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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Background
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Background
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Diet Quality Changes by Educational Level among Adults in Spain from 2017 to 2021
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Lower Vegetable Variety and Worsening Diet Quality Over Time Are Associated With Higher 15-Year Health Care Claims and Costs Among Australian Women
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Food Compass Score predicts incident cardiovascular disease: The ATTICA cohort study (2002–2022)
Damigou, E., Detopoulou, P., Antonopoulou, S., Chrysohoou, C. A., Barkas, F., Vlachopoulou, E., Vafia, C., Tsioufis, C. P., Liberopoulos, E. N., Sfikakis, P. P., et al. (2023) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.13247 · Cited by 6
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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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