Heidemann Christin, Schulze Matthias B, Franco Oscar H, van Dam Rob M, Mantzoros Christos S, Hu Frank B
Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02215, USA.
Circulation. 2008 Jul 15;118(3):230-7. doi: 10.1161/CIRCULATIONAHA.108.771881. Epub 2008 Jun 23.
The impact of overall dietary patterns that reflect actual eating behaviors on mortality caused by cardiovascular or other chronic diseases is largely unknown.
We prospectively evaluated the relation between dietary patterns and risk of cardiovascular, cancer, and all-cause mortality among 72,113 women who were free of myocardial infarction, angina, coronary artery surgery, stroke, diabetes mellitus, or cancer and were followed up from 1984 to 2002. Dietary patterns were derived by factor analysis based on validated food frequency questionnaires administered every 2 to 4 years. Two major dietary patterns were identified: High prudent pattern scores represented high intakes of vegetables, fruit, legumes, fish, poultry, and whole grains, whereas high Western pattern scores reflected high intakes of red meat, processed meat, refined grains, french fries, and sweets/desserts. During 18 years of follow-up, 6011 deaths occurred, including 1154 cardiovascular deaths and 3139 cancer deaths. After multivariable adjustment, the prudent diet was associated with a 28% lower risk of cardiovascular mortality (95% confidence interval [CI], 13 to 40) and a 17% lower risk of all-cause mortality (95% CI, 10 to 24) when the highest quintile was compared with the lowest quintile. In contrast, the Western pattern was associated with a higher risk of mortality from cardiovascular disease (22%; 95% CI, 1 to 48), cancer (16%; 95% CI, 3 to 30), and all causes (21%; 95% CI, 12 to 32).
Greater adherence to the prudent pattern may reduce the risk of cardiovascular and total mortality, whereas greater adherence to the Western pattern may increase the risk among initially healthy women.
反映实际饮食行为的总体饮食模式对心血管疾病或其他慢性疾病所致死亡率的影响很大程度上尚不清楚。
我们前瞻性评估了饮食模式与72113名女性心血管疾病、癌症及全因死亡率风险之间的关系，这些女性无心肌梗死、心绞痛、冠状动脉手术、中风、糖尿病或癌症，于1984年至2002年进行随访。饮食模式通过基于每2至4年进行一次的有效食物频率问卷的因子分析得出。确定了两种主要饮食模式：高谨慎模式得分代表蔬菜、水果、豆类、鱼类、家禽和全谷物的高摄入量，而高西方模式得分反映红肉、加工肉类、精制谷物、炸薯条和糖果/甜点的高摄入量。在18年的随访期间，发生了6011例死亡，包括1154例心血管疾病死亡和3139例癌症死亡。多变量调整后，将最高五分位数与最低五分位数相比，谨慎饮食与心血管疾病死亡率降低28%（95%置信区间[CI]，13至40）和全因死亡率降低17%（95%CI，10至24）相关。相比之下，西方模式与心血管疾病死亡率较高（22%；95%CI，1至48）、癌症死亡率较高（16%；95%CI，3至30）以及全因死亡率较高（21%；95%CI，12至32）相关。
更多地遵循谨慎模式可能降低心血管疾病和总死亡率风险，而更多地遵循西方模式可能增加初发健康女性的死亡风险。
