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Association of Changes in Diet Quality with Total and Cause-Specific Mortality
Open accessAbstract
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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“A core component of CC models is the involvement of several health care professionals working together; with CC teams typically including a physician, a case manager, and a mental health clinician.357,358”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [357]
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Metadata
- 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
- 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
- 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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