Associations of key diet-quality indexes with mortality in the Multiethnic Cohort: the Dietary Patterns Methods Project1–5

Background: Healthy dietary patterns have been linked positively with health and longevity. However, prospective studies in diverse populations in the United States addressing dietary patterns and mortality are limited. Objective: We assessed the ability of the following 4 diet-quality indexes [the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the alternate Mediterranean diet score (aMED), and the Dietary Approaches to Stop Hypertension (DASH)] to predict the reduction in risk of mortality from all causes, cardio-vascular disease (CVD), and cancer. Design: White, African American, Native Hawaiian, Japanese American, and Latino adults (n = 215,782) from the Multiethnic Cohort completed a quantitative food-frequency questionnaire. Scores for each dietary index were computed and divided into quin-tiles for men and women. Mortality was documented over 13–18 y of follow-up. HRs and 95 % CIs were computed by using adjusted Cox models. Results: High HEI-2010, AHEI-2010, aMED, and DASH scores were all inversely associated with risk of mortality from all causes, CVD, and cancer in both men and women (P-trend, 0.0001 for all models). For men, the HEI-2010 was consistently associated with a reduction in risk of mortality for all causes (HR: 0.75; 95 % CI: 0.71, 0.79), CVD (HR: 0.74; 95 % CI: 0.69, 0.81), and cancer (HR: 0.76; 95 % CI: 0.70, 0.83) when lowest and highest quintiles were compared. In women, the AHEI and aMED showed large reduction