Comparison of 4 established DASH diet indexes: examining associations of index scores and colorectal cancer
- 1 September 2013
- journal article
- research article
- Published by Elsevier BV in The American Journal of Clinical Nutrition
- Vol. 98 (3), 794-803
- https://doi.org/10.3945/ajcn.113.063602
Abstract
Background: Multiple diet indexes have been developed to capture the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and examine relations with health outcomes but have not been compared within the same study population to our knowledge. Objective: We compared 4 established DASH indexes and examined associations with colorectal cancer. Design: Scores were generated from a food-frequency questionnaire in the NIH-AARP Diet and Health Study (n = 491,841). Separate indexes defined by Dixon (7 food groups, saturated fat, and alcohol), Mellen (9 nutrients), Fung (7 food groups and sodium), and Günther (8 food groups) were used. HRs and 95% CIs for colorectal cancer were generated by using Cox proportional hazard models. Results: From 1995 through 2006, 6752 incident colorectal cancer cases were ascertained. In men, higher scores were associated with reduced colorectal cancer incidence by comparing highest to lowest quintiles for all indexes as follows: Dixon (HR: 0.77; 95% CI: 0.69, 0.87), Mellen (HR: 0.78; 95% CI: 0.71, 0.86), Fung (HR: 0.75; 95% CI: 0.68, 0.83), and Günther (HR: 0.81; 95% CI: 0.74, 0.90). Higher scores in women were inversely associated with colorectal cancer incidence by using methods defined by Mellen (HR: 0.79; 95% CI: 0.68, 0.91), Fung (HR: 0.84; 95% CI: 0.73, 0.96), and Günther (HR: 0.84; 95% CI: 0.73.0.97) but not Dixon (HR: 1.01; 95% CI: 0.80, 1.28). Conclusion: The consistency in findings, particularly in men, suggests that all indexes capture an underlying construct inherent in the DASH dietary pattern, although the specific index used can affect results.This publication has 23 references indexed in Scilit:
- Dealing With Dietary Measurement Error in Nutritional Cohort StudiesJNCI Journal of the National Cancer Institute, 2011
- Adherence to a DASH-Style Diet and Risk of Coronary Heart Disease and Stroke in WomenArchives of Internal Medicine, 2008
- Performance of a food-frequency questionnaire in the US NIH–AARP (National Institutes of Health–American Association of Retired Persons) Diet and Health StudyPublic Health Nutrition, 2008
- Degree of Concordance With DASH Diet Guidelines and Incidence of Hypertension and Fatal Cardiovascular DiseaseAmerican Journal of Hypertension, 2007
- American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer With Healthy Food Choices and Physical ActivityCA: A Cancer Journal for Clinicians, 2006
- Dietary patterns and health outcomesJournal of the American Dietetic Association, 2004
- Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino AcidsJournal of the American Dietetic Association, 2002
- Design and Serendipity in Establishing a Large Cohort with Wide Dietary Intake DistributionsAmerican Journal of Epidemiology, 2001
- The Comprehensive Approach to Diet: A Critical ReviewJournal of Nutrition, 2001
- Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) DietThe New England Journal of Medicine, 2001