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Diet quality indexes and mortality in postmenopausal women: the Iowa Women's Health Study.

ABSTRACT: A priori diet scores such as the Alternative Healthy Eating Index (AHEI) and the food-based a priori diet quality score predict chronic disease risk.We compared the AHEI and a priori diet quality score relative to mortality.Postmenopausal women who were free of diabetes, cardiovascular disease (CVD), and cancer in the Iowa Women's Health Study (in 1986, n = 29,634 with a mean 6 SD age of 61.4 6 4.2 y; in 2004, n = 15,076 with a mean 6 SD age of 79.7 6 4.0 y). A food-frequency questionnaire was used. Through 31 December 2008, 10,343 total, 3646 CVD, 3207 cancer, and 2888 inflammatory-related deaths were identified through record linkage. HRs were computed for quartiles of each diet score at baseline and 2004. To compare scores, the residual of each score given the other score was computed by using linear regression.At baseline, indexes had a correlation of 0.65. For the AHEI, the multivariable-adjusted HRs (95% CIs) for total, CVD, cancer, and inflammatory-related mortality were 0.82 (0.77, 0.87), 0.79 (0.72, 0.88), 0.88 (0.79, 0.98), and 0.76 (0.68, 0.84), respectively. The a priori score had corresponding HRs of 0.80 (0.76, 0.85), 0.79 (0.72, 0.88), 0.86 (0.77, 0.95), and 0.75 (0.67, 0.84), respectively. Each score added information to the other score for total, CVD mortality, and inflammatory-related mortality. In 2004, both scores predicted total, CVD, and inflammatory-related mortality, and the a priori score also predicted cancer mortality. The a priori score added independent information for all outcomes except cancer, whereas the AHEI added information only for total mortality.Two correlated diet quality scores predicted total and disease-specific mortality, but their residuals also predicted complementarily.

SUBMITTER: Mursu J

PROVIDER: S-EPMC3712553 | biostudies-literature | 2013 Aug

REPOSITORIES: biostudies-literature

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Diet quality indexes and mortality in postmenopausal women: the Iowa Women's Health Study.

Mursu Jaakko J Steffen Lyn M LM Meyer Katie A KA Duprez Daniel D Jacobs David R DR

The American journal of clinical nutrition 20130801 2

<h4>Background</h4>A priori diet scores such as the Alternative Healthy Eating Index (AHEI) and the food-based a priori diet quality score predict chronic disease risk.<h4>Objective</h4>We compared the AHEI and a priori diet quality score relative to mortality.<h4>Design</h4>Postmenopausal women who were free of diabetes, cardiovascular disease (CVD), and cancer in the Iowa Women's Health Study (in 1986, n = 29,634 with a mean 6 SD age of 61.4 6 4.2 y; in 2004, n = 15,076 with a mean 6 SD age of ...[more]

PMID: 23783291

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Project description:BackgroundThe prevalence of metabolic syndrome is higher among minority populations, including individuals of Mexican ethnic descent. Whether alignment to healthy dietary patterns is associated with lower risk of metabolic syndrome in this population is largely unknown.ObjectiveTo prospectively evaluate the associations between a priori diet quality scores and risk of metabolic syndrome and its components among postmenopausal women of Mexican ethnic descent.MethodsA total of 334 women of Mexican ethnic descent who participated in the Women's Health Initiative (WHI) observational study without metabolic syndrome or diabetes at baseline (1993-1998) were included. Baseline diets were scored with the Alternate Mediterranean Diet (aMED), the Dietary Approaches to Stop Hypertension (DASH), the Healthy Eating Index (HEI-2010), the Mediterranean Diet Score (MDS), and the traditional Mexican Diet (MexD) score. Multivariable linear and logistic regression models were used to test the associations between baseline diet quality and risk of metabolic syndrome and its individual components at follow-up (2012-2013).ResultsApproximately 16% of women met the criteria for metabolic syndrome at follow-up. None of the diet quality indices were associated with risk of metabolic syndrome. However, higher vs lower DASH scores were associated with lower waist circumference (85.2 vs 88.0?cm) and glucose concentrations (90.0 vs 95.1?mg/dL), and higher HDL cholesterol (62.6 vs 59.0?mg/dL), while higher vs lower HEI-2010 scores were associated with lower waist circumference (83.9 vs 88.1?cm), triglycerides (103 vs 117?mg/dL) and glucose concentrations (89.5 vs 94.4?mg/dL), and higher HDL cholesterol levels (63.9 vs 58.5?mg/dL).ConclusionsDiet quality was not associated with risk of metabolic syndrome in this population. However, the results suggest that alignment to DASH and HEI-2010 recommendations may be beneficial for reducing some individual components of metabolic syndrome among postmenopausal women of Mexican descent.

Project description:Nitrate is a drinking water contaminant arising from agricultural sources, and it is a precursor in the endogenous formation of N-nitroso compounds (NOC), which are possible bladder carcinogens.We investigated the ingestion of nitrate and nitrite from drinking water and diet and bladder cancer risk in women.We identified incident bladder cancers among a cohort of 34,708 postmenopausal women in Iowa (1986-2010). Dietary nitrate and nitrite intakes were estimated from a baseline food frequency questionnaire. Drinking water source and duration were assessed in a 1989 follow-up. For women using public water supplies (PWS) > 10 years (n = 15,577), we estimated average nitrate (NO3-N) and total trihalomethane (TTHM) levels and the number of years exceeding one-half the maximum contaminant level (NO3-N: 5 mg/L, TTHM: 40 ?g/mL) from historical monitoring data. We computed hazard ratios (HRs) and 95% confidence intervals (CIs), and assessed nitrate interactions with TTHM and with modifiers of NOC formation (smoking, vitamin C).We identified 258 bladder cancer cases, including 130 among women > 10 years at their PWS. In multivariable-adjusted models, we observed nonsignificant associations among women in the highest versus lowest quartile of average drinking water nitrate concentration (HR = 1.48; 95% CI: 0.92, 2.40; ptrend = 0.11), and we found significant associations among those exposed ? 4 years to drinking water with > 5 mg/L NO3-N (HR = 1.62; 95% CI: 1.06, 2.47; ptrend = 0.03) compared with women having 0 years of comparable exposure. TTHM adjustment had little influence on associations, and we observed no modification by vitamin C intake. Relative to a common reference group of never smokers with the lowest nitrate exposures, associations were strongest for current smokers with the highest nitrate exposures (HR = 3.67; 95% CI: 1.43, 9.38 for average water NO3-N and HR = 3.48; 95% CI: 1.20, 10.06 and ? 4 years > 5 mg/L, respectively). Dietary nitrate and nitrite intakes were not associated with bladder cancer.Long-term ingestion of elevated nitrate in drinking water was associated with an increased risk of bladder cancer among postmenopausal women. Citation: Jones RR, Weyer PJ, DellaValle CT, Inoue-Choi M, Anderson KE, Cantor KP, Krasner S, Robien K, Beane Freeman LE, Silverman DT, Ward MH. 2016. Nitrate from drinking water and diet and bladder cancer among postmenopausal women in Iowa. Environ Health Perspect 124:1751-1758;?http://dx.doi.org/10.1289/EHP191.

Dataset Information

Diet quality indexes and mortality in postmenopausal women: the Iowa Women's Health Study.

Publications

Diet quality indexes and mortality in postmenopausal women: the Iowa Women's Health Study.

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