The association between four dietary indices and mortality risk in cardiovascular disease patients

Mengshan Pan1, Tongle Yin1, Ying Yang1

  • 1School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou City, 310053, Zhejiang Province, China.

PubMed

Insights

Healthy dietary patterns like the Planetary Healthy Diet Index-United States, Healthy Eating Index, and Mediterranean Diet are linked to lower mortality risk in cardiovascular patients. Conversely, a higher Dietary Inflammation Index is associated with increased mortality.

Area of Science:

  • Cardiovascular Disease Research
  • Nutritional Epidemiology
  • Public Health Nutrition

Background:

  • Previous studies indicate associations between various dietary patterns and mortality in cardiovascular patients.
  • The Planetary Healthy Diet Index-United States (PHDI-US), Healthy Eating Index (HEI), Mediterranean Diet (MD), and Dietary Inflammatory Index (DII) are recognized dietary assessment tools.
  • Understanding the impact of these specific dietary patterns on mortality risk in U.S. cardiovascular patients is crucial for public health initiatives.

Purpose of the Study:

  • To investigate the association between adherence to four distinct dietary patterns and all-cause mortality risk among U.S. adults with cardiovascular disease.
  • To determine if the PHDI-US, HEI, MD, and DII predict mortality outcomes in a representative U.S. cardiovascular patient population.
  • To provide evidence-based dietary recommendations for improving survival rates in individuals with cardiovascular conditions.

Main Methods:

  • Utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018, including adults aged 19 and older.
  • Assessed dietary intake using 24-hour dietary recalls to calculate scores for the PHDI-US, HEI, MD, and DII.
  • Employed survey-weighted multivariable Cox proportional hazards regression models to analyze the relationship between dietary indices and all-cause mortality, adjusting for potential confounders.

Main Results:

  • Higher adherence to the PHDI-US, HEI, and MD was significantly associated with a reduced risk of all-cause mortality in cardiovascular disease patients.
  • Conversely, a higher DII score was significantly associated with an increased risk of all-cause mortality.
  • These associations remained significant after full adjustment for potential confounding factors, underscoring the robustness of the findings.

Conclusions:

  • Adherence to healthier dietary patterns, including the PHDI-US, HEI, and MD, is associated with lower all-cause mortality among U.S. cardiovascular disease patients.
  • Conversely, a pro-inflammatory dietary pattern, as indicated by a higher DII, is linked to increased mortality risk in this population.
  • Specific dietary patterns showed differential associations with mortality in subgroups, such as congestive heart failure and angina pectoris patients, highlighting the need for tailored dietary guidance.
Abstract

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