Diet Quality and Incident Non-Communicable Disease in the 1946–1951 Cohort of the Australian Longitudinal Study on Women’s Health

Abstract

Diet quality indices (DQIs) can be useful predictors of diet–disease relationships, including non-communicable disease (NCD) multimorbidity. We aimed to investigate whether overall diet quality (DQ) predicted NCD, multimorbidity, and all-cause mortality. Women from the 1945–51 cohort of the Australia Longitudinal Study on Women’s Health (ALSWH) were included if they: responded to S3 in 2001 and at least one survey between 2004 (S4) and 2016 (S8), and had no NCD history and complete dietary data at S3. DQ was summarized by the Healthy Eating Index for Australian Adults-2013 (HEIFA-2013), Mediterranean Diet Score (MDS), and Alternative Healthy Eating Index-2010 (AHEI-2010). Outcomes included each NCD (diabetes mellitus (DM), coronary heart disease (CHD), hypertension (HT), asthma, cancer (except skin cancer), depression and/or anxiety) independently, multimorbidity, and all-cause mortality. Repeated multivariate logistic regressions were used to test associations between DQIs and NCD outcomes across the 15 years of follow-up. The mean (±sd) of DQIs of participants (n = 5350) were 57.15 ± 8.16 (HEIFA-2013); 4.35 ± 1.75 (MDS), and 56.01 ± 10.32 (AHEI-2010). Multivariate regressions indicated that women reporting the highest quintile of AHEI-2010 had lower odds of DM (42–56% (S5–S8)), HT (26% (S8)), asthma (35–37% (S7, S8)), and multimorbidity (30–35% (S7, S8)). The highest quintile of HEIFA-2013 and MDS had lower odds of HT (26–35% (S7, S8); 24–27% (S6–S8), respectively) and depression and/or anxiety (30% (S6): 30–34% (S7, S8)). Our findings support evidence that DQ is an important predictor of some NCDs and a target for prevention in middle-aged women.

Alternative Healthy Eating Index-2010 and Incident Non-Communicable Diseases: Findings from a 15-Year Follow Up of Women from the 1973–78 Cohort of the Australian Longitudinal Study on Women’s Health

“…In our study, we did not find any association between DQ and cancer (excluding skin cancer). The previous analysis conducted among the ALSWH cohort showed similar results [ 50 ]. The discrepancies between studies might be partly explained by shorter follow-up durations since cancer cannot be detected within a far shorter period [ 116 ].…”

“…Therefore, in our ALSWH 1973–78 cohort, DQ at S3 was used to examine the association between DQ and incident NCDs during a 15-year follow up (from S4 to S8). The AHEI-2010 was selected based on its relevance to current dietary recommendations [ 71 ], having performed well when critically appraised compared with other DQIs based on a specific dietary pattern [ 72 ], and because it allowed us to make comparisons across generations based on our previous ALSWH 1946–51 cohort analyses [ 50 ]. The detailed scoring of AHEI-2010 is provided in Supplementary Table S2 .…”

“…However, in term of the clustering of NCDs, evidence on the relationship between overall diet and NCD multimorbidity is very limited [ 49 ]. Previously, we examined the relationship between DQ (measured as Healthy Eating Index for Australian Adults-2013 (HEIFA-2013), Mediterranean Diet Score (MDS), and Alternative Healthy Eating Index-2010 (AHEI-2010)) and the incidence of NCDs, including multimorbidity among a cohort of women born between 1946 and 1951 that was drawn from the Australian Longitudinal Study on Women’s Health (ALSWH) [ 50 ]. Data showed that mid-aged women with the highest DQI quintiles had reduced odds of NCDs in later surveys (9 to 15 years later), and AHEI-2010 was the most sensitive DQI for prediction of NCDs [ 50 ].…”

Health Behaviors of Austrian Secondary School Teachers and Principals at a Glance: First Results of the From Science 2 School Study Focusing on Sports Linked to Mixed, Vegetarian, and Vegan Diets

“…The association between the mixed diet and weight gain has also been suggested by Tucker et al [ 80 ]. However, it should be generally considered that irrespective of diet type, diet quality and food components (which were absent from investigation in the present study) have been shown to be remarkable predictors of health and weight management [ 19 ], and thus, caution must be warranted when interpreting the findings. Regardless of this fact, plant-based diets have a significant weight-loss effect, which in general terms could be considered positive in those individuals who need to reduce their weight for health purposes [ 78 , 79 ].…”

“…Adherence to healthy diets seems to be associated with a better weight-related profile (i.e., lower body mass index (BMI) and waist circumference) [ 17 ]. While certain diet types are associated with a lower incidence of cancer [ 18 ], diet quality is an important predictor of non-communicable diseases and, therefore, could be considered an effective preventive intervention [ 19 ]. In general, healthier diets may lead to higher overall health [ 20 ].…”