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Title: Diet Quality Scores and Prediction of All-Cause, Cardiovascular and Cancer Mortality in a Pan-European Cohort Study.
Authors: Lassale, Camille
Gunter, Marc J
Romaguera, Dora
Peelen, Linda M
Van der Schouw, Yvonne T
Beulens, Joline W J
Freisling, Heinz
Muller, David C
Ferrari, Pietro
Huybrechts, Inge
Fagherazzi, Guy
Boutron-Ruault, Marie-Christine
Affret, Aurélie
Overvad, Kim
Dahm, Christina C
Olsen, Anja
Roswall, Nina
Tsilidis, Konstantinos K
Katzke, Verena A
Kühn, Tilman
Buijsse, Brian
Quirós, José-Ramón
Sánchez-Cantalejo, Emilio
Etxezarreta, Nerea
Huerta, José María
Barricarte, Aurelio
Bonet, Catalina
Khaw, Kay-Tee
Key, Timothy J
Trichopoulou, Antonia
Bamia, Christina
Lagiou, Pagona
Palli, Domenico
Agnoli, Claudia
Tumino, Rosario
Fasanelli, Francesca
Panico, Salvatore
Bueno-de-Mesquita, H Bas
Boer, Jolanda M A
Sonestedt, Emily
Nilsson, Lena Maria
Renström, Frida
Weiderpass, Elisabete
Skeie, Guri
Lund, Eiliv
Moons, Karel G M
Riboli, Elio
Tzoulaki, Ioanna
metadata.dc.subject.mesh: Age Distribution
Cardiovascular Diseases
Cohort Studies
Life Style
Middle Aged
Risk Factors
Sex Distribution
White People
Issue Date: 13-Jul-2016
Abstract: 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.
metadata.dc.identifier.doi: 10.1371/journal.pone.0159025
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