ArticleThe American journal of clinical nutrition2015
WHO guidelines for a healthy diet and mortality from cardiovascular disease in European and American elderly: the CHANCES project.
Article in The American journal of clinical nutrition, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 75 citations in OpenAlex.
- Effects of intervention on lifestyle changes among coronary artery disease patients: A 6-month follow-up study.Nursing open · 2022Trial
- Dietary intake, fatty acid in adipose tissue and cardio-metabolic health: cross-sectional study from the TwinsUK cohort.Nutrition & diabetes · 2026Article
- Association between age and malnutrition in oldest-old and centenarian populations.BMC geriatrics · 2025Article
- Analysis of risk factors for carotid artery plaque in asymptomatic adults.BMC cardiovascular disorders · 2024Article
- Implementation of mobile-health technology is associated with five-year survival among individuals in rural areas of Indonesia.PLOS digital health · 2024Article
- Advancing nutrition risk assessment in middle-aged and older individuals with diverse food cultures: A data-driven personalized approach to predict incident hypertension, diabetes and mortality.The journal of nutrition, health & aging · 2024Article
- Westernized and Diverse Dietary Patterns Are Associated With Overweight-Obesity and Abdominal Obesity in Mexican Adult Men.Frontiers in nutrition · 2022Article
- Downregulation of p300/CBP-associated factor inhibits cardiomyocyte apoptosis via suppression of NF-κB pathway in ischaemia/reperfusion injury rats.Journal of cellular and molecular medicine · 2021Article
- Quality Diet Index and Risk of Pancreatic Cancer: Findings from the Singapore Chinese Health Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Article
- Factors Related to Diet Quality: A Cross-Sectional Study of 1055 University Students.Nutrients · 2021Article
- Quality diet indexes and risk of hepatocellular carcinoma: Findings from the Singapore Chinese Health Study.International journal of cancer · 2021Article
- Food group intakes and all-cause mortality among a young older Japanese population of the same age: the New Integrated Suburban Seniority Investigation Project.Nagoya journal of medical science · 2021Article
- Introducing a Suite of Low-Burden Diet Quality Indicators That Reflect Healthy Diet Patterns at Population Level.Current developments in nutrition · 2020Article
- Defining diet quality: a synthesis of dietary quality metrics and their validity for the double burden of malnutrition.The Lancet. Planetary health · 2020Review
- Higher dietary diversity scores and protein-rich food consumption were associated with lower risk of all-cause mortality in the oldest old.Clinical nutrition (Edinburgh, Scotland) · 2020Article
- Noninvasive Imaging to Assess Atherosclerotic Plaque Composition and Disease Activity: Coronary and Carotid Applications.JACC. Cardiovascular imaging · 2020Review
- DNA methylation of antisense noncoding RNA in the INK locus (ANRIL) is associated with coronary artery disease in a Chinese population.Scientific reports · 2019Article
- Dietary Macronutrient Management to Treat Mitochondrial Dysfunction in Parkinson's Disease.International journal of molecular sciences · 2019Review
- The World Health Organization's Healthy Diet Indicator and its associated factors: A cross-sectional study in central Kinki, Japan.Preventive medicine reports · 2018Article
- Pretreatment with Total Flavonoid Extract from Dracocephalum Moldavica L. Attenuates Ischemia Reperfusion-induced Apoptosis.Scientific reports · 2018Article
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Authors and funding
26 authors at 14 institutions in 11 countries.
Funding
Abstract
backgroundCardiovascular disease (CVD) represents a leading cause of mortality worldwide, especially in the elderly. Lowering the number of CVD deaths requires preventive strategies targeted on the elderly.
objectiveThe objective was to generate evidence on the association between WHO dietary recommendations and mortality from CVD, coronary artery disease (CAD), and stroke in the elderly aged ≥60 y.
designWe analyzed data from 10 prospective cohort studies from Europe and the United States comprising a total sample of 281,874 men and women free from chronic diseases at baseline. Components of the Healthy Diet Indicator (HDI) included saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, dietary fiber, and fruit and vegetables. Cohort-specific HRs adjusted for sex, education, smoking, physical activity, and energy and alcohol intakes were pooled by using a random-effects model.
resultsDuring 3,322,768 person-years of follow-up, 12,492 people died of CVD. An increase of 10 HDI points (complete adherence to an additional WHO guideline) was, on average, not associated with CVD mortality (HR: 0.94; 95% CI: 0.86, 1.03), CAD mortality (HR: 0.99; 95% CI: 0.85, 1.14), or stroke mortality (HR: 0.95; 95% CI: 0.88, 1.03). However, after stratification of the data by geographic region, adherence to the HDI was associated with reduced CVD mortality in the southern European cohorts (HR: 0.87; 95% CI: 0.79, 0.96; I(2) = 0%) and in the US cohort (HR: 0.85; 95% CI: 0.83, 0.87; I(2) = not applicable).
conclusionOverall, greater adherence to the WHO dietary guidelines was not significantly associated with CVD mortality, but the results varied across regions. Clear inverse associations were observed in elderly populations in southern Europe and the United States.
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