Dietary patterns and 15-y risks of major coronary events, diabetes, and mortality.
BACKGROUND
Few studies have examined the long-term effect of habitual diet on risks of incident diabetes, coronary heart disease, and mortality.


OBJECTIVE
We analyzed the prospective relation of dietary patterns with incident chronic disease and mortality during 15 y of follow-up in the Whitehall II study.


METHODS
We conducted a prospective analysis (106,633 person-years at risk) among men and women (n = 7731) with a mean age of 50 y at the time of dietary assessment (127-item food-frequency questionnaire). Coronary death or nonfatal myocardial infarction and incident diabetes were verified by record tracing and oral-glucose-tolerance tests.


RESULTS
Cluster analysis identified 4 dietary patterns at baseline. The patterns were termed unhealthy (white bread, processed meat, fries, and full-cream milk; n = 2665), sweet (white bread, biscuits, cakes, processed meat, and high-fat dairy products; n = 1042), Mediterranean-like (fruit, vegetables, rice, pasta, and wine; n = 1361), and healthy (fruit, vegetables, whole-meal bread, low-fat dairy, and little alcohol; n = 2663). Compared with the unhealthy pattern, the healthy pattern reduced the risk of coronary death or nonfatal myocardial infarction and diabetes; hazard ratios (95% CI) were 0.71 (0.51, 0.98) and 0.74 (0.58, 0.94), respectively, after adjustment for age, sex, ethnicity, dietary energy misreporting, social position, smoking status, and leisure-time physical activity. Dietary pattern was not associated with all-cause mortality. Residual confounding by socioeconomic factors was unlikely to account for the observed dietary effects.


CONCLUSIONS
The healthy eating pattern reduced risks of diabetes and major coronary events. Such dietary patterns offer considerable health benefits to individuals and contribute to public health.
Brunner
Eric J
EJ
Department of Epidemiology and Public Health, University College London, London, United Kingdom. e.brunner@ucl.ac.uk
Mosdøl
Annhild
A
Witte
Daniel R
DR
Martikainen
Pekka
P
Stafford
Mai
M
Shipley
Martin J
MJ
Marmot
Michael G
MG
D016000:Cluster Analysis; D003327:Coronary Disease / Q000453:epidemiology* / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000401:mortality; D004032:Diet / Q000706:statistics & numerical data / Q000639:trends*; D038441:Diet, Mediterranean; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires