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. 2016 May 11;146(7):1341–1347. doi: 10.3945/jn.115.227900

TABLE 2.

HRs (95% CIs) of incident physical impairment, measured by the Physical Function scale of the SF-36, in women in the Nurses’ Health Study by quintile of the overall AHEI-2010 score and AHEI-2010 score components1

Quintiles of AHEI-2010 score
Q1 Q2 Q3 Q4 Q5 P-trend
Overall AHEI-2010 score
 Median 39.9 46.8 51.9 57.3 65.2
 Person-years 41,377 45,493 47,158 50,108 53,704
 Age-adjusted HR (95% CI) 1.0 (Ref) 0.94 (0.91, 0.98) 0.89 (0.86, 0.92) 0.82 (0.79, 0.85) 0.71 (0.69, 0.73) <0.001
 Multivariable-adjusted HR2 (95% CI) 1.0 (Ref) 0.96 (0.93, 0.99) 0.93 (0.90, 0.96) 0.90 (0.87, 0.93) 0.87 (0.84, 0.90) <0.001
Natural categories of AHEI-2010 score components
 Vegetables
  Median, servings/d 1.63 2.42 3.09 3.90 5.34
  Person-years 42,434 46,635 48,751 49,172 50,848
  Age-adjusted HR (95% CI) 1.0 (Ref) 0.98 (0.95, 1.02) 0.96 (0.93, 1.00) 0.94 (0.91, 0.97) 0.87 (0.84, 0.90) <0.001
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 0.99 (0.96, 1.03) 0.98 (0.95, 1.01) 0.98 (0.95, 1.02) 0.95 (0.91, 0.98) 0.003
 Fruits
  Median, servings/d 0.54 1.01 1.43 1.92 2.81
  Person-years 44,459 47,792 48,913 48,876 47,800
  Age-adjusted HR (95% CI) 1.0 (Ref) 0.93 (0.90, 0.96) 0.90 (0.87, 0.93) 0.87 (0.84, 0.90) 0.79 (0.77, 0.82) <0.001
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 0.95 (0.92, 0.98) 0.96 (0.92, 0.99) 0.95 (0.92, 0.98) 0.94 (0.91, 0.98) 0.02
 Nuts and legumes
  Median, servings/d 0.07 0.15 0.25 0.38 0.68
  Person-years 43,529 46,267 48,023 49,324 50,697
  Age-adjusted HR (95% CI) 1.0 (Ref) 1.04 (1.00, 1.07) 1.03 (0.99, 1.06) 1.02 (0.99, 1.05) 0.97 (0.93, 1.00) <0.001
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 1.02 (0.98, 1.05) 1.01 (0.97, 1.04) 1.03 (0.99, 1.06) 1.06 (1.02, 1.10) <0.001
 Red and processed meats
  Median, servings/d 0 0.45 0.77 1.10 1.61
  Person-years 46,287 48,844 49,857 48,752 44,100
  Age-adjusted HR (95% CI) 1.0 (Ref) 0.94 (0.91, 0.97) 1.03 (0.99, 1.06) 1.11 (1.07, 1.14) 1.20 (1.16, 1.24) <0.001
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 0.90 (0.87, 0.93) 0.92 (0.89, 0.95) 0.94 (0.91, 0.97) 0.97 (0.94, 1.00) 0.4
 Sugar-sweetened beverages
  Median, servings/d 0.18 0.55 0.93 1.29 2.05
  Person-years 47,908 48,423 47,191 48,126 46,192
  Age-adjusted HR (95% CI) 1.0 (Ref) 1.06 (1.03, 1.10) 1.03 (0.99, 1.06) 1.01 (0.98, 1.04) 1.04 (1.00, 1.07) 0.5
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 1.04 (1.00, 1.07) 1.01 (0.98, 1.05) 1.03 (0.99, 1.06) 1.08 (1.04, 1.12) <0.001
 Alcohol
  Median, drinks/d 0 0.04 0.14 0.45 1.27
  Person-years 51,988 31,210 49,156 53,398 52,088
  Age-adjusted HR (95% CI) 1.0 (Ref) 1.04 (1.00, 1.08) 0.93 (0.90, 0.96) 0.88 (0.85, 0.90) 0.87 (0.84, 0.90) <0.001
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 0.94 (0.90, 0.97) 0.91 (0.88, 0.94) 0.90 (0.87, 0.93) 0.92 (0.89, 0.95) 0.02
 Whole grains
  Median, g/d 5.3 10.9 16.4 23.0 34.9
  Person-years 41,021 47,176 49,132 50,258 50,253
  Age-adjusted HR (95% CI) 1.0 (Ref) 1.03 (0.99, 1.06) 0.99 (0.96, 1.02) 0.96 (0.92, 0.99) 0.88 (0.85, 0.91) <0.001
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 1.00 (0.97, 1.04) 1.00 (0.96, 1.03) 1.01 (0.97, 1.04) 1.03 (1.00, 1.07) 0.04
 trans fats
  Median, % of energy 0.009 0.012 0.014 0.017 0.021
  Person-years 52,234 49,654 48,139 43,019 41,794
  Age-adjusted HR (95% CI) 1.0 (Ref) 1.14 (1.10, 1.17) 1.23 (1.19, 1.27) 1.30 (1.26, 1.34) 1.28 (1.24, 1.32) <0.001
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 0.98 (0.95, 1.01) 1.01 (0.98, 1.04) 1.02 (0.98, 1.05) 1.02 (0.98, 1.06) 0.03
 ω-3 FAs
  Median, mg/d 75.5 130 190 270 422.5
  Person-years 44,211 45,915 49,173 49,490 49,051
  Age-adjusted HR (95% CI) 1.0 (Ref) 1.04 (1.01, 1.07) 1.01 (0.98, 1.05) 0.98 (0.95, 1.01) 0.95 (0.92, 0.98) <0.001
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 1.01 (0.97, 1.04) 0.98 (0.95, 1.01) 0.98 (0.94, 1.01) 0.98 (0.95, 1.02) 0.2
 PUFAs
  Median, % of energy 4.35 5.14 5.73 6.37 7.41
  Person-years 46,411 48,190 49,007 48,323 45,909
  Age-adjusted HR (95% CI) 1.0 (Ref) 1.06 (1.02, 1.09) 1.11 (1.08, 1.15) 1.12 (1.08, 1.16) 1.12 (1.08, 1.16) <0.001
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 0.97 (0.94, 1.00) 0.99 (0.96, 1.03) 0.98 (0.94, 1.01) 1.01 (0.97, 1.04) 0.6
 Sodium
  Median, mg/d 1357 1772 2102 2479 3113
  Person-years 47,444 49,024 48,730 48,135 44,507
  Age-adjusted HR (95% CI) 1.0 (Ref) 1.08 (1.04, 1.11) 1.14 (1.10, 1.18) 1.16 (1.12, 1.20) 1.26 (1.21, 1.30) <0.001
  Multivariable-adjusted HR3 (95% CI) 1.0 (Ref) 1.04 (1.01, 1.08) 1.09 (1.05, 1.13) 1.10 (1.05, 1.14) 1.15 (1.10, 1.19) <0.001
1

AHEI-2010, Alternative Healthy Eating Index-2010; MET, metabolic equivalent of task; Q, quintile; Ref, reference; SF-36, Medical Outcomes Short Form-36.

2

Models adjusted for BMI (continuous), total caloric intake (quintiles), physical activity (<3.0, 3.0–8.9, 9.0–17.9, 18.0–26.9, or ≥27 METs/wk), SF-36 Mental Health Index (continuous), smoking (never, past, current 1–14 cigarettes/d, current 15–24 cigarettes/d, or current ≥25 cigarettes/d), hypertension (yes or no), high cholesterol (yes or no), myocardial infarction (yes or no), stroke (yes or no), and type 2 diabetes (yes or no).

3

Models adjusted for BMI (continuous), total caloric intake (quintiles), physical activity (<3.0, 3.0–8.9, 9.0–17.9, 18.0–26.9, or ≥27 METs/wk), SF-36 Mental Health Index (continuous), smoking (never, past, current 1–14 cigarettes/d, current 15–24 cigarettes/d, or current ≥25 cigarettes/d), hypertension (yes or no), high cholesterol (yes or no), myocardial infarction (yes or no), stroke (yes or no), type 2 diabetes (yes or no), and the AHEI-2010 score without the component of interest.