Dietary diversity and subsequent mortality in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.
We examined the relation of dietary diversity to subsequent all-cause mortality by using data from the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study, 1982-1987. The analytic cohort consisted of 4160 men and 6264 women (including 2556 deaths), 25-74 y at baseline (1971-1975). Twenty-four-hour dietary recalls were evaluated for variety among the five major food groups: dairy, meat, grain, fruit, and vegetable, with a dietary diversity score (DDS); consumption of each food group contributed 1 point to a maximum possible DDS of 5. Age-adjusted risk of mortality was inversely related to DDS (P < or = 0.0009) in men and women. The inverse diversity-mortality association was adjusted for potential confounders: education, race, smoking status, and dietary fiber intake; the relative risk of mortality in men and women consuming two or fewer food groups was 1.5 (95% CI 1.2-1.8) and 1.4 (95% CI 1.1-1.9), respectively. In conclusion, diets that omitted several food groups were associated with an increased risk of mortality.
Kant
A K
AK
City University of New York, Queens College, Flushing 11367-0904.
Schatzkin
A
A
Harris
T B
TB
Ziegler
R G
RG
Block
G
G
D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D004032:Diet; D004043:Dietary Fiber / Q000627:therapeutic use; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009749:Nutrition Surveys; D044469:Racial Groups; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking