Extended Data Table 1.
Associations between cumulative average dietary patterns (comparing the 90th to 10th percentile) and secondary outcomes in the pooled data
| Outcome | Coronary Heart Disease |
Stroke | Obesity-related Cancer |
Smoking-related Cancer |
Alternative Major Chronic Disease |
|
|---|---|---|---|---|---|---|
| Cases | 8,083 | 5,398 | 8,660 | 9,118 | 53,524 | |
| Person-year | 5,185,291 | 5,203,823 | 5,189,782 | 5,204,833 | 4,852,894 | |
| Pattern | Model | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) |
| AHEI-2010 | Age | 0.57 (0.54, 0.61) | 0.72 (0.67, 0.77) | 0.83 (0.78, 0.88) | 0.68 (0.64, 0.72) | 0.60 (0.59, 0.62) |
| MVa | 0.72 (0.68, 0.77) | 0.84 (0.78, 0.91) | 0.92 (0.86, 0.97) | 0.87 (0.82, 0.93) | 0.74 (0.72, 0.76) | |
| MV + nSESb | 0.75 (0.70, 0.80) | 0.86 (0.79, 0.93) | 0.92 (0.87, 0.98) | 0.87 (0.82, 0.93) | 0.76 (0.74, 0.78) | |
| MV + BMIc | 0.75 (0.71, 0.80) | 0.86 (0.79, 0.93) | 0.94 (0.89, 1.00) | 0.88 (0.83, 0.94) | 0.79 (0.77, 0.81) | |
| AMED | Age | 0.60 (0.57, 0.64) | 0.71 (0.66, 0.76) | 0.81 (0.77, 0.86) | 0.64 (0.61, 0.68) | 0.62 (0.61, 0.63) |
| MVa | 0.78 (0.73, 0.83) | 0.84 (0.77, 0.91) | 0.91 (0.86, 0.97) | 0.86 (0.81, 0.92) | 0.78 (0.76, 0.80) | |
| MV + nSESb | 0.80 (0.75, 0.85) | 0.85 (0.79, 0.92) | 0.92 (0.86, 0.97) | 0.86 (0.81, 0.92) | 0.79 (0.77, 0.81) | |
| MV + BMIc | 0.81 (0.76, 0.87) | 0.86 (0.79, 0.93) | 0.94 (0.89, 1.00) | 0.87 (0.82, 0.92) | 0.84 (0.82, 0.86) | |
| hPDI | Age | 0.67 (0.63, 0.71) | 0.81 (0.76, 0.87) | 0.87 (0.83, 0.92) | 0.79 (0.75, 0.84) | 0.68 (0.67, 0.70) |
| MVa | 0.80 (0.75, 0.85) | 0.91 (0.84, 0.98) | 0.94 (0.89, 0.99) | 0.92 (0.87, 0.98) | 0.79 (0.77, 0.81) | |
| MV + nSESb | 0.80 (0.76, 0.86) | 0.92 (0.85, 0.99) | 0.94 (0.89, 0.99) | 0.92 (0.87, 0.98) | 0.80 (0.78, 0.82) | |
| MV + BMIc | 0.82 (0.77, 0.87) | 0.92 (0.86, 1.00) | 0.96 (0.90, 1.01) | 0.93 (0.88, 0.98) | 0.83 (0.81, 0.85) | |
| DASH | Age | 0.59 (0.55, 0.62) | 0.69 (0.64, 0.74) | 0.81 (0.76, 0.86) | 0.60 (0.57, 0.64) | 0.60 (0.59, 0.62) |
| MVa | 0.79 (0.74, 0.84) | 0.84 (0.78, 0.91) | 0.94 (0.88, 1.00) | 0.87 (0.82, 0.92) | 0.78 (0.77, 0.80) | |
| MV + nSESb | 0.81 (0.76, 0.87) | 0.86 (0.79, 0.93) | 0.94 (0.89, 1.00) | 0.87 (0.82, 0.92) | 0.80 (0.78, 0.82) | |
| MV + BMIc | 0.81 (0.76, 0.87) | 0.86 (0.79, 0.93) | 0.96 (0.90, 1.02) | 0.87 (0.82, 0.93) | 0.83 (0.81, 0.85) | |
| DRRD | Age | 0.58 (0.55, 0.62) | 0.67 (0.62, 0.72) | 0.84 (0.79, 0.89) | 0.73 (0.69, 0.77) | 0.58 (0.57, 0.60) |
| MVa | 0.71 (0.67, 0.76) | 0.76 (0.70, 0.82) | 0.91 (0.86, 0.97) | 0.88 (0.83, 0.94) | 0.70 (0.68, 0.71) | |
| MV + nSESb | 0.73 (0.69, 0.78) | 0.77 (0.71, 0.83) | 0.91 (0.86, 0.97) | 0.88 (0.83, 0.94) | 0.71 (0.69, 0.72) | |
| MV + BMIc | 0.74 (0.69, 0.79) | 0.77 (0.71, 0.83) | 0.94 (0.88, 0.99) | 0.89 (0.84, 0.94) | 0.74 (0.72, 0.76) | |
| WCRF/AICR | Age | 0.77 (0.73, 0.82) | 0.87 (0.81, 0.93) | 0.89 (0.85, 0.94) | 0.71 (0.67, 0.75) | 0.81 (0.79, 0.83) |
| MVa | 1.00 (0.94, 1.06) | 1.03 (0.95, 1.11) | 1.00 (0.95, 1.06) | 0.95 (0.90, 1.01) | 1.00 (0.98, 1.03) | |
| MV + nSESb | 1.01 (0.95, 1.07) | 1.03 (0.96, 1.11) | 1.00 (0.95, 1.06) | 0.95 (0.90, 1.01) | 1.01 (0.99, 1.04) | |
| MV + BMIc | 0.98 (0.92, 1.04) | 1.01 (0.94, 1.09) | 0.98 (0.93, 1.04) | 0.95 (0.89, 1.00) | 0.97 (0.95, 1.00) | |
| rEDIH | Age | 0.56 (0.53, 0.59) | 0.71 (0.66, 0.76) | 0.81 (0.76, 0.85) | 0.80 (0.76, 0.85) | 0.53 (0.51, 0.54) |
| MVa | 0.63 (0.60, 0.67) | 0.76 (0.71, 0.82) | 0.84 (0.80, 0.89) | 0.89 (0.84, 0.94) | 0.59 (0.58, 0.60) | |
| MV + nSESb | 0.65 (0.61, 0.69) | 0.77 (0.72, 0.83) | 0.84 (0.80, 0.89) | 0.89 (0.84, 0.94) | 0.60 (0.59, 0.61) | |
| MV + BMIc | 0.71 (0.67, 0.76) | 0.82 (0.77, 0.89) | 0.93 (0.88, 0.99) | 0.92 (0.87, 0.97) | 0.73 (0.71, 0.75) | |
| rEDIP | Age | 0.63 (0.59, 0.66) | 0.75 (0.70, 0.81) | 0.83 (0.79, 0.88) | 0.95 (0.90, 1.00) | 0.59 (0.58, 0.60) |
| MVa | 0.65 (0.61, 0.68) | 0.77 (0.71, 0.82) | 0.83 (0.79, 0.87) | 0.91 (0.87, 0.96) | 0.62 (0.60, 0.63) | |
| MV + nSESb | 0.66 (0.62, 0.69) | 0.77 (0.72, 0.83) | 0.83 (0.79, 0.88) | 0.91 (0.87, 0.96) | 0.62 (0.61, 0.64) | |
| MV + BMIc | 0.71 (0.67, 0.75) | 0.82 (0.76, 0.88) | 0.90 (0.86, 0.96) | 0.94 (0.89, 0.99) | 0.73 (0.72, 0.75) | |
AHEI-2010, Alternative Healthy Eating Index-2010; AMED, Alternate Mediterranean Diet score; BMI, body mass index; CI, Confidence interval; DASH, Dietary Approaches to Stop Hypertension score; DRRD, Diabetes Risk Reduction Diet; hPDI, Healthful plant-based diet index; HR, Hazard ratio; MV, multivariable; nSES, neighborhood socioeconomic status; rEDIH, reversed Empirical dietary index for hyperinsulinemia; rEDIP, reversed Empirical dietary inflammation pattern; WCRF/AICR, World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) dietary score.
Analyses were stratified by age (in month), calendar year, and cohort. MV model: adjusted for physical activity (<3.0, 3.0-8.9, 9.0-17.9, 18.0-26.9, 27.0-41.9, or ≥42 MET-h/week), cigarette smoking status (never, former quitting ≥10 y, former quitting <10 y, current), cigarette smoking pack-years (0, 1-4, 5-14, 15-24, or ≥25 pack-years), multivitamin use (yes or no), regular aspirin use (yes or no), regular non-steroidal anti-inflammatory drugs use (yes or no), postmenopausal hormone use (premenopausal, never, former, or current use) for women, and total energy intake (quintiles). Alcohol consumption (<5.0, 5.0-14.9, or ≥15.0 g/d) was adjusted for DASH, hPDI, and DRRD. For alternative major chronic disease, the model was additionally adjusted for family history of diabetes (yes or no), family history of cancer (yes or no), family history of cardiovascular disease (yes or no). For coronary heart disease and stroke, the model was additionally adjusted for family history of cardiovascular disease (yes or no). For obesity-related or smoking-related cancer, the model was additionally adjusted for family history of cancer (yes or no) and height (continuous).
Additionally adjusted for nSES (continuous).
Additionally adjusted for BMI (continuous).