遵循健康饮食指数-2015 及其他饮食模式可能降低心血管疾病、心血管死亡率和全因死亡率的风险。
Adherence to the Healthy Eating Index-2015 and Other Dietary Patterns May Reduce Risk of Cardiovascular Disease, Cardiovascular Mortality, and All-Cause Mortality.
机构信息
Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
出版信息
J Nutr. 2020 Feb 1;150(2):312-321. doi: 10.1093/jn/nxz218.
BACKGROUND
The Healthy Eating Index-2015 (HEI-2015) score measures adherence to recommendations from the 2015-2020 Dietary Guidelines for Americans. The HEI-2015 was altered from the HEI-2010 by reclassifying sources of dietary protein and replacing the empty calories component with 2 new components: saturated fats and added sugars.
OBJECTIVES
Our aim was to assess whether the HEI-2015 score, along with 3 other previously defined indices, were associated with incident cardiovascular disease (CVD), CVD mortality, and all-cause mortality.
METHODS
We conducted a prospective analysis of 12,413 participants aged 45-64 y (56% women) from the Atherosclerosis Risk in Communities (ARIC) Study. The HEI-2015, Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean (aMed) diet, and Dietary Approaches to Stop Hypertension Trial (DASH) scores were computed using the average dietary intakes of Visits 1 (1987-1989) and 3 (1993-1995). Incident CVD, CVD mortality, and all-cause mortality data were ascertained from baseline through 31 December, 2017. We used Cox proportional hazards models to estimate HRs and 95% CIs.
RESULTS
There were 4509 cases of incident CVD, 1722 cases of CVD mortality, and 5747 cases of all-cause mortality over a median of 24-25 y of follow-up. Compared with participants in the lowest quintile of HEI-2015, participants in the highest quintile had a 16% lower risk of incident CVD (HR: 0.84; 95% CI: 0.76-0.93; P-trend < 0.001), 32% lower risk of CVD mortality (HR: 0.68; 95% CI: 0.58-0.80; P-trend < 0.001), and 18% lower risk of all-cause mortality (HR: 0.82; 95% CI: 0.75-0.89; P-trend < 0.001) after adjusting for demographic and lifestyle covariates. There were similar protective associations for AHEI-2010, aMed, and DASH scores, and no significant interactions by race.
CONCLUSIONS
Higher adherence to the 2015-2020 Dietary Guidelines for Americans was associated with lower risks of incident CVD, CVD mortality, and all-cause mortality among US adults.
背景
健康饮食指数-2015（HEI-2015）评分衡量的是对 2015-2020 年美国人饮食指南的建议的遵守程度。HEI-2015 是通过重新分类饮食蛋白质来源和用 2 个新成分替代空卡路里成分来修改的：饱和脂肪和添加糖。
目的
我们的目的是评估 HEI-2015 评分以及其他 3 个先前定义的指数是否与心血管疾病（CVD）的发生、CVD 死亡率和全因死亡率有关。
方法
我们对 12413 名年龄在 45-64 岁的参与者（56%为女性）进行了前瞻性分析，这些参与者来自社区动脉粥样硬化风险研究（ARIC）。使用 Visits 1（1987-1989 年）和 3（1993-1995 年）的平均饮食摄入量计算了 HEI-2015、替代健康饮食指数-2010（AHEI-2010）、替代地中海（aMed）饮食和停止高血压膳食试验（DASH）评分。从基线到 2017 年 12 月 31 日，通过监测获得了 CVD 发病、CVD 死亡率和全因死亡率的数据。我们使用 Cox 比例风险模型来估计 HR 和 95%CI。
结果
在中位 24-25 年的随访中，共有 4509 例新发 CVD、1722 例 CVD 死亡和 5747 例全因死亡。与 HEI-2015 评分最低五分位组的参与者相比，评分最高五分位组的参与者发生 CVD 的风险降低了 16%（HR：0.84；95%CI：0.76-0.93；P-trend <0.001），CVD 死亡率的风险降低了 32%（HR：0.68；95%CI：0.58-0.80；P-trend <0.001），全因死亡率的风险降低了 18%（HR：0.82；95%CI：0.75-0.89；P-trend <0.001），经过调整人口统计学和生活方式协变量后。对于 AHEI-2010、aMed 和 DASH 评分，也存在类似的保护关联，且种族之间没有显著的相互作用。
结论
美国成年人对 2015-2020 年美国人饮食指南的更高依从性与新发 CVD、CVD 死亡率和全因死亡率的风险降低有关。
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