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

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

PLOS ONE, 2016, vol. 11, issue 7, 1-18

Abstract: 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.

Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0159025

DOI: 10.1371/journal.pone.0159025

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