Background: Cardiovascular disease (CVD) and dementia are the leading causes of death for Australian women. Diet is a modifiable risk factor; however, extent of risk reduction by type of diet is unclear.

Objective: To evaluate the relationship between indices of diet quality: Australian Recommended Food Score (ARFS), Mediterranean Food Score (MDFS) and cluster analysis, with all-cause mortality, CVD and dementia in women. A secondary aim was to investigate the influence of socioeconomic status (SES) on the relationship.

Methods: 9,584 participants from the Australian Longitudinal Study on Women's Health (ALSWH) 1946-1951 cohort, with diet information from Food Frequency Questionnaires in 2001 and outcomes assessed at 2020. Five food clusters were identified using the K-means approach. Cox models were used to obtain hazard ratios (HRs) and 95% CIs for all-cause mortality, CVD and dementia according to quarters of the ARFS and MDFS and by food group clusters, with final models adjusted for health status, behaviours and SES.

Results: There were 656 deaths, 1585 incidents of CVD and 165 dementia diagnoses during 17.2 years of follow-up. For all-cause mortality, HRs comparing the highest (best) to lowest quarter of diet quality were 0.60 (95% CI 0.46, 0.78, p-value <0.001) for the ARFS, 0.64 (0.47, 0.87, p-value 0.005) for the MDFS, and 0.67 (0.47,0.95, p-value 0.02) when comparing a diet higher in protein intake and lower milk/yoghurt intake to diets higher in discretionary foods and lower in fruit and vegetables. There were no associations between diet indices with CVD and dementia outcomes or influence of SES on findings.

Conclusion: Better quality diets were associated with a lower risk of all-cause mortality while there were no associations identified between diet and CVD or dementia outcomes. These findings provide insights into the potential benefits of improving diet quality of Australian women to improve longevity.

Keywords: Cardiovascular disease; Dementia; Dietary Patterns; Nutrition; Women’s Health.

Copyright © 2025. Published by Elsevier Inc.

背景：心血管疾病（CVD）和痴呆症是澳大利亚女性的主要死亡原因。饮食是可以改变的风险因素；然而，不同类型的饮食对风险减少的影响程度尚不清楚。

目的：评估饮食质量指标：澳大利亚推荐食品分数（ARFS）、地中海食物评分（MDFS）和聚类分析与女性全因死亡率、CVD和痴呆症之间的关系。次要目的是研究社会经济地位（SES）对这种关系的影响。

方法：该研究使用了澳大利亚妇女健康纵向研究（ALSWH）1946-1951队列中的9,584名参与者的数据，这些数据包括2001年食品频率问卷上的饮食信息和在2020年的结果评估。利用K均值方法确定了五个食物聚类。使用Cox模型来获取根据ARFS、MDFS四分位数以及食物群聚类的全因死亡率、CVD和痴呆症的风险比（HRs）及其95%置信区间，最终模型调整了健康状况、行为和SES。

结果：在17.2年的随访期间记录了656例死亡、1,585例CVD事件和165例痴呆症诊断。对于全因死亡率，最高（最佳）四分位数与最低四分位数的饮食质量风险比分别为：ARFS 0.60（95% CI 0.46, 0.78，p值

结论：更好的饮食质量与全因死亡率的较低风险相关联，而未发现饮食与CVD或痴呆症结果之间存在任何关联。这些发现为提高澳大利亚女性的饮食质量以延长寿命提供了潜在的好处。

版权所有 © 2025。由Elsevier Inc.出版。