SCIENCE@home

Modified-weight Healthy Eating Index-2015 scores are more strongly associated with mortality risk than standard scores.

H. Parker,B. Oaks,Ashley L. Buchanan,Maya Vadiveloo

Published 2023 in Journal of the Academy of Nutrition and Dietetics

ABSTRACT

BACKGROUND Various diet quality scores are consistently and similarly associated with mortality risk. Emerging evidence suggests that individual diet quality components are differentially associated with mortality risk, but it is unclear whether modified weights reflective of relative component differences would strengthen mortality associations. OBJECTIVE This study examined whether Healthy Eating Index-2015 (HEI-2015) scores with modified (vs. standard) component weights are differentially associated with mortality risk. DESIGN This was a longitudinal analysis of the National Health and Nutrition Examination Survey III (1988-94) with 23 years of mortality follow-up. The HEI-2015 and modified-weight scores were calculated from one 24-hour recall. The a priori Key Facets HEI was a subset score equivalently weighting fruits, vegetables, whole grains, and seafood and plant proteins. In the LASSO regression (LR)-weighted HEI, components were assigned weights reflecting relative mortality risk associations. PARTICIPANTS /setting: Analyses included 10,789 U.S. adults (≥ 20 years) who were not pregnant and without prior diabetes, cancer, cardiovascular disease (CVD), or chronic kidney disease diagnoses. MAIN OUTCOME MEASURES All-cause and CVD mortality risk were the primary outcomes examined. STATISTICAL ANALYSES PERFORMED Three energy-adjusted HEI scores were assigned to quintiles; covariate-adjusted sex-stratified Cox models with age as the timescale assessed associations between and trends across quintiles of HEI scores and all-cause and CVD mortality risk. RESULTS Modified-weight HEI scores were associated with 23% to 38% reduced all-cause mortality risk in the highest vs. lowest quintile, while comparisons were only significant for women (Key Facets p=0.02 and LR-weighted p=0.001; for men p=0.06 on both scores), trends across quintiles of modified-weight scores were significant for men and women. The HEI-2015 was not significantly associated with all-cause mortality risk, and none of the scores were associated with CVD mortality risk. CONCLUSIONS Only modified-weight HEI scores were associated with reduced all-cause mortality risk. Findings suggest modified diet quality weighting schemes warrant further examination to determine their replicability.

PUBLICATION RECORD

CITATION MAP

EXTRACTION MAP

CLAIMS

  • No claims are published for this paper.

CONCEPTS

  • No concepts are published for this paper.

REFERENCES

Showing 1-45 of 45 references · Page 1 of 1

CITED BY

  • No citing papers are available for this paper.

Showing 0-0 of 0 citing papers · Page 1 of 1