The Experts below are selected from a list of 135 Experts worldwide ranked by ideXlab platform
Walter C Willett - One of the best experts on this subject based on the ideXlab platform.
-
evaluating pre pregnancy dietary diversity vs dietary quality scores as predictors of gestational diabetes and hypertensive disorders of pregnancy
PLOS ONE, 2018Co-Authors: Selma Gicevic, Bernard Rosner, Audrey J Gaskins, Teresa T Fung, Deirdre K Tobias, Sheila Isanaka, Walter C WillettAbstract:Background Dietary diversity scores (DDS) are considered as metrics for monitoring the implementation of the UN’s Sustainable Development Goals, but they need to be rigorously evaluated. Objective To examine two DDS, the Food Groups Index (FGI), and the Minimum Dietary Diversity-Women (MDD-W), alongside two dietary quality scores, the Alternate Healthy Eating Index (AHEI-2010) and the Prime Diet Quality Score (PDQS), with risks of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDPs). Design The analysis included 21,312 (GDM) and 19,917 (HDPs) singleton births reported in the Nurses’ Health Study II cohort (1991–2001), among women without Major Chronic Disease or GDM/HDPs. Scores were derived using prepregnancy diet collected by a comprehensive food frequency questionnaire. Multivariable models were utilized to calculate relative risks (RR) and confidence intervals (95%CIs). Results Incident GDM (n = 916) and HDPs (n = 1,421) were reported. The MDD-W and FGI were not associated with risk of GDM or HDPs, but the AHEI-2010 and PDQS were associated with a lower risk of GDM and marginally lower risk of HDP. The RR’s of GDM comparing the highest vs. lowest quintiles were 1.00 (95%CI: 0.79, 1.27; p-trend = 0.82) for MDD-W, 0.96 (95%CI: 0.76, 1.22; p-trend = 0.88) for FGI, 0.63 (95%CI: 0.50, 0.81; p-trend <0.0001) for the AHEI-2010 and 0.68 (95%CI: 0.54, 0.86; p-trend = 0.003) for the PDQS. Similarly, the RR’s of HDPs were 0.92 (95%CI: 0.75, 1.12, p-trend = 0.94) for MDD-W, 0.97 (95%CI: 0.79, 1.17; p-trend = 0.83) for FGI, 0.84 (95%CI: 0.70, 1.02; p-trend = 0.07) for AHEI-2010 and 0.89 (95%CI: 0.74, 1.09; p-trend = 0.07) for PDQS. Conclusions MDD-W and FGI did not predict the risk of GDM and HDPs. These DDS should not be widely used as metrics for achieving dietary goals in their present form. The Prime Diet Quality Score warrants further testing as a promising measure of a sustainable and healthy diet on a global scale.
-
the association between a nutritional quality index and risk of Chronic Disease
American Journal of Preventive Medicine, 2011Co-Authors: Walter C Willett, Stephanie E Chiuve, Laura SampsonAbstract:Background The Overall Nutritional Quality Index (ONQI) algorithm is a nutrient profiling scheme that incorporates more than 30 dietary components, and it aims to rank foods by relative healthfulness. Purpose To assess whether diets with a higher ONQI score predict lower risk of Major Chronic Disease risk. Methods A total of 62,284 healthy women from the Nurses' Health Study and 42,382 healthy men from Health Professionals Follow-Up Study were followed from 1986 to 2006. Dietary data were collected from questionnaires at baseline. Each food was scored by the ONQI algorithm and the average ONQI score for the diet consumed by each participant was computed. Total Chronic Disease was defined as cardiovascular Disease (CVD); cancer; diabetes; and nontrauma death. Data analysis was conducted in 2010. Results A total of 20,004 and 13,520 Chronic Disease events were documented in women and men, respectively. The ONQI score was inversely associated with risk of total Chronic Disease, CVD, diabetes, and all-cause mortality (p-trend≤0.01), but not cancer, in both cohorts. Women in the highest compared to lowest quintile of the ONQI score had a relative risk (95% CI) of 0.91 (0.87, 0.95) for Chronic Disease; 0.79 (0.71, 0.88) for CVD; 0.86 (0.78, 0.96) for diabetes; and 0.90 (0.84, 0.97) for all-cause mortality. Men in the highest compared to lowest quintile of the ONQI score had a relative risk of 0.88 (0.83, 0.93) for Chronic Disease; 0.77 (0.70, 0.85) for CVD; 0.84 (0.73, 0.96) for diabetes; and 0.89 (0.83, 0.97) for all-cause mortality. Conclusions Consumption of foods that lead to a higher score for the ONQI scoring system is associated with modestly lower risk of Chronic Disease and all-cause mortality.
-
dietary pattern analysis for the evaluation of dietary guidelines
Asia Pacific Journal of Clinical Nutrition, 2008Co-Authors: Walter C Willett, Marjorie L McculloughAbstract:Dietary Guidelines for the promotion of overall good health and the prevention of Disease often play an important role in setting nutritional policy and in the education of the public about healthy food choices. Although much has been written about adherence to such guidelines, until recently there was no evidence on whether adherence to specific dietary guidelines is associated with better health. As an outcome variable for such analyses, we have used the incidence of Major Chronic Disease, which includes incidence of any Major cardiovascular Disease, cancer, or death from any cause excluding violence. We have evaluated the Dietary Guidelines for Americans using a scoring system called the Healthy Eating Index developed by the Department of Agriculture to quantify adherence to these guidelines. We found that adherence to the Dietary Guidelines and the Food Guide Pyramid was associated with only a small reduction in Major Chronic Disease risk in a population of over 100,000 US adult men and women. We also assessed whether an alternate index, which took into account the type of fat and quality of carbohydrate, would better predict risk. In contrast with the original Healthy Eating Index, adherence to the alternative index predicted lower rates of Major Chronic Disease, and particularly cardiovascular Disease, suggesting that the Dietary Guidelines were not offering optimal dietary guidance. These analyses suggest that dietary guidelines should be evaluated for their ability to predict the occurrence of Major illness, and that such analyses can help refine these guidelines.
-
evaluating adherence to recommended diets in adults the alternate healthy eating index
Public Health Nutrition, 2006Co-Authors: Marjorie L Mccullough, Walter C WillettAbstract:Harvard School of Public Health, Departments of Nutrition, Epidemiology, and theChanning Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School,Boston, MA 02115, USAAbstractObjective: The Healthy Eating Index (HEI), designed to assess adherence to theDietary Guidelines for Americans and the Food Guide Pyramid, was previouslyassociated with only a small reduction in Major Chronic Disease risk in US adult menand women. We assessed whether an alternate index would better predict risk.Design: Dietary intake reported by men and women from two prospective cohortswas scored according to an a priori designed Alternate Healthy Eating Index (AHEI).In contrast with the original HEI, the AHEI distinguished quality within food groupsand acknowledged health benefits of unsaturated oils. The score was then used topredict development of CVD, cancer or other causes of death in the same populationpreviously tested.Subjects: 67271 women from the Nurses’ Health Study and 38615 men from theHealth Professionals’ Follow-up Study.Results: Men and women with AHEI scores in the top vs. bottom quintile had asignificant 20% and 11% reduction in overall Major Chronic Disease, respectively.Reductions were stronger for CVD risk in men (RR ¼ 0.61, 95% CI 0.49–0.75) andwomen (RR ¼ 0.72, 95% CI 0.60–0.86). The score did not predict cancer risk.Conclusions: The AHEI was twice as strong at predicting Major Chronic Disease andCVD risk compared to the original HEI, suggesting thatMajor Chronic Disease risk canbe further reduced with more comprehensive and detailed dietary guidance.KeywordsAlternate Healthy Eating IndexDietary patternsMediterranean dietCardiovascular DiseaseCancerCohort studiesCardiovascular Disease (CVD) and cancer are the twoleading causes of death in the USA
-
fruit and vegetable intake and risk of Major Chronic Disease
Journal of the National Cancer Institute, 2004Co-Authors: Hsinchia Hung, Kkaumudi J Joshipura, Stephanie A Smithwarner, Donna Spiegelman, Frank B Hu, David J Hunter, Graham A Colditz, Rui Jiang, Bernard Rosner, Walter C WillettAbstract:Background: Studies of fruit and vegetable consumption in relation to overall health are limited. We evaluated the relationship between fruit and vegetable intake and the incidence of cardiovascular Disease and cancer and of deaths from other causes in two prospective cohorts. Methods: A total of 71 910 female participants in the Nurses' Health study and 37 725 male participants in the Health Professionals' Follow-up Study who were free of Major Chronic Disease completed baseline semiquantitative food-frequency questionnaires in 1984 and 1986, respectively. Dietary information was updated in 1986, 1990, and 1994 for women and in 1990 and 1994 for men. Participants were followed up for incidence of cardiovascular Disease, cancer, or death through May 1998 (women) and January 1998 (men). Multivariable-adjusted relative risks were calculated with Cox proportional hazards analysis. Results: We ascertained 9329 events (1964 cardiovascular, 6584 cancer, and 781 other deaths) in women and 4957 events (1670 cardiovascular Diseases, 2500 cancers, and 787 other deaths) in men during follow-up. For men and women combined, participants in the highest quintile of total fruit and vegetable intake had a relative risk for Major Chronic Disease of 0.95 (95% confidence interval [CI] = 0.89 to 1.01) times that of those in the lowest. Total fruit and vegetable intake was inversely associated with risk of cardiovascular Disease but not with overall cancer incidence, with relative risk for an increment of five servings daily of 0.88 (95% CI = 0.81 to 0.95) for cardiovascular Disease and 1.00 (95% CI = 0.95 to 1.05) for cancer. Of the food groups analyzed, green leafy vegetable intake showed the strongest inverse association with Major Chronic Disease and cardiovascular Disease. For an increment of one serving per day of green leafy vegetables, relative risks were 0.95 (95% CI = 0.92 to 0.99) for Major Chronic Disease and 0.89 (95% CI = 0.83 to 0.96) for cardiovascular Disease. Conclusions: Increased fruit and vegetable consumption was associated with a modest although not statistically significant reduction in the development of Major Chronic Disease. The benefits appeared to be primarily for cardiovascular Disease and not for cancer.
Eric B Rimm - One of the best experts on this subject based on the ideXlab platform.
-
vigorous intensity leisure time physical activity and risk of Major Chronic Disease in men
Medicine and Science in Sports and Exercise, 2012Co-Authors: Andrea K Chomistek, Nancy R Cook, Alan J Flint, Eric B RimmAbstract:ABSTRACTPurposeAlthough studies have shown health benefits for moderate-intensity physical activity, there is limited evidence to support beneficial effects for high amounts of vigorous activity among middle-age and older men. The objective of this study was to examine the relationship between vigor
-
fish consumption and risk of Major Chronic Disease in men
The American Journal of Clinical Nutrition, 2008Co-Authors: Jyrki K Virtanen, Dariush Mozaffarian, Stephanie E Chiuve, Eric B RimmAbstract:Background: Although fish consumption may reduce specific Diseaseendpoints,suchassuddencardiacdeathandprostatecancer,the effects of Major Chronic Disease on total burden, reflecting sums of effects on a variety of endpoints and risk pathways, are not well established. Higher n6 fatty acid consumption has also been hypothesized to reduce the health benefits of n3 fatty acids in fish. Objective: The aim was to study the associations of fish and n3 fatty acid consumption with risk of total Major Chronic Disease (cardiovascular Disease, cancer, and death) and to determine whether a high n6 intake modifies the associations. Design:Lifestyle and other risk factors were assessed every2yand diet ever y4yi n40,230 US male health professionals aged 40–75 y andfreeofMajorChronicDiseaseatbaselinein1986.During18yof follow-up, 9715 Major Chronic Disease events occurred, including 3639 cardiovascular Disease events, 4690 cancers, and 1386 deaths from other causes. Results: After multivariable adjustment, neither fish nor dietary n3fattyacidconsumptionwassignificantlyassociatedwithriskof totalMajorChronicDisease.Comparedwithfishconsumptionof1 serving/mo, consumption of 1 serving/wk and of 2–4 servings/wk was associated with a lower risk of total cardiovascular Disease of 15%. No significant associations were seen with cancer risk. Higher or lower n6 fatty acid intake did not significantly modify the results (P for interaction 0.10). Conclusions: Modest fish consumption was associated with a lower risk of total cardiovascular Disease, consistent with cardiac mortality benefits but not with total cancer or overall Major Chronic Disease; n6 fatty acid consumption did not influence these relations. Am J Clin Nutr 2008;88:1618–25.
-
joint association of alcohol and folate intake with risk of Major Chronic Disease in women
American Journal of Epidemiology, 2003Co-Authors: Rui Jiang, Donna Spiegelman, Bernard Rosner, Eric B Rimm, Edward Giovannucci, Meir J Stampfer, Walter C WillettAbstract:Alcohol interferes with folate metabolism and has opposing effects on the risks of cardiovascular Disease and cancer. The authors examined the joint association of alcohol and folate intake with risk of Major Chronic Disease, defined as fatal or nonfatal cardiovascular Disease or cancer, or other nontraumatic death. This study included 83,929 women aged 34–59 years with no previous history of cardiovascular Disease or cancer who provided dietary data in 1980. During 16 years of follow-up, the authors documented 10,666 new cases of Major Chronic Disease. Overall, heavy drinkers (>30 g/day) with a lower total folate intake (<180 µg/day) had the highest risk; in comparison with abstainers with a folate intake of 400–599 µg/day, the multivariate relative risk was 1.36 (95% confidence interval: 1.10, 1.70). However, the increased risk of Major Chronic Disease associated with heavy drinking was largely diminished among women with a higher folate intake (p for interaction = 0.02). The positive association between heavy alcohol/low folate intake and risk of Major Chronic Disease was most apparent among women younger than age 60 years. Adequate folate intake may be important in the primary prevention of overall Major Chronic Disease in women, especially among younger women consuming more than two alcoholic drinks per day.
-
diet quality and Major Chronic Disease risk in men and women moving toward improved dietary guidance
The American Journal of Clinical Nutrition, 2002Co-Authors: Marjorie L Mccullough, Donna Spiegelman, David J Hunter, Graham A Colditz, Eric B Rimm, Edward Giovannucci, Meir J Stampfer, Diane Feskanich, Walter C WillettAbstract: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 nontraumatic 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. Am J Clin Nutr 2002;76:1261‐71.
Marjorie L Mccullough - One of the best experts on this subject based on the ideXlab platform.
-
dietary pattern analysis for the evaluation of dietary guidelines
Asia Pacific Journal of Clinical Nutrition, 2008Co-Authors: Walter C Willett, Marjorie L McculloughAbstract:Dietary Guidelines for the promotion of overall good health and the prevention of Disease often play an important role in setting nutritional policy and in the education of the public about healthy food choices. Although much has been written about adherence to such guidelines, until recently there was no evidence on whether adherence to specific dietary guidelines is associated with better health. As an outcome variable for such analyses, we have used the incidence of Major Chronic Disease, which includes incidence of any Major cardiovascular Disease, cancer, or death from any cause excluding violence. We have evaluated the Dietary Guidelines for Americans using a scoring system called the Healthy Eating Index developed by the Department of Agriculture to quantify adherence to these guidelines. We found that adherence to the Dietary Guidelines and the Food Guide Pyramid was associated with only a small reduction in Major Chronic Disease risk in a population of over 100,000 US adult men and women. We also assessed whether an alternate index, which took into account the type of fat and quality of carbohydrate, would better predict risk. In contrast with the original Healthy Eating Index, adherence to the alternative index predicted lower rates of Major Chronic Disease, and particularly cardiovascular Disease, suggesting that the Dietary Guidelines were not offering optimal dietary guidance. These analyses suggest that dietary guidelines should be evaluated for their ability to predict the occurrence of Major illness, and that such analyses can help refine these guidelines.
-
evaluating adherence to recommended diets in adults the alternate healthy eating index
Public Health Nutrition, 2006Co-Authors: Marjorie L Mccullough, Walter C WillettAbstract:Harvard School of Public Health, Departments of Nutrition, Epidemiology, and theChanning Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School,Boston, MA 02115, USAAbstractObjective: The Healthy Eating Index (HEI), designed to assess adherence to theDietary Guidelines for Americans and the Food Guide Pyramid, was previouslyassociated with only a small reduction in Major Chronic Disease risk in US adult menand women. We assessed whether an alternate index would better predict risk.Design: Dietary intake reported by men and women from two prospective cohortswas scored according to an a priori designed Alternate Healthy Eating Index (AHEI).In contrast with the original HEI, the AHEI distinguished quality within food groupsand acknowledged health benefits of unsaturated oils. The score was then used topredict development of CVD, cancer or other causes of death in the same populationpreviously tested.Subjects: 67271 women from the Nurses’ Health Study and 38615 men from theHealth Professionals’ Follow-up Study.Results: Men and women with AHEI scores in the top vs. bottom quintile had asignificant 20% and 11% reduction in overall Major Chronic Disease, respectively.Reductions were stronger for CVD risk in men (RR ¼ 0.61, 95% CI 0.49–0.75) andwomen (RR ¼ 0.72, 95% CI 0.60–0.86). The score did not predict cancer risk.Conclusions: The AHEI was twice as strong at predicting Major Chronic Disease andCVD risk compared to the original HEI, suggesting thatMajor Chronic Disease risk canbe further reduced with more comprehensive and detailed dietary guidance.KeywordsAlternate Healthy Eating IndexDietary patternsMediterranean dietCardiovascular DiseaseCancerCohort studiesCardiovascular Disease (CVD) and cancer are the twoleading causes of death in the USA
-
diet quality and Major Chronic Disease risk in men and women moving toward improved dietary guidance
The American Journal of Clinical Nutrition, 2002Co-Authors: Marjorie L Mccullough, Donna Spiegelman, David J Hunter, Graham A Colditz, Eric B Rimm, Edward Giovannucci, Meir J Stampfer, Diane Feskanich, Walter C WillettAbstract: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 nontraumatic 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. Am J Clin Nutr 2002;76:1261‐71.
-
adherence to the dietary guidelines for americans and risk of Major Chronic Disease in women
The American Journal of Clinical Nutrition, 2000Co-Authors: Marjorie L Mccullough, David J Hunter, Graham A Colditz, Bernard Rosner, Meir J Stampfer, Diane Feskanich, Jayachandran N Variyam, Walter C WillettAbstract:Background Little is known about the overall health effects of adherence to the Dietary Guidelines for Americans. The healthy eating index (HEI), developed at the US Department of Agriculture, measures how well Americans' diets conform to these guidelines. Objective We tested whether the HEI (scores range from 0 to 100; 100 is best) calculated from food-frequency questionnaires (HEI-f) would predict risk of Major Chronic Disease in women. Design A total of 67272 US female nurses who were free of Major Disease completed detailed questionnaires on diet and Chronic Disease risk factors in 1984 and repeatedly over 12 y. Major Chronic Disease was defined as fatal or nonfatal cardiovascular Disease (myocardial infarction or stroke, n = 1365), fatal or nonfatal cancer (n = 5216), or other nontraumatic deaths (n = 496), whichever came first. We also examined cardiovascular Disease and cancer as separate outcomes. Results After adjustment for smoking and other risk factors, the HEI-f score was not associated with risk of overall Major Chronic Disease in women [relative risk (RR) = 0.97; 95% CI: 0.89, 1.06 comparing the highest with the lowest quintile of HEI-f score]. Being in the highest HEI-f quintile was associated with a 14% reduction in cardiovascular Disease risk (RR = 0.86; 95% CI: 0.72, 1. 03) and was not associated with lower cancer risk (RR = 1.02; 95% CI: 0.93, 1.12). Conclusion These data suggest that adherence to the 1995 Dietary Guidelines for Americans, as measured by the HEI-f, will have limited benefit in preventing Major Chronic Disease in women.
Bernard Rosner - One of the best experts on this subject based on the ideXlab platform.
-
evaluating pre pregnancy dietary diversity vs dietary quality scores as predictors of gestational diabetes and hypertensive disorders of pregnancy
PLOS ONE, 2018Co-Authors: Selma Gicevic, Bernard Rosner, Audrey J Gaskins, Teresa T Fung, Deirdre K Tobias, Sheila Isanaka, Walter C WillettAbstract:Background Dietary diversity scores (DDS) are considered as metrics for monitoring the implementation of the UN’s Sustainable Development Goals, but they need to be rigorously evaluated. Objective To examine two DDS, the Food Groups Index (FGI), and the Minimum Dietary Diversity-Women (MDD-W), alongside two dietary quality scores, the Alternate Healthy Eating Index (AHEI-2010) and the Prime Diet Quality Score (PDQS), with risks of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDPs). Design The analysis included 21,312 (GDM) and 19,917 (HDPs) singleton births reported in the Nurses’ Health Study II cohort (1991–2001), among women without Major Chronic Disease or GDM/HDPs. Scores were derived using prepregnancy diet collected by a comprehensive food frequency questionnaire. Multivariable models were utilized to calculate relative risks (RR) and confidence intervals (95%CIs). Results Incident GDM (n = 916) and HDPs (n = 1,421) were reported. The MDD-W and FGI were not associated with risk of GDM or HDPs, but the AHEI-2010 and PDQS were associated with a lower risk of GDM and marginally lower risk of HDP. The RR’s of GDM comparing the highest vs. lowest quintiles were 1.00 (95%CI: 0.79, 1.27; p-trend = 0.82) for MDD-W, 0.96 (95%CI: 0.76, 1.22; p-trend = 0.88) for FGI, 0.63 (95%CI: 0.50, 0.81; p-trend <0.0001) for the AHEI-2010 and 0.68 (95%CI: 0.54, 0.86; p-trend = 0.003) for the PDQS. Similarly, the RR’s of HDPs were 0.92 (95%CI: 0.75, 1.12, p-trend = 0.94) for MDD-W, 0.97 (95%CI: 0.79, 1.17; p-trend = 0.83) for FGI, 0.84 (95%CI: 0.70, 1.02; p-trend = 0.07) for AHEI-2010 and 0.89 (95%CI: 0.74, 1.09; p-trend = 0.07) for PDQS. Conclusions MDD-W and FGI did not predict the risk of GDM and HDPs. These DDS should not be widely used as metrics for achieving dietary goals in their present form. The Prime Diet Quality Score warrants further testing as a promising measure of a sustainable and healthy diet on a global scale.
-
fruit and vegetable intake and risk of Major Chronic Disease
Journal of the National Cancer Institute, 2004Co-Authors: Hsinchia Hung, Kkaumudi J Joshipura, Stephanie A Smithwarner, Donna Spiegelman, Frank B Hu, David J Hunter, Graham A Colditz, Rui Jiang, Bernard Rosner, Walter C WillettAbstract:Background: Studies of fruit and vegetable consumption in relation to overall health are limited. We evaluated the relationship between fruit and vegetable intake and the incidence of cardiovascular Disease and cancer and of deaths from other causes in two prospective cohorts. Methods: A total of 71 910 female participants in the Nurses' Health study and 37 725 male participants in the Health Professionals' Follow-up Study who were free of Major Chronic Disease completed baseline semiquantitative food-frequency questionnaires in 1984 and 1986, respectively. Dietary information was updated in 1986, 1990, and 1994 for women and in 1990 and 1994 for men. Participants were followed up for incidence of cardiovascular Disease, cancer, or death through May 1998 (women) and January 1998 (men). Multivariable-adjusted relative risks were calculated with Cox proportional hazards analysis. Results: We ascertained 9329 events (1964 cardiovascular, 6584 cancer, and 781 other deaths) in women and 4957 events (1670 cardiovascular Diseases, 2500 cancers, and 787 other deaths) in men during follow-up. For men and women combined, participants in the highest quintile of total fruit and vegetable intake had a relative risk for Major Chronic Disease of 0.95 (95% confidence interval [CI] = 0.89 to 1.01) times that of those in the lowest. Total fruit and vegetable intake was inversely associated with risk of cardiovascular Disease but not with overall cancer incidence, with relative risk for an increment of five servings daily of 0.88 (95% CI = 0.81 to 0.95) for cardiovascular Disease and 1.00 (95% CI = 0.95 to 1.05) for cancer. Of the food groups analyzed, green leafy vegetable intake showed the strongest inverse association with Major Chronic Disease and cardiovascular Disease. For an increment of one serving per day of green leafy vegetables, relative risks were 0.95 (95% CI = 0.92 to 0.99) for Major Chronic Disease and 0.89 (95% CI = 0.83 to 0.96) for cardiovascular Disease. Conclusions: Increased fruit and vegetable consumption was associated with a modest although not statistically significant reduction in the development of Major Chronic Disease. The benefits appeared to be primarily for cardiovascular Disease and not for cancer.
-
joint association of alcohol and folate intake with risk of Major Chronic Disease in women
American Journal of Epidemiology, 2003Co-Authors: Rui Jiang, Donna Spiegelman, Bernard Rosner, Eric B Rimm, Edward Giovannucci, Meir J Stampfer, Walter C WillettAbstract:Alcohol interferes with folate metabolism and has opposing effects on the risks of cardiovascular Disease and cancer. The authors examined the joint association of alcohol and folate intake with risk of Major Chronic Disease, defined as fatal or nonfatal cardiovascular Disease or cancer, or other nontraumatic death. This study included 83,929 women aged 34–59 years with no previous history of cardiovascular Disease or cancer who provided dietary data in 1980. During 16 years of follow-up, the authors documented 10,666 new cases of Major Chronic Disease. Overall, heavy drinkers (>30 g/day) with a lower total folate intake (<180 µg/day) had the highest risk; in comparison with abstainers with a folate intake of 400–599 µg/day, the multivariate relative risk was 1.36 (95% confidence interval: 1.10, 1.70). However, the increased risk of Major Chronic Disease associated with heavy drinking was largely diminished among women with a higher folate intake (p for interaction = 0.02). The positive association between heavy alcohol/low folate intake and risk of Major Chronic Disease was most apparent among women younger than age 60 years. Adequate folate intake may be important in the primary prevention of overall Major Chronic Disease in women, especially among younger women consuming more than two alcoholic drinks per day.
-
adherence to the dietary guidelines for americans and risk of Major Chronic Disease in women
The American Journal of Clinical Nutrition, 2000Co-Authors: Marjorie L Mccullough, David J Hunter, Graham A Colditz, Bernard Rosner, Meir J Stampfer, Diane Feskanich, Jayachandran N Variyam, Walter C WillettAbstract:Background Little is known about the overall health effects of adherence to the Dietary Guidelines for Americans. The healthy eating index (HEI), developed at the US Department of Agriculture, measures how well Americans' diets conform to these guidelines. Objective We tested whether the HEI (scores range from 0 to 100; 100 is best) calculated from food-frequency questionnaires (HEI-f) would predict risk of Major Chronic Disease in women. Design A total of 67272 US female nurses who were free of Major Disease completed detailed questionnaires on diet and Chronic Disease risk factors in 1984 and repeatedly over 12 y. Major Chronic Disease was defined as fatal or nonfatal cardiovascular Disease (myocardial infarction or stroke, n = 1365), fatal or nonfatal cancer (n = 5216), or other nontraumatic deaths (n = 496), whichever came first. We also examined cardiovascular Disease and cancer as separate outcomes. Results After adjustment for smoking and other risk factors, the HEI-f score was not associated with risk of overall Major Chronic Disease in women [relative risk (RR) = 0.97; 95% CI: 0.89, 1.06 comparing the highest with the lowest quintile of HEI-f score]. Being in the highest HEI-f quintile was associated with a 14% reduction in cardiovascular Disease risk (RR = 0.86; 95% CI: 0.72, 1. 03) and was not associated with lower cancer risk (RR = 1.02; 95% CI: 0.93, 1.12). Conclusion These data suggest that adherence to the 1995 Dietary Guidelines for Americans, as measured by the HEI-f, will have limited benefit in preventing Major Chronic Disease in women.
Eilee Rillamassu - One of the best experts on this subject based on the ideXlab platform.
-
the influence of physical activity and sedentary behavior on living to age 85 years without Disease and disability in older women
Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2018Co-Authors: Eilee Rillamassu, Michael J Lamonte, Kelly R Evenso, Cynthia A Thomso, Shirley A A Eresford, Mathilda Coday, Todd M Manini, Andrea Z LacroiAbstract:Author(s): Rillamas-Sun, Eileen; LaMonte, Michael J; Evenson, Kelly R; Thomson, Cynthia A; Beresford, Shirley A; Coday, Mathilda C; Manini, Todd M; Li, Wenjun; LaCroix, Andrea Z | Abstract: Background:Whether physical activity (PA) and sedentary behavior influence the odds of women living to age 85 years without Chronic Disease or disability is not well described. Methods:Participants of the Women's Health Initiative (n = 49,612) were categorized based on health status by age 85 years: (i) lived without developing Major Chronic Disease or mobility disability ("healthy"); (ii) lived and developed mobility disability with or without Disease; (iii) lived and developed Major Chronic Disease, but not mobility disability; and (iv) died before their 85th birth year. Multinomial logistic regression models that adjusted for covariates such as age, race/ethnicity, and body size estimated associations of self-reported PA and sitting time on developing Major Disease or mobility disability or dying before age 85 relative to being healthy. Results:Mean ± SD baseline age was 70.2 ± 3.6 years. Distributions were: 22% healthy, 23% had mobility disability, 26% had Major Disease, and 29% died. Relative to those with high total PA, the adjusted odds ratios (OR) (confidence intervals [CI]) for mobility disability was 1.6 (1.4-1.7), 1.2 (1.1-1.3), and 1.1 (1.0-1.2) for women with no, low, and moderate total PA, respectively (p-trend l .001). The corresponding covariate-adjusted OR (CI) for mortality was 1.7 (1.5-1.8), 1.2 (1.1-1.3), and 1.0 (1.0-1.1) (p-trend l .001). Total PA was not associated with developing Chronic Disease before age 85 years. Sitting ≥10 relative to l5 hours per day increased the odds of mobility disability (1.1, CI: 1.0-1.3) and mortality (1.2, CI: 1.0-1.3) prior to age 85 years (p l .001). Conclusions:Increasing PA to recommended levels and reducing sitting time are modifiable behaviors that may improve healthy aging in older women.
-
obesity and late age survival without Major Disease or disability in older women
JAMA Internal Medicine, 2014Co-Authors: Mara Z Vitolins, Eilee Rillamassu, Andrea Z Lacroi, Molly E Waring, Candyce H Kroenke, Rebecca A Segui, Michael J LamonteAbstract:Importance The effect of obesity on late-age survival in women without Disease or disability is unknown. Objective To investigate whether higher baseline body mass index and waist circumference affect women’s survival to 85 years of age without Major Chronic Disease (coronary Disease, stroke, cancer, diabetes mellitus, or hip fracture) and mobility disability. Design, Setting, and Participants Examination of 36 611 women from the Women’s Health Initiative observational study and clinical trial programs who could have reached 85 years or older if they survived to the last outcomes evaluation on September 17, 2012. Recruitment was from 40 US clinical centers from October 1993 through December 1998. Multinomial logistic regression models were used to estimate odds ratios and 95% CIs for the association of baseline body mass index and waist circumference with the outcomes, adjusting for demographic, behavioral, and health characteristics. Main Outcomes and Measures Mutually exclusive classifications: (1) survived without Major Chronic Disease and without mobility disability (healthy); (2) survived with 1 or more Major Chronic Disease at baseline but without new Disease or disability (prevalent Diseased); (3) survived and developed 1 or more Major Chronic Disease but not disability during study follow-up (incident Diseased); (4) survived and developed mobility disability with or without Disease (disabled); and (5) did not survive (died). Results Mean (SD) baseline age was 72.4 (3.0) years (range, 66-81 years). The distribution of women classified as healthy, prevalent Diseased, incident Diseased, disabled, and died was 19.0%, 14.7%, 23.2%, 18.3%, and 24.8%, respectively. Compared with healthy-weight women, underweight and obese women were more likely to die before 85 years of age. Overweight and obese women had higher risks of incident Disease and mobility disability. Disability risks were striking. Relative to healthy-weight women, adjusted odds ratios (95% CIs) of mobility disability were 1.6 (1.5-1.8) for overweight women and 3.2 (2.9-3.6), 6.6 (5.4-8.1), and 6.7 (4.8-9.2) for class I, II, and III obesity, respectively. Waist circumference greater than 88 cm was also associated with higher risk of earlier death, incident Disease, and mobility disability. Conclusions and Relevance Overall and abdominal obesity were important and potentially modifiable factors associated with dying or developing mobility disability and Major Chronic Disease before 85 years of age in older women.
