Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Can Nutritional Scores Improve the Who Calibrated Non-Laboratory Risk Prediction Model for Cardiovascular Disease? Golestan Cohort Study Publisher



Jabbari M1 ; Einizinab H1 ; Kalhori A2 ; Barati M3 ; Zayeri F4 ; Poustchi H5 ; Pourshams A6 ; Hekmatdoost A7 ; Malekzadeh R6
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Department of Food Science and Technology, Nutritional Science, The Ohio State University, Columbus, OH, United States
  3. 3. Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Proteomics Research Center, Department of Biostatistics, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Liver and Pancreaticobiliary Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, 14117-13135, Iran
  6. 6. Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Journal of Diabetes and Metabolic Disorders Published:2024


Abstract

Purpose: Evaluation of the added value of Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diet scores on the prediction model of the World Health Organization (WHO) to predict 10-year cardiovascular disease (CVD) mortality using the Golestan Cohort Study data. Methods: A total of 44,648 participants (25,268 women and 18,531 men) were included in the final analysis. To assess the external validity of the non-laboratory risk model of WHO, the Area Under the Curve (AUC) and calibration plot methods were used. The multivariate Cox proportional hazards regression analysis was used to evaluate the association of 10-year CVD mortality risk with DASH and Mediterranean scores and their components. The added value of each significant variables was evaluated by the concordance C-statistic and integrated discrimination improvement (IDI). Statistical significance was defined as p-value < 0.05. Results: DASH and Mediterranean diet scores were not significant predictors of 10-year CVD mortality in both genders (p > 0.05). However, sodium and total vegetable in both genders and added sugar in women were significant predictors for 10-year stroke mortality (p < 0.05). Sodium intake in women and monounsaturated fatty acid (MUFA) to saturated fatty acid (SFA) ratio in men had significant associations with 10-year mortality of myocardial infarction/coronary heart disease (MI/CHD). Calculation of IDI showed that none of the evaluated nutritional indices/variables could significantly improve the WHO model performance and predictive ability. Conclusion: Inclusion of DASH and Mediterranean diet scores and their components did not improve WHO risk prediction model performance and predictive ability to predict 10-year CVD mortality. © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2024.
Related Docs
View other Related Docs
1. Development of a Cvd Mortality Risk Score Using Nutritional Predictors: A Risk Prediction Model in the Golestan Cohort Study, Nutrition, Metabolism and Cardiovascular Diseases (2025)
2. Major Dietary Protein Sources in Relation to Pancreatic Cancer: A Large Prospective Study, Archives of Iranian Medicine (2016)
3. Pars Cohort Study of Non-Communicable Diseases in Iran: Protocol and Preliminary Results, International Journal of Public Health (2017)
4. Individual and Combined Effects of Environmental Risk Factors for Esophageal Cancer Based on Results From the Golestan Cohort Study, Gastroenterology (2019)
5. Population Attributable Fraction of Dietary Risk Factors for Cancer Mortality With a Focus on Gastrointestinal Cancers in a Population Based Cohort Study, Scientific Reports (2025)
6. Habitual Dietary Intake of Flavonoids and All-Cause and Cause-Specific Mortality: Golestan Cohort Study, Nutrition Journal (2020)
7. Oral Health and Mortality in the Golestan Cohort Study, International Journal of Epidemiology (2017)
8. The Effect of Family Empowerment on Preventive Lifestyle of Cardiovascular Disease Risk Factors in Middle-Aged Women During the Covid-19 Pandemic: A Randomized Clinical Trial, Iranian Journal of Health Education and Health Promotion (2023)
Experts (# of related papers)
View all Related Experts
Hossein Poustchi (71)
Reza Malekzadeh (63)
Other Related Docs
9. Dietary Protein Sources and All-Cause and Cause-Specific Mortality: The Golestan Cohort Study in Iran, American Journal of Preventive Medicine (2017)
10. Household Fuel Use and the Risk of Gastrointestinal Cancers: The Golestan Cohort Study, Environmental Health Perspectives (2020)
11. Dental Health and Lung Cancer Risk in the Golestan Cohort Study, BMC Cancer (2024)
12. Mineral Intake and Cardiovascular Disease, Cancer, and All-Cause Mortality: Findings From the Golestan Cohort Study, Nutrients (2024)
13. Hazards of Cigarettes, Smokeless Tobacco and Waterpipe in a Middle Eastern Population: A Cohort Study of 50 000 Individuals From Iran, Tobacco Control (2017)
14. The Protocol of a Population-Based Prospective Cohort Study in Southwest of Iran to Analyze Common Non-Communicable Diseases: Shahrekord Cohort Study, BMC Public Health (2018)
15. Adherence to the Dietary Approaches to Stop Hypertension (Dash) Diet and Risk of Total and Cause-Specific Mortality: Results From the Golestan Cohort Study, International Journal of Epidemiology (2019)
16. Meat Consumption and Risk of Esophageal and Gastric Cancer in the Golestan Cohort Study, Iran, International Journal of Cancer (2022)
17. Causes of Premature Death and Their Associated Risk Factors in the Golestan Cohort Study, Iran, BMJ Open (2018)
18. Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study, International Journal of Epidemiology (2021)
19. An Office-Based Cardiovascular Prediction Model Developed and Validated in Cohort Studies of a Middle-Income Country, Journal of Clinical Epidemiology (2022)
20. Dietary Advanced Glycation End Products and Risk of Overall and Cause-Specific Mortality: Results From the Golestan Cohort Study, International Journal of Environmental Research and Public Health (2023)
21. Validity of the Models Predicting 10-Year Risk of Cardiovascular Diseases in Asia: A Systematic Review and Prediction Model Metaanalysis, PLoS ONE (2023)
22. The Combined Effects of Healthy Lifestyle Behaviors on All-Cause Mortality: The Golestan Cohort Study, Archives of Iranian Medicine (2016)
23. The Application of Six Dietary Scores to a Middle Eastern Population: A Comparative Analysis of Mortality in a Prospective Study, European Journal of Epidemiology (2019)
24. Dairy Food Intake and All-Cause, Cardiovascular Disease, and Cancer Mortality: The Golestan Cohort Study, American Journal of Epidemiology (2017)
25. Dietary Amino Acids Intake and All-Cause and Cause-Specific Mortality: Results From the Golestan Cohort Study, Nutrition Journal (2024)
26. Diet Quality and Subsequent Incidence of Upper Gastrointestinal Cancers: Results From the Golestan Cohort Study, Archives of Iranian Medicine (2023)
27. Long-Term Opiate Use and Risk of Cardiovascular Mortality: Results From the Golestan Cohort Study, European Journal of Preventive Cardiology (2021)
28. Impact of Dash and Mediterranean Diets on Mood and Happiness in Young Adult Males: A Cross-Sectional Study, BMC Research Notes (2025)
29. Dietary Acid Load and Mortality From All Causes, Cvd and Cancer: Results From the Golestan Cohort Study, British Journal of Nutrition (2022)
30. Oral Health and Risk of Upper Gastrointestinal Cancers in a Large Prospective Study From a High-Risk Region: Golestan Cohort Study, Cancer Prevention Research (2021)
31. Association Between Prediagnostic Risk Factors and Survival After Colorectal Cancer Diagnosis in Golesten Cohort Study, Scientific Reports (2025)
32. Adherence to the Mediterranean Dietary Pattern in Relation to Glioma: A Case–Control Study, Clinical Nutrition (2021)
33. Iron, Copper, and Magnesium Concentration in Hair and Risk of Esophageal Cancer: A Nested Case-Control Study, Archives of Iranian Medicine (2023)
34. The Association of Dietary Intake and Plasma Fatty Acid Panel in Pancreatic Cancer Patients: Results From Golestan Cohort Study, Nutrition and Health (2022)
35. The Contribution of Metabolic Risk Factors to Cardiovascular Mortality in Golestan Cohort Study: Population Attributable Fraction Estimation, International Journal of Cardiology: Cardiovascular Risk and Prevention (2024)
36. White Rice Intake and Incidence of Type-2 Diabetes: Analysis of Two Prospective Cohort Studies From Iran, BMC Public Health (2017)
37. Cardiovascular Disease Mortality and Years of Life Lost Attributable to Non-Optimal Systolic Blood Pressure and Hypertension in Northeastern Iran, Archives of Iranian Medicine (2015)
38. Impaired Fasting Glucose and Major Adverse Cardiovascular Events by Hypertension and Dyslipidemia Status: The Golestan Cohort Study, BMC Cardiovascular Disorders (2020)
39. The Association Between Dietary Fat Intake and Pancreatic Cancer Risk: A Large Prospective Study, Govaresh (2017)
40. Hypertension and Mortality in the Golestan Cohort Study: A Prospective Study of 50 000 Adults in Iran, Journal of Human Hypertension (2016)
41. Higher Intake of Dietary Fiber, But Not Fruits or Vegetables Is Associated With Lower Risk of Pancreatic Cancer: A Large Prospective Study, Govaresh (2017)
42. Household Fuel Use and Cardiovascular Disease Mortality, Circulation (2016)
43. Development of a Digestive Cancer Risk Score Based on Nutritional Predictors: A Risk Prediction Model in the Golestan Cohort Study, Nutrition and Cancer (2025)
44. Higher Intakes of Fiber, Total Vegetables, and Fruits May Attenuate the Risk of All-Cause and Cause-Specific Mortality: Findings From a Large Prospective Cohort Study, Nutrition Journal (2023)
45. Diet and Upper Gastrointestinal Malignancies, Gastroenterology (2015)
46. Exposure to Volatile Organic Compounds and Chronic Respiratory Disease Mortality, a Case-Cohort Study, Respiratory Research (2025)
47. Prevalence and Determinants of Chronic Kidney Disease in Northeast of Iran: Results of the Golestan Cohort Study, PLoS ONE (2017)
48. Survival Assessment and Pre-Diagnostic Risk Factors for Lung Cancer Incidence: Insights From the Golestan Cohort Study, PLoS ONE (2025)
49. Population Attributable Fractions of Cancer Mortality Related to Indoor Air Pollution, Animal Contact, and Water Source As Environmental Risk Factors: Findings From the Golestan Cohort Study, PLoS ONE (2024)
50. Nut Consumption and the Risk of Oesophageal Squamous Cell Carcinoma in the Golestan Cohort Study, British Journal of Cancer (2018)