McCullough M L, Feskanich D, Stampfer M J, Rosner B A, Hu F B, Hunter D J, Variyam J N, Colditz G A, Willett W C
Departments of Nutrition, Epidemiology, and Biostatistics, Harvard School of Public Health, Boston, MA, USA.
Am J Clin Nutr. 2000 Nov;72(5):1214-22. doi: 10.1093/ajcn/72.5.1214.
Little is known about the overall health effects of adherence to the Dietary Guidelines for Americans. The healthy eating index (HEI), developed at the US Department of Agriculture, measures how well Americans' diets conform to these guidelines.
We tested whether the HEI (scores range from 0 to 100; 100 is best) calculated from food-frequency questionnaires (HEI-f) would predict risk of major chronic disease in women.
A total of 67272 US female nurses who were free of major disease completed detailed questionnaires on diet and chronic disease risk factors in 1984 and repeatedly over 12 y. Major chronic disease was defined as fatal or nonfatal cardiovascular disease (myocardial infarction or stroke, n = 1365), fatal or nonfatal cancer (n = 5216), or other nontraumatic deaths (n = 496), whichever came first. We also examined cardiovascular disease and cancer as separate outcomes.
After adjustment for smoking and other risk factors, the HEI-f score was not associated with risk of overall major chronic disease in women [relative risk (RR) = 0.97; 95% CI: 0.89, 1.06 comparing the highest with the lowest quintile of HEI-f score]. Being in the highest HEI-f quintile was associated with a 14% reduction in cardiovascular disease risk (RR = 0.86; 95% CI: 0.72, 1. 03) and was not associated with lower cancer risk (RR = 1.02; 95% CI: 0.93, 1.12).
These data suggest that adherence to the 1995 Dietary Guidelines for Americans, as measured by the HEI-f, will have limited benefit in preventing major chronic disease in women.
关于遵循《美国膳食指南》对整体健康的影响，人们了解甚少。美国农业部制定的健康饮食指数（HEI）衡量美国人的饮食与这些指南的符合程度。
我们测试了通过食物频率问卷计算得出的HEI（分数范围为0至100；100为最佳）是否能预测女性患主要慢性病的风险。
共有67272名无重大疾病的美国女性护士于1984年完成了关于饮食和慢性病风险因素的详细问卷，并在12年期间多次填写。主要慢性病定义为致命或非致命的心血管疾病（心肌梗死或中风，n = 1365）、致命或非致命的癌症（n = 5216）或其他非创伤性死亡（n = 496），以最先出现的为准。我们还将心血管疾病和癌症作为单独的结果进行了研究。
在对吸烟和其他风险因素进行调整后，HEI-f分数与女性整体主要慢性病风险无关[相对风险（RR）= 0.97；95%置信区间：0.89，1.06，比较HEI-f分数最高与最低五分位数]。处于HEI-f最高五分位数与心血管疾病风险降低14%相关（RR = 0.86；95%置信区间：0.72，1.03），与较低的癌症风险无关（RR = 1.02；95%置信区间：0.93，1.12）。
这些数据表明，以HEI-f衡量的遵循1995年《美国膳食指南》在预防女性主要慢性病方面的益处有限。
