Voortman Trudy, Kiefte-de Jong Jessica C, Ikram M Arfan, Stricker Bruno H, van Rooij Frank J A, Lahousse Lies, Tiemeier Henning, Brusselle Guy G, Franco Oscar H, Schoufour Josje D
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Leiden University College, The Hague, The Netherlands.
Eur J Epidemiol. 2017 Nov;32(11):993-1005. doi: 10.1007/s10654-017-0295-2. Epub 2017 Aug 19.
We aimed to evaluate the criterion validity of the 2015 food-based Dutch dietary guidelines, which were formulated based on evidence on the relation between diet and major chronic diseases. We studied 9701 participants of the Rotterdam Study, a population-based prospective cohort in individuals aged 45 years and over [median 64.1 years (95%-range 49.0-82.8)]. Dietary intake was assessed at baseline with a food-frequency questionnaire. For all participants, we examined adherence (yes/no) to fourteen items of the guidelines: vegetables (≥200 g/day), fruit (≥200 g/day), whole-grains (≥90 g/day), legumes (≥135 g/week), nuts (≥15 g/day), dairy (≥350 g/day), fish (≥100 g/week), tea (≥450 mL/day), ratio whole-grains:total grains (≥50%), ratio unsaturated fats and oils:total fats (≥50%), red and processed meat (<300 g/week), sugar-containing beverages (≤150 mL/day), alcohol (≤10 g/day) and salt (≤6 g/day). Total adherence was calculated as sum-score of the adherence to the individual items (0-14). Information on disease incidence and all-cause mortality during a median follow-up period of 13.5 years (range 0-27.0) was obtained from data collected at our research center and from medical records. Using Cox proportional-hazards models adjusted for confounders, we observed every additional component adhered to was associated with a 3% lower mortality risk (HR 0.97, 95% CI 0.95; 0.98), lower risk of stroke (HR 0.95, 95% CI 0.92; 0.99), chronic obstructive pulmonary disease (HR 0.94, 95% CI 0.91; 0.98), colorectal cancer (HR 0.90, 95% CI 0.84; 0.96), and depression (HR 0.97, 95% CI 0.95; 0.999), but not with incidence of coronary heart disease, type 2 diabetes, heart failure, lung cancer, breast cancer, or dementia. These associations were not driven by any of the individual dietary components. To conclude, adherence to the Dutch dietary guidelines was associated with a lower mortality risk and a lower risk of developing some but not all of the chronic diseases on which the guidelines were based.
我们旨在评估2015年荷兰食物膳食指南的标准效度，该指南是基于饮食与主要慢性病之间关系的证据制定的。我们研究了鹿特丹研究的9701名参与者，这是一项针对45岁及以上人群（中位数64.1岁，95%范围49.0 - 82.8岁）的基于人群的前瞻性队列研究。在基线时使用食物频率问卷评估饮食摄入量。对于所有参与者，我们检查了对指南中14项内容的遵守情况（是/否）：蔬菜（≥200克/天）、水果（≥200克/天）、全谷物（≥90克/天）、豆类（≥135克/周）、坚果（≥15克/天）、乳制品（≥350克/天）、鱼（≥100克/周）、茶（≥450毫升/天）、全谷物与总谷物比例（≥50%）、不饱和脂肪与总脂肪比例（≥50%）、红肉和加工肉（<300克/周）、含糖饮料（≤150毫升/天）、酒精（≤10克/天）和盐（≤6克/天）。总遵守情况通过对各项内容遵守情况的得分总和计算得出（0 - 14分）。在中位随访期13.5年（范围0 - 27.0年）内的疾病发病率和全因死亡率信息来自我们研究中心收集的数据和医疗记录。使用针对混杂因素进行调整的Cox比例风险模型，我们观察到每多遵守一项内容与死亡风险降低3%相关（风险比0.97，95%置信区间0.95；0.98），中风风险降低（风险比0.95，95%置信区间0.92；0.99），慢性阻塞性肺疾病风险降低（风险比0.94，95%置信区间0.91；0.98），结直肠癌风险降低（风险比0.90，95%置信区间0.84；0.96），以及抑郁症风险降低（风险比0.97，95%置信区间0.95；0.999），但与冠心病、2型糖尿病、心力衰竭、肺癌、乳腺癌或痴呆的发病率无关。这些关联并非由任何单一饮食成分驱动。总之，遵守荷兰膳食指南与较低的死亡风险以及患某些但并非所有指南所基于的慢性病的较低风险相关。
