A prospective study of dietary patterns and mortality in Chinese women

Background: Many foods and nutrients have been suggested to influence life expectancy. However, previous studies have not examined the relationship between dietary patterns and cause-specific mortality. Our study prospectively examines the relationship of dietary patterns with total mortality and cause-specific mortality in a population-based cohort study of Chinese women. Methods: The Shanghai Women's Health Study is a population-based cohort study of 74,942 women age 40 to 70 years at the time of recruitment (September 1996 to May 2000). Detailed dietary information was collected using a validated, quantitative food frequency questionnaire. The cohort has been followed using a combination of in-person interviews and record linkage with various registries. Dietary patterns, derived from principal component analysis, were examined for their relation to total mortality and cause-specific mortality using Cox regression models. Results: After an average of 5.7 years of follow-up (423,717 person-years of observation), there were 1565 deaths. We derived 3 major dietary patterns (vegetable-rich, fruit-rich, and meat-rich). The adjusted hazard ratios for the fruit-rich diet were 0.94 (95% CI = 0.89-0.98) for all causes of death and 0.89 (0.81-0.99), 0.79 (0.69-0.91), and 0.51 (0.39-0.65) for death caused by cardiovascular disease, stroke, and diabetes, respectively. The meat-rich diet was associated with increased risk of diabetes (HR = 1.18; 95% CI = 0.98-1.42) and a slightly elevated risk of total mortality. Conclusion: In general, a fruit-rich diet was related to lower mortality, whereas a meat-rich diet appeared to increase the probability of death.