McCullough M L, Feskanich D, Rimm E B, Giovannucci E L, Ascherio A, Variyam J N, Spiegelman D, Stampfer M J, 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):1223-31. doi: 10.1093/ajcn/72.5.1223.
The Dietary Guidelines for Americans and the food guide pyramid aim to reduce the risk of major chronic disease in the United States, but data supporting their overall effectiveness are sparse. The healthy eating index (HEI) measures the concordance of dietary patterns with these guidelines.
We tested whether a high HEI score (range: 0-100; 100 is best) calculated from a validated food-frequency questionnaire (HEI-f) could predict lower risk of major chronic disease in men.
A cohort of US male health professionals without major disease completed detailed questionnaires on food intake and other risk factors for heart disease and cancer in 1986 and repeatedly during the 8-y follow-up. Major chronic disease outcome was defined as incident major cardiovascular disease (stroke or myocardial infarction, n = 1092), cancer (n = 1661), or other non-trauma-related deaths (n = 366).
The HEI-f was weakly inversely associated with risk of major chronic disease [comparing highest with lowest quintile of the HEI-f, relative risk (RR) = 0.89; 95% CI: 0.79, 1.00; P: < 0.001 for trend]. The HEI-f was associated with moderately lower risk of cardiovascular disease (RR = 0.72; 95% CI: 0.60, 0.88; P: < 0.001) but was not associated with lower cancer risk.
The HEI-f was only weakly associated with risk of major chronic disease, suggesting that improvements to the HEI may be warranted. Further research on the HEI could have implications for refinements to the Dietary Guidelines for Americans and the food guide pyramid.
《美国膳食指南》和食物指南金字塔旨在降低美国主要慢性病的风险，但支持其整体有效性的数据稀少。健康饮食指数（HEI）衡量饮食模式与这些指南的一致性。
我们测试了根据经过验证的食物频率问卷（HEI-f）计算出的高HEI分数（范围：0 - 100；100为最佳）是否能预测男性患主要慢性病的较低风险。
一组无重大疾病的美国男性健康专业人员于1986年完成了关于食物摄入量以及心脏病和癌症其他风险因素的详细问卷，并在8年随访期间多次填写。主要慢性病结局定义为新发主要心血管疾病（中风或心肌梗死，n = 1092）、癌症（n = 1661）或其他非创伤相关死亡（n = 366）。
HEI-f与主要慢性病风险呈弱负相关[比较HEI-f最高与最低五分位数，相对风险（RR）= 0.89；95%置信区间（CI）：0.79，1.00；趋势P值< 0.001]。HEI-f与心血管疾病风险适度降低相关（RR = 0.72；95% CI：0.60，0.88；P值< 0.001），但与癌症风险降低无关。
HEI-f与主要慢性病风险仅呈弱相关，这表明可能有必要改进HEI。对HEI的进一步研究可能会对完善《美国膳食指南》和食物指南金字塔产生影响。
