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(Circulation. 2008;118:214-215.)
© 2008 American Heart Association, Inc.

Editorial

Dietary Patterns and Longevity

Expanding the Blue Zones

Lawrence J. Appel, MD, MPH

From the Departments of Medicine, Epidemiology, and International Health (Human Nutrition), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Md.

Correspondence to Lawrence J. Appel, MD, MPH, Johns Hopkins University, 2024 E Monument St, Suite 2-618, Baltimore, MD 21205-2223. E-mail lappel@jhmi.edu

Key Words: Editorials • cancer • cardiovascular disease • diet • lifestyle • mortality

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The scientific literature on diet and health is large and burgeoning. Until now, researchers have focused predominantly on the effects of individual nutrients and sometimes foods, but rarely on dietary patterns. Outcomes are often biomarkers, risk factors, or morbidity. Studies with total mortality as an outcome are uncommon, in large part because the sample size must be extremely large and/or the duration of follow-up long. Nonetheless, such studies are important because mortality as an outcome has unequivocal clinical relevance. In this issue of Circulation, Heidemann and colleagues¹ document the relationship of 2 dietary patterns with total and cause-specific mortality.

Article p 230

The setting is the Nurses’ Health Study. In this large, prospective, observational study of 72 113 female nurses who were free of coronary heart disease, stroke, diabetes, and cancer, factor analysis identified 2 dietary patterns from data collected on serial food frequency questionnaires. One pattern, called prudent, was characterized by a high consumption of vegetables, fruit, legumes, fish, poultry, and whole grains. The other pattern, called Western, corresponded to a high consumption of red meat, processed meat, refined grains, french fries, sweets, and desserts. Individuals were classified by their level of adherence to both the prudent diet and the Western diet. After baseline data collection in 1984, follow-up lasted 18 years, during which time 6011 deaths occurred (3319 [52%] as a result of cancer; 1154 [19%] resulting from cardiovascular disease [CVD]; and 1718 [29%] resulting from other causes).

In multivariable analyses, there was a 17% lower risk . . . [Full Text of this Article]

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