Dietary indices, cardiovascular risk factors and mortality in middle-aged adults: findings from the Aerobics Center Longitudinal Study

Abstract

PurposeWe examined the association between three predefined dietary indices and both cardiovascular disease (CVD) risk factors and long-term mortality in adult Aerobics Center Longitudinal Study’s participants. MethodsBetween 1987 and 1999, 12,449 (77% male) participants aged 20–84 years completed a clinical examination, which included dietary assessment by 3-day diet records. Three dietary indices were calculated: the Ideal Diet Index, the Diet Quality Index, and the Mediterranean Diet Score. CVD risk factors measurements included body mass index, total cholesterol, fasting glucose, blood pressure, and cardiorespiratory fitness. We calculated hazard ratios from Cox regression analyses, adjusting for potential confounders including physical fitness. ResultsHigher Ideal Diet Index, Diet Quality Index, and Mediterranean Diet Score scores were consistently associated with lower body mass index, cholesterol and glucose levels, and diastolic blood pressure, and higher cardiorespiratory fitness (all P < .05). However, after adjusting for age, sex, energy intake, and baseline examination year, the indices were not significantly related to all-cause, CVD, or cancer mortality. No association was observed in fully adjusted models, which controlled for fitness. ConclusionsAlthough these dietary indices based on 3-day diet records are strongly associated cross-sectionally to CVD risk profile of middle-aged men and women, they do not add to ability to predict long-term mortality in follow-up.