Diet Quality and Dietary Acid Load in Relation to Cardiovascular Disease Mortality: Results From Fasa PERSIAN Cohort Study

Abstract

Background: Dietary intake is a determining factor in the morbidity and the mortality of chronic disorders. However, not many documents have investigated this relationship. The aim of this study was to evaluate the associations of the Dietary Inflammatory Index (DII), Alternative healthy eating index (AHEI), Mediterranean dietary score (MDS), DASH score, and dietary acid load with cardiovascular disease (CVD) mortality. Method: 2158 CVD patients (mean age of 54.73 ± 8.62 years) from the Fasa Cohort Study, Iran participated in the current study. Diet quality indices including DII, AHEI, MDS, DASH, and dietary acid load (NEAP score) were computed using a validated 125-item Food Frequency Questionnaire (FFQ). Cox regression analyses were used to determine HRs and 95% CIs. Results: During a follow-up of 3 years, we documented 59 CVD deaths. After adjusting for relevant confounders (age, gender, smoking, alcohol intake, physical activity, family history of CVD, and HTN) in the final model, we found that higher DII scores and dietary acid load were significantly related to increased mortality due to CVD (HR =1.11; 95% CI =1.01-1.24 and HR =1.02; 95% CI =1.01-1.03). However, the DASH score was insignificantly associated with decreased CVD mortality by 20.4% (HR =0.79; 95% CI =0.57-1.09). There was no significant relationship among AHEI score, MDS, and CVD mortality. Conclusions: This study showed that increasing dietary acidity and the use of inflammatory food compounds could contribute to CVD mortality. Also, adherence to the DASH diet may be associated with a reduced CVD mortality.