Healthy Diet May Reduce Mortality In Low Income Populations Interview with:
Wei Zheng, MD, PhD, Professor of Medicin
Anne Potter Wilson Chair in Medicine
Director, Vanderbilt Epidemiology Center and

Danxia Yu, PhD Research Fellow
Vanderbilt Epidemiology Center
Vanderbilt University School of Medicine
Nashville, TN, 37203

Medical Research: What is the background for this study? What are the main findings?

Response: The Dietary Guidelines for Americans (DGA) provide the most authoritative advice in the US about healthy eating. Higher adherence to the DGA, reflected by a higher Healthy Eating Index (HEI) score, has been found to be associated with lower risk of developing or dying from chronic diseases (e.g. diabetes, cardiovascular disease, and certain cancers) in several US studies. However, these studies recruited mostly non-Hispanic white individuals and middle to high income Americans. It has been reported that racial/ethnical background and socioeconomic status may influence food choices and diet quality. However, no previous study has adequately evaluated the association between adherence to the DGA and risk of death due to diseases in racial/ethnical minorities and low-income Americans. Therefore, it is uncertain whether the health benefits of adherence to the current DGA can be generalized to these underserved populations.

We analyzed diet and mortality data from the Southern Community Cohort Study (SCCS), a large, prospective cohort study including approximately 85,000 American adults, 40-79 years old, enrolled from 12 southeastern states between 2002 and 2009. Two-thirds of the SCCS participants were African-American and more than half reported an annual household income <$15,000.

During a mean follow-up of 6.2 years, we identified 6,906 deaths in the SCCS, including 2,244 from cardiovascular disease, 1,794 from cancer, and 2,550 from other diseases. Using multivariate analysis methods, we found that participants in the top 20% of the HEI score (highest adherence to the DGA) had only about 80% of the risk of death due to any diseases compared with those in the bottom 20% of the HEI score. This protective association was found regardless of sex, race and income levels.

Medical Research: What should clinicians and patients take away from your report?

Response: Similar to what was reported previously in studies conducted in mostly non-Hispanic white individuals and middle to high income Americans, our study suggests that having a healthy diet, as described in the DGA, may help to reduce disease mortality in African Americans and low-income populations.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: African Americans and low-income populations experience a disproportionally high disease burden. Future studies are needed in these underserved populations to directly evaluate cost-effective disease prevention strategies to reduce the morbidity and mortality of diseases in these populations.


Yu D, Sonderman J, Buchowski MS, McLaughlin JK, Shu X-O, Steinwandel M, et al. (2015) Healthy Eating and Risks of Total and Cause-Specific Death among Low-Income Populations of African-Americans and Other Adults in the Southeastern United States: A Prospective Cohort Study. PLoS Med 12(5): e1001830. DOI: 10.1371/journal.pmed.1001830

[wysija_form id=”3″] Interview with: Wei Zheng, MD, PhD, Professor of Medicine, Anne Potter Wilson Chair in Medicine, Director, Vanderbilt Epidemiology Center and, Danxia Yu, PhD Research Fellow Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, & Nashville, TN, 37203 (2015). Healthy Diet May Reduce Mortality In Low Income Populations 

Last Updated on June 14, 2015 by Marie Benz MD FAAD