植物源和动物源单不饱和脂肪酸与两项美国前瞻性队列研究中全因和死因特异性死亡的相关性。
Associations of Monounsaturated Fatty Acids From Plant and Animal Sources With Total and Cause-Specific Mortality in Two US Prospective Cohort Studies.
机构信息
From the Department of Nutrition (M.G.-F., G.Z., W.C.W., F.B.H., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.G.-F., W.C.W., F.B.H., Q.S.).
出版信息
Circ Res. 2019 Apr 12;124(8):1266-1275. doi: 10.1161/CIRCRESAHA.118.313996.
RATIONALE
Dietary monounsaturated fatty acids (MUFAs) can come from both plant and animal sources with divergent nutrient profiles that may potentially obscure the associations of total MUFAs with chronic diseases.
OBJECTIVE
To investigate the associations of cis-MUFA intake from plant (MUFA-P) and animal (MUFA-A) sources with total and cause-specific mortality.
METHODS AND RESULTS
We followed 63 412 women from the NHS (Nurses' Health Study; 1990-2012) and 29 966 men from the HPFS (Health Professionals Follow-Up Study; 1990-2012). MUFA-Ps and MUFA-As were calculated based on data collected through validated food frequency questionnaires administered every 4 years and updated food composition databases. During 1 896 864 person-years of follow-up, 20 672 deaths occurred. Total MUFAs and MUFA-Ps were inversely associated with total mortality after adjusting for potential confounders, whereas MUFA-As were associated with higher mortality. When MUFA-Ps were modeled to isocalorically replace other macronutrients, hazard ratios (HRs, 95% CIs) of total mortality were 0.84 (0.77-0.92; P<0.001) for replacing saturated fatty acids, 5% of energy); 0.86 (0.82-0.91; P<0.001) for replacing refined carbohydrates (5% energy); 0.91 (0.85-0.97; P<0.001) for replacing trans fats (2% energy), and 0.77 (0.71-0.82; P<0.001) for replacing MUFA-As (5% energy). For isocalorically replacing MUFA-As with MUFA-Ps, HRs (95% CIs) were 0.74 (0.64-0.86; P<0.001) for cardiovascular mortality; 0.73 (0.65-0.82; P<0.001) for cancer mortality, and 0.82 (0.73-0.91; P<0.001) for mortality because of other causes.
CONCLUSIONS
Higher intake of MUFA-Ps was associated with lower total mortality, and MUFA-As intake was associated with higher mortality. Significantly lower mortality risk was observed when saturated fatty acids, refined carbohydrates, or trans fats were replaced by MUFA-Ps, but not MUFA-As. These data suggest that other constituents in animal foods, such as saturated fatty acids, may confound the associations for MUFAs when they are primarily derived from animal products. More evidence is needed to elucidate the differential associations of MUFA-Ps and MUFA-As with mortality.
背景
膳食单不饱和脂肪酸（MUFAs）可来自植物和动物源，其营养成分不同，这可能会掩盖总 MUFAs 与慢性病的关联。
目的
研究植物源（MUFA-P）和动物源（MUFA-A）顺式 MUFA 摄入量与总死亡率和病因特异性死亡率的关系。
方法和结果
我们随访了来自 NHS（护士健康研究；1990-2012 年）的 63412 名女性和来自 HPFS（卫生专业人员随访研究；1990-2012 年）的 29966 名男性。MUFA-Ps 和 MUFA-As 是根据通过每 4 年进行一次的验证后的食物频率问卷收集的数据以及更新的食物成分数据库计算得出的。在 1896864 人年的随访期间，有 20672 人死亡。在调整了潜在混杂因素后，总 MUFAs 和 MUFA-Ps 与总死亡率呈负相关，而 MUFA-A 与死亡率升高相关。当 MUFA-Ps 被模拟为等热量替代其他宏量营养素时，总死亡率的危害比（HR，95%CI）分别为：0.84（0.77-0.92；P<0.001），替代饱和脂肪酸（5%能量）；0.86（0.82-0.91；P<0.001），替代精制碳水化合物（5%能量）；0.91（0.85-0.97；P<0.001），替代反式脂肪（2%能量），0.77（0.71-0.82；P<0.001），替代 MUFA-A（5%能量）。等热量替代 MUFA-A 为 MUFA-P 时，心血管死亡率的 HR（95%CI）为 0.74（0.64-0.86；P<0.001）；癌症死亡率的 HR（95%CI）为 0.73（0.65-0.82；P<0.001）；其他原因导致的死亡率的 HR（95%CI）为 0.82（0.73-0.91；P<0.001）。
结论
MUFA-Ps 摄入量较高与总死亡率较低相关，MUFA-A 摄入量与死亡率升高相关。当用 MUFA-Ps 替代饱和脂肪酸、精制碳水化合物或反式脂肪时，死亡率风险显著降低，但用 MUFA-A 替代时则不然。这些数据表明，当 MUFAs 主要来源于动物产品时，动物食品中的其他成分（如饱和脂肪酸）可能会混淆 MUFAs 的关联。需要更多的证据来阐明 MUFA-Ps 和 MUFA-A 与死亡率的差异关联。
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