title: Dietary patterns and mortality in a Chinese population.
abstract: BACKGROUND
  Limited research has examined the association between dietary patterns and mortality, especially in non-Western populations.
  
  
  OBJECTIVE
  We examined the association of dietary patterns with all-cause mortality and cause-specific mortality in the Singapore Chinese Health Study, which included a unique ethnic population with strong Western and South Asian cultural influences.
  
  
  METHODS
  We conducted a prospective data analysis of the Singapore Chinese Health Study, which included 52,584 Chinese men and women (aged 45-74 y) who were free of diabetes, cardiovascular disease (CVD), and cancer at baseline (1993-1998) and followed through 2011 with 10,029 deaths. The following 2 major dietary patterns were identified by using a principal components analysis: a vegetable-, fruit-, and soy-rich (VFS) pattern and a dim sum- and meat-rich (DSM) dietary pattern. Pattern scores for each participant were calculated and examined with all-cause and cause-specific mortality risks by using a Cox proportional hazards regression.
  
  
  RESULTS
  The VFS pattern was inversely associated with all-cause mortality and each cause-specific category (CVD, cancer, and respiratory) of mortality during the follow-up period. Compared with the lowest quintile of the VFS pattern, HRs for quintiles 2-5 for all-cause mortality were 0.90, 0.79, 0.80, and 0.75, respectively (P-trend < 0.0001). The DSM pattern was positively associated with CVD mortality in the whole population (HR for fifth quintile compared with first quintile: 1.23; 95% CI: 1.07, 1.40; P-trend = 0.001). Positive associations between the DSM pattern and cancer and all-cause mortality were only present in ever-smokers. In ever-smokers, relative to the first quintile, HRs for quintiles 2-5 of the DSM pattern for all-cause mortality were 1.04, 1.04, 1.13, and 1.24, respectively (P-trend < 0.0001). Similarly, HRs for quintiles 2-5 for cancer mortality were 1.08, 1.03, 1.25, and 1.34, respectively (P-trend < 0.0001). The DSM pattern was not associated with respiratory mortality.
  
  
  CONCLUSIONS
  Dietary patterns are strongly associated with mortality in Chinese Singaporeans.
authors: From the School of Public Health Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (AOO, MDG, and MAP); The Duke-National University of Singapore Graduate Medical School, Singapore (W-PK); the Saw Swee Hock School of Public Health, National University of Singapore (W-PK); the Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA (J-MY); and the Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA (J-MY).
authors: Andrew O
authors: AO
authors: Odegaard
authors: From the School of Public Health Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (AOO, MDG, and MAP); The Duke-National University of Singapore Graduate Medical School, Singapore (W-PK); the Saw Swee Hock School of Public Health, National University of Singapore (W-PK); the Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA (J-MY); and the Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA (J-MY).
authors: Woon-Puay
authors: WP
authors: Koh
authors: From the School of Public Health Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (AOO, MDG, and MAP); The Duke-National University of Singapore Graduate Medical School, Singapore (W-PK); the Saw Swee Hock School of Public Health, National University of Singapore (W-PK); the Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA (J-MY); and the Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA (J-MY).
authors: Jian-Min
authors: JM
authors: Yuan
authors: From the School of Public Health Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (AOO, MDG, and MAP); The Duke-National University of Singapore Graduate Medical School, Singapore (W-PK); the Saw Swee Hock School of Public Health, National University of Singapore (W-PK); the Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA (J-MY); and the Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA (J-MY).
authors: Myron D
authors: MD
authors: Gross
authors: From the School of Public Health Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (AOO, MDG, and MAP); The Duke-National University of Singapore Graduate Medical School, Singapore (W-PK); the Saw Swee Hock School of Public Health, National University of Singapore (W-PK); the Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA (J-MY); and the Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA (J-MY).
authors: Mark A
authors: MA
authors: Pereira
mesh_terms: D000368:Aged; D044466:Asian People; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000209:etiology* / Q000401:mortality; D002681:China / Q000208:ethnology; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D008460:Meat / Q000009:adverse effects*; D008875:Middle Aged; D009026:Mortality; D009043:Motor Activity; D009369:Neoplasms / Q000208:ethnology / Q000209:etiology* / Q000401:mortality; D025341:Principal Component Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012846:Singapore / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology / Q000401:mortality; D011795:Surveys and Questionnaires