Women On Prudent Dietary Pattern May Reduce Risk Of Death

Women who eat a diet rich in vegetables, fruits, legumes, whole grains, fish and poultry may reduce their risk of death from cardiovascular disease and all causes. Women who follow a traditional "Western" diet of red and processed meat, refined grains, fries and sweets may increase their risk.

That's the conclusion of researchers who reported the results of a Harvard School of Public Health study in Circulation: Journal of the American Heart Association.

The study of 72,113 healthy women found that high adherence to the "prudent" dietary pattern was associated with a 28 percent lower risk of death from cardiovascular disease and a 17 percent lower risk of premature death from all causes when compared to the lowest adherence.

In contrast, high adherence to the "Western" dietary pattern was associated with a 22 percent higher risk of death from cardiovascular disease, a 21 percent higher risk of premature death from all causes and a 16 percent increase in death from cancer when compared to the lowest adherence.

Women on the "prudent" diet didn't have a statistically significant reduced risk of cancer deaths after adjustments for age, body mass index, physical activity, smoking status, hypertension, hormone replacement and vitamin supplements, researchers said.

"These results highlight the importance of intensifying public health efforts to promote the adoption of a healthy overall diet including high intakes of vegetables, fruit, legumes, whole grains, fish and poultry and low intakes of red and processed meat, refined grains, French fries and sweets," said Christin Heidemann, Dr.P.H., M.Sc., lead author of the study and a research scientist in the epidemiology department at the German Institute of Human Nutrition in Germany. "Traditionally, there has been a focus on single nutrients or foods, but in terms of longevity a greater focus on dietary patterns can take into account the complexity of the overall diet."

The study followed healthy women, 30 to 55 years old, from 1984 to 2002, from the Nurses' Health Study cohort. The women had no history of heart attack, angina, coronary artery surgery, stroke, diabetes or cancer.

Participants completed food frequency questionnaires every two to four years. To determine dietary patterns, researchers aggregated answers to the questionnaires into 37 to 39 food groups, depending on the year. The women gauged their intake of foods from "never" or "less than once per month" to "six or more times a day."

If a woman was diagnosed with cardiovascular disease, diabetes or cancer, the dietary pattern scores were no longer updated.

The "prudent" and "Western" diets emerged as major dietary patterns.

During 18 years of follow-up, 6,011 deaths occurred in the women including 1,154 from cardiovascular disease, 3,139 from cancer and 1,718 from other causes.

The "prudent" diet was associated with reduced deaths and the "Western" diet was associated with increased deaths from cardiovascular disease as well as deaths from all causes, said Heidemann, who worked in the nutrition department at the Harvard School of Public Health during the study.

"A higher adherence to the Western diet was also associated with a higher risk of death from cancer," Heidemann said. "But the direct association between the Western pattern and cancer death can't be explained by this kind of study. Observational studies can reveal associations but don't provide the underlying mechanisms."

The few studies that have investigated the relation of dietary patterns to death from cardiovascular disease and death from all causes have been generally "small and inadequately powered," Heidemann said. "The relation of overall dietary patterns with death due to cardiovascular disease and other chronic disease has not been widely examined."

The "prudent" diet is consistent with the American Heart Association dietary and lifestyle recommendations for healthy adults age 2 and older: