Adherence to the Healthy Eating Index and Alternative Healthy Eating Index dietary patterns and mortality from all causes, cardiovascular disease and cancer: a meta-analysis of observational studies.
This meta-analysis investigated the association of diet quality indices, as assessed by HEI and AHEI, and the risk of all-cause, cardiovascular and cancer mortality.



We used PubMed, ISI Web of Science and Google Scholar to search for eligible articles published before July 2015. A total of 12 cohort studies (38 reports) and one cross-sectional study (three reports) met the inclusion criteria and were included in our meta-analysis.



The highest level of adherence to the Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI) was significantly associated with a reduced risk of all-cause mortality [relative risk (RR) = 0.77, 95% confidence intterval (CI) = 0.76-0.78], cardiovascular mortality (RR = 0.77, 95% CI = 0.74-0.80) and cancer mortality (RR = 0.83, 95% CI = 0.81-0.86). Egger regression tests provided no evidence of publication bias.



The present study indicates that high adherence to HEI and AHEI dietary patterns, indicating high diet quality, are associated with reduced risk of all-cause mortality (as well as cardiovascular mortality and cancer mortality).
Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Onvani
Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Haghighatdoost
Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
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Surkan
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Larijani
Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.|Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.|Department of Community Nutrition, School of nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Azadbakht
D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control*; D016208:Databases, Factual; D000072001:Diet, Healthy; D063427:Food Quality; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000401:mortality* / Q000517:prevention & control*; D064887:Observational Studies as Topic; D010349:Patient Compliance
Alternative Healthy Eating Index; Healthy Eating Index; cancer; cardiovascular; mortality