The association between diet quality and all-cause mortality in Chinese population is unclear. We aimed to study the associations of three a priori diet quality indices-including the Diet Quality Index-International (DQI-I), Chinese Healthy Eating Index (CHEI), and energy-adjusted Dietary Inflammatory Index (E-DII)-and their included components with all-cause mortality. We used baseline data from the 2004, 2006, 2009, and 2011 waves of the China Health and Nutrition Survey (CHNS). We used a multivariable-adjusted Cox model to examine the associations between DQI-I, CHEI, and E-DII with all-cause mortality. During a mean of 7 years of follow-up, a total of 461 deaths occurred among 12,914 participants. For DQI-I, there were significant inverse associations with mortality for the variety score (HRQ4 vs. Q1 = 0.69, 95%CI = 0.52-0.92) and overall balance score (HR>0 vs. 0 = 0.81, 95%CI = 0.66-0.91). The adequacy score of CHEI was associated with 40% less risk of all-cause mortality (HRQ4 vs. Q1 = 0.60, 95%CI = 0.43-0.84). E-DII was not associated with mortality. An estimated 20.1%, 13.9%, and 31.3% of total mortality would be averted if the DQI-I variety score, DQI-I overall balance score, and CHEI adequacy score improved from the bottom to the top quartile, respectively. Improving diet quality, especially improving diet variety and adequacy, and having a more balanced diet may reduce all-cause mortality in Chinese adults.

We intended to precisely evaluate the dietary quality of male and female medical college students using canteen data from the \"Intelligent Ordering System\" (IOS), combined with the supplemental food frequency questionnaire (SFFQ) and the Chinese Healthy Eating Index (CHEI) in Shanghai, China, to explore the potential factors influencing dietary quality. A total of 283 college students with the average age of 24.67 ± 3.21 years and Body Mass Index of 21.46 ± 3.49 kg/m2 in the medical school were enrolled in this study, and an online questionnaire investigation was conducted to collect the general information, lifestyle behavior, and SFFQ. The dietary data of the study participants from the school canteen were exported from the IOS of the Information Office of Fudan University. The CHEI consists of 17 components and the total score is 100, with a maximum score of each component of 5 or 10. We calculated each component score of the CHEI and aggregated the total score for male and female study participants. The Chi-square test and Wilcoxon rank sum test were employed in comparing the differences between the demographic characteristics and CHEI component scores of males and females. Univariate and multiple linear regression models were employed to examine the potential influencing factors of the total CHEI score. The CHEI median score was 66.65, and the component score for total grains was relatively low. Added sugars was the most overconsumed CHEI component. There were relatively serious deficiencies, based on the CHEI component scores, in fruits, soybeans, fish and seafood, and seeds and nuts in both sexes. Females had significantly higher CHEI scores than males (68.38 versus 64.31). The scores for tubers, total vegetables, dark vegetables, fruits, fish and seafood, dairy, and red meats were significantly higher in females than in males. Influencing factors including sex, education, dietary health literacy, and amount of time spent sedentarily were significantly associated with CHEI score. Our research revealed that the overall dietary quality needs to be further improved for college students at the medical school in Shanghai, China, with low intakes of total grains, fruits, soybeans, fish and seafood, and seeds and nuts, and high intakes of added sugars. Compared with males, females showed higher diet quality and conformed more strongly with the recommended Dietary Guideline for Chinese. Education, dietary health literacy, and amount of time spent sedentarily should be noted for improving the dietary quality of college students.

Little is known about which currently available a priori dietary indexes provide best guidance for reducing cardiometabolic risk factors (CMRF) among hyperlipidemic patients. This study was designed to compare the associations between four a priori dietary indexes, including Diet Balance Index (DBI-16), Chinese Healthy Eating Index (CHEI), Mediterranean Diet Score (MDS) and Dietary Approaches to Stop Hypertension (DASH) and CMRF among hyperlipidemic patients. A total of 269 participants were enrolled into the cross-sectional study. DBI-16, CHEI, MDS, and DASH scores were calculated using established methods. CMRF was measured using standard methods. DBI-total scores (DBI-TS) were inversely associated with triglyceride concentrations and TC:HDL-C ratio, and positively associated with HDL-C and ApoA1 concentrations (all p < 0.05), while the results for DBI-low bound scores (DBI-LBS) were opposite. DBI-high bound scores (DBI-HBS) and DASH scores were positively and inversely associated with glucose concentrations, respectively (both p < 0.05). Higher diet quality distance (DQD) was positively associated with higher TC, LDL-C and ApoB concentrations, and TC:HDL-C and LDL-C:HDL-C ratios, and lower HDL-C and ApoA1 concentrations and ApoA1:ApoB ratio (all p < 0.05). CHEI scores were inversely associated with triglyceride concentrations (p = 0.036). None of the dietary indexes was associated with blood pressures. DBI-16 provided most comprehensive evaluations of the overall diet quality and balance for optimizing cardiometabolic health among hyperlipidemic individuals.

OBJECTIVE: Adherence to dietary recommendations has been linked to a reduced risk of developing hepatocellular carcinoma (HCC) and dying of chronic liver disease. However, its role in the prognosis of HCC is still unclear. We prospectively investigated the association of two dietary quality indices, the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index-2015 (HEI-2015), with all-cause and HCC-specific mortality in a large prospective cohort of HCC survivors.
METHODS: We included 887 patients with newly diagnosed, previously untreated HCC enrolled in the Guangdong Liver Cancer Cohort (GLCC) between September 2013 and April 2017 in the analysis. CHEI and HEI-2015 scores were calculated based on the dietary intake in the year before diagnosis of HCC. Cox proportional hazards regression models were used to estimate multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for each index.
RESULTS: During a median follow-up of 797 days, 389 deaths were identified, including 347 from HCC. Higher CHEI scores, reflecting favorable adherence to the 2016 Dietary Guidelines for Chinese, were associated with a lower risk of all-cause mortality (T3 vs. T1 : HR = 0.75, 95% CI: 0.58-0.98) and HCC-specific mortality (T3 vs. T1 : HR = 0.74, 95% CI: 0.56-0.98). Non-significant, inverse associations of HEI-2015 score with all-cause mortality (T3 vs. T1 : HR = 0.86, 95% CI: 0.67-1.11) and HCC-specific mortality (T3 vs. T1 : HR = 0.93, 95% CI: 0.71-1.21) were suggested.
CONCLUSIONS: Our findings suggest that better adherence to the 2016 Dietary Guidelines for Chinese may reduce the risk of all-cause and HCC-specific mortality in patients with HCC.