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Diet and Mortality in Women
Most of the general population consumes a fairly complex diet, usually consisting of a combination of foods containing multiple nutrients and non-nutrients. This complexity can make it difficult, if not impossible, to assess the influence of singular nutrients and/or foods on health and mortality.
Many studies have examined the association of single nutrients, foods or food groups with disease, but this study is one of few to evaluate the health effects of overall diet quality derived from current food-based dietary guidelines. Data from phase 2 (1987-89) of the Breast Cancer Detection Demonstration Project included the results of a 62-item food-frequency questionnaire completed by 42,254 women. The main outcome measure was all-cause mortality by quartile (quartile 1 = high score, quartile 4 = low score) of the "Recommended Food Score" (RFS): the sum of the number of foods recommended by current dietary guidelines that subjects reported consuming at least once a week.
Results: Compared with those in the lowest quartile of RFS scores, subjects in the upper quartiles (greater RFS scores) had a lower relative risk of all-cause mortality: 0.82 for quartile 2, 0.71 for quartile 3, and 0.69 for quartile 4. These results were maintained after adjusting for education; ethnicity; age; body mass index; smoking status; alcohol use; level of physical activity; menopausal hormone use; and history of disease. As the authors note, these findings emphasize the value of current dietary guidelines recommending a diet characterized by adequate intake of fruits, vegetables, whole grains, low-fat dairy products, and lean meat.

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