Xiong-Fei Pan, Miaobing Zheng, Cliona Ni Mhurchu, Fraser Taylor, Chantal Julia, Dianna J. Magliano, Bruce Neal, Jonathan E. Shaw, Jason H Y Wu, Maria Shahid, An Pan, The George Institute for Global Health [Sydney] (GIGH), The University of Sydney, Baker Heart and Diabetes Institute (AUSTRALIA), Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University [Burwood] -Deakin University [Burwood], Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Santé Publique [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Huazhong University of Science and Technology [Wuhan] (HUST), China Postdoctoral Council International Postdoctoral Exchange Fellowship20180062National Key Research and Development Program of China2017YFC0907504University of New South Wales Scientia FellowshipCommonwealth Department of Health and Aged CareAbbott LaboratoriesAppeared in source as:Abbott Australasia Pty Ltd.Alphapharm Pty Ltd.AstraZenecaAventis PharmaceuticalBristol-Myers SquibbAppeared in source as:Bristol-Myers Squibb PharmaceuticalsEli LillyAppeared in source as:Eli Lilly (Aust) Pty Ltd.GlaxoSmithKlineJanssen-Cilag (Aust) Pty Ltd.Merck Lipha s.a.Merck & CompanyAppeared in source as:Merck Sharp Dohme (Aust)Novartis Pharmaceutical (Aust) Pty Ltd.Novo NordiskAppeared in source as:Novo Nordisk Pharmaceutical Pty Ltd.PharmaciaUpjohn Pty Ltd.PfizerAppeared in source as:Pfizer Pty Ltd.Roche DiagnosticsSanofi Synthelabo (Aust) Pty Ltd.Servier Laboratories (Aust) Pty Ltd.BioRad Laboratories Pty Ltd.HITECH Pathology Pty Ltd.Australian Kidney FoundationDiabetes AustraliaDiabetes Australia (Northern Territory)Queensland HealthDepartment for Environment, Food & Rural Affairs (DEFRA)Appeared in source as:South Australian Department of Human ServicesTasmanian Department of Health and Human ServicesNorthern Territory Health ServicesVictorian Department of Human ServicesVictorian OIS programHealth Department of Western Australia, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Lallemant, Christopher
Background The Health Star Rating (HSR) is the government-endorsed front-of-pack labeling system in Australia and New Zealand. Objectives We aimed to examine prospective associations of a dietary index (DI) based on the HSR, as an indicator of overall diet quality, with all-cause and cardiovascular disease (CVD) mortality. Methods We utilized data from the national population-based Australian Diabetes, Obesity and Lifestyle Study. The HSR-DI at baseline (1999–2000) was constructed by 1) calculation of the HSR points for individual foods in the baseline FFQ, and 2) calculation of the HSR-DI for each participant based on pooled HSR points across foods, weighted by the proportion of energy contributed by each food. Vital status was ascertained by linkage to the Australian National Death Index. Associations of HSR-DI with mortality risk were assessed by Cox proportional hazards regression. Results Among 10,025 eligible participants [baseline age: 51.6 ± 14.3 y (mean ± standard deviation)] at entry, higher HSR-DI (healthier) was associated with higher consumption of healthy foods such as fruits, vegetables, and nuts, and lower consumption of discretionary foods such as processed meats and confectionery (P-trend, Better diet quality as defined by an Australian government–endorsed nutrient profiling system was associated with lower risk of all-cause and CVD mortality among Australian adults.