Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance
Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance
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DOI：
10.1093/ajcn/76.6.1261
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发表时间：
2002-12-01
影响因子：
7.1
通讯作者：
Willett, WC
中科院分区：
文献类型：
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作者：
McCullough, ML;Feskanich, D;Willett, WC
背景：依据美国农业部健康饮食指数（HEI）衡量，对《美国人膳食指南》的遵循仅与主要慢性疾病风险的小幅降低相关。研究表明，更具针对性的指导可能会使风险更大幅度地降低。
目的：我们评估了两种替代的饮食质量衡量指标，即替代健康饮食指数（AHEI）和推荐食物评分（RFS），是否会比HEI更有效地预测慢性疾病风险的降低。
设计：共有来自健康专业人员随访研究的38615名男性和来自护士健康研究的67271名女性完成了饮食调查问卷。主要慢性疾病定义为在8 - 12年的随访期间首次发生心血管疾病（CVD）、癌症或非创伤性死亡。
结果：在比较最高和最低五分位数时，较高的AHEI评分与男性（多变量相对风险（RR）：0.80；95%置信区间：0.71，0.91）和女性（RR：0.89；95%置信区间：0.82，0.96）主要慢性疾病风险的显著降低相关。男性（RR：0.61；95%置信区间：0.49，0.75）和女性（RR：0.72；95%置信区间：0.60，0.86）心血管疾病风险的降低尤为显著。在男性而非女性中，RFS可预测主要慢性疾病风险（RR：0.93；95%置信区间：0.83，1.04）和心血管疾病风险（RR：0.77；95%置信区间：0.64，0.93）。
结论：AHEI比RFS（或我们先前研究中的HEI）能更好地预测慢性疾病风险，主要是因为其与心血管疾病呈强负相关。通过提供更具针对性和全面的建议，膳食指南可以得到改进。
Background: Adherence to the Dietary Guidelines for Americans, measured with the US Department of Agriculture Healthy Eating Index (HEI), was associated with only a small reduction in major chronic disease risk. Research suggests that greater reductions in risk are possible with more specific guidance.Objective: We evaluated whether 2 alternate measures of diet quality, the Alternate Healthy Eating Index (AHEI) and the Recommended Food Score (RFS), would predict chronic disease risk reduction more effectively than did the HEI.Design: A total of 38 615 men from the Health Professional's Follow-up Study and 67 271 women from the Nurses' Health Study completed dietary questionnaires. Major chronic disease was defined as the initial occurrence of cardiovascular disease (CVD), cancer, or nontraurnatic death during 8-12 y of follow-up.Results: High AHEI scores were associated with significant reductions in risk of major chronic disease in men [multivariate relative risk (RR): 0.80; 95% CI: 0.71, 0.91] and in women (RR: 0.89; 95% CI: 0.82, 0.96) when comparing the highest and lowest quintiles. Reductions in risk were particularly strong for CVD in men (RR: 0.61; 95% CI: 0.49,0.75) and in women (RR: 0.72; 95% CI: 0.60, 0.86). In men but not in women, the RFS predicted risk of major chronic disease (RR: 0.93; 95% CI: 0.83, 1.04) and CVD (RR: 0.77; 95% CI: 0.64,0.93).Conclusions: The AHEI predicted chronic disease risk better than did the RFS (or the HEI, in our previous research) primarily because of a strong inverse association with CVD. Dietary guidelines can be improved by providing more specific and comprehensive advice.