Aasheim Erlend T, Sharp Stephen J, Appleby Paul N, Shipley Martin J, Lentjes Marleen A H, Khaw Kay-Tee, Brunner Eric, Key Tim J, Wareham Nicholas J
Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
PLoS One. 2015 Feb 25;10(2):e0117796. doi: 10.1371/journal.pone.0117796. eCollection 2015.
Dietary recommendations to promote health include fresh, frozen and tinned fruit, but few studies have examined the health benefits of tinned fruit. We therefore studied the association between tinned fruit consumption and mortality. We followed up participants from three prospective cohorts in the United Kingdom: 22,421 participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort (1993-2012), 52,625 participants from the EPIC-Oxford cohort (1993-2012), and 7440 participants from the Whitehall II cohort (1991-2012), all reporting no history of heart attack, stroke, or cancer when entering these studies. We estimated the association between frequency of tinned fruit consumption and all cause mortality (primary outcome measure) using Cox regression models within each cohort, and pooled hazard ratios across cohorts using random-effects meta-analysis. Tinned fruit consumption was assessed with validated food frequency questionnaires including specific questions about tinned fruit. During 1,305,330 person years of follow-up, 8857 deaths occurred. After adjustment for lifestyle factors and risk markers the pooled hazard ratios (95% confidence interval) of all cause mortality compared with the reference group of tinned fruit consumption less often than one serving per month were: 1.05 (0.99, 1.12) for one to three servings per month, 1.10 (1.03, 1.18) for one serving per week, and 1.13 (1.04, 1.23) for two or more servings per week. Analysis of cause-specific mortality showed that tinned fruit consumption was associated with mortality from cardiovascular causes and from non-cardiovascular, non-cancer causes. In a pooled analysis of three prospective cohorts from the United Kingdom self-reported tinned fruit consumption in the 1990s was weakly but positively associated with mortality during long-term follow-up. These findings raise questions about the evidence underlying dietary recommendations to promote tinned fruit consumption as part of a healthy diet.
促进健康的饮食建议包括食用新鲜、冷冻和罐装水果,但很少有研究探讨罐装水果对健康的益处。因此,我们研究了食用罐装水果与死亡率之间的关联。我们对来自英国三个前瞻性队列的参与者进行了随访:欧洲癌症与营养前瞻性调查(EPIC)-诺福克队列的22421名参与者(1993 - 2012年)、EPIC-牛津队列的52625名参与者(1993 - 2012年)以及白厅II队列的7440名参与者(1991 - 2012年),所有参与者在进入这些研究时均无心脏病发作、中风或癌症病史。我们使用每个队列中的Cox回归模型估计罐装水果食用频率与全因死亡率(主要结局指标)之间的关联,并使用随机效应荟萃分析汇总各队列的风险比。通过经过验证的食物频率问卷评估罐装水果的食用情况,问卷包括有关罐装水果的具体问题。在1305330人年的随访期间,发生了8857例死亡。在调整生活方式因素和风险标志物后,与每月食用罐装水果少于一份这一参考组相比,全因死亡率的汇总风险比(95%置信区间)为:每月食用一至三份时为1.05(0.99,1.12),每周食用一份时为1.10(1.03,1.18),每周食用两份或更多份时为1.13(1.04,1.23)。特定病因死亡率分析表明,食用罐装水果与心血管病因死亡率以及非心血管、非癌症病因死亡率相关。在对来自英国的三个前瞻性队列进行的汇总分析中,20世纪90年代自我报告的罐装水果食用情况与长期随访期间的死亡率呈弱但正相关。这些发现引发了对于将食用罐装水果作为健康饮食一部分的饮食建议所依据证据的质疑。