By factor analysis of dietary information from the 1984 Nurses' Health Study food frequency questionnaire, Fung et al identified the "prudent" dietary pattern (PP), characterized by higher intakes of vegetables, poultry, and whole grains; and the "Western" pattern (WP), higher intakes of red meats, sweets and desserts, and refined grains. Women with higher PP scores smoked less, used more vitamin supplements, and drank more alcohol, the opposite of the WP women. Of 74 209 women followed up for 12 years, those without diagnosed cardiovascular disease, cancer, diabetes, or high cholesterol levels, 893 new cases of coronary heart disease (CHD) (259 fatal cardiac events, 634 nonfatal myocardial infarcts) were noted. Adjusting for age, smoking, and other CHD risk factors, those with top quintile PP scores had a relative risk (RR) of 0.65 (95% CI = 0.52-0.82) for CHD compared with those at the bottom quintile, ie, WP score group (RR, 1.45 [95% CI = 1.08-1.95]). Data results from the stratified analyses by body mass index, smoking status, and family history of CHD consistently showed that overall dietary patterns defined by factor analysis predict future risk of CHD in women.