Abstract
BACKGROUND: The consumption of a healthy diet may play an important role in the prevention of noncommunicable diseases (NCDs). Although associations between nutrient patterns and cardiometabolic risk factors or NCDs have been examined, the associations between nutrient patterns and mortality remain unknown. The present study examined the relationships between nutrient patterns and all-cause and cause-specific mortalities in a large Japanese population. METHODS: A prospective cohort analysis was performed on the data of 72,939 participants aged 35-69 years with a mean follow-up of 11.7 years in the Japan Multi-Institutional Collaborative Cohort Study. A factor analysis was applied to the energy-adjusted intakes of 21 nutrients, and 4 nutrient patterns were extracted: Factor 1 (folate, carotene, fiber, vitamin C, potassium, iron, and retinol patterns); Factor 2 (unsaturated fatty acid and vitamin E patterns); Factor 3 (saturated fatty acid, calcium, vitamin B2 and low carbohydrate patterns); and Factor 4 (sodium, protein and vitamin D patterns). A multivariable Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortalities according to the quartiles of nutrient patterns adjusted for potential confounders including age, sex, research site, drinking and smoking habits. RESULTS: During the follow-up period, 3,488 deaths were identified. A higher Factor 1 (folate, carotene, fiber, vitamin C, potassium, iron, and retinol) score was associated with lower all-cause (HR 0.81, 95% CI 0.73-0.90), CVD (HR 0.65, 95% CI 0.49-0.85) and cerebrovascular disease (HR 0.60, 95% CI 0.38-0.96) mortalities. The second lowest quartile group of the Factor 2 (unsaturated fatty acid and vitamin E) score was associated with lower all-cause (HR 0.86, 95% CI 0.79-0.94) and cancer (HR 0.85, 95% CI 0.76-0.95) mortalities. On the other hand, a higher Factor 2 score was associated with greater cerebrovascular disease mortality (HR 1.57, 95% CI 1.03-2.40). CONCLUSIONS: The results of the present study suggest that increased adherence to nutrient patterns rich in folate, carotene, fiber, vitamin C, potassium, iron, and retinol or moderate adherence to unsaturated fatty acids and vitamin E are associated with a decreased risk of mortality in Japanese adults.