Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA.
J Nutr. 2019 Jun 1;149(6):1065-1074. doi: 10.1093/jn/nxz010.
The preventable premature mortality achievable by improvement in dietary quality at a global level is unclear.
The aim of this study was to assess dietary quality globally, and to quantify the potential global impact of improving dietary quality on population health.
We applied the Alternate Healthy Eating Index (AHEI, potential range 0-100) to a global dietary database to assess dietary quality among adults in 190 countries/territories. The relation of AHEI score to risks of major chronic disease was estimated from 2 large cohorts of men and women for whom many repeated dietary assessments during up to 30 years were available. We calculated the preventable premature deaths achievable by shifting from current national diets to a reference healthy diet.
The global mean AHEI score in 2017 was 49.5 for males and 50.5 for females. Large differences between current and target intakes existed for whole grains, sodium, long-chain n-3 polyunsaturated fats, polyunsaturated fats, and fruits. From 1990 to 2017, the global mean AHEI score increased modestly from 45.4 to 50.0. Diet quality varied substantially across the world. Coastal Mediterranean nations, the Caribbean region, and Eastern Asia (except China and Mongolia) had a higher AHEI score, whereas Central Asia, the South Pacific, and Eastern and Northern Europe had a lower score. An improvement in dietary quality from the current global diet to the reference healthy diet could prevent >11 million premature deaths, ∼24% of total deaths in 2017. These included 1.6 million cancer deaths, 3.9 million coronary artery disease deaths, 1.0 million stroke deaths, 1.7 million respiratory disease deaths, 0.4 million neurodegenerative disease deaths, 0.5 million kidney disease deaths, 0.6 million diabetes deaths, and 1.2 million digestive disease deaths.
Global dietary quality is slowly improving, but remains far from optimal and varies across countries. Improvements in dietary quality have the potential to reduce mortality rates substantially.
通过改善全球饮食质量，可预防的过早死亡率尚不清楚。
本研究旨在评估全球饮食质量，并量化改善饮食质量对人口健康的潜在全球影响。
我们应用替代健康饮食指数（AHEI，潜在范围 0-100）对全球饮食数据库进行评估，以评估 190 个国家/地区成年人的饮食质量。从 2 个大型男性和女性队列中估计 AHEI 评分与主要慢性疾病风险的关系，这些队列中在长达 30 年的时间内进行了多次重复饮食评估。我们计算了通过从当前国家饮食转向参考健康饮食来预防过早死亡的人数。
2017 年男性的全球平均 AHEI 得分为 49.5，女性为 50.5。目前的摄入量与目标摄入量之间存在很大差异，主要是全谷物、钠、长链 n-3 多不饱和脂肪、多不饱和脂肪和水果。从 1990 年到 2017 年，全球平均 AHEI 得分从 45.4 略有增加到 50.0。全球各地的饮食质量差异很大。地中海沿岸国家、加勒比地区和东亚（中国和蒙古除外）的 AHEI 得分较高，而中亚、南太平洋和东欧和北欧的得分较低。从目前的全球饮食改善到参考健康饮食可以预防超过 1100 万人过早死亡，占 2017 年总死亡人数的 24%。这包括 160 万癌症死亡、390 万冠心病死亡、100 万中风死亡、170 万呼吸疾病死亡、40 万神经退行性疾病死亡、50 万肾脏疾病死亡、60 万糖尿病死亡和 120 万消化系统疾病死亡。
全球饮食质量正在缓慢改善，但仍远非最佳，而且在国家之间存在差异。改善饮食质量有可能大幅降低死亡率。
