Abstract
Objective: The objective of this study was to assess the prospective association between diet quality, as well as a 6-year change in diet quality, and risk of incident CVD and diabetes in a community-based population.Design: We used Cox regression models to estimate the prospective association between diet quality, assessed using the Healthy Eating Index (HEI)-2015 and the Alternative HEI (AHEI)-2010 scores, as well as change in diet quality, and incident CVD and diabetes.Setting: The ARIC Study recruited 15 792 black and white men and women (45-64 years) from four US communities.Participants: We included 10 808 study participants who reported usual dietary intake via FFQ at visit 1 (1987-1989) and who had not developed CVD, diabetes, or cancer at baseline.Results: Overall, 3070 participants developed CVD (median follow-up of 26 years) and 3452 developed diabetes (median follow-up of 22 years) after visit 1. Higher diet score at the initial visit was associated with a significantly lower risk of CVD (HR per 10 % higher HEI-2015 diet quality score: 0·90 (95 % CI: 0·86, 0·95) and HR per 10 % higher AHEI-2010 diet quality score: 0·96 (95 % CI: 0·93, 0·99)). We did not observe a significant association between initial diet score and incident diabetes. There were no significant associations between change in diet score and CVD or diabetes risk in the overall study population.Conclusions: Higher diet quality assessed using HEI-2015 and AHEI-2010 was strongly associated with lower CVD risk but not diabetes risk within a middle-aged, community-based US population.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 329-338 |
| Number of pages | 10 |
| Journal | Public health nutrition |
| Volume | 23 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2020 |
Bibliographical note
Funding Information:Acknowledgements: The authors thank the staff and participants of the Atherosclerosis Risk in Communities (ARIC) Study for their important contributions. Financial support: The Atherosclerosis Risk in Communities study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, HHSN268201700005I). C.M.R. was supported by a Mentored Research Scientist Development Award from the National Institute of Diabetes and Digestive and Kidney Disease (K01 DK107782). E.S. was supported by NIH/NIDDK grants K24DK106414 and R01DK089174. Z.X. was supported by the China Scholarship Council (CSC). The funders had no role in the design, analysis, or writing of this article. Conflicts of interest: None. Authorship: The authors’ contributions to the manuscript were as follows: Z.X., C.M.R., and E.S. designed the research; E.S. and C.M.R. provided databases; Z.X. performed the statistical analysis; Z.X. drafted the manuscript; and L.M.S., E.S., and C.M.R. provided critical feedback on the manuscript. Z.X. and C.M.R. had primary responsibility for final content. All authors have read and approved the final manuscript. Ethics of human subject participation: This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects were approved by Institutional Review Boards at all participating study centres. Written informed consent was obtained from all subjects.
Publisher Copyright:
© 2019 The Authors.
Keywords
- AHEI-2010
- CVD
- Diabetes
- Diet quality
- HEI-2015
