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American Journal of Clinical Nutrition, Vol. 83, No. 5, 1170-1176, May 2006
© 2006 American Society for Nutrition


ORIGINAL RESEARCH COMMUNICATION

Dietary patterns and survival in older Dutch women1,4

Patricia MCM Waijers, Marga C Ocké, Caroline TM van Rossum, Petra HM Peeters, Christina Bamia, Yiannis Chloptsios, Yvonne T van der Schouw, Nadia Slimani and H Bas Bueno-de-Mesquita

1 From the National Institute for Public Health and the Environment, Bilthoven, Netherlands (PMCMW, MCO, CTMvR, and HBBM); the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands (PHMP and YTvdS); the Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece (CB and YC); and the International Agency for Research on Cancer, Lyon, France (NS)

Background: The need to gain insight into prevailing eating patterns and their health effects is evident.

Objective: This study aimed to identify dietary patterns and their relation to total mortality in older Dutch women.

Design: A principal component analysis of 22 food groups was used to identify dietary patterns in 5427 women aged 60–69 y who were included in the Dutch European Prospective Investigation into Cancer and Nutrition-Elderly cohort (follow-up: {approx}8.2 y). Mortality ratios for 3 major principal components were assessed by using Cox proportional hazard analysis.

Results: The most relevant principal components were a Mediterranean-like dietary pattern (high intakes of vegetable oils, pasta and rice, sauces, fish, and wine), a Traditional Dutch dinner dietary pattern (high intakes of meat, potatoes, vegetables, and alcoholic beverages), and a Healthy Traditional Dutch dietary pattern (healthy variant of the Traditional Dutch dinner dietary pattern; high intakes of vegetables, fruit, nonalcoholic drinks, dairy products, and potatoes). Differences in mean intakes between the highest and lowest tertiles of the 3 patterns were greatest for fruit, dairy products, potatoes, and alcoholic beverages. Consumption of Mediterranean foods, such as fish and oils, was relatively low overall. Two hundred seventy-seven deaths occurred in 44 667 person-years. Independent of age, education, and other lifestyle factors, only the Healthy Traditional dietary pattern score was associated with a lower mortality rate. Women in the highest tertile of this pattern experienced a 30% reduction in mortality risk.

Conclusion: A Healthy Traditional Dutch diet, rather than a Mediterranean diet, appears beneficial for longevity and feasible for health promotion in older Dutch women. This diet is comparable with other reported healthy or prudent diets that have been shown to be protective against morbidity or mortality.

Key Words: Dietary patterns • eating patterns • factor analysis • older Dutch women • European Prospective Investigation into Cancer and Nutrition-Elderly




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