Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in men

Background: The Dietary Guidelines Sor 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 guideli nes. Objective: We tested whether a high HEI score (range: 0-100; 100 is best) c alculated from a validated food-frequency questionnaire (HEI-f) could predi ct lower risk of major chronic disease in men. Design: A cohort of US male health professionals without major disease comp leted detailed questionnaires on food intake and other risk factors for hea rt disease and cancer in 1986 and repeatedly during the 8-y follow-up. Majo r chronic disease outcome was defined as incident major cardiovascular dise ase (stroke or myocardial infarction, n = 1092), cancer (n = 1661), or othe r non-trauma-related deaths (n = 366). Results: The HEI-f was weakly inversely associated with risk of major chron ic disease [comparing highest with lowest quintile of the HEI-f, relative r isk (RR)= 0.89; 95% CI: 0.79, 1.00; P < 0.001 for trend]. The HEI-f was ass ociated 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. Conclusions: The HEI-f was only weakly associated with risk of major chroni c disease, suggesting that improvements to the HEI may be warranted. Furthe r research on the HEI could have implications for refinements to the Dietar y Guidelines for Americans and the food guide pyramid.