title: Dietary indices, cardiovascular risk factors and mortality in middle-aged adults: findings from the Aerobics Center Longitudinal Study.
abstract: OBJECTIVE
  We 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.
  
  
  METHODS
  Between 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.
  
  
  RESULTS
  Higher 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.
  
  
  CONCLUSIONS
  Although 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.
authors: Department of Medical Physiology, School of Medicine, University of Granada, Spain; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia. Electronic address: mmcuenca@ugr.es.
authors: Magdalena
authors: M
authors: Cuenca-García
authors: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia; Area of Physical Education and Sport, School of Education, Nursing and Physiotherapy, University of Almería, Spain.
authors: Enrique G
authors: EG
authors: Artero
authors: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia.
authors: Xuemei
authors: X
authors: Sui
authors: Department of Kinesiology, College of Human Sciences, Iowa State University, Ames.
authors: Duck-chul
authors: DC
authors: Lee
authors: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia; South Carolina Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia.
authors: James R
authors: JR
authors: Hebert
authors: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia.
authors: Steven N
authors: SN
authors: Blair
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013781:Texas; D055815:Young Adult
keywords: All-cause mortality; Cancer; Cardiovascular disease; Dietary patterns; Physical fitness