Table 4.
Sex-Combined Hazard Ratios for Pancreatic Ductal Adenocarcinoma According to Quintile of Dietary Index (n = 535,824) in the National Institutes of Health–AARP Diet and Health Study, United States, 1995–2011
| Diet Quality | No. | Person-Years | No. ofPDACCases | Age- and Sex-AdjustedHR a | 95%CI | P forTrend b | Multivariable-AdjustedHR c | 95%CI | P forTrend b |
|---|---|---|---|---|---|---|---|---|---|
| HEI-2015 | |||||||||
| Quintile 1 (lowest) | 107,165 | 1,408,256 | 649 | 1.00 | Referent | 1.00 | Referent | ||
| Quintile 2 | 107,165 | 1,429,681 | 657 | 0.96 | 0.86, 1.07 | 0.97 | 0.87, 1.09 | ||
| Quintile 3 | 107,165 | 1,440,965 | 629 | 0.89 | 0.80, 0.99 | 0.91 | 0.82, 1.02 | ||
| Quintile 4 | 107,165 | 1,449,913 | 598 | 0.82 | 0.74, 0.92 | 0.85 | 0.76, 0.95 | ||
| Quintile 5 (highest) | 107,164 | 1,461,910 | 604 | 0.80 | 0.71, 0.89 | 0.84 | 0.75, 0.94 | ||
| Continuousb | 0.99 | 0.99, 0.99 | <0.0001 | 0.99 | 0.99, 1.00 | <0.0001 | |||
| AHEI-2010 | |||||||||
| Quintile 1 (lowest) | 107,165 | 1,408,789 | 628 | 1.00 | Referent | 1.00 | Referent | ||
| Quintile 2 | 107,165 | 1,426,679 | 607 | 0.93 | 0.83, 1.04 | 0.94 | 0.84, 1.05 | ||
| Quintile 3 | 107,165 | 1,439,012 | 633 | 0.95 | 0.85, 1.06 | 0.96 | 0.86, 1.04 | ||
| Quintile 4 | 107,165 | 1,448,879 | 641 | 0.95 | 0.85, 1.06 | 0.96 | 0.86, 1.08 | ||
| Quintile 5 (highest) | 107,164 | 1,467,366 | 628 | 0.91 | 0.82, 1.02 | 0.93 | 0.83, 1.04 | ||
| Continuousb | 1.00 | 0.99, 1.00 | 0.11 | 1.00 | 0.99, 1.00 | 0.25 | |||
| aMed | |||||||||
| Quintile 1 (lowest) | 121,940 | 1,605,797 | 752 | 1.00 | Referent | 1.00 | Referent | ||
| Quintile 2 | 101,616 | 1,357,028 | 632 | 0.98 | 0.88, 1.09 | 0.98 | 0.88, 1.09 | ||
| Quintile 3 | 110,164 | 1,480,186 | 627 | 0.89 | 0.80, 0.99 | 0.88 | 0.79, 0.98 | ||
| Quintile 4 | 126,137 | 1,318,288 | 548 | 0.86 | 0.77, 0.96 | 0.85 | 0.77, 0.95 | ||
| Quintile 5 (highest) | 75,967 | 1,429,426 | 578 | 0.83 | 0.75, 0.93 | 0.82 | 0.73, 0.93 | ||
| Continuousb | 0.96 | 0.95, 0.98 | 0.003 | 0.96 | 0.94, 0.98 | <0.0001 | |||
| DASH-Fung | |||||||||
| Quintile 1 (lowest) | 137,469 | 1,821,046 | 836 | 1.00 | Referent | 1.00 | Referent | ||
| Quintile 2 | 102,388 | 1,370,756 | 585 | 0.89 | 0.80, 0.99 | 0.90 | 0.81, 1.00 | ||
| Quintile 3 | 110,007 | 1,478,219 | 644 | 0.90 | 0.81, 0.99 | 0.90 | 0.81, 1.00 | ||
| Quintile 4 | 92,204 | 1,244,921 | 534 | 0.87 | 0.78, 0.97 | 0.88 | 0.79, 0.98 | ||
| Quintile 5 (highest) | 93,756 | 1,275,784 | 538 | 0.84 | 0.76, 0.94 | 0.85 | 0.77, 0.95 | ||
| Continuousb | 0.98 | 0.98, 0.99 | 0.001 | 0.99 | 0.98, 1.00 | 0.004 | |||
| DASH-Mellen | |||||||||
| Quintile 1 (lowest) | 145,245 | 1,926,722 | 895 | 1.00 | Referent | 1.00 | Referent | ||
| Quintile 2 | 112,929 | 1,508,785 | 663 | 0.92 | 0.84, 1.02 | 0.92 | 0.83, 1.02 | ||
| Quintile 3 | 111,671 | 1,501,068 | 640 | 0.88 | 0.80, 0.97 | 0.89 | 0.80, 0.99 | ||
| Quintile 4 | 81,945 | 1,111,486 | 468 | 0.86 | 0.77, 0.96 | 0.88 | 0.79, 0.99 | ||
| Quintile 5 (highest) | 84,034 | 1,142,666 | 471 | 0.83 | 0.74, 0.93 | 0.86 | 0.77, 0.96 | ||
| Continuousb | 0.96 | 0.95, 0.98 | <0.0001 | 0.97 | 0.95, 0.99 | 0.006 |
Abbreviations: AHEI-2010, Alternative Heathy Eating Index; aMed, alternate Mediterranean diet; CI, confidence interval; DASH, Dietary Approaches to Stop Hypertension; HEI-2015, Healthy Eating Index-2015; HR, hazard ratio; PDAC, pancreatic ductal adenocarcinoma.
a Estimated using Cox proportional hazard regression model with person-years as the underlying time metric. HRs compares the risk of developing PDAC for participants in each quintile of diet quality score compared with participants in the lowest quintile (lower adherence).
b HRs (95% CIs) and P for trend per 1-standard deviation increase.
c Multivariable models adjusted for age at baseline (years, continuous), sex, smoking status (never smoker, quit >10 years ago, quit 5–9 years ago, quit 1–4 years ago, quit <1 year or current smoker ≤20 cigarettes/day, quit <1 year or current smoker >20 cigarettes/day, or missing), body mass index (weight (kg)/height (m)2: <25.0, 25.0–29.9, ≥30.0, or missing), diabetes (yes vs. no), and total energy intake (kcal/day).