Nöthlings Ute, Schulze Matthias B, Weikert Cornelia, Boeing Heiner, van der Schouw Yvonne T, Bamia Christina, Benetou Vasiliki, Lagiou Pagona, Krogh Vittorio, Beulens Joline W J, Peeters Petra H M, Halkjaer Jytte, Tjønneland Anne, Tumino Rosario, Panico Salvatore, Masala Giovanna, Clavel-Chapelon Francoise, de Lauzon Blandine, Boutron-Ruault Marie-Christine, Vercambre Marie-Noël, Kaaks Rudolf, Linseisen Jakob, Overvad Kim, Arriola Larraitz, Ardanaz Eva, Gonzalez Carlos A, Tormo Marie-Jose, Bingham Sheila, Khaw Kay-Tee, Key Tim J A, Vineis Paolo, Riboli Elio, Ferrari Pietro, Boffetta Paolo, Bueno-de-Mesquita H Bas, van der A Daphne L, Berglund Göran, Wirfält Elisabet, Hallmans Göran, Johansson Ingegerd, Lund Eiliv, Trichopoulo Antonia
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, 14558 Germany.
J Nutr. 2008 Apr;138(4):775-81. doi: 10.1093/jn/138.4.775.
We examined the associations of intake of vegetables, legumes and fruit with all-cause and cause-specific mortality in a population with prevalent diabetes in Europe. A cohort of 10,449 participants with self-reported diabetes within the European Prospective Investigation into Cancer and Nutrition study was followed for a mean of 9 y. Intakes of vegetables, legumes, and fruit were assessed at baseline between 1992 and 2000 using validated country-specific questionnaires. A total of 1346 deaths occurred. Multivariate relative risks (RR) for all-cause mortality were estimated in Cox regression models and RR for cause-specific mortality were derived in a competing risk model. An increment in intake of total vegetables, legumes, and fruit of 80 g/d was associated with a RR of death from all causes of 0.94 [95% CI 0.90-0.98]. Analyzed separately, vegetables and legumes were associated with a significantly reduced risk, whereas nonsignificant inverse associations for fruit intake were observed. Cardiovascular disease (CVD) mortality and mortality due to non-CVD/non-cancer causes were significantly inversely associated with intake of total vegetables, legumes, and fruit (RR 0.88 [95% CI 0.81-0.95] and 0.90 [0.82-0.99], respectively) but not cancer mortality (1.08 [0.99-1.17]). Intake of vegetables, legumes, and fruit was associated with reduced risks of all-cause and CVD mortality in a diabetic population. The findings support the current state of evidence from general population studies that the protective potential of vegetable and fruit intake is larger for CVD than for cancer and suggest that diabetes patients may benefit from a diet high in vegetables and fruits.
我们在欧洲患有糖尿病的人群中,研究了蔬菜、豆类和水果的摄入量与全因死亡率及特定病因死亡率之间的关联。在欧洲癌症与营养前瞻性调查研究中,对10449名自我报告患有糖尿病的参与者进行了队列研究,平均随访9年。1992年至2000年期间,使用经过验证的各国特定问卷在基线时评估了蔬菜、豆类和水果的摄入量。共发生1346例死亡。在Cox回归模型中估计全因死亡率的多变量相对风险(RR),并在竞争风险模型中得出特定病因死亡率的RR。蔬菜、豆类和水果的总摄入量每天增加80克,与全因死亡RR为0.94[95%CI 0.90-0.98]相关。单独分析时,蔬菜和豆类与风险显著降低相关,而水果摄入量的负相关不显著。心血管疾病(CVD)死亡率以及非CVD/非癌症原因导致的死亡率与蔬菜、豆类和水果的总摄入量显著负相关(RR分别为0.88[95%CI 0.81-0.95]和0.90[0.82-0.99]),但与癌症死亡率无关(1.08[0.99-1.17])。在糖尿病患者中,蔬菜、豆类和水果的摄入量与全因死亡率和CVD死亡率降低相关。这些发现支持了一般人群研究的现有证据状态,即蔬菜和水果摄入对CVD的保护作用大于对癌症的保护作用,并表明糖尿病患者可能从高蔬菜和水果饮食中获益。