Higher diet quality is inversely associated with mortality in African-American women.
BACKGROUND
Diet quality has been inversely associated with overall mortality in white populations, but the evidence in African-American populations is limited.


OBJECTIVE
The goal of the present study was to assess diet quality in relation to all-cause mortality in the Black Women's Health Study, a follow-up study of African-American women begun in 1995.


METHODS
Data used in this study were obtained via biennial questionnaires from 1995 to 2011. Based on food-frequency questionnaire data collected in 1995 and 2001, we calculated an index-based diet quality score [Dietary Approaches to Stop Hypertension (DASH)] and derived dietary patterns (prudent and Western) with the use of factor analysis. We followed 37,001 women who were aged 30-69 y and free of cancer, cardiovascular disease, and diabetes at baseline for mortality through 2011. Multivariable Cox regression was used to estimate HRs and 95% CIs. Analyses were conducted in 2014.


RESULTS
Based on a total of 1678 deaths during 16 y of follow-up, higher DASH scores were associated with reduced all-cause mortality (HR: 0.75; 95% CI: 0.63, 0.89 for highest vs. lowest quintiles). The DASH components most strongly associated with lower mortality were high intake of whole grains and low intake of red and processed meat. A Western dietary pattern, characterized by high intake of red and processed meat, was associated with increased all-cause mortality rates (HR: 1.37; 95% CI: 1.17, 1.60 for highest vs. lowest quintiles of score); a prudent dietary pattern was not associated with risk.


CONCLUSIONS
A DASH-style diet high in intake of whole grains and low in consumption of red meat is associated with reduced mortality rates in healthy African-American women.
Slone Epidemiology Center at Boston University, Boston, MA.
Deborah A
DA
Boggs
Slone Epidemiology Center at Boston University, Boston, MA.
Yulun
Y
Ban
Slone Epidemiology Center at Boston University, Boston, MA.
Julie R
JR
Palmer
Slone Epidemiology Center at Boston University, Boston, MA lrosenbe@bu.edu.
Lynn
L
Rosenberg
D000328:Adult; D001741:Black or African American; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004032:Diet; D066273:Diet, Western; D023381:Endpoint Determination; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology*; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology; D015596:Nutrition Assessment; D010349:Patient Compliance; D016016:Proportional Hazards Models; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016387:Women's Health
African Americans; all-cause mortality; cohort study; diet quality; women's health