Nineteen-Year Associations between Three Diet Quality Indices and All-Cause and Cardiovascular Disease Mortality: The Australian Diabetes, Obesity, and Lifestyle Study.
Study Goal
The researchers aimed to examine the association between the MIND diet (which includes DASH principles) and the risk of all-cause mortality, CVD mortality, and nonfatal CVD events over a long-term follow-up period.
Results Summary
Higher adherence to the MIND diet (incorporating DASH elements) was associated with lower risks of all-cause mortality (HR 0.93) and CVD mortality (HR 0.90), but no significant association was found with nonfatal CVD events.
Population
10,009 Australian adults (mean age 51.8 years; 52% female).
Effective Dosage
Not specified
Duration
Mean follow-ups of 17.7 years (all-cause mortality), 17.4 years (CVD mortality), and 9.6 years (nonfatal CVD events).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
higher Australian Dietary Guideline Index (DGI) | decrease | risk of all-cause mortality | 10,009 adults from the Australian Diabetes, Obesity, and Lifestyle study | HR 0.94 (95% CI: 0.89, 0.99) | associated with | #1 |
higher Dietary Inflammatory Index (DII) | increase | risk of all-cause mortality | 10,009 adults from the Australian Diabetes, Obesity, and Lifestyle study | HR 1.08 (95% CI: 1.02, 1.15) | associated with | #2 |
higher Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet index | decrease | risk of all-cause mortality | 10,009 adults from the Australian Diabetes, Obesity, and Lifestyle study | HR 0.93 (95% CI: 0.89, 0.98) | associated with | #3 |
higher Australian Dietary Guideline Index (DGI) | decrease | risk of CVD mortality | 10,009 adults from the Australian Diabetes, Obesity, and Lifestyle study | HR 0.93 (95% CI: 0.85, 0.99) | associated with | #4 |
higher Dietary Inflammatory Index (DII) | increase | risk of CVD mortality | 10,009 adults from the Australian Diabetes, Obesity, and Lifestyle study | HR 1.10 (95% CI: 1.00, 1.24) | associated with | #5 |
higher Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet index | decrease | risk of CVD mortality | 10,009 adults from the Australian Diabetes, Obesity, and Lifestyle study | HR 0.90 (95% CI: 0.82, 0.98) | associated with | #6 |
diet quality (DGI, DII, MIND) | no change | nonfatal CVD events | 10,009 adults from the Australian Diabetes, Obesity, and Lifestyle study | - | limited evidence of associations with | #7 |
a better quality diet | decrease | all-cause and CVD mortality | Australian adults | - | predicted lower risk of | #8 |
a more inflammatory diet | increase | mortality | Australian adults | - | predicted higher risk of | #9 |
BACKGROUND: Examining a variety of diet quality methodologies will inform best practice use of diet quality indices for assessing all-cause and cardiovascular disease (CVD) mortality. OBJECTIVES: To examine the association between 3 diet quality indices (Australian Dietary Guideline Index, DGI; Dietary Inflammatory Index, DII; Mediterranean-DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay, MIND) and risk of all-cause mortality, CVD mortality, and nonfatal CVD events ≤19 y later. METHODS: Data on 10,009 adults (mean age 51.8 y; 52% female) from the Australian Diabetes, Obesity, and Lifestyle study were used. An FFQ was used to calculate DGI, DII, and MIND at baseline. Cox proportional hazard models were used to estimate HRs and 95% CI of all-cause mortality, CVD mortality, and nonfatal CVD events (stroke; myocardial infarction) according to 1 SD increase in diet quality, adjusted for age, sex, education, smoking, physical activity, energy intake, history of stroke or heart attack, and diabetes and hypertension status. RESULTS: Deaths due to all-cause (n = 1955) and CVD (n = 520), and nonfatal CVD events (n = 264) were identified during mean follow-ups of 17.7, 17.4, and 9.6 y, respectively. For all-cause mortality, HRs associated with higher DGI, DII, and MIND were 0.94 (95% CI: 0.89, 0.99), 1.08 (95% CI: 1.02, 1.15), and 0.93 (95% CI: 0.89, 0.98), respectively. For CVD mortality, HRs associated with higher DGI, DII, and MIND were 0.93 (95% CI: 0.85, 0.99), 1.10 (95% CI: 1.00, 1.24), and 0.90 (95% CI: 0.82, 0.98), respectively. There was limited evidence of associations between diet quality and nonfatal CVD events. CONCLUSIONS: A better quality diet predicted lower risk of all-cause and CVD mortality in Australian adults, whereas a more inflammatory diet predicted higher mortality risk. These findings highlight the applicability of following Australian dietary guidelines, a Mediterranean-style diet, and a low-inflammatory diet for the reduction of all-cause and CVD mortality risk.