Introduction
Methods
Study sample
Medical examination
Dietary assessment
Dietary Approaches to Stop Hypertension score
Modified Mediterranean Diet Score
Healthy Nordic Food Index
Statistical analysis
Association of adherence to defined dietary patterns with mortality
Stratified analyses, assessment of interactions, and sensitivity analysis
Association of adherence to defined food groups with mortality
Results
Characterization of the study sample
Total sample (n = 836) | Deceased1 (n = 93) | Alive1 (n = 743) | |
---|---|---|---|
Survival time in years1 | 11 [10; 11] | 8 [5; 10] | 11 [10; 12] |
Female sex, n (%) | 366 (43.8%) | 27 (29.0%) | 339 (45.6%) |
Age in years | 62.4 [55.1; 71.1] | 71.9 [64.1; 76.5] | 61.7 [54.1; 70.1] |
Height in cm | 171.5 [164.0; 178.5] | 170.0 [164.0; 176.5] | 172.0 [164.0; 178.5] |
Weight in kg | 79.5 [69.6; 90.7] | 76.2 [67.5; 87.7] | 79.7 [69.8; 91.0] |
BMI in kg/m2 | 26.7 [24.3; 29.7] | 26.6 [24.2; 30.1] | 26.7 [24.3; 29.6] |
WHR | 0.94 [0.88; 1.00] | 0.98 [0.92; 1.03] | 0.94 [0.88; 1.00] |
Diabetes, n (%) | 78 (9.3%) | 20 (21.5%) | 58 (7.8%) |
Hypertension3, n (%) | 537 (64.3%) | 73 (78.5%) | 464 (62.5%) |
Physical Activity in MET-h/week | 88.6 [57.5; 129.2] | 77.0 [53.0; 123.6] | 90.0 [58.5; 130.5] |
DASH | 24 [20; 27] | 24 [22; 27] | 24 [20; 27] |
DASH (energy-adjusted)2 | 23.7 [20.4; 27.0] | 24.4 [22.0; 27.0] | 23.6 [20.3; 27.1] |
MMDS | 5 [4; 6] | 5 [4; 6] | 5 [4; 6] |
MMDS (energy-adjusted)2 | 5.0 [3.9; 6.0] | 4.7 [3.5; 5.7] | 5.0 [3.9; 6.0] |
HNFI | 3 [2; 4] | 3 [1; 4] | 3 [2; 4] |
HNFI (energy-adjusted)2 | 3.1 [2.0; 4.2] | 2.9 [1.6; 4.2] | 3.1 [2.0; 4.2] |
Energy intake in kcal/d | 2106.7 [1753.6; 2564.2] | 2165.2 [1823.3; 2605.3] | 2100.6 [1746.7; 2555.7] |
Men | 2367.4 [2004.2; 2798.9] | 2315.0 [1934.4; 2723.9] | 2378.7 [2010.2; 2800.7] |
Women | 1821.6 [1590.9; 2129.5] | 1650.5 [1441.6; 2206.1] | 1828.0 [1597.2; 2115.1] |
Education | |||
≤ 9 years, n (%) | 287 (34.3%) | 44 (47.3%) | 243 (32.7%) |
10 years, n (%) | 281 (33.6%) | 23 (24.7%) | 258 (34.7%) |
≥ 11 years, n (%) | 268 (32.1%) | 26 (28.0%) | 242 (32.6%) |
Smoking status | |||
Never, n (%) | 353 (42.2%) | 28 (30.1%) | 325 (43.7%) |
Current, n (%) | 109 (13.0%) | 10 (10.8%) | 99 (13.3%) |
Former, n (%) | 374 (44.7%) | 55 (59.1%) | 319 (42.9%) |
Association of defined dietary pattern scores with survival
1-SD increment2 | Quartiles1 | ||||
---|---|---|---|---|---|
13 | 2 | 3 | 4 | ||
DASH | |||||
All individuals, n (%) | 836 (100.0%) | 209 (25.0%) | 209 (25.0%) | 209 (25.0%) | 209 (25.0%) |
Deceased, n (%) | 93 (11.1%) | 17 (8.1%) | 26 (12.4%) | 28 (13.4%) | 22 (10.5%) |
Score | 24 [20; 27] | 18 [17; 20] | 22 [21; 23] | 25 [24; 26] | 30 [29; 31] |
Score (energy-adjusted)4 | 23.7 [20.4; 27.0] | 18.4 [16.6; 19.4] | 22.4 [21.4; 23.0] | 25.2 [24.6; 26.2] | 29.5 [28.2; 30.8] |
Model 1 | 0.91 [0.74–1.13] | Ref | 0.97 [0.52–1.81] | 1.07 [0.59–1.95] | 0.87 [0.47–1.63] |
Model 2 | 0.95 [0.77–1.19] | Ref | 1.05 [0.56–1.96] | 1.12 [0.66–2.19] | 1.00 [0.53–1.90] |
MMDS | |||||
All individuals, n (%) | 836 (100.0%) | 209 (25.0%) | 209 (25.0%) | 209 (25.0%) | 209 (25.0%) |
Deceased, n (%) | 93 (11.1%) | 28 (13.4%) | 23 (11.0%) | 24 (11.5%) | 18 (8.6%) |
Score | 5 [4; 6] | 3 [2; 3] | 4 [4; 4] | 5 [5; 6] | 7 [7; 8] |
Score (energy-adjusted)4 | 5.0 [3.9; 6.0] | 3.0 [2.2; 3.3] | 4.2 [4.1; 4.7] | 5.2 [5.1; 5.8] | 6.9 [6.2; 7.2] |
Model 1 | 0.87 [0.71–1.06] | Ref | 0.75 [0.43–1.31] | 0.91 [0.53–1.57] | 0.65 [0.36–1.18] |
Model 2 | 0.88 [0.72–1.07] | Ref | 0.76 [0.44–1.33] | 0.98 [0.56–1.71] | 0.67 [0.37–1.23] |
HNFI | |||||
All individuals, n (%) | 836 (100.0%) | 209 (25.0%) | 209 (25.0%) | 209 (25.0%) | 209 (25.0%) |
Deceased, n (%) | 93 (11.1%) | 31 (14.8%) | 22 (10.5%) | 25 (12.0%) | 15 (7.2%) |
Score | 3 [2; 4] | 1 [0; 1] | 3 [2; 3] | 4 [4; 4] | 5 [5; 6] |
Score (energy-adjusted)4 | 3.1 [2.0; 4.2] | 1.2 [0.7; 1.5] | 2.4 [2.2; 2.8] | 3.5 [3.3; 3.8] | 4.8 [4.4; 5.3] |
Model 1 | 0.76 [0.62–0.94] | Ref | 0.56 [0.33–0.98] | 0.68 [0.40–1.15] | 0.44 [0.24–0.82] |
Model 2 | 0.79 [0.64–0.98] | Ref | 0.56 [0.32–0.98] | 0.77 [0.45–1.32] | 0.47 [0.25–0.89] |
Assessment of interactions and stratified analyses
Smoking status | BMI classes | Diabetes | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Never (n = 353) | Current (n = 109) | Former (n = 374) | p value3 | ≤ 24.9 kg/m2 (n = 257) | 25.0–29.9 kg/m2 (n = 387) | ≥ 30.0 kg/m2 (n = 192) | p value3 | No (n = 758) | Yes (n = 78) | p value3 | |
DASH1 (energy-adjusted)2 | 1.34 [0.85–2.11] | 0.40 [0.17–0.94] | 0.96 [0.73–1.27] | 0.4690 | 0.70 [0.48–1.01] | 1.25 [0.88–1.78] | 1.26 [0.78–2.04] | 0.0842 | 0.99 [0.77–1.28] | 0.85 [0.47–1.52] | 0.5825 |
MMDS1 (energy-adjusted)2 | 0.80 [0.54–1.18] | 0.51 [0.21–1.21] | 0.97 [0.74–1.26] | 0.3162 | 0.81 [0.55–1.21] | 0.99 [0.73–1.35] | 0.83 [0.55–1.25] | 0.9925 | 0.92 [0.73–1.16] | 0.51 [0.30–0.88] | 0.2382 |
HNFI1 (energy-adjusted)2 | 0.86 [0.57–1.30] | 0.41 [0.18–0.94] | 0.85 [0.65–1.11] | 0.7078 | 0.76 [0.53–1.09] | 1.00 [0.70–1.43] | 0.64 [0.41–0.99] | 0.7808 | 0.87 [0.69–1.11] | 0.39 [0.21–0.73] | 0.0251 |