Abstract
A systematic review of the literature on dietary patterns (multiple dietary components
operationalized as a single exposure) in relation to nutrient adequacy, lifestyle
and demographic variables, and health outcome was conducted. Most of the published
reports on the subject have used one of two methods to determine dietary patterns:
(a) diet indexes or scores that assess compliance with prevailing dietary guidance
as dietary patterns, and (b) data-driven methods that use factor or cluster analysis
to derive dietary patterns. Irrespective of the approach used, patterns characterized
by fruit/vegetable/whole grain/fish/poultry consumption generally have been reported
to relate to micronutrient intake, and to selected biomarkers of dietary exposure
and disease risk in the expected direction. Age, income, and education have been reported
to be among positive predictors of the so-called more healthful dietary patterns.
An inverse association of healthful dietary patterns with all-cause mortality and
cardiovascular disease risk was reported in most studies. However, the magnitude of
risk reduction was modest and was attenuated after control for confounders. Few published
studies showed an association between risk of most incident cancers and dietary patterns.
Both of the currently used approaches for extracting dietary patterns have limitations,
are subject to dietary measurement errors, and have not generated new diet and disease
hypotheses.
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References
- Social and cultural influences on food consumption and nutritional status.in: Shils M.E. Olson J.A. Shike M. Ross A.C. Modern Nutrition in Health and Disease. 9th ed. Lippincott Williams and Wilkins, New York, NY1999: 1783-1792
- Social and biocultural determinants of food selection.Prog Food Nutr Sci. 1986; 10: 179-203
- Genetic and environmental influences on eating patterns of twins aged ≥50 y.Am J Clin Nutr. 1999; 70: 456-465
- Foods and nutrients.J Am Diet Assoc. 1984; 84: 769-770
- Micronutrient interactions.Ann NY Acad Sci. 1980; 355: 1-208
- Phytochemicals.J Am Diet Assoc. 1997; 97: S199-S204
- A clinical trial of the effects of dietary patterns on blood pressure.N Engl J Med. 1997; 336: 1117-1124
- Mediterranean dietary pattern in a randomized trial. Prolonged survival and possible reduced cancer rate.Arch Intern Med. 1998; 158: 1181-1187
- Indexes of overall diet quality.J Am Diet Assoc. 1996; 96: 785-791
- Food intake patterns and body mass index in observational studies.Int J Obes. 2001; 25: 1741-1751
- Quantitative use of the Food Guide Pyramid to evaluate dietary intake of college students.J Am Diet Assoc. 1996; 96: 453-457
- Diet quality and diet diversity in France.J Am Diet Assoc. 1996; 96: 663-669
- Dietary diversity in the US population, NHANES II, 1976–80.J Am Diet Assoc. 1991; 91: 1526-1531
- The dietary variety score.J Am Diet Assoc. 1997; 97: 266-271
- Food intakes of children and adolescents compared with recommendations.Pediatrics. 1997; 100: 323-329
- Measures of overall diet quality from a food frequency questionnaire.Nutr Res. 1997; 17: 1443-1456
- Food variety—A good indicator of nutritional adequacy of the diet? A case study from an urban area in Mali, West Africa.Eur J Clin Nutr. 1998; 52: 891-898
- The Diet Quality Index Revised.J Am Diet Assoc. 1999; 99: 697-704
- Diet quality index.J Am Diet Assoc. 1994; 94: 57-64
- Measuring diet quality in China.Eur J Clin Nutr. 2000; 54: 811-821
- The choice of a diet quality indicator to evaluate the nutritional health of populations.Public Health Nutr. 2000; 3: 357-365
- Diet profiles in a population sample from Mediterranean southern France.Public Health Nutr. 2001; 4: 173-182
- The Mediterranean score of dietary habits in Chinese populations in four different geographical areas.Eur J Clin Nutr. 2001; 55: 215-220
- Dietary patterns and cognitive function in elderly men in Finland, Italy, and the Netherlands.Eur J Clin Nutr. 1998; 52: 826-831
- Profiles of a healthful diet and its relationship to biomarkers in a population sample from Mediterranean southern France.J Am Diet Assoc. 2000; 100: 1164-1171
- Validation of the Healthy Eating Index with use of plasma biomarkers in a clinical sample of women.Am J Clin Nutr. 2001; 74: 479-486
- Dietary quality and survival among middle-aged and older adults in the NHANES I epidemiologic follow-up study.Nutr Res. 1996; 16: 1641-1650
- Diet and overall survival in elderly people.BMJ. 1995; 311: 1457-1460
- Dietary pattern and 20-y mortality in elderly men in Finland, Italy, and the Netherlands.BMJ. 1997; 315: 13-17
- Diet and mortality in a cohort of elderly people in North European community.Int J Epidemiol. 1997; 26: 155-159
- A prospective study of diet quality and mortality in women.JAMA. 2000; 283: 2109-2115
- Adherence to the Dietary Guidelines for Americans and risk of major chronic diseases in women.Am J Clin Nutr. 2000; 72: 1214-1222
- The Healthy Eating Index.J Am Diet Assoc. 1995; 95: 1103-1108
- Adherence to the Dietary Guidelines for Americans and risk of major chronic diseases in men.Am J Clin Nutr. 2000; 72: 1223-1231
- Dietary patterns and mortality in Danish men and women.Br J Nutr. 2001; 85: 219-225
- Food intake patterns and risk of coronary heart disease.Eur J Clin Nutr. 2002; 56: 568-574
- An evaluation of the Dietary Guidelines for Americans in relation to cancer occurrence.Am J Clin Nutr. 2002; 76: 889-896
- A prospective study of variety of healthy foods and mortality in women.Int J Epidemiol. 2002; 31: 847-854
- Diet quality and major chronic disease risk in men and women.Am J Clin Nutr. 2002; 76: 1261-1271
- Diet quality and cancer incidence in Nova Scotia, Canada.Nutr Cancer. 2002; 43: 127-132
- Diet diversity and the risk of colorectal cancer in Northern Italy.Cancer Epidemiol Biomarkers Prev. 1996; 5: 433-436
- Diet diversity, diet composition, and risk of colon cancer (United States).Cancer Causes Control. 1997; 8: 872-882
- Diet diversity and colorectal cancer.Prev Med. 2000; 31: 11-14
- Effect of dietary patterns on measures of lipid peroxidation.Circulation. 1998; 98: 2390-2395
- Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction.Circulation. 1999; 99: 779-785
- Effect of dietary patterns on serum homocysteine.Circulation. 2000; 102: 852-857
- The effect of dietary patterns on blood pressure control in hypertensive patients.Am J Hypertens. 2000; 13: 949-955
- Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet.N Engl J Med. 2001; 344: 3-10
- Dietary patterns leading to high fat intake.Can J Public Health. 1995; 86: 389-391
- Dietary patterns of adults in Quebec and their nutritional adequacy.Can J Public Health. 1998; 89: 347-351
- Multivariate analysis of diet among three-year old children and associations with socio-demographic factors.Eur J Clin Nutr. 2000; 54: 73-80
- Dietary patterns and their association with food and nutrient intake in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study.Br J Nutr. 2001; 85: 363-373
- Fundamental dietary patterns and their correlation among US whites.J Am Diet Assoc. 2001; 101: 929-932
- Dietary patterns of Australian adults and their association with socioeconomic status.Eur J Clin Nutr. 2002; 56: 687-693
- Maternal eating patterns and birth weight of Mexican American infants.Nutr Health. 1995; 10: 121-134
- Specific patterns of food consumption and preparation are associated with diabetes in a Native Canadian Community.J Nutr. 1998; 128: 541-547
- Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire.Am J Clin Nutr. 1999; 69: 243-249
- Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk.Am J Clin Nutr. 2001; 73: 61-67
- Dietary patterns are associated with body mass index in multiethnic women.J Nutr. 2000; 130: 3068-3072
- Food intake patterns and gall bladder disease in Mexican Americans.Public Health Nutr. 2000; 3: 233-243
- A cross-sectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome.Br J Nutr. 2000; 83: 257-266
- Dietary patterns and their associations with obesity in the Brazilian city of Rio de Janeiro.Obesity Res. 2002; 10: 42-48
- Patterns of food consumption and risk factors for cardiovascular disease in the general Dutch population.Am J Clin Nutr. 2003; 77: 1156-1163
- Dietary patterns and their associations with demographic, lifestyle, and health variables in a random sample of British adults.Br J Nutr. 1996; 76: 17-30
- Effect of food intake on all-cause mortality in the community elderly.J Nutr Health Aging. 1999; 3: 29-33
- Food intake patterns and the 25-year mortality from coronary heart disease.Eur J Epidemiol. 1999; 15: 507-515
- Factor analysis of digestive cancer mortality and food consumption in 65 Chinese counties.J Epidemiol. 1999; 9: 275-284
- Prospective study of major dietary patterns and risk of coronary heart disease in men.Am J Clin Nutr. 2000; 72: 912-921
- Prospective study of major dietary patterns and colorectal cancer risk in women.Am J Epidemiol. 2001; 154: 1143-1149
- Prospective study of major dietary patterns and the risk of breast cancer.Cancer Epidemiol Biomarkers Prev. 2001; 10: 1281-1285
- Dietary patterns and the risk of coronary heart disease in women.Arch Intern Med. 2001; 161: 1857-1862
- Dietary patterns and risk of type 2 diabetes in US men.Ann Intern Med. 2002; 136: 201-209
- Major dietary patterns and the risk of colorectal cancer in women.Arch Intern Med. 2003; 163: 309-314
- Eating patterns and risk of colon cancer.Am J Epidemiol. 1998; 148: 4-18
- Dietary patterns, nutrient intake, and gastric cancer in a high-risk area of Italy.Cancer Causes Control. 2001; 12: 163-172
- Analysis of patterns of food intake in nutritional epidemiology.Public Health Nutr. 2001; 4 (989-987)
- Dietary patterns of elderly Boston-area residents defined by cluster analysis.J Am Diet Assoc. 1992; 92: 1487-1492
- Dietary patterns and cardiovascular risk factors in elderly men.Int J Epidemiol. 1995; 24: 313-320
- Dietary patterns of men and women suggest targets for health promotion.Am J Health Promot. 1996; 11: 42-53
- Using cluster analysis to examine dietary patterns.J Am Diet Assoc. 1997; 97: 272-279
- Factors which influence “healthy” eating patterns.Public Health Nutr. 1998; 1: 193-198
- Food patterns defined by cluster analysis and their utility as dietary exposure variables.Public Health Nutr. 2000; 3: 159-173
- Seven unique food consumption patterns identified among women the UK women’s study.Eur J Clin Nutr. 2000; 54: 314-320
- Validation of a dietary pattern approach for evaluating nutritional risk.J Am Diet Assoc. 2001; 101: 187-194
- The internal validity of a dietary pattern analysis, The Framingham Nutrition Studies.J Epidemiol Commun Health. 2002; 56: 381-388
- Dietary patterns among a national random sample of British adults.J Epidemiol Commun Health. 2001; 55: 29-37
- Identification of groups who report similar patterns of diet among a representative national sample of British adults aged 65 years and more.Public Health Nutr. 2001; 4: 787-795
- Food patterns and components of the metabolic syndrome in men and women.Am J Epidemiol. 2001; 154: 1150-1159
- Evaluation of dietary quality in relationship to nutritional and lifestyle factors in elderly people of the US Framingham Heart Study and the European SENECA study.Eur J Clin Nutr. 2001; 55: 870-880
- Dietary patterns and nutrient intakes of 7-y old children taking part in an atherosclerosis prevention project in Finland.J Am Diet Assoc. 2002; 102: 518-524
- Bone mineral density and dietary patterns in older adults.Am J Clin Nutr. 2002; 76: 245-252
- Dietary patterns and the odds of carotid atherosclerosis in women.Prev Med. 2002; 35: 540-547
- Dietary patterns and adenocarcinoma of the esophagus and distal stomach.Am J Clin Nutr. 2002; 75: 137-144
- Dietary patterns.Public Health Nutr. 2002; 5: 89-90
- Invited Commentary.Am J Epidemiol. 1998; 148: 17-19
- Cluster Analysis.in: Sage University Paper. Sage Publications, Beverly Hills, CA1984 (Series 44)
- Introduction to Factor Analysis.in: Sage University Paper. Sage Publications, Beverly Hills, CA1982
- Factor Analysis.in: Statistical Methods and Practical Issues. Sage University Paper. Sage Publications, Beverly Hills, CA1981
- Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project.Public Health Nutr. 2002; 5: 1311-1328
- Pattern analysis in nutrition.Clin Nutr. 1986; 5: 249-253
- Is principal components analysis necessary to characterize dietary behavior in studies of diet and disease?.Public Health Nutr. 2001; 4: 903-908
- The effect of fruit and vegetable intake on risk for coronary heart disease.Ann Intern Med. 2001; 13: 1106-1114
- Frequent nut consumption and risk of coronary heart disease in women.BMJ. 1998; 317: 1341-1346
- Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women.Am J Clin Nutr. 1997; 70: 1001-1008
- Intake of trans fatty acids and risk of coronary heart disease among women.Lancet. 1993; 341: 581-585
Biography
A. K. Kant is a professor in the Department of Family, Nutrition, and Exercise Sciences, Queens College of the City University of New York, Flushing.
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© 2004 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
