Abstract
OBJECTIVE: To evaluate the potential dose-response relationships of all-cause and cardiovascular death with the accumulation of various dietary habits. SETTING: A prospective cohort study. METHODS: Twenty-three dietary habits were assessed through face-to-face interviews with 57,737 participants in health check-up programs from 2015 to 2021. The total score of various dietary habits was calculated as the sum of each dietary habit multiplied by its own full-adjusted coefficient (β) for all-cause mortality in Cox proportional hazard models. Cox proportional hazard models were fitted for the associations of total and cause-specific mortality with the scores of various dietary habits. RESULTS: 1,692 deaths occurred after the earliest check-ups in our center, followed up for a median time of 2.14 years (range: 1.01-7.71 years). Total mortality was 11.23/1,000 person-years, and the mean scores of dietary habits were 2.83±2.14. All-cause mortality increased significantly with the cumulative score of dietary habits (the highest quartile vs. lowest quartile: adjusted hazard ratio [AHR], 1.72; 95 % confidence interval [CI], 1.49-1.99; P(linear) <0.01). Significance was also found for cardiovascular disease (CVD) mortality (HR, 1.82; 95 % CI, 1.47-2.27; P(linear) <0.01), cancer mortality (AHR, 1.59; 95 % CI, 1.23-2.04; P(linear) <0.01), and other-cause mortality (AHR, 2.00; 95 % CI, 1.46-2.73; P(linear) <0.01). These dose-response trends were more significant in total mortality and CVD mortality among middle-aged adults, and non-obese population. CONCLUSIONS: The greater the accumulation of diverse dietary habits, the higher the total mortality, CVD mortality, cancer mortality, and other mortality. This additive effect was particularly pronounced in the risk of death among middle-aged individuals and those with average body statures.