title: Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in women.
abstract: 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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departments of Nutrition, Epidemiology, and Biostatistics, Harvard School of Public Health, Boston, MA, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: McCullough
authors.forename: D
authors.initials: D
authors.lastname: Feskanich
authors.forename: M J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: B A
authors.initials: BA
authors.lastname: Rosner
authors.forename: F B
authors.initials: FB
authors.lastname: Hu
authors.forename: D J
authors.initials: DJ
authors.lastname: Hunter
authors.forename: J N
authors.initials: JN
authors.lastname: Variyam
authors.forename: G A
authors.initials: GA
authors.lastname: Colditz
authors.forename: W C
authors.initials: WC
authors.lastname: Willett
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease; D015331:Cohort Studies; D004032:Diet; D002149:Energy Intake; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D009726:Nurses; D018673:Nutrition Policy; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D011795:Surveys and Questionnaires