饮食质量变化与全因死亡率和特定原因死亡率的关联。
Association of Changes in Diet Quality with Total and Cause-Specific Mortality.
作者信息
Sotos-Prieto Mercedes, Bhupathiraju Shilpa N, Mattei Josiemer, Fung Teresa T, Li Yanping, Pan An, Willett Walter C, Rimm Eric B, Hu Frank B
机构信息
From the Departments of Nutrition (M.S.-P., S.N.B., J.M., T.T.F., Y.L., W.C.W., E.B.R., F.B.H.) and Epidemiology (W.C.W., E.B.R., F.B.H.), Harvard T.H. Chan School of Public Health, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (S.N.B., W.C.W., E.B.R., F.B.H.), and Simmons College (T.T.F.) - all in Boston; the Division of Food and Nutrition Sciences, School of Applied Health Sciences and Wellness, Ohio University, Athens (M.S.-P.); and the Department of Epidemiology and Biostatistics and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.).
出版信息
N Engl J Med. 2017 Jul 13;377(2):143-153. doi: 10.1056/NEJMoa1613502.
BACKGROUND
Few studies have evaluated the relationship between changes in diet quality over time and the risk of death.
METHODS
We used Cox proportional-hazards models to calculate adjusted hazard ratios for total and cause-specific mortality among 47,994 women in the Nurses' Health Study and 25,745 men in the Health Professionals Follow-up Study from 1998 through 2010. Changes in diet quality over the preceding 12 years (1986-1998) were assessed with the use of the Alternate Healthy Eating Index-2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score.
RESULTS
The pooled hazard ratios for all-cause mortality among participants who had the greatest improvement in diet quality (13 to 33% improvement), as compared with those who had a relatively stable diet quality (0 to 3% improvement), in the 12-year period were the following: 0.91 (95% confidence interval [CI], 0.85 to 0.97) according to changes in the Alternate Healthy Eating Index score, 0.84 (95 CI%, 0.78 to 0.91) according to changes in the Alternate Mediterranean Diet score, and 0.89 (95% CI, 0.84 to 0.95) according to changes in the DASH score. A 20-percentile increase in diet scores (indicating an improved quality of diet) was significantly associated with a reduction in total mortality of 8 to 17% with the use of the three diet indexes and a 7 to 15% reduction in the risk of death from cardiovascular disease with the use of the Alternate Healthy Eating Index and Alternate Mediterranean Diet. Among participants who maintained a high-quality diet over a 12-year period, the risk of death from any cause was significantly lower - by 14% (95% CI, 8 to 19) when assessed with the Alternate Healthy Eating Index score, 11% (95% CI, 5 to 18) when assessed with the Alternate Mediterranean Diet score, and 9% (95% CI, 2 to 15) when assessed with the DASH score - than the risk among participants with consistently low diet scores over time.
CONCLUSIONS
Improved diet quality over 12 years was consistently associated with a decreased risk of death. (Funded by the National Institutes of Health.).
背景
很少有研究评估饮食质量随时间的变化与死亡风险之间的关系。
方法
我们使用Cox比例风险模型，计算了1998年至2010年护士健康研究中的47994名女性和健康专业人员随访研究中的25745名男性全因死亡率和特定病因死亡率的调整后风险比。使用替代健康饮食指数-2010得分、替代地中海饮食得分和终止高血压饮食（DASH）得分评估此前12年（1986 - 1998年）饮食质量的变化。
结果
在12年期间，饮食质量改善最大（改善13%至33%）的参与者与饮食质量相对稳定（改善0%至3%）的参与者相比，全因死亡率的合并风险比分别如下：根据替代健康饮食指数得分变化为0.91（95%置信区间[CI]，0.85至0.97），根据替代地中海饮食得分变化为0.84（95%CI，0.78至0.91），根据DASH得分变化为0.89（95%CI，0.84至0.95）。饮食得分增加20百分位（表明饮食质量改善）与使用三种饮食指数时全因死亡率降低8%至17%以及使用替代健康饮食指数和替代地中海饮食时心血管疾病死亡风险降低7%至15%显著相关。在12年期间保持高质量饮食的参与者中，任何原因导致的死亡风险显著低于饮食得分一直较低的参与者，使用替代健康饮食指数得分评估时低14%（95%CI，8至19），使用替代地中海饮食得分评估时低11%（95%CI，5至18），使用DASH得分评估时低9%（95%CI，2至15）。
结论
12年期间饮食质量的改善始终与死亡风险降低相关。（由美国国立卫生研究院资助。）
Zotero 插件