BACKGROUND: Although substantial information on individual nutrients or foods 
and risk of coronary heart disease (CHD) is available, little is known about the 
role of overall eating pattern.
METHODS: Using dietary information from a food frequency questionnaire in 1984 
from the Nurses' Health Study, we conducted factor analysis and identified 2 
major dietary patterns-"prudent" and "Western"-and calculated factor scores of 
each pattern for individuals in the cohort. We used logistic regression to 
examine prospectively the associations between dietary patterns and CHD risk 
among 69 017 women aged 38 to 63 years in 1984 without history of major chronic 
diseases.
RESULTS: The prudent pattern was characterized by higher intakes of fruits, 
vegetables, legumes, fish, poultry, and whole grains, while the Western pattern 
was characterized by higher intakes of red and processed meats, sweets and 
desserts, french fries, and refined grains. Between 1984 and 1996, we documented 
821 CHD cases. After adjusting for coronary risk factors, the prudent diet score 
was associated with a relative risk (RR) of 0.76 (95% confidence interval (CI), 
0.60-0.98; P for trend test,.03) comparing the highest with lowest quintile. 
Extreme quintile comparison yielded an RR of 1.46 (95% CI, 1.07-1.99; P for 
trend test,.02) for the Western pattern. Those who were jointly in the highest 
prudent diet quintile and lowest Western diet quintile had an RR of 0.64 (95% 
CI, 0.44-0.92) compared with those with the opposite pattern profile.
CONCLUSION: A diet high in fruits, vegetables, whole grains, legumes, poultry, 
and fish and low in refined grains, potatoes, and red and processed meats may 
lower risk of CHD.