Schwingshackl Lukas, Schwedhelm Carolina, Hoffmann Georg, Lampousi Anna-Maria, Knüppel Sven, Iqbal Khalid, Bechthold Angela, Schlesinger Sabrina, Boeing Heiner
German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany;
German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany.
Am J Clin Nutr. 2017 Jun;105(6):1462-1473. doi: 10.3945/ajcn.117.153148. Epub 2017 Apr 26.
Suboptimal diet is one of the most important factors in preventing early death and disability worldwide. The aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages, with risk of all-cause mortality. We conducted a systematic search in PubMed, Embase, and Google Scholar for prospective studies investigating the association between these 12 food groups and risk of all-cause mortality. Summary RRs and 95% CIs were estimated with the use of a random effects model for high-intake compared with low-intake categories, as well as for linear and nonlinear relations. Moreover, the risk reduction potential of foods was calculated by multiplying the RR by optimal intake values (serving category with the strongest association) for risk-reducing foods or risk-increasing foods, respectively. With increasing intake (for each daily serving) of whole grains (RR: 0.92; 95% CI: 0.89, 0.95), vegetables (RR: 0.96; 95% CI: 0.95, 0.98), fruits (RR: 0.94; 95% CI: 0.92, 0.97), nuts (RR: 0.76; 95% CI: 0.69, 0.84), and fish (RR: 0.93; 95% CI: 0.88, 0.98), the risk of all-cause mortality decreased; higher intake of red meat (RR: 1.10; 95% CI: 1.04, 1.18) and processed meat (RR: 1.23; 95% CI: 1.12, 1.36) was associated with an increased risk of all-cause mortality in a linear dose-response meta-analysis. A clear indication of nonlinearity was seen for the relations between vegetables, fruits, nuts, and dairy and all-cause mortality. Optimal consumption of risk-decreasing foods results in a 56% reduction of all-cause mortality, whereas consumption of risk-increasing foods is associated with a 2-fold increased risk of all-cause mortality. Selecting specific optimal intakes of the investigated food groups can lead to a considerable change in the risk of premature death.
不良饮食是全球范围内预防过早死亡和残疾的最重要因素之一。本荟萃分析的目的是综合有关12种主要食物组（包括全谷物、精制谷物、蔬菜、水果、坚果、豆类、鸡蛋、乳制品、鱼类、红肉、加工肉类和含糖饮料）的摄入量与全因死亡率风险之间关系的知识。我们在PubMed、Embase和谷歌学术上进行了系统检索，以查找调查这12种食物组与全因死亡率风险之间关联的前瞻性研究。使用随机效应模型估计高摄入量与低摄入量类别相比以及线性和非线性关系的汇总相对风险（RR）和95%置信区间（CI）。此外，分别通过将RR乘以降低风险食物或增加风险食物的最佳摄入量值（关联最强的份数类别）来计算食物的风险降低潜力。随着全谷物（RR：0.92；95%CI：0.89，0.95）、蔬菜（RR：0.96；95%CI：0.95，0.98）、水果（RR：0.94；95%CI：0.92，0.97）、坚果（RR：0.76；95%CI：0.69，0.84）和鱼类（RR：0.93；95%CI：0.88，0.98）摄入量的增加（每日每份），全因死亡率风险降低；在一项线性剂量反应荟萃分析中，红肉摄入量较高（RR：1.10；95%CI：1.04，1.18）和加工肉类摄入量较高（RR：1.23；95%CI：1.12，1.36）与全因死亡率风险增加相关。蔬菜、水果、坚果和乳制品与全因死亡率之间的关系呈现出明显的非线性迹象。食用降低风险的食物可使全因死亡率降低56%，而食用增加风险的食物则与全因死亡率风险增加两倍相关。选择所研究食物组的特定最佳摄入量可导致过早死亡风险发生相当大的变化。
