Nutr Res Pract.  2018 Jun;12(3):258-264. 10.4162/nrp.2018.12.3.258.

An association between diet quality index for Koreans (DQI-K) and total mortality in Health Examinees Gem (HEXA-G) study

Affiliations
  • 1Department of Preventive Medicine, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul 03080, Korea. dhkang@snu.ac.kr
  • 2Division of Infectious Disease Control, Centers for Disease Control and Prevention, Chungbuk 28160, Korea.
  • 3Department of Food and Nutrition, Chung-Ang University, Gyeonggi 17546, Korea.
  • 4Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea.
  • 5JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul 03087, Korea.
  • 6Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea.
  • 7Department of Preventive Medicine, Kangwon National University Scool of Medicine, Gangwon 24341, Korea.

Abstract

BACKGROUND/OBJECTIVES
Diet quality scores or indices, based on dietary guidelines, are used to summarize dietary intake into a single numeric variable. The aim of this study was to examine the association between the modified diet quality index for Koreans (DQI-K) and mortality among Health Examinees-Gem (HEXA-G) study participants.
SUBJECTS/METHODS
The DQI-K was modified from the original diet quality index. A total of 134,547 participants (45,207 men and 89,340 women) from the HEXA-G study (2004 and 2013) were included. The DQI-K is based on eight components: 1) daily protein intake, 2) percent of energy from fat, 3) percent of energy from saturated fat, 4) daily cholesterol intake, 5) daily whole-grain intake, 6) daily fruit intake, 7) daily vegetable intake, and 8) daily sodium intake. The association between all-cause mortality and the DQI-K was examined using Cox proportional hazard regression models. Hazard ratios and confidence intervals were estimated after adjusting for age, gender, income, smoking status, alcohol drinking, body mass index, and total energy intake.
RESULTS
The total DQI-K score was calculated by summing the scores of the eight components (range 0-9). In the multivariable adjusted models, with good diet quality (score 0-4) as a reference, poor diet quality (score 5-9) was associated with an increased risk of all-cause mortality (hazard ratios = 1.23, 95% confidence intervals = 1.06-1.43). Moreover, a one-unit increase in DQI-K score resulted in a 6% higher mortality risk.
CONCLUSIONS
A poor diet quality DQI-K score was associated with an increased risk of mortality. The DQI-K in the present study may be used to assess the diet quality of Korean adults.

Keyword

Diet; cohort studies; mortality; HEXA; Korea

MeSH Terms

Adult
Alcohol Drinking
Body Mass Index
Cholesterol
Cohort Studies
Diet*
Energy Intake
Fruit
Humans
Korea
Male
Mortality*
Nutrition Policy
Smoke
Smoking
Sodium
Vegetables
Cholesterol
Smoke
Sodium

Figure

  • Fig. 1 Flow diagram of sample selection criteria: the HEXA-G study (2004-2013). HEXA, health examinees study; FFQ, food frequency questionnaire.


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