TY - JOUR
T1 - Adherence to a Healthy Diet According to the World Health Organization Guidelines and All-Cause Mortality in Elderly Adults From Europe and the United States
AU - Jankovic, Nicole
AU - Geelen, Anouk
AU - Streppel, Martinette T.
AU - de Groot, Lisette C. P. G. M.
AU - Orfanos, Philippos
AU - van den Hooven, Edith H.
AU - Pikhart, Hynek
AU - Boffetta, Paolo
AU - Trichopoulou, Antonia
AU - Bobak, Martin
AU - Bueno-de-Mesquita, H. B.
AU - Kee, Frank
AU - Franco, Oscar H.
AU - Park, Yikyung
AU - Hallmans, Göran
AU - Tjønneland, Anne
AU - May, Anne M.
AU - Pajak, Andrzej
AU - Malyutina, Sofia
AU - Kubinova, Růžena
AU - Amiano, Pilar
AU - Kampman, Ellen
AU - Feskens, Edith J.
N1 - Supplementary data available as zip file.
PY - 2014/11/15
Y1 - 2014/11/15
N2 - The World Health Organization (WHO) has formulated guidelines for a healthy diet to prevent chronic diseases and postpone death worldwide. Our objective was to investigate the association between the WHO guidelines, measured using the Healthy Diet Indicator (HDI), and all-cause mortality in elderly men and women from Europe and the United States. We analyzed data from 396,391 participants (42% women) in 11 prospective cohort studies who were 60 years of age or older at enrollment (in 1988-2005). HDI scores were based on 6 nutrients and 1 food group and ranged from 0 (least healthy diet) to 70 (healthiest diet). Adjusted cohort-specific hazard ratios were derived by using Cox proportional hazards regression and subsequently pooled using random-effects meta-analysis. During 4,497,957 person-years of follow-up, 84,978 deaths occurred. Median HDI scores ranged from 40 to 54 points across cohorts. For a 10-point increase in HDI score (representing adherence to an additional WHO guideline), the pooled adjusted hazard ratios were 0.90 (95% confidence interval (CI): 0.87, 0.93) for men and women combined, 0.89 (95% CI: 0.85, 0.92) for men, and 0.90 (95% CI: 0.85, 0.95) for women. These estimates translate to an increased life expectancy of 2 years at the age of 60 years. Greater adherence to the WHO guidelines is associated with greater longevity in elderly men and women in Europe and the United States.
AB - The World Health Organization (WHO) has formulated guidelines for a healthy diet to prevent chronic diseases and postpone death worldwide. Our objective was to investigate the association between the WHO guidelines, measured using the Healthy Diet Indicator (HDI), and all-cause mortality in elderly men and women from Europe and the United States. We analyzed data from 396,391 participants (42% women) in 11 prospective cohort studies who were 60 years of age or older at enrollment (in 1988-2005). HDI scores were based on 6 nutrients and 1 food group and ranged from 0 (least healthy diet) to 70 (healthiest diet). Adjusted cohort-specific hazard ratios were derived by using Cox proportional hazards regression and subsequently pooled using random-effects meta-analysis. During 4,497,957 person-years of follow-up, 84,978 deaths occurred. Median HDI scores ranged from 40 to 54 points across cohorts. For a 10-point increase in HDI score (representing adherence to an additional WHO guideline), the pooled adjusted hazard ratios were 0.90 (95% confidence interval (CI): 0.87, 0.93) for men and women combined, 0.89 (95% CI: 0.85, 0.92) for men, and 0.90 (95% CI: 0.85, 0.95) for women. These estimates translate to an increased life expectancy of 2 years at the age of 60 years. Greater adherence to the WHO guidelines is associated with greater longevity in elderly men and women in Europe and the United States.
KW - aging
KW - cohort
KW - Consortium on Health and Ageing: Network of Cohorts in Europe and the United States
KW - diet
KW - longevity
KW - meta-analysis
U2 - 10.1093/aje/kwu229
DO - 10.1093/aje/kwu229
M3 - Article
C2 - 25318818
VL - 180
SP - 978
EP - 988
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
SN - 0002-9262
IS - 10
ER -