Associations of evolutionary-concordance diet, Mediterranean diet and evolutionary-concordance lifestyle pattern scores with all-cause and cause-specific mortality.

• Type of Material: Article
• Authors: En Cheng, Emory University; Caroline Y. Um, Emory University; Anna Prizment, University of Minnesota; DeAnn Lazovich, University of Minnesota; Roberd Bostick, Emory University
• Language: English
• Date: 2018-12-18
• Publisher: Cambridge University Press
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © The Authors 2018.
• Final Published Version (URL): http://dx.doi.org/10.1017/S0007114518003483
• Title of Journal or Parent Work: British Journal of Nutrition
• Start Page: 1
• End Page: 10
• Grant/Funding Information: The study was supported by National Cancer Institute of the National Institutes of Health (grant R01 CA039742).
• Keywords: Cohort studies; Paleolithic diet; Mediterranean diet; Mortality; HR hazard ratio; ICD International Classification of Diseases; Lifestyle
• Research Categories: Health Sciences, Nutrition; Health Sciences, Public Health; Health Sciences, Epidemiology; Health Sciences, Human Development

Abstract

Various individual diet and lifestyle factors are associated with mortality. Investigating these factors collectively may help clarify whether dietary and lifestyle patterns contribute to life expectancy. We investigated the association of previously described evolutionary-concordance and Mediterranean diet pattern scores and a novel evolutionary-concordance lifestyle pattern score with all-cause and cause-specific mortality in the prospective Iowa Women's Health Study (1986-2012). We created the diet pattern scores from Willett FFQ responses, and the lifestyle pattern score from self-reported physical activity, BMI and smoking status, and assessed their associations with mortality, using multivariable Cox proportional hazards regression. Of the 35 221 55- to 69-year-old cancer-free women at baseline, 18 687 died during follow-up. The adjusted hazard ratios (HR) and 95 % CI for all-cause, all CVD, and all-cancer mortality among participants in the highest relative to the lowest quintile of the evolutionary-concordance lifestyle score were, respectively, 0·52 (95 % CI 0·50, 0·55), 0·53 (95 % CI 0·49, 0·57) and 0·51 (95 % CI 0·46, 0·57). The corresponding findings for the Mediterranean diet score were HR 0·85 (95 % CI 0·82, 0·90), 0·83 (95 % CI 0·76, 0·90) and 0·93 (95 % CI 0·84, 1·03), and for the evolutionary-concordance diet score they were close to null and not statistically significant. The lowest estimated risk was among those in the highest joint quintile of the lifestyle score and either diet score (both Pinteraction <0·01). Our findings suggest that (1) a more Mediterranean-like diet pattern and (2) a more evolutionary-concordant lifestyle pattern, alone and in interaction with a more evolutionary-concordant or Mediterranean diet pattern, may be inversely associated with mortality.