Department of Food Science, Faculty of Home Economics, Otsuma Women's University, Tokyo, Japan.
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
Eur J Clin Nutr. 2020 Jan;74(1):54-66. doi: 10.1038/s41430-019-0416-y. Epub 2019 Mar 19.
BACKGROUND/OBJECTIVES: Eating a variety of foods has been recommended in the dietary guidelines of many developed nations, as well as global dietary guidelines. We investigated the potential effect of dietary diversity on the risk of total mortality and major causes of mortality in a large-scale cohort study involving the Japanese population.
SUBJECTS/METHODS: From 1995 to 2012, 79,904 participants (37,240 men and 42,664 women) aged 45 to 74 years, without histories of ischemic heart disease, stroke, or cancer were followed-up for a median of 14.9 years. We used 133 food and beverage items listed on a 5-year follow-up food frequency questionnaire, and the daily frequency of consumption for each item (excluding five alcoholic beverages) was counted. Multivariable-adjusted Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) to compare the highest and lowest quintiles.
An inverse association was identified between total dietary diversity and mortality rates in women (highest quintile HR: 0.81; 95% CI: 0.71, 0.92; p for trend = 0.002) but the same trend was not observed in men (highest quintile HR: 0.96; 95% CI: 0.87, 1.10; p for trend = 0.266). In addition, fruit diversity was associated with lower mortality rates in men (highest quintile HR: 0.87; 95% CI: 0.79, 0.95; p for trend = 0.006), whereas soy diversity was associated with lower mortality rates in women (highest quintile HR: 0.89; 95% CI: 0.79, 1.00; p for trend = 0.004). With regard to men, meat and fish diversity were associated with higher mortality rates (highest quintiles of meat and fish diversity HR: 1.15 [95% CI: 1.06, 1.25] and 1.12 [95% CI: 1.02, 1.22], respectively).
These findings indicate that consuming a greater diversity of total foods and increasing the diversity of fruit and soy consumed have considerable public health implications.
背景/目的：许多发达国家以及全球饮食指南都建议人们食用多种食物。我们在一项涉及日本人群的大规模队列研究中，调查了饮食多样性对总死亡率和主要死因的潜在影响。
研究对象/方法：1995 年至 2012 年，共纳入 79904 名年龄在 45 至 74 岁、无缺血性心脏病、中风或癌症病史的参与者，中位随访时间为 14.9 年。我们使用了 5 年随访食物频率问卷中列出的 133 种食物和饮料项目，计算了每种食物（不包括 5 种酒精饮料）的每日消费频率。使用多变量调整的 Cox 比例风险回归模型计算了风险比（HR）和相应的 95%置信区间（CI），以比较最高和最低五分位数。
在女性中，总饮食多样性与死亡率呈负相关（最高五分位数 HR：0.81；95%CI：0.71，0.92；趋势检验 P=0.002），但在男性中未观察到相同趋势（最高五分位数 HR：0.96；95%CI：0.87，1.10；趋势检验 P=0.266）。此外，水果多样性与男性较低的死亡率相关（最高五分位数 HR：0.87；95%CI：0.79，0.95；趋势检验 P=0.006），而大豆多样性与女性较低的死亡率相关（最高五分位数 HR：0.89；95%CI：0.79，1.00；趋势检验 P=0.004）。对于男性，肉类和鱼类多样性与较高的死亡率相关（最高五分位数的肉类和鱼类多样性 HR：1.15[95%CI：1.06，1.25]和 1.12[95%CI：1.02，1.22]）。
这些发现表明，食用更多种类的食物和增加水果和大豆的食用多样性对公共健康具有重要意义。
