Shah NS, et al. – An observational study was performed to determine whether dietary patterns were associated with long–term survival in a middle–aged, healthy population. Accumulated evidence suggested that the Dietary Approaches to Stop Hypertension (DASH) dietary pattern was associated with significantly lower all–cause mortality over nearly two decades of follow–up in a middle–aged, generally healthy population. The main predictors of all–cause mortality were added solid fat and added sugar intake. Hence, a healthy dietary pattern must be implemented in middle age, before the development of comorbid risk factors.

Methods

• In this study, a volunteer sample of 11,376 men and women with no history of myocardial infarction or stroke completed a baseline dietary assessment between 1987–1999.
• Participants were observed for an average of 18 years.
• Proportional hazard regressions, including a tree–augmented model, were used to assess the association of the Dietary Approaches to Stop Hypertension (DASH) dietary pattern, Mediterranean dietary pattern, and individual dietary components with mortality.
• Death from all causes was the primary outcome.
• The secondary outcome was death from cardiovascular disease.

Results

• 47 years was the mean baseline age.
• Each quintile increase in the DASH diet score was associated with a 6% lower adjusted risk for all–cause mortality (P<0.02).
• The Mediterranean diet was not independently associated with all–cause or cardiovascular mortality.
• The most predictive of mortality were solid fats and added sugars.
• A highest risk for all–cause mortality was observed in subjects who consumed >34% of their daily calories as solid fats.