title: A prospective cohort study of dietary indices and incidence of epithelial ovarian cancer.
abstract: BACKGROUND
  Several dietary indices have been developed to measure overall diet quality, including the Healthy Eating Index-2005 (HEI-2005), which measures adherence to the 2005 Dietary Guidelines from the USDA; the Alternative Healthy Eating Index-2010 (AHEI-2010), which is based on foods and nutrients predictive of chronic disease risk; and the Alternate Mediterranean Diet Score (aMDS), which is an index that characterizes traditional food patterns of Mediterranean countries. Few studies have evaluated diet quality and ovarian cancer risk.
  
  
  METHODS
  We assessed the associations of the HEI-2005, AHEI-2010, and aMDS with risk of epithelial ovarian cancer prospectively among women in the Nurses' Health Study. We used Cox proportional hazards models, adjusting for known ovarian cancer risk factors.
  
  
  RESULTS
  During 24 years of follow-up, we documented 696 incident epithelial ovarian cancer cases among 82,948 women with diet information. The multivariate adjusted hazard ratios (95% confidence interval; Ptrend) of epithelial ovarian cancer comparing the highest with the lowest quintile were 1.03 (0.80-1.34; 0.77) for the AHEI-2010, 0.85 (0.65-1.12; 0.57) for the HEI-2005, and 0.91 (0.71-1.18; 0.44) for the aMDS.
  
  
  CONCLUSIONS
  We did not observe any clear association of three diet quality scores with ovarian cancer risk. Further work should other metrics of evaluating diet quality that may be more relevant cancer risk.
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA. jix719@mail.harvard.edu.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. jix719@mail.harvard.edu.
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA. nhlip@channing.harvard.edu.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. nhlip@channing.harvard.edu.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Poole
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. kterry@partners.org.|Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. kterry@partners.org.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Terry
authors.affiliation: Department of Nutrition, Simmons College, Boston, MA, USA. teresa.fung@simmons.edu.
authors.forename: Teresa T
authors.initials: TT
authors.lastname: Fung
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA. stbar@channing.harvard.edu.|Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA. stbar@channing.harvard.edu.
authors.forename: Bernard A
authors.initials: BA
authors.lastname: Rosner
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA. wwillett@hsph.harvard.edu.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. wwillett@hsph.harvard.edu.|Department of Nutrition, Harvard School of Public Health, Boston, MA, USA. wwillett@hsph.harvard.edu.
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA. nhsst@channing.harvard.edu.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. nhsst@channing.harvard.edu.
authors.forename: Shelley S
authors.initials: SS
authors.lastname: Tworoger
mesh_terms: D000328:Adult; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D038441:Diet, Mediterranean; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015999:Multivariate Analysis; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology* / Q000209:etiology; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors