School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA.
JAMA Intern Med. 2013 Jul 8;173(13):1230-8. doi: 10.1001/jamainternmed.2013.6473.
Some evidence suggests vegetarian dietary patterns may be associated with reduced mortality, but the relationship is not well established.
To evaluate the association between vegetarian dietary patterns and mortality.
Prospective cohort study; mortality analysis by Cox proportional hazards regression, controlling for important demographic and lifestyle confounders.
Adventist Health Study 2 (AHS-2), a large North American cohort.
A total of 96,469 Seventh-day Adventist men and women recruited between 2002 and 2007, from which an analytic sample of 73,308 participants remained after exclusions.
Diet was assessed at baseline by a quantitative food frequency questionnaire and categorized into 5 dietary patterns: nonvegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan.
The relationship between vegetarian dietary patterns and all-cause and cause-specific mortality; deaths through 2009 were identified from the National Death Index.
There were 2570 deaths among 73,308 participants during a mean follow-up time of 5.79 years. The mortality rate was 6.05 (95% CI, 5.82-6.29) deaths per 1000 person-years. The adjusted hazard ratio (HR) for all-cause mortality in all vegetarians combined vs nonvegetarians was 0.88 (95% CI, 0.80-0.97). The adjusted HR for all-cause mortality in vegans was 0.85 (95% CI, 0.73-1.01); in lacto-ovo-vegetarians, 0.91 (95% CI, 0.82-1.00); in pesco-vegetarians, 0.81 (95% CI, 0.69-0.94); and in semi-vegetarians, 0.92 (95% CI, 0.75-1.13) compared with nonvegetarians. Significant associations with vegetarian diets were detected for cardiovascular mortality, noncardiovascular noncancer mortality, renal mortality, and endocrine mortality. Associations in men were larger and more often significant than were those in women.
Vegetarian diets are associated with lower all-cause mortality and with some reductions in cause-specific mortality. Results appeared to be more robust in males. These favorable associations should be considered carefully by those offering dietary guidance.
一些证据表明，素食饮食模式可能与降低死亡率有关，但这种关系尚未得到很好的确立。
评估素食饮食模式与死亡率之间的关系。
前瞻性队列研究；使用 Cox 比例风险回归进行死亡率分析，控制重要的人口统计学和生活方式混杂因素。
Adventist Health Study 2（AHS-2），一个大型的北美队列。
总共招募了 96469 名 Seventh-day Adventist 男性和女性，招募时间为 2002 年至 2007 年，排除后剩余分析样本为 73308 名参与者。
饮食在基线时通过定量食物频率问卷进行评估，并分为 5 种饮食模式：非素食、半素食、鱼素食、乳蛋素食和纯素食。
素食饮食模式与全因和特定原因死亡率之间的关系；通过国家死亡指数确定 2009 年之前的死亡情况。
在平均随访时间为 5.79 年期间，73308 名参与者中有 2570 人死亡。死亡率为每 1000 人年 6.05（95%CI，5.82-6.29）例死亡。与非素食者相比，所有素食者的全因死亡率调整后的危险比（HR）为 0.88（95%CI，0.80-0.97）。素食者的全因死亡率调整后的 HR 为 0.85（95%CI，0.73-1.01）；乳蛋素食者为 0.91（95%CI，0.82-1.00）；鱼素食者为 0.81（95%CI，0.69-0.94）；半素食者为 0.92（95%CI，0.75-1.13）。与非素食者相比，素食饮食与心血管死亡率、非心血管非癌症死亡率、肾脏死亡率和内分泌死亡率显著相关。在男性中观察到与素食饮食相关的关联更大且更频繁，而在女性中则不然。
素食饮食与全因死亡率降低和某些特定原因死亡率降低有关。结果在男性中似乎更为可靠。这些有利的关联应引起提供饮食指导的人的关注。
