Context Most studies of diet and health care have focused on the role of single
nutrients, foods, or food groups in disease prevention or promotion. Few studies
have addressed the health effects of dietary patterns, which include complex
mixtures of foods containing multiple nutrients and nonnutrients.
Objective To examine the association of mortality with a multifactorial diet quality
Design and Setting Data from phase 2 (1987-1989) of a prospective cohort study of breast
cancer screening, the Breast Cancer Detection Demonstration Project, with
a median follow-up of 5.6 years.
Participants A total of 42,254 women (mean age, 61.1 years) who completed the food
frequency questionnaire portion of the survey.
Main Outcome Measure All-cause mortality by quartile of Recommended Food Score (RFS; the
sum of the number of foods recommended by current dietary guidelines [fruits,
vegetables, whole grains, low-fat dairy, and lean meats and poultry] that
were reported on the questionnaire to be consumed at least once a week, for
a maximum score of 23).
Results There were 2065 deaths due to all causes in the cohort. The RFS was
inversely associated with all-cause mortality. Compared with those in the
lowest quartile, subjects in the upper quartiles of the RFS had relative risks
for all-cause mortality of 0.82 (95% confidence interval [CI], 0.73-0.92)
for quartile 2, 0.71 (95% CI, 0.62-0.81) for quartile 3, and 0.69 (95% CI,
0.61-0.78) for quartile 4 adjusted for education, ethnicity, age, body mass
index, smoking status, alcohol use, level of physical activity, menopausal
hormone use, and history of disease (χ21 for trend=35.64, P<.001 for trend).
Conclusions These data suggest that a dietary pattern characterized by consumption
of foods recommended in current dietary guidelines is associated with decreased
risk of mortality in women.