HHS Public Access Author manuscript Author Manuscript
Circulation. Author manuscript; available in PMC 2016 December 08. Published in final edited form as: Circulation. 2015 December 8; 132(23): 2212–2219. doi:10.1161/CIRCULATIONAHA.115.017158.
Changes in Diet Quality Scores and Risk of Cardiovascular Disease Among US Men and Women Mercedes Sotos-Prieto, PhD1, Shilpa N. Bhupathiraju, PhD1, Josiemer Mattei, PhD, MPH1, Teresa T. Fung, ScD1,2, Yanping Li, PhD1, An Pan, PhD3, Walter C. Willett, MD, DrPH1,4,5, Eric B. Rimm, ScD1,4,5, and Frank B. Hu, MD, PhD1,4,5 1Department
Author Manuscript
2Simmons
of Nutrition, Harvard T.H Chan School of Public Health, Boston, MA
College, Boston, MA
3Department
of Epidemiology and Biostatistics, and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China 4Department
of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA
5Channing
Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
Abstract Author Manuscript
Background—Adherence to several diet quality scores including the Alternative Healthy Eating Index (AHEI), Alternative Mediterranean diet score (AMED), and Dietary Approach to Stop Hypertension (DASH) has been associated with lower risk of cardiovascular disease (CVD), but little is known about how changes in these scores over time influence subsequent CVD risk.
Author Manuscript
Methods and Results—We analyzed the association between 4-year changes in three diet quality scores (AHEI, AMED, and DASH) and subsequent CVD risk among 29,343 men in the Health Professionals Follow-up Study and 51,195 women in the Nurses’ Health Study (1986– 2010). During 1,394,702 person-years of follow up, we documented 11,793 CVD cases. Compared with participants whose diet quality remained relatively stable in each 4-year period, those with the greatest improvement in diet quality scores had a 7%–8% lower CVD risk in the subsequent 4-year period (pooled hazard ratio, 0.92 [95% confidence interval (CI): 0.87–0.99] for AHEI; 0.93 [95% CI: 0.85–1.02] for AMED; and 0.93 [95% CI: 0.87–0.99] for DASH; all Ptrend
Circulation. Author manuscript; available in PMC 2016 December 08. Published in final edited form as: Circulation. 2015 December 8; 132(23): 2212–2219. doi:10.1161/CIRCULATIONAHA.115.017158.
Changes in Diet Quality Scores and Risk of Cardiovascular Disease Among US Men and Women Mercedes Sotos-Prieto, PhD1, Shilpa N. Bhupathiraju, PhD1, Josiemer Mattei, PhD, MPH1, Teresa T. Fung, ScD1,2, Yanping Li, PhD1, An Pan, PhD3, Walter C. Willett, MD, DrPH1,4,5, Eric B. Rimm, ScD1,4,5, and Frank B. Hu, MD, PhD1,4,5 1Department
Author Manuscript
2Simmons
of Nutrition, Harvard T.H Chan School of Public Health, Boston, MA
College, Boston, MA
3Department
of Epidemiology and Biostatistics, and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China 4Department
of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA
5Channing
Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
Abstract Author Manuscript
Background—Adherence to several diet quality scores including the Alternative Healthy Eating Index (AHEI), Alternative Mediterranean diet score (AMED), and Dietary Approach to Stop Hypertension (DASH) has been associated with lower risk of cardiovascular disease (CVD), but little is known about how changes in these scores over time influence subsequent CVD risk.
Author Manuscript
Methods and Results—We analyzed the association between 4-year changes in three diet quality scores (AHEI, AMED, and DASH) and subsequent CVD risk among 29,343 men in the Health Professionals Follow-up Study and 51,195 women in the Nurses’ Health Study (1986– 2010). During 1,394,702 person-years of follow up, we documented 11,793 CVD cases. Compared with participants whose diet quality remained relatively stable in each 4-year period, those with the greatest improvement in diet quality scores had a 7%–8% lower CVD risk in the subsequent 4-year period (pooled hazard ratio, 0.92 [95% confidence interval (CI): 0.87–0.99] for AHEI; 0.93 [95% CI: 0.85–1.02] for AMED; and 0.93 [95% CI: 0.87–0.99] for DASH; all Ptrend
