Abstract
BACKGROUND: Examining dietary patterns in relation to mortality offers a more comprehensive view of food and nutrient intake. However, to our knowledge, the association of the Korean population's dietary patterns with mortality remains scarce and unclear. We aim to investigate the association between dietary patterns and all-cause, cardiovascular disease (CVD), and cancer mortality in the Korean population. METHODS: This prospective cohort study included 18,019 men and 26,604 women aged ≥ 19 years who participated in the Korea National Health and Nutrition Examination Surveys 2007-2015. Dietary data were collected from a 24-hour dietary recall. Mortality from all causes, CVD, and cancer were ascertained from linkage to Statistics Korea. We identified dietary patterns through factor analysis. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the all-cause, CVD, and cancer mortality according to diet pattern scores. RESULTS: During a mean follow-up of 8.19 person-years, 2,622 deaths were identified, with 595 due to CVD and 827 due to cancer. Factor analysis based on 22 food groups, three dietary patterns were obtained: (1) "animal food and condiment pattern," (2) "seafood and vegetable pattern," and (3) "dairy products and processed meat pattern." After multivariable adjustment, the "seafood and vegetable pattern" score was associated with a lower risk of all-cause and CVD mortality. HRs (95% CIs) for all-cause mortality for the second to the highest quintile of "seafood and vegetable pattern", compared with the first quintile were 0.86 (0.75-0.99), 0.75 (0.65-0.87), 0.81 (0.69-0.94), and 0.87 (0.73-1.05), respectively (P for trend = 0.191). For CVD mortality, the HRs were 0.82 (0.62-1.07), 0.80 (0.58-1.08), 0.70 (0.50-0.99), and 0.63 (0.42-0.96), respectively (P for trend = 0.027). No statistically significant associations were found in "animal food and condiment pattern" or "dairy products and processed meat pattern" for all-cause, CVD, and cancer mortality. CONCLUSIONS: We observed that the "seafood and vegetable" dietary pattern decreased the risk of all-cause and CVD mortality in Korean adults.