Table 5.
Hazard Ratios for Pancreatic Ductal Adenocarcinoma According to Quintile of Dietary Index for Men (n = 315,780) in the National Institutes of Health–AARP Diet and Health Study, United States, 1995–2011
| Diet Quality | No. | Person-Years | No. ofPDAC Cases | Age-AdjustedHR a | 95%CI | P forTrend b | Multivariable-Adjusted HR c | 95%CI | P forTrend b |
|---|---|---|---|---|---|---|---|---|---|
| HEI-2015 | |||||||||
| Quintile 1 (lowest) | 63,156 | 816,953 | 421 | 1.00 | Referent | 1.00 | Referent | ||
| Quintile 2 | 63,156 | 828,856 | 422 | 0.95 | 0.83, 1.09 | 0.96 | 0.83, 1.09 | ||
| Quintile 3 | 63,156 | 836,086 | 391 | 0.85 | 0.74, 0.98 | 0.86 | 0.75, 0.99 | ||
| Quintile 4 | 63,156 | 841,643 | 381 | 0.80 | 0.70, 0.92 | 0.82 | 0.72, 0.95 | ||
| Quintile 5 (highest) | 63,156 | 849,410 | 373 | 0.75 | 0.66, 0.87 | 0.78 | 0.68, 0.90 | ||
| Continuousb | 0.99 | 0.99, 0.99 | <0.0001 | 0.99 | 0.99, 1.00 | <0.0001 | |||
| AHEI-2010 | |||||||||
| Quintile 1 (lowest) | 63,156 | 816,127 | 404 | 1.00 | Referent | 1.00 | Referent | ||
| Quintile 2 | 63,156 | 826,876 | 390 | 0.93 | 0.81, 1.06 | 0.93 | 0.81, 1.07 | ||
| Quintile 3 | 63,156 | 833,982 | 405 | 0.94 | 0.82, 1.08 | 0.95 | 0.83, 1.09 | ||
| Quintile 4 | 63,156 | 841,860 | 397 | 0.91 | 0.79, 1.04 | 0.92 | 0.80, 1.05 | ||
| Quintile 5 (highest) | 63,156 | 854,104 | 392 | 0.87 | 0.76, 1.00 | 0.89 | 0.77, 1.02 | ||
| Continuousb | 1.00 | 0.99, 1.00 | 0.03 | 1.00 | 0.99, 1.00 | 0.07 | |||
| aMed | |||||||||
| Quintile 1 (lowest) | 74,653 | 967,310 | 480 | 1.00 | Referent | 1.00 | Referent | ||
| Quintile 2 | 59,913 | 787,764 | 398 | 1.00 | 0.88, 1.14 | 1.00 | 0.88, 1.14 | ||
| Quintile 3 | 64,601 | 854,540 | 391 | 0.90 | 0.79, 1.03 | 0.90 | 0.78, 1.02 | ||
| Quintile 4 | 56,399 | 753,150 | 360 | 0.94 | 0.82, 1.07 | 0.93 | 0.81, 1.07 | ||
| Quintile 5 (highest) | 60,214 | 810,185 | 359 | 0.86 | 0.75, 0.98 | 0.85 | 0.74, 0.98 | ||
| Continuousb | 0.97 | 0.95, 1.00 | 0.03 | 0.97 | 0.95, 1.00 | 0.04 | |||
| DASH-Fung | |||||||||
| Quintile 1 (lowest) | 55,786 | 727,251 | 376 | 1.00 | Referent | 1.00 | Referent | ||
| Quintile 2 | 85,120 | 1,119,633 | 531 | 0.88 | 0.77, 1.00 | 0.88 | 0.77, 1.00 | ||
| Quintile 3 | 32,847 | 434,230 | 214 | 0.89 | 0.76, 1.06 | 0.89 | 0.76, 1.06 | ||
| Quintile 4 | 86,892 | 1,152,784 | 543 | 0.84 | 0.74, 0.96 | 0.84 | 0.74, 0.96 | ||
| Quintile 5 (highest) | 55,135 | 739,051 | 324 | 0.77 | 0.66, 0.89 | 0.77 | 0.66, 0.90 | ||
| Continuousb | 0.98 | 0.97, 0.99 | 0.0009 | 0.98 | 0.97, 0.99 | 0.002 | |||
| DASH-Mellen | |||||||||
| Quintile 1 (lowest) | 55,145 | 720,680 | 360 | 1.00 | Referent | 1.00 | Referent | ||
| Quintile 2 | 61,838 | 811,813 | 431 | 1.04 | 0.91, 1.20 | 1.04 | 0.90, 1.19 | ||
| Quintile 3 | 71,040 | 937,207 | 432 | 0.89 | 0.77, 1.02 | 0.89 | 0.77, 1.02 | ||
| Quintile 4 | 59,862 | 794,981 | 371 | 0.89 | 0.77, 1.03 | 0.90 | 0.77, 1.04 | ||
| Quintile 5 (highest) | 67,895 | 908,269 | 394 | 0.81 | 0.70, 0.93 | 0.82 | 0.71, 0.95 | ||
| Continuousb | 0.95 | 0.93, 0.98 | 0.0002 | 0.95 | 0.93, 0.98 | 0.0006 |
Abbreviations: AHEI-2010, Alternative Healthy Eating Index-2010; 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 Hazard ratios and P for trend per 1-standard deviation increase. P for interaction by sex > 0.07 for all scores.
c Multivariable models adjusted for age at baseline (years, continuous), 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).