International food group-based diet quality and risk of coronary heart disease in men and women
International food group-based diet quality and risk of coronary heart disease in men and women
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DOI：
10.1093/ajcn/nqx015
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发表时间：
2018-01-01
影响因子：
7.1
通讯作者：
Willett, Walter C.
中科院分区：
文献类型：
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作者：
Fung, Teresa T.;Isanaka, Sheila;Willett, Walter C.
背景：需要标准饮食质量评估工具来衡量微量营养素充足度和与疾病相关的食物消耗并适用于不同人群，以跟踪实现与饥饿、粮食安全和营养相关的可持续发展目标的进展情况。已经针对高收入和低收入国家构建了饮食质量评分，但没有一个易于管理或在国际上适用。 目的：我们前瞻性地研究了 3 个美国队列的食物类别指数 (FGI)、女性最低饮食多样性评分 (MDDW) 和新的主要饮食质量评分 (PDQS) 与缺血性心脏病 (IHD) 风险之间的关联。 对没有心血管疾病史的 75,045 名女性（基线年龄 43-63 岁）、43,966 名男性（40-75 岁）和 93,131 名年轻女性（27-44 岁）进行了随访至 28 岁。使用食物频率问卷对饮食进行多次评估，并计算每个人的 3 个饮食质量得分。与 IHD 的关联采用 Cox 比例风险模型进行建模，控制潜在的混杂因素。 结果：在随访期间，我们在护士健康研究中确定了 2908 例 IHD 事件，在健康专业人员随访研究中确定了 3722 例，在护士健康研究 II 中确定了 505 例。在任何队列中，FGI 均与总 IHD 无关。在所有 3 个队列中，PDQS 均与 IHD 显着相关，每次 SD 增加的汇总 RR 为 0.89（95% CI：0.87，0.91）。这与 MDDW 的汇总 RR 0.93（95% CI：0.90，0.96）和 FGI 的 RR 0.98（95% CI：0.95，1.01）显着不同。该关联似乎没有因年龄而异。结论：我们发现，在高收入国家，对健康和不健康食品进行最详细区分的 PDQS 与较低的 IHD 风险相关。另一方面，不考虑不健康食品的饮食质量评分与 IHD 的关联有限。
Background: Standard diet quality assessment tools, which measure micronutrient sufficiency and food consumption related to disease and applicable to different populations, are needed to track progress in meeting the Sustainable Development Goals related to hunger, food security, and nutrition. Diet quality scores have been constructed for high- and low-income countries, but none are simple to administer or applicable internationally.Objective: We prospectively examined the association between the Food Group Index (FGI), the Minimal Diet Diversity Score for Women (MDDW), and a new Prime Diet Quality Score (PDQS), and the risk of ischemic heart disease (IHD) in 3 US cohorts.Design: In total, 75,045 women (baseline age 43-63 y), 43,966 men (aged 40-75 y), and 93,131 younger women (aged 27-44 y) without a history of cardiovascular disease were followed up to 28 y. Diet was assessed multiple times using food frequency questionnaires and the 3 diet quality scores were computed for each individual. The association with IHD was modeled with Cox proportional hazard models, controlling for potential confounders.Results: During follow-up, we ascertained 2908 incident IHD cases in the Nurses' Health Study, 3722 in the Health Professionals Followup Study, and 505 in the Nurses' Health Study II. The FGI was not associated with total IHD in any cohort. The PDQS was significantly associated with IHD in all 3 cohorts separately and the pooled RR for each SD increase was 0.89 (95% CI: 0.87, 0.91). This was significantly different than the pooled RR of 0.93 for MDDW(95% CI: 0.90, 0.96) and the RR of 0.98 for the FGI (95% CI: 0.95, 1.01). The association did not appear to differ by age.Conclusion: We found that the PDQS with the most detailed differentiation of healthy and unhealthy foods was associated with a lower risk of IHD in a high-income country. On the other hand, diet quality scores that do not account for unhealthy foods had a limited association with IHD.