23% in cancer-specific mortality risks [9].”
BackgroundResult

Authors: Sotos-Prieto, M., Bhupathiraju, S. N., Mattei, J., Fung, T. T., Li, Y., Pan, A., Willett, W. C., Rimm, E. B., & Hu, F. B.
Affiliations: Brigham and Women's Hospital (US)
ORCID: Bhupathiraju, Shilpa N.
Mattei, Josiemer
Fung, Teresa T.
Li, Yanping
Pan, An
Willett, Walter C.
Rimm, Eric B.
Hu, Frank B.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2017-07-13
Volume: 377
Issue: 2
Pages: 143-153
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa1613502
PMC: PMC5589446
OpenAlex: W2734661169
Cited by: 466
References: 37
Citations by year: 2026: 27 · 2025: 38 · 2024: 45 · 2023: 55 · 2022: 47 · 2021: 76 · 2020: 66 · 2019: 46 · 2018: 56 · 2017: 10
FWCI: 45.71
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5k01hl120951-05)
National Heart, Lung, and Blood Institute (R01HL060712, K01‐HL120951, R01HL035464, R01HL034594, R01HL088521)
National Cancer Institute (P01CA087969, P01CA055075, UM1CA186107, UM1CA167552)
National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords: diet quality, dietary change over time, all-cause mortality, cause-specific mortality, cardiovascular mortality, Alternative Healthy Eating Index, alternate Mediterranean diet, DASH diet, diet quality index, Nurses' Health Study, Health Professionals Follow-up Study, men and women comparison, diet and longevity, diet and disease prevention, diet and cancer prevention
MeSH terms: Diet, Healthy, Adult, Aged, Cause of Death, Diet, Female, Follow-Up Studies, Humans, Male, Middle Aged, Risk, Multivariate Analysis, Proportional Hazards Models

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Association of Changes in Diet Quality with Total and Cause-Specific Mortality

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