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Diet quality measured by four a priori-defined diet quality indices is associated with lipid-soluble micronutrients in the Multiethnic Cohort Study (MEC)



This study examined the long-term relation of lipid-soluble micronutrients with diet quality as assessed by four a priori-defined dietary patterns.


In a prospective design, nutritional biomarkers (carotenoids, tocopherols, retinol, and coenzyme Q10) were measured using a validated HPLC-based assay. General linear models were applied to obtain covariate-adjusted means of biomarkers for tertiles of four a priori diet quality indices: Healthy Eating Index (HEI) 2010, Alternative HEI (AHEI) 2010, Alternate Mediterranean Diet Score (aMED), and Dietary Approaches to Stop Hypertension (DASH). For a subcohort of 8367 participants within the Multiethnic Cohort (MEC), diet was assessed by a validated quantitative food frequency questionnaire in 1993–96 and serum was collected in 2001–06.


Participants with the highest diet-quality scores had significantly higher serum concentrations of all carotenoids, total tocopherols, and α-tocopherol, whereas γ-tocopherol was inversely associated with diet quality. Adjusted means for the lowest vs. highest tertile of HEI 2010 were 1.2 vs. 1.5 mg/L for total carotenoids, 11.4 vs. 12.3 mg/L for total tocopherols, and 1.9 vs. 1.6 mg/L for γ-tocopherol (ptrend < 0.0001). The associations for the other dietary indices were similar; no indication for sex and ethnic differences was detected. Vegetable and fruit components were major predictors of most circulating micronutrients, but most other components were also associated.


Higher diet-quality scores measured by four a priori diet quality indices were significantly associated higher serum concentrations of carotenoids and α-tocopherol, whereas γ-tocopherol was inversely associated with diet quality.

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The Multiethnic Cohort has been supported by NCI grants R37 CA54281 (PI: LNK), U01 CA164973 (PI: LLM/CAH/LRW), and P30 CA71789 (PI: R. Holcombe). NA was supported by a student fellowship from the German Research Foundation (PROMOS) and from the Susanne Marie Sophie Haufen Foundation. None of the funders had a role in the design, analysis, or writing of this article

Author contributions:

LNK, LLM, and LRW led the design and implementation of the prospective cohort. CJB provided nutritional support and developed the diet scores. AF provided analytical services for micronutrient quantitation. NA and GM analyzed the data and wrote the paper. NA, CJB, AF, RVC, CAH, LRW, LNK, KRM, and GM contributed to the interpretation of the data, the critical revision of the article for important intellectual content, and the final approval of the version to be published. NA had primary responsibility for final content.

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The authors declare that they have no conflict of interest.

Correspondence to Nicole Aumueller.

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