Table 3.
Overall and within-pair associations of moderation-quantified healthy diet (MQHD) score with the risk of mortality from specific and all causes in the whole cohort pooled by zygosity*
(Hazard ratios and 95 % confidence intervals per 10-unit increment; n 910)
| Items | CHD
|
CVD
|
All causes
|
||||||
|---|---|---|---|---|---|---|---|---|---|
| HR | 95 % CI | P | HR | 95 % CI | P | HR | 95 % CI | P | |
| Overall association | |||||||||
| No. of deaths | 113 | 198 | 610 | ||||||
| Energy adjusted | 0·74 | 0·63, 0·86 | 0·0002 | 0·86 | 0·77, 0·95 | 0·003 | 0·94 | 0·90, 0·99 | 0·014 |
| Multivariable adjusted | 0·76 | 0·66, 0·88 | 0·0003 | 0·87 | 0·79, 0·96 | 0·004 | 0·95 | 0·91, 0·996 | 0·03 |
| Within-pair association | |||||||||
| No. of deaths | 55 MZ, 58 DZ | 98 MZ, 100 DZ | 301 MZ, 309 DZ | ||||||
| Energy adjusted | 0·77 | 0·63, 0·96 | 0·02 | 0·86 | 0·75, 0·98 | 0·03 | 0·96 | 0·89, 1·02 | 0·16 |
| Multivariable adjusted | 0·79 | 0·64, 0·96 | 0·02 | 0·87 | 0·76, 0·998 | 0·047 | 0·96 | 0·90, 1·03 | 0·24 |
| Test for interaction with zygosity | – | 0·82 | – | 0·54 | – | 0·84 | |||
| Between-pair association | |||||||||
| Energy adjusted | 0·71 | 0·57, 0·87 | 0·001 | 0·86 | 0·74, 0·98 | 0·03 | 0·93 | 0·88, 0·997 | 0·04 |
| Multivariable adjusted | 0·74 | 0·61, 0·90 | 0·003 | 0·87 | 0·77, 0·99 | 0·03 | 0·95 | 0·89, 1·003 | 0·07 |
MZ, monozygotic twins; DZ, dizygotic twins.
Overall associations were equivalent to general population associations, and their HR and 95 % CI were estimated for each 10-unit increment in diet score (continuous variable). Within-pair associations were additionally controlled for genetic and common environmental factors, and their HR were estimated for per within-pair 10-unit difference in diet score (continuous variable). Between-pair associations were the associations between familial predisposition and other environmental factors shared between co-twins and outcomes, and their HR were estimated for per 10-unit increment in the average of diet score of the twin pair through frailty survival model. Frailty survival models were used for analyses to account for within-pair clustering, in which the frailty was a random effect to account for the clustering. Energy-adjusted model controlled for total energy intake (continuous). Multivariable-adjusted covariates included total energy intake (continuous), marital status (never, not married currently and married currently), years of education (continuous), BMI (continuous), modified Framingham Risk Score (continuous) and antihypertensives (yes/no).