Christina C. Dahm

Diet Quality Scores and Prediction of All-Cause, Cardiovascular and Cancer Mortality in a Pan-European Cohort Study

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Camille Lassale, United Kingdom
  • Marc J Gunter, United Kingdom
  • Dora Romaguera, United Kingdom
  • Linda M Peelen, France
  • Yvonne T Van der Schouw, Netherlands
  • Joline W J Beulens, Netherlands
  • Heinz Freisling, France
  • David C Muller, France
  • Pietro Ferrari, France
  • Inge Huybrechts, France
  • Guy Fagherazzi, France
  • Marie-Christine Boutron-Ruault, France
  • Aurélie Affret, France
  • Kim Overvad
  • Christina C Dahm
  • Anja Olsen
  • Nina Roswall, Denmark
  • Konstantinos K Tsilidis, United Kingdom
  • Verena A Katzke, Germany
  • Tilman Kühn, Germany
  • Brian Buijsse, Greece
  • José-Ramón Quirós, Spain
  • Emilio Sánchez-Cantalejo, Spain
  • Nerea Etxezarreta, Spain
  • José María Huerta, Spain
  • Aurelio Barricarte, Spain
  • Catalina Bonet, Spain
  • Kay-Tee Khaw, United Kingdom
  • Timothy J Key, United Kingdom
  • Antonia Trichopoulou, Greece
  • Christina Bamia, Greece
  • Pagona Lagiou, Greece
  • Domenico Palli, Italy
  • Claudia Agnoli, Italy
  • Rosario Tumino, Italy
  • Francesca Fasanelli, Italy
  • Salvatore Panico, Italy
  • H Bas Bueno-de-Mesquita, Netherlands
  • Jolanda M A Boer, Netherlands
  • Emily Sonestedt, Sweden
  • Lena Maria Nilsson, Sweden
  • Frida Renström, Sweden
  • Elisabete Weiderpass, Norway
  • Guri Skeie, Norway
  • Eiliv Lund, Norway
  • Karel G M Moons, Netherlands
  • Elio Riboli, United Kingdom
  • Ioanna Tzoulaki, United Kingdom

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.

Original languageEnglish
JournalP L o S One
Pages (from-to)e0159025
Number of pages18
Publication statusPublished - 13 Jul 2016

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