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1 Supplementary Online Content Li S, Chiuve SE, Flint A, et al. Better diet quality and decreased mortality among myocardial infarction survivors. JAMA Intern Med. Published online September 2, doi: /jamainternmed etable. Multivariate adjusted hazard ratios for all-cause and cardiovascular mortality according to simple-updated post-mi (without alcohol component), changes from pre- to post-mi period of (without alcohol component) This supplementary material has been provided by the authors to give readers additional information about their work.

2 etable. Multivariate Adjusted Hazard Ratios for All-cause and Cardiovascular Mortality According to Simple-Updated Post- MI (Without Alcohol Component), Changes From Pre- to Post-MI Period of (Without Alcohol Component) All-cause mortality Cardiovascular mortality Women Men Pooled Q1 Q2 Q3 Q4 Q5 P Tre nd 36.9 (18.5, 40.8) 44.1 (40.8, 46.8) ) 38.2 (12.1, 42.9) 46.2 (42.9, 49.1) (0.9, 1.62) (0.89, 1.28) 49.4 (46.8, 52.1) 0.79 (0.62, 1.01) 52.0 (49.2, 54.7) ) ) 55.1 (52.1, 58.8) 0.79 (0.61, 1.02) 57.7 (54.7, 61.4) ) 0.87 (0.71, 1.06) Post-MI score 63.9 (58.8, 90.1) ) 66.8 (61.4, 93.5) ) 0.73 (0.58, 0.93) c 36.9 (18.5, 40.8) Q1 Q2 Q3 Q4 Q5 P Tre nd 44.1 (40.8, 46.8) (0.80, 1.51) 38.2 (12.1, 42.9) 46.2 (42.9, 49.1) (0.91, 2.17) (0.95, 1.58) 49.4 (46.8, 52.1) 0.78 ( ) 52.0 (49.2, 54.7) ) ) 55.1 (52.1, 58.8) ) 57.7 (54.7, 61.4) 1.31 (0.81, 2.11) 0.95 (0.71, 1.27) 63.9 (58.8, 90.1) 0.80 (0.53, 1.21) 66.8 (61.4, 93.5) ) 0.85 (0.61, 1.19) d

3 Women change in Men change in Pooled -8.9 (-31.9, -4.4) -1.4 (-4.4, 0.9) (0.65, 1.13) -7.6 (-32.8, -3.3) -0.3 (-3.3, 1.9) (0.72, 1.3) (0.75, 1.13) Changes of score pre- to post-mi period 3.5 (0.9, 5.8) 0.84 (0.62, 1.12) 4.3 (1.9, 6.6) 1.11 (0.83, 1.50) ) 8.6 (5.8, 11.6) ) 9.4 (6.6, 12.7) 0.96 (0.68, 1.34) 0.84 (0.67, 1.05) 16.9 (11.6, 44.6) 0.66 (0.47, 0.91) 17.5 (12.7, 55.7) 1.00 (0.70, 1.42) 0.81 (0.64, 1.04) e -8.9 (-31.9, - 4.4) -1.4 (-4.4, 0.9) ) -7.6 (-32.8, - 3.3) -0.3 (-3.3, 1.9) (0.82, 1.91) (0.88, 1.60) 3.5 (0.9, 5.8) 0.91 (0.59, 1.42) 4.3 (1.9, 6.6) 1.34 (0.87, 2.07) 1.12 (0.82, 1.53) 8.6 (5.8, 11.6) ) 9.4 (6.6, 12.7) 0.98 (0.60, 1.60) 0.89 (0.64, 1.25) 16.9 (11.6, 44.6) 0.58 (0.35, 0.97) 17.5 (12.7, 55.7) 1.10 (0.66, 1.85) 0.82 (0.57, 1.18) f Abbreviations: CI, confidence interval;, hazard ratio; Q, quintile a Adjusted for: time since MI onset, age at diagnosis (continuous), calendar year (questionnaire cycle, continuous, 2-year period), total caloric intake (quintiles of Kcal), physical activity (simple updated, quintiles of metabolic equivalents/week), aspirin use (yes or no), diabetes(yes or no), hypertension (yes or no), lipid lowering medication use(yes or no), currently married (yes or no), body mass index (<21, , , , , >30; calculated as weight in kilograms divided by height in meters squared), coronary artery bypass surgery (CABG, yes or no) and pre-mi diet score (quintiles) and alcohol consumption (0 g/d, g/d, g/d, or 30 g/d).

4 For women, additionally adjusted for post-menopausal hormone use status (pre-menopause, post-menopausal hormone never user, post-menopausal hormone current user, post-menopausal hormone past user), and smoking (never smoker or missing, past smoker, current smoker 1-14 cigarettes per day, current smoker cigarettes per day, current smoker 25+ cigarettes per day). For men, additionally adjusted for heart failure (yes or no), left ventricular ejection fraction ( 40%, <40%, or missing), acute therapy during hospitalization (received either angioplasty or thrombolytics, or none), and smoking (never smoker or missing, past smoker, current smoker <15 cigarettes per day, current smoker 15+ cigarettes per day). b Adjusted for: time since MI onset, age at diagnosis (continuous), calendar year (questionnaire cycle, continuous, 2-year period), aspirin use (never taker, new taker, always taker), diabetes (no diabetes, new diabetes, always diabetes), hypertension (no hypertension, new hypertension, always hypertension), lipid lowering medication use (never taker, new taker, always taker), married (never married, always married, not married anymore), coronary artery bypass (CABG) surgery (never CABG, always CABG, new CABG), changes in smoking status (always never smoker, always past smokers, always current smoker 1-14 cigarettes per day post- MI period, always current smoking 15+ cigarettes per day post-mi period, quit smoking after MI 1-14 cigarettes per day pre-mi period, quit smoking after MI 15+ cigarettes per day pre-mi period), and pre-mi diet score (quintiles). For women, additionally adjusted for: changes in total caloric intake (quintiles of kilocalories), changes in physical activity (quintiles of changes in metabolic equivalents/week), changes in body mass index (quintiles of changes in kg/m 2 ), changes in alcohol consumption (quintiles of changes in g/d) and post-menopausal hormone use status (simple updated, pre-menopause, postmenopausal hormone never user, post-menopausal hormone current user, post-menopausal hormone past user). For men, additionally adjusted for: changes in total caloric intake (tertiles of kilocalories), changes in physical activity (tertiles of changes in metabolic equivalents per week), changes in body mass index (tertiles of changes; calculated as weight in kilograms divided by height in meters squared), heart failure (simple updated, yes or no), left ventricular ejection fraction (simple updated, 40%, <40%, or missing), changes in alcohol consumption (tertiles of changes in grams per day), and acute therapy during hospitalization (simple updated, received either angioplasty or thrombolytics, or none). c Fixed-effect model for heterogeneity, P=.85. d Fixed-effect model for heterogeneity, P =.35. e Fixed-effect model for heterogeneity, P =.11. f Fixed-effect model for heterogeneity, P =.11.

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