Higher baseline DASH and AHEI scores were associated with lower IHD mortality during 2010-2021, with similar effect estimates per 1-SD higher score and broadly comparable model fit, but direct pairwise comparisons showed no statistically significant differences between these scores and the other dietary scores.
Higher food supply-based DASH scores in 2010 were associated with lower country-level age-standardized IHD mortality over 2010-2021.
Higher food supply-based AHEI scores in 2010 were associated with lower country-level IHD mortality over 2010-2021.
No significant associations with IHD mortality were observed for the Mediterranean Diet Score, Traditional Japanese Diet Score, Planetary Health Diet Index, or QUANTIDD.
DASH had the best model fit by AIC weight, followed closely by AHEI, with a slightly higher marginal R2 for DASH.
Direct pairwise comparisons found no statistically significant differences in effect estimates between DASH and AHEI or between either of them and the other dietary scores.
The authors conclude that the relevance of a dietary score may depend on the outcome and analytic context rather than on the superiority of a single index, and that findings are ecological and not individual-level causal effects.
This study looked at 148 countries to see whether the kinds of foods available nationally in 2010 were linked to deaths from ischemic heart disease (heart disease caused by narrowed arteries) in the following years, 2010 to 2021. The researchers used national food supply data to score each country's food environment with six different diet-quality indices, including DASH, AHEI, Mediterranean, traditional Japanese, planetary health, and dietary diversity scores. Countries whose food supply scored higher on the DASH or AHEI indices had about 9% lower heart disease death rates per one standard deviation higher score, after accounting for other factors. The Mediterranean, traditional Japanese, planetary health, and diversity scores showed no significant link. DASH fit the data slightly best, followed by AHEI, but statistical comparisons between the scores did not show that any one was meaningfully better than the others. This research suggests that national food environments resembling DASH- or AHEI-style patterns may go along with lower heart disease mortality, but it does not show that any single index is best. Because the study compares countries rather than individuals, it cannot show that diet caused the differences in deaths, and the results should not be read as effects on any one person.
Nosaka S, Kawase F, Imai T, Sezaki A, Miyamoto K, Abe C, et al.. (2026). Baseline Food Supply-Based Dietary Scores and Ischemic Heart Disease Mortality: A Longitudinal Cross-Country Study.. Nutrients. https://doi.org/10.3390/nu18203456