Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Canada; Vitalité Health Network Research Centre, Moncton, Canada; Centre de formation médicale du Nouveau-Brunswick, Moncton, Canada.
Vitalité Health Network Research Centre, Moncton, Canada.
Public Health. 2014 Mar;128(3):222-30. doi: 10.1016/j.puhe.2013.11.003. Epub 2014 Mar 5.
Despite strong evidence indicating that unbalanced diets relate to chronic diseases and mortality, most adults do not comply with dietary recommendations. To help determine which recommendations could yield the most benefits, the number of deaths attributable to cardiovascular diseases and cancer that could be delayed or averted in Canada if adults changed their diet to adhere to recommendations were estimated.
Macrosimulation based on national population-based survey and vital statistics data.
A macrosimulation model was used to draw age- and sex-specific changes in relative risks based on the results of meta-analyses of relationship between food components and risk of cardiovascular disease and diet-related cancers. Inputs in the model included Canadian recommendations (fruit and vegetable, fibre, salt, and total-, monounsaturated-, polyunsaturated-, saturated-, and trans-fats), average dietary intake (from 35,107 participants with 24-h recall), and mortality from specific causes (from Canadian Vital Statistics). Monte Carlo analyses were used to compute 95% credible intervals (CI).
The estimates of this study suggest that 30,540 deaths (95% CI: 24,953, 34,989) per year could be averted or delayed if Canadians adhered to their dietary recommendations. By itself, the recommendation for fruit and vegetable intake could save as many as 72% (55-87%) of these deaths. It is followed by recommendations for fibres (29%, 13-43%) and salt (10%, 9-12%).
A considerable number of lives could be saved if Canadians adhered to the national dietary intake recommendations. Given the scarce resources available to promote guideline adhesion, priority should be given to recommendations for fruit and vegetable intake.
尽管有强有力的证据表明，饮食不均衡与慢性病和死亡率有关，但大多数成年人并不遵守饮食建议。为了确定哪些建议能带来最大的益处，评估了如果加拿大成年人改变饮食习惯以遵守建议，可延迟或避免多少与心血管疾病和癌症相关的死亡。
基于全国人口调查和生命统计数据的宏模拟。
使用宏模拟模型，根据食物成分与心血管疾病风险和饮食相关癌症之间关系的荟萃分析结果，推断出年龄和性别特异性相对风险的变化。模型的输入包括加拿大的建议（水果和蔬菜、纤维、盐以及总脂肪、单不饱和脂肪、多不饱和脂肪、饱和脂肪和反式脂肪）、平均饮食摄入量（来自 35107 名有 24 小时回忆的参与者）和特定原因的死亡率（来自加拿大生命统计）。使用蒙特卡罗分析计算 95%可信区间（CI）。
本研究的估计表明，如果加拿大人遵守其饮食建议，每年可避免或延迟 30540 例（95%CI：24953，34989）死亡。仅水果和蔬菜摄入量的建议就可避免多达 72%（55-87%）的此类死亡。其次是纤维（29%，13-43%）和盐（10%，9-12%）的建议。
如果加拿大人遵守国家饮食摄入建议，可挽救相当多的生命。鉴于促进指南遵守的资源有限，应优先考虑水果和蔬菜摄入量的建议。
