A SIMPLE FOOD QUALITY INDEX PREDICTS MORTALITY IN ELDERLY TAIWANESE

Objectives: To assess the relative predictive ability for mortality of the Overall Dietary Index-Revised (ODI-R) and the Dietary Diversity Score (DDS) among representative Taiwanese aged 65 and older. Design: Prospective cohort. Setting: The Elderly Nutrition and Health Survey in Taiwan during 1999-2000. Participants: One thousand seven hundred forty three (860 men and 883 women). Measurements: Dietary quality measures, the ODI-R (0-100) and DDS (0-6) were based on 24-hour dietary recall and a food frequency questionnaire at baseline. Death by National Death Registry up to 2008 was the outcome measure. Results: During follow-up, 624 subjects died. The survivors had both significantly higher (P<0.001) ODI-R (66.9 vs. 63.6) and DDS (4.69 vs. 4.30) than the deceased. The two indices were correlated (r=0.46). After adjustment for potential covariates, the hazard ratios (HR) (95% CI) were 0.63 (0.42-0.97), 0.71 (0.49-1.04) and 0.53 (0.37-0.76) for those whose ODI-R scores were 60-65, 65-70, >70, respectively, compared to those whose ODI-R scores were (sic) 50 (P for trend <0.001). For DDS, the multi-variable HRs (95% CI) were 0.74 (0.55-1.00), 0.52 (0.38-0.72) and 0.50 (0.31-0.81) for those whose DDS were 4, 5, 6, respectively, compared to those whose DDS were <3 (P for trend <0.001). Total cancer, diabetes mortalities and pneumonia were similarly benefited according to trends. Conclusion: ODIR = 60, and DDS = 4 are predictors of all-cause and cause-specific mortalities. Of the two, DDS is the more predictive. Nutrition policy could be informed and clinical practice enhanced by these population relevant food-health relationships.