中国成年人饮食结构转变及其与心血管代谢死亡率的关系：基于人群的横断面研究，1982-2012 年。
The dietary transition and its association with cardiometabolic mortality among Chinese adults, 1982-2012: a cross-sectional population-based study.
机构信息
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
出版信息
Lancet Diabetes Endocrinol. 2019 Jul;7(7):540-548. doi: 10.1016/S2213-8587(19)30152-4. Epub 2019 May 10.
BACKGROUND
Few studies have used nationally representative data to describe dietary trends and the related cardiometabolic mortality burden in China. Thus, we aimed to characterise the trends in disease-related dietary factors as well as their associated disease burden among Chinese adults from 1982 to 2012.
METHODS
For this cross-sectional population-based study, we analysed a nationally representative sample of 204 802 adults aged 20 years or older, using data from the 1982, 1992, 2002, and 2010-12 China National Nutrition Surveys (CNNS). We did a comparative risk assessment, in which the effects of suboptimal intakes of 12 dietary factors, individually and collectively, on cardiometabolic mortality were estimated by calculating the population attributable fraction (PAF) to estimate the proportional reduction in cardiometabolic deaths that would occur if exposure to each dietary risk factor was reduced to an alternative optimal level.
FINDINGS
The overall PAF of mortality from cardiovascular disease and type 2 diabetes that was associated with suboptimal dietary quality was 62·2% in 1982, 57·9% in 1992, 56·2% in 2002, and 51·0% in 2010-12, which accounted for 21·6% of total mortality in China in 1982, 16·6% in 1992, 17·6% in 2002, and 20·8% in 2010-12. The estimated number of cardiometabolic deaths associated with suboptimal dietary intakes was 1·07 million in 1982, 0·93 million in 1992, 1·18 million in 2002, and 1·51 million in 2010-12. Of all 12 dietary factors examined, high sodium intake (17·3%), low fruit consumption (11·5%), and low marine omega-3 fatty acids (9·7%) were associated with the largest numbers of estimated cardiometabolic deaths in 2010-12.
INTERPRETATION
We observed an improvement in several dietary factors in China in the past few decades. However, current intakes of these dietary factors remain suboptimal. Poor diet quality is estimated to be associated with a substantial proportion of deaths from heart disease, stroke, and type 2 diabetes in China.
FUNDING
Ministry of Health, China, and Ministry of Science and Technology, China.
背景
很少有研究使用全国代表性数据来描述中国的饮食趋势和相关的心血管代谢死亡负担。因此，我们旨在描述 1982 年至 2012 年期间中国成年人相关疾病的饮食因素趋势及其相关疾病负担。
方法
在这项基于人群的横断面研究中，我们使用了 1982 年、1992 年、2002 年和 2010-12 年中国国家营养调查（CNNS）的数据，对 204802 名 20 岁或以上成年人进行了全国代表性样本分析。我们进行了比较风险评估，通过计算人群归因分数（PAF）来估计每种饮食风险因素的亚最佳摄入量对心血管代谢死亡率的影响，以估计如果将每种饮食风险因素暴露降低到替代的最佳水平，心血管代谢死亡人数将减少的比例。
结果
1982 年，与饮食质量不佳相关的心血管疾病和 2 型糖尿病总死亡率的整体 PAF 为 62.2%，1992 年为 57.9%，2002 年为 56.2%，2010-12 年为 51.0%，占 1982 年中国总死亡率的 21.6%，1992 年为 16.6%，2002 年为 17.6%，2010-12 年为 20.8%。与亚最佳饮食摄入相关的估计心血管代谢死亡人数为 1982 年为 107 万人，1992 年为 93 万人，2002 年为 118 万人，2010-12 年为 151 万人。在所检查的 12 种饮食因素中，高钠摄入（17.3%）、低水果摄入（11.5%）和低海洋 omega-3 脂肪酸（9.7%）与 2010-12 年估计的最大数量的心血管代谢死亡有关。
解释
我们观察到在过去几十年中，中国的几种饮食因素有所改善。然而，目前这些饮食因素的摄入量仍然不理想。不良的饮食质量估计与中国心脏病、中风和 2 型糖尿病的大量死亡有关。
结论
在中国，我们观察到在过去几十年中，一些饮食因素有所改善。然而，目前这些饮食因素的摄入量仍然不理想。不良的饮食质量估计与中国心脏病、中风和 2 型糖尿病的大量死亡有关。
资金
中国卫生部和中国科学技术部。
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