Diet Quality Scores and Prediction of All-Cause, Cardiovascular and Cancer Mortality in a Pan-European Cohort Study

Publication

Diet Quality Scores and Prediction of All-Cause, Cardiovascular and Cancer Mortality in a Pan-European Cohort Study

Journal Paper/Review - Jul 13, 2016

Tzoulaki Ioanna, Tumino Rosario, Agnoli Claudia, Palli Domenico, Lagiou Pagona, Bamia Christina, Trichopoulou Antonia, Key Timothy J, Khaw Kay-Tee, Bonet Catalina, Barricarte Aurelio, Fasanelli Francesca, Panico Salvatore, Riboli Elio, Moons Karel G M, Lund Eiliv, Skeie Guri, Weiderpass Elisabete, Renström Frida, Nilsson Lena Maria, Sonestedt Emily, Boer Jolanda M A, Bueno-de-Mesquita H Bas, Huerta José María, Etxezarreta Nerea, Fagherazzi Guy, Huybrechts Inge, Ferrari Pietro, Muller David C, Freisling Heinz, Beulens Joline W J, Van der Schouw Yvonne T, Peelen Linda M, Romaguera Dora, Gunter Marc J, Boutron-Ruault Marie-Christine, Affret Aurélie, Sánchez-Cantalejo Emilio, Quirós José-Ramón, Buijsse Brian, Kühn Tilman, Katzke Verena A, Tsilidis Konstantinos K, Roswall Nina, Olsen Anja, Dahm Christina C, Overvad Kim, Lassale Camille

Citation

Tzoulaki I, Tumino R, Agnoli C, Palli D, Lagiou P, Bamia C, Trichopoulou A, Key T, Khaw K, Bonet C, Barricarte A, Fasanelli F, Panico S, Riboli E, Moons K, Lund E, Skeie G, Weiderpass E, Renström F, Nilsson L, Sonestedt E, Boer J, Bueno-de-Mesquita H, Huerta J, Etxezarreta N, Fagherazzi G, Huybrechts I, Ferrari P, Muller D, Freisling H, Beulens J, Van der Schouw Y, Peelen L, Romaguera D, Gunter M, Boutron-Ruault M, Affret A, Sánchez-Cantalejo E, Quirós J, Buijsse B, Kühn T, Katzke V, Tsilidis K, Roswall N, Olsen A, Dahm C, Overvad K, Lassale C. Diet Quality Scores and Prediction of All-Cause, Cardiovascular and Cancer Mortality in a Pan-European Cohort Study. PloS one 2016; 11:e0159025.

Type

Journal Paper/Review (English)

Journal

PloS one 2016; 11

Publication Date

Jul 13, 2016

Issn Electronic

1932-6203

Pages

e0159025

Brief description/objective

Scores of overall diet quality have received increasing attention in relation to disease aetiology; however, their value in risk prediction has been little examined. The objective was to assess and compare the association and predictive performance of 10 diet quality scores on 10-year risk of all-cause, CVD and cancer mortality in 451,256 healthy participants to the European Prospective Investigation into Cancer and Nutrition, followed-up for a median of 12.8y. All dietary scores studied showed significant inverse associations with all outcomes. The range of HRs (95% CI) in the top vs. lowest quartile of dietary scores in a composite model including non-invasive factors (age, sex, smoking, body mass index, education, physical activity and study centre) was 0.75 (0.72-0.79) to 0.88 (0.84-0.92) for all-cause, 0.76 (0.69-0.83) to 0.84 (0.76-0.92) for CVD and 0.78 (0.73-0.83) to 0.91 (0.85-0.97) for cancer mortality. Models with dietary scores alone showed low discrimination, but composite models also including age, sex and other non-invasive factors showed good discrimination and calibration, which varied little between different diet scores examined. Mean C-statistic of full models was 0.73, 0.80 and 0.71 for all-cause, CVD and cancer mortality. Dietary scores have poor predictive performance for 10-year mortality risk when used in isolation but display good predictive ability in combination with other non-invasive common risk factors.