健康的植物性饮食与美国成年人全因死亡率降低相关。
Healthy Plant-Based Diets Are Associated with Lower Risk of All-Cause Mortality in US Adults.
机构信息
Center for Human Nutrition, Department of International Health.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
出版信息
J Nutr. 2018 Apr 1;148(4):624-631. doi: 10.1093/jn/nxy019.
BACKGROUND
Plant-based diets, often referred to as vegetarian diets, are associated with health benefits. However, the association with mortality is less clear.
OBJECTIVE
We investigated associations between plant-based diet indexes and all-cause and cardiovascular disease mortality in a nationally representative sample of US adults.
METHODS
Analyses were based on 11,879 participants (20-80 y of age) from NHANES III (1988-1994) linked to data on all-cause and cardiovascular disease mortality through 2011. We constructed an overall plant-based diet index (PDI), which assigns positive scores for plant foods and negative scores for animal foods, on the basis of a food-frequency questionnaire administered at baseline. We also constructed a healthful PDI (hPDI), in which only healthy plant foods received positive scores, and a less-healthful (unhealthy) PDI (uPDI), in which only less-healthful plant foods received positive scores. Cox proportional hazards models were used to estimate the association between plant-based diet consumption in 1988-1994 and subsequent mortality. We tested for effect modification by sex.
RESULTS
In the overall sample, PDI and uPDI were not associated with all-cause or cardiovascular disease mortality after controlling for demographic characteristics, socioeconomic factors, and health behaviors. However, among those with an hPDI score above the median, a 10-unit increase in hPDI was associated with a 5% lower risk in all-cause mortality in the overall study population (HR: 0.95; 95% CI: 0.91, 0.98) and among women (HR: 0.94; 95% CI: 0.88, 0.99), but not among men (HR: 0.95; 95% CI: 0.90, 1.01). There was no effect modification by sex (P-interaction > 0.10).
CONCLUSIONS
A nonlinear association between hPDI and all-cause mortality was observed. Healthy plant-based diet scores above the median were associated with a lower risk of all-cause mortality in US adults. Future research exploring the impact of quality of plant-based diets on long-term health outcomes is necessary.
背景
植物性饮食，通常被称为素食，与健康益处有关。然而，与死亡率的关系尚不清楚。
目的
我们调查了美国成年人全国代表性样本中植物性饮食指数与全因和心血管疾病死亡率之间的关联。
方法
分析基于 NHANES III（1988-1994 年）的 11879 名参与者（20-80 岁），通过 2011 年的数据将全因和心血管疾病死亡率与数据相关联。我们根据基线时进行的食物频率问卷构建了一个整体植物性饮食指数（PDI），该指数为植物性食物分配正分，为动物性食物分配负分。我们还构建了一个健康的 PDI（hPDI），其中只有健康的植物性食物获得正分，以及一个不太健康（不健康）的 PDI（uPDI），其中只有不太健康的植物性食物获得正分。使用 Cox 比例风险模型估计 1988-1994 年植物性饮食摄入与随后死亡率之间的关联。我们测试了性别对效果的修饰作用。
结果
在整个样本中，在控制人口统计学特征、社会经济因素和健康行为后，PDI 和 uPDI 与全因或心血管疾病死亡率无关。然而，在 hPDI 得分高于中位数的人群中，hPDI 每增加 10 个单位，全因死亡率降低 5%（总体研究人群中的 HR：0.95；95%CI：0.91，0.98）和女性（HR：0.94；95%CI：0.88，0.99），但男性则不然（HR：0.95；95%CI：0.90，1.01）。性别没有影响修饰作用（P 交互作用>0.10）。
结论
观察到 hPDI 与全因死亡率之间存在非线性关联。美国成年人 hPDI 得分高于中位数与全因死亡率降低相关。需要进一步研究探索植物性饮食质量对长期健康结果的影响。
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