Although many studies have examined the role of single nutrients, foods, or food groups in the etiology of disease, relatively little research has addressed the health effects of dietary patterns comprising multiple interdependent dietary factors. Research on dietary patterns is warranted on several grounds. First, complex diets consumed by free-living individuals do not consist of single nutrients or foods but rather a combination of foods containing multiple nutrients and non-nutrients. Second, intercorrelation of dietary variables makes it difficult to isolate effects of single nutrients or foods. Third, in vivo biological activities of nutrients are interdependent. Finally, recommendations for disease prevention implicitly reflect the dietary pattern approach by emphasizing the simultaneous change of several dietary behaviors such as increasing fruit, vegetable, and grain intake, and decreasing fat intake. The purpose of this small grant proposal is to analyze data from two large national cohorts [National Health Interview Surveys of 1987 (n=22,080; 2937 deaths due to all causes), and 1992 (n=12,005; 1033 deaths due to all causes)] to examine prospectively the relation of overall diet quality to all-cause and, cause-specific mortality. Measures of overall diet quality developed from food frequency questionnaire collected as a supplement to the core survey will be examined in relation to risk of mortality over a followup period of 5-10 years. Cox's proportional hazards regression analysis will be used to test the independent association of diet quality with each outcome using statistical software (SUDAAN) appropriate for analysis of data from surveys with a complex study design.
