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Associations of evolutionary-concordance diet, Mediterranean diet and evolutionary-concordance lifestyle pattern scores with all-cause and cause-specific mortality

Published online by Cambridge University Press:  18 December 2018

En Cheng Open the ORCID record for En Cheng [Opens in a new window] ,
Caroline Y. Um Open the ORCID record for Caroline Y. Um [Opens in a new window] ,
Anna Prizment ,
DeAnn Lazovich  and
Roberd M. Bostick
En Cheng
Affiliation:
Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
Caroline Y. Um
Affiliation:
Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
Anna Prizment
Affiliation:
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
DeAnn Lazovich
Affiliation:
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
Roberd M. Bostick*
Affiliation:
Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA Winship Cancer Institute, Emory University, Atlanta, GA, USA
*
*Corresponding author: R. M. Bostick, fax +1 404 727 8737, email rmbosti@emory.edu
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Abstract

Various individual diet and lifestyle factors are associated with mortality. Investigating these factors collectively may help clarify whether dietary and lifestyle patterns contribute to life expectancy. We investigated the association of previously described evolutionary-concordance and Mediterranean diet pattern scores and a novel evolutionary-concordance lifestyle pattern score with all-cause and cause-specific mortality in the prospective Iowa Women’s Health Study (1986–2012). We created the diet pattern scores from Willett FFQ responses, and the lifestyle pattern score from self-reported physical activity, BMI and smoking status, and assessed their associations with mortality, using multivariable Cox proportional hazards regression. Of the 35 221 55- to 69-year-old cancer-free women at baseline, 18 687 died during follow-up. The adjusted hazard ratios (HR) and 95 % CI for all-cause, all CVD, and all-cancer mortality among participants in the highest relative to the lowest quintile of the evolutionary-concordance lifestyle score were, respectively, 0·52 (95 % CI 0·50, 0·55), 0·53 (95 % CI 0·49, 0·57) and 0·51 (95 % CI 0·46, 0·57). The corresponding findings for the Mediterranean diet score were HR 0·85 (95 % CI 0·82, 0·90), 0·83 (95 % CI 0·76, 0·90) and 0·93 (95 % CI 0·84, 1·03), and for the evolutionary-concordance diet score they were close to null and not statistically significant. The lowest estimated risk was among those in the highest joint quintile of the lifestyle score and either diet score (both Pinteraction <0·01). Our findings suggest that (1) a more Mediterranean-like diet pattern and (2) a more evolutionary-concordant lifestyle pattern, alone and in interaction with a more evolutionary-concordant or Mediterranean diet pattern, may be inversely associated with mortality.

Keywords

MortalityLifestylePaleolithic dietMediterranean dietCohort studies

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