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- Jankovic, N., et al.
(author)
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ASSOCIATION BETWEEN A HEALTHY DIET ACCORDING TO WHO GUIDELINES AND ALL-CAUSE MORTALITY IN EUROPEAN AND AMERICAN ELDERLY, THE CHANCES PROJECT
- 2013
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In: Annals of Nutrition and Metabolism. - : S. Karger. - 0250-6807 .- 1421-9697. ; 63:Supplement 1, s. 234-234
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Journal article (other academic/artistic)abstract
- Background and objectives: The Healthy Diet Indicator(HDI) measures adherence to the WHO guidelines for preventingdiet related chronic diseases, and can be applied to assessassociations of diet with health across populations. We examinedthe association between the HDI and all-cause mortalityin European and American elderly people aged 60 years andabove.Methods: We analysed data on 395,863 men and womenfrom 11 prospective cohort studies from the Consortium onHealth and Ageing: Network of Cohorts In Europe And TheUnited States (CHANCES). Across cohorts, the follow-upperiods ranged from 10 to 20 yrs. Diet was assessed throughvalidated methods. For the translation of foods to nutrients,country specific food composition tables were used. The continuouslyscored HDI (range mean and SD HDI score 45±9to 54±7 across cohorts) was based on intakes of saturated andpolyunsaturated fatty acids, mono-and disaccharides, protein,cholesterol, dietary fibre and fruits and vegetables. The associationbetween the HDI and all-cause mortality was evaluated ineach cohort separately, by multiple Cox proportional hazardsregression. A pooled hazard ratio (HR) was subsequently estimatedusing a random-effects model.Results: Across all cohorts, 84,863 people died during4,492,298 person-years of follow-up. Adjusted HR of death, fora 10 point increment in HDI score, ranged between 0.81 (95%CI 0.77-0.86) in Denmark and 0.99 (95% CI, 0.84-1.16) in Poland.The pooled adjusted HR estimate showed a significantinverse association of 0.90 (95% CI 0.87-0.93) but there was asignificant heterogeneity between studies (p=0.001, I2=66%).Conclusion: Our results show that higher dietary quality isinversely associated with all- cause mortality but
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- Jankovic, Nicole, et al.
(author)
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Adherence to a healthy diet according to the world health organization guidelines and all-cause mortality in elderly adults from Europe and the United States
- 2014
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In: American Journal of Epidemiology. - : Oxford University Press. - 0002-9262 .- 1476-6256. ; 180:10, s. 978-988
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Journal article (peer-reviewed)abstract
- The World Health Organization (WHO) has formulated guidelines for a healthy diet to prevent chronic diseases and postpone death worldwide. Our objective was to investigate the association between the WHO guidelines, measured using the Healthy Diet Indicator (HDI), and all-cause mortality in elderly men and women from Europe and the United States. We analyzed data from 396,391 participants (42% women) in 11 prospective cohort studies who were 60 years of age or older at enrollment (in 1988-2005). HDI scores were based on 6 nutrients and 1 food group and ranged from 0 (least healthy diet) to 70 (healthiest diet). Adjusted cohort-specific hazard ratios were derived by using Cox proportional hazards regression and subsequently pooled using random-effects meta-analysis. During 4,497,957 person-years of follow-up, 84,978 deaths occurred. Median HDI scores ranged from 40 to 54 points across cohorts. For a 10-point increase in HDI score (representing adherence to an additional WHO guideline), the pooled adjusted hazard ratios were 0.90 (95% confidence interval (CI): 0.87, 0.93) for men and women combined, 0.89 (95% CI: 0.85, 0.92) for men, and 0.90 (95% CI: 0.85, 0.95) for women. These estimates translate to an increased life expectancy of 2 years at the age of 60 years. Greater adherence to the WHO guidelines is associated with greater longevity in elderly men and women in Europe and the United States.
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- Borrell, C, et al.
(author)
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Socioeconomic inequalities in mortality in 16 European cities
- 2014
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 42:3, s. 245-254
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Journal article (peer-reviewed)abstract
- Aims: To explore inequalities in total mortality between small areas of 16 European cities for men and women, as well as to analyse the relationship between these geographical inequalities and their socioeconomic indicators. Methods: A cross-sectional ecological design was used to analyse small areas in 16 European cities (26,229,104 inhabitants). Most cities had mortality data for a period between 2000 and 2008 and population size data for the same period. Socioeconomic indicators included an index of socioeconomic deprivation, unemployment, and educational level. We estimated standardised mortality ratios and controlled for their variability using Bayesian models. We estimated relative risk of mortality and excess number of deaths according to socioeconomic indicators. Results: We observed a consistent pattern of inequality in mortality in almost all cities, with mortality increasing in parallel with socioeconomic deprivation. Socioeconomic inequalities in mortality were more pronounced for men than women, and relative inequalities were greater in Eastern and Northern European cities, and lower in some Western (men) and Southern (women) European cities. The pattern of excess number of deaths was slightly different, with greater inequality in some Western and Northern European cities and also in Budapest, and lower among women in Madrid and Barcelona. Conclusions: In this study, we report a consistent pattern of socioeconomic inequalities in mortality in 16 European cities. Future studies should further explore specific causes of death, in order to determine whether the general pattern observed is consistent for each cause of death.
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