title: Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in men.
abstract: BACKGROUND
  The Dietary Guidelines for Americans and the food guide pyramid aim to reduce the risk of major chronic disease in the United States, but data supporting their overall effectiveness are sparse. The healthy eating index (HEI) measures the concordance of dietary patterns with these guidelines.
  
  
  OBJECTIVE
  We tested whether a high HEI score (range: 0-100; 100 is best) calculated from a validated food-frequency questionnaire (HEI-f) could predict lower risk of major chronic disease in men.
  
  
  METHODS
  A cohort of US male health professionals without major disease completed detailed questionnaires on food intake and other risk factors for heart disease and cancer in 1986 and repeatedly during the 8-y follow-up. Major chronic disease outcome was defined as incident major cardiovascular disease (stroke or myocardial infarction, n = 1092), cancer (n = 1661), or other non-trauma-related deaths (n = 366).
  
  
  RESULTS
  The HEI-f was weakly inversely associated with risk of major chronic disease [comparing highest with lowest quintile of the HEI-f, relative risk (RR) = 0.89; 95% CI: 0.79, 1.00; P: < 0.001 for trend]. The HEI-f was associated with moderately lower risk of cardiovascular disease (RR = 0.72; 95% CI: 0.60, 0.88; P: < 0.001) but was not associated with lower cancer risk.
  
  
  CONCLUSIONS
  The HEI-f was only weakly associated with risk of major chronic disease, suggesting that improvements to the HEI may be warranted. Further research on the HEI could have implications for refinements to the Dietary Guidelines for Americans and the food guide pyramid.
authors.affiliation: Departments of Nutrition, Epidemiology, and Biostatistics, Harvard School of Public Health, Boston, MA, USA. mmccullo@cancer.org
authors.forename: M L
authors.initials: ML
authors.lastname: McCullough
authors.forename: D
authors.initials: D
authors.lastname: Feskanich
authors.forename: E B
authors.initials: EB
authors.lastname: Rimm
authors.forename: E L
authors.initials: EL
authors.lastname: Giovannucci
authors.forename: A
authors.initials: A
authors.lastname: Ascherio
authors.forename: J N
authors.initials: JN
authors.lastname: Variyam
authors.forename: D
authors.initials: D
authors.lastname: Spiegelman
authors.forename: M J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: W C
authors.initials: WC
authors.lastname: Willett
mesh_terms: D000428:Alcohol Drinking; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease; D015331:Cohort Studies; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage; D002523:Edible Grain; D002149:Energy Intake; D015444:Exercise; D006801:Humans; D008019:Life Style; D008297:Male; D008460:Meat; D009369:Neoplasms / Q000453:epidemiology; D018673:Nutrition Policy; D012307:Risk Factors; D014675:Vegetables
chemical_list: D004041:Dietary Fats