Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California.
US Census Bureau, Washington, DC.
Cancer. 2020 Mar 1;126(5):1102-1111. doi: 10.1002/cncr.32571. Epub 2019 Nov 25.
Previous research suggests that Adventists, who often follow vegetarian diets, live longer and have lower risks for many cancers than others, but there are no national data and little published comparative data for black subjects.
This study compared all-cause mortality and cancer incidence between the nationally inclusive Adventist Health Study 2 (AHS-2) and nonsmokers in US Census populations: the National Longitudinal Mortality Study (NLMS) and its Surveillance, Epidemiology, and End Results substudy. Analyses used proportional hazards regression adjusting for age, sex, race, cigarette smoking history, and education.
All-cause mortality and all-cancer incidence in the black AHS-2 population were significantly lower than those for the black NLMS populations (hazard ratio [HR] for mortality, 0.64; 95% confidence interval [CI], 0.59-0.69; HR for incidence, 0.78; 95% CI, 0.68-0.88). When races were combined, estimated all-cause mortality was also significantly lower in the AHS-2 population at the age of 65 years (HR, 0.67; 95% CI, 0.64-0.69) and at the age of 85 years (HR, 0.78; 95% CI, 0.75-0.81), as was cancer mortality; this was also true for the rate of all incident cancers combined (HR, 0.70; 95% CI, 0.67-0.74) and the rates of breast, colorectal, and lung cancers. Survival curves confirmed the mortality results and showed that among males, AHS-2 blacks survived longer than white US subjects.
Substantially lower rates of all-cause mortality and cancer incidence among Adventists have implications for the effects of lifestyle and perhaps particularly diet on the etiology of these health problems. Trends similar to those seen in the combined population are also found in comparisons of black AHS-2 and NLMS subjects.
先前的研究表明,经常遵循素食饮食的复临信徒比其他人寿命更长,患多种癌症的风险更低,但针对黑人受试者,尚无全国性数据,且公布的相关比较数据也很少。
本研究将全国性的复临信徒健康研究 2 期(AHS-2)与美国人口普查中的不吸烟者进行了比较,包括全国纵向死亡率研究(NLMS)及其监测、流行病学和结果子研究:所有原因死亡率和癌症发病率。分析采用比例风险回归,调整年龄、性别、种族、吸烟史和教育程度。
黑人 AHS-2 人群的全因死亡率和所有癌症发病率明显低于黑人 NLMS 人群(死亡率的危险比[HR],0.64;95%置信区间[CI],0.59-0.69;发病率的 HR,0.78;95% CI,0.68-0.88)。当合并种族时,AHS-2 人群在 65 岁(HR,0.67;95% CI,0.64-0.69)和 85 岁(HR,0.78;95% CI,0.75-0.81)的全因死亡率也明显较低,癌症死亡率也如此;所有新发癌症合并的发生率也如此(HR,0.70;95% CI,0.67-0.74),乳腺癌、结直肠癌和肺癌的发病率也如此。生存曲线证实了死亡率结果,并表明在男性中,AHS-2 的黑人比美国白人受试者存活时间更长。
复临信徒的全因死亡率和癌症发病率明显较低,这对生活方式的影响,也许尤其是饮食对这些健康问题病因的影响具有启示意义。在比较 AHS-2 的黑人和 NLMS 受试者时,也发现了与综合人群中相似的趋势。