食用坚果频率与 PREDIMED 营养干预试验死亡率风险。
Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial.
机构信息
Human Nutrition Unit, Hospital Universitari de Sant Joan de Reus, Faculty of Medicine and Health Sciences, IISPV (Institut d'Investigació Sanitària Pere Virgili), Universitat Rovira i Virgili, Reus, Spain.
出版信息
BMC Med. 2013 Jul 16;11:164. doi: 10.1186/1741-7015-11-164.
BACKGROUND
Prospective studies in non-Mediterranean populations have consistently related increasing nut consumption to lower coronary heart disease mortality. A small protective effect on all-cause and cancer mortality has also been suggested. To examine the association between frequency of nut consumption and mortality in individuals at high cardiovascular risk from Spain, a Mediterranean country with a relatively high average nut intake per person.
METHODS
We evaluated 7,216 men and women aged 55 to 80 years randomized to 1 of 3 interventions (Mediterranean diets supplemented with nuts or olive oil and control diet) in the PREDIMED ('PREvención con DIeta MEDiterránea') study. Nut consumption was assessed at baseline and mortality was ascertained by medical records and linkage to the National Death Index. Multivariable-adjusted Cox regression and multivariable analyses with generalized estimating equation models were used to assess the association between yearly repeated measurements of nut consumption and mortality.
RESULTS
During a median follow-up of 4.8 years, 323 total deaths, 81 cardiovascular deaths and 130 cancer deaths occurred. Nut consumption was associated with a significantly reduced risk of all-cause mortality (P for trend<0.05, all). Compared to non-consumers, subjects consuming nuts>3 servings/week (32% of the cohort) had a 39% lower mortality risk (hazard ratio (HR) 0.61; 95% CI 0.45 to 0.83). A similar protective effect against cardiovascular and cancer mortality was observed. Participants allocated to the Mediterranean diet with nuts group who consumed nuts>3 servings/week at baseline had the lowest total mortality risk (HR 0.37; 95% CI 0.22 to 0.66).
CONCLUSIONS
Increased frequency of nut consumption was associated with a significantly reduced risk of mortality in a Mediterranean population at high cardiovascular risk.Please see related commentary: http://www.biomedcentral.com/1741-7015/11/165.
TRIAL REGISTRATION
Clinicaltrials.gov. International Standard Randomized Controlled Trial Number (ISRCTN): 35739639. Registration date: 5 October 2005.
背景
非地中海人群的前瞻性研究一致表明，增加坚果的摄入量与降低冠心病死亡率有关。也有研究提示坚果摄入与全因和癌症死亡率的降低存在较小的保护作用。为了研究西班牙这一地中海国家人群中，心血管病高危个体的坚果摄入频率与死亡率之间的关系，该研究纳入了 PREDIMED（地中海饮食中添加坚果或橄榄油与对照饮食的预防研究）研究中的 7216 名 55 至 80 岁的男性和女性。在基线时评估了坚果的摄入量，通过病历和与国家死亡索引的链接确定了死亡率。使用多变量调整的 Cox 回归和广义估计方程模型评估了每年重复测量的坚果摄入量与死亡率之间的关联。
方法
我们评估了 PREDIMED 研究中随机分配到 3 种干预措施（地中海饮食中添加坚果或橄榄油和对照饮食）的 7216 名 55 至 80 岁的男性和女性。在基线时评估了坚果的摄入量，通过病历和与国家死亡索引的链接确定了死亡率。使用多变量调整的 Cox 回归和广义估计方程模型评估了每年重复测量的坚果摄入量与死亡率之间的关联。
结果
在中位随访 4.8 年期间，发生了 323 例全因死亡、81 例心血管死亡和 130 例癌症死亡。坚果的摄入量与全因死亡率呈显著负相关（趋势 P<0.05，均）。与非食用者相比，每周食用坚果>3 份（队列的 32%）的受试者死亡率降低 39%（风险比（HR）0.61；95%置信区间 0.45 至 0.83）。观察到对心血管疾病和癌症死亡率也有类似的保护作用。基线时食用坚果>3 份/周的参与者被分配到地中海饮食加坚果组，其总死亡率最低（HR 0.37；95%置信区间 0.22 至 0.66）。
结论
在心血管病高危的地中海人群中，增加坚果的摄入量与死亡率的显著降低相关。请参见相关评论：http://www.biomedcentral.com/1741-7015/11/165。
试验注册
Clinicaltrials.gov。国际标准随机对照试验编号（ISRCTN）：35739639。注册日期：2005 年 10 月 5 日。
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