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Although diets that modulate these biologic pathways may influence MM patient survival, studies have not examined the association of dietary patterns with MM survival. We conducted pooled prospective survival analyses of 423\u2009MM patients from the Nurses' Health Study (1986\u20132016) and the Health Professionals Follow\u2010up Study (1988\u20132016) using Cox regression models. We used data from repeated food frequency questionnaires (FFQ) to compute dietary patterns as of the last prediagnosis FFQ, including the Alternate Healthy Eating Index (AHEI)\u20102010, alternate Mediterranean Diet, Dietary Approaches to Stop Hypertension, Prudent, Western and empirical dietary inflammatory patterns and empirical dietary indices for insulin resistance and hyperinsulinemia. During follow\u2010up, we documented 295\u2009MM\u2010related deaths among 345 total deaths. MM\u2010specific mortality was 15\u201324% lower per one standard deviation (SD) increase (e.g., toward healthier habits) in favorable dietary pattern scores. For example, the multivariable\u2010adjusted hazard ratio [HR] and 95% confidence interval [CI] per 1\u2010SD increase in AHEI\u20102010 score were 0.76, 0.67\u20130.87 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). In contrast, MM\u2010specific mortality was 16\u201324% higher per 1\u2010SD increase (e.g., toward less healthy habits) in \u201cunhealthy\u201d diet scores; for example, the multivariable\u2010adjusted HR, 95% CI per 1\u2010SD increase in Western pattern score were 1.24, 1.07\u20131.44 (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.005). Associations were similar for all\u2010cause mortality. In conclusion, our consistent findings for multiple dietary patterns provide the first evidence that MM patients with healthier prediagnosis dietary habits may have longer survival than those with less healthy diets.\n                  <\/jats:p>","DOI":"10.1002\/ijc.32928","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T00:16:08Z","timestamp":1581984968000},"page":"1823-1830","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Prediagnosis dietary pattern and survival in patients with multiple myeloma"],"prefix":"10.1002","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1329-4637","authenticated-orcid":false,"given":"Dong Hoon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Nutrition Harvard T.H. Chan School of Public Health  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa T.","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Nutrition Harvard T.H. Chan School of Public Health  Boston MA"},{"name":"Department of Nutrition Simmons University  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8193-7150","authenticated-orcid":false,"given":"Fred K.","family":"Tabung","sequence":"additional","affiliation":[{"name":"Department of Nutrition Harvard T.H. Chan School of Public Health  Boston MA"},{"name":"Division of Medical Oncology, Department of Internal Medicine The Ohio State University College of Medicine  Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine R.","family":"Marinac","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston MA"},{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth E.","family":"Devore","sequence":"additional","affiliation":[{"name":"Channing Division of Network Medicine, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6907-0056","authenticated-orcid":false,"given":"Bernard A.","family":"Rosner","sequence":"additional","affiliation":[{"name":"Channing Division of Network Medicine, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene M.","family":"Ghobrial","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham A.","family":"Colditz","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Washington University School of Medicine  St. Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward L.","family":"Giovannucci","sequence":"additional","affiliation":[{"name":"Department of Nutrition Harvard T.H. 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