Although considerable evidence exists for associations between diet and subsequent cardiovascular disease (CVD) among younger and middle-aged adults, no comprehensive studies of these relationships have been conducted using a national sample of older Americans. National guidelines have recommended reductions of dietary fat, saturated fat, cholesterol and sodium as dietary practice to reduce CVD. However, it is possible that the focus on eliminating dietary components may obscure the advantages of consuming diets that are nutritionally adequate. This research proposes: 1) to examine the associations between several measures of dietary quality at baseline and subsequent 14-year morbidity and mortality from CVD for a national sample of 6109 U.S. adults aged 45 to 74 years at baseline; 2) to assess the relative importance of the associations of dietary quality and CVD for older adults compared to middle-aged adults. The study will use public use data from the First National Health and Nutrition Examination Survey (NHANES I, 1971-75) and the three cycles of the NHANES I Epidemiologic Followup Study (NHEFS), 1982-84, 1986, 1987). No new data will be collected. Dietary variables will be based on responses to the 24-hour dietary recall and the food frequency questionnaire administered at baseline and will include a composite measure of dietary quality, intakes of specific nutrients, and usual consumption of foods from 19 food groups. Baseline measures to be considered as covariates include body mass index, blood pressure, serum cholesterol, sociodemographic variables (e.g., age, race, income, occupation), behavioral variables (e.g., smoking, alcohol consumption, activity level), and chronic health conditions. CVD outcomes will be determined from medical history questionnaires, hospital records and death certificates. Change in blood pressure between baseline and 10-year followup will be examined as an outcome variable as well as a covariate in the association between diet and CVD. Findings from this study could have important implications for setting research priorities to further study the effects of specific dietary variables on CVD, and for implementing national nutrition policies to assist Americans in selecting healthy diets.
