Mazidi Mohsen, Katsiki Niki, Mikhailidis Dimitri P, Pella Daniel, Banach Maciej
Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital, Strand, London, UK.
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
Arch Med Sci. 2020 Feb 11;16(2):260-272. doi: 10.5114/aoms.2020.92890. eCollection 2020.
The long-term effect of potato consumption on mortality and cardiovascular (CV) and cardiometabolic risk factors is still largely unknown. Using the National Health and Nutrition Examination Surveys (NHANES) 1999-2010, we evaluted the long-term impact of potato intake on total and cause-specific (cardiovascular disease (CVD), cerebrovascular disease and cancer) mortality, and the results were next validated in a systematic review and meta-analysis of cohort studies investigating pooled associations of potato consumption with all-cause and cause-specific death.
Vital status up to December 31, 2011 was ascertained in NHANES. Cox proportional hazards were applied to determine the hazard ratios (HRs) and 95% confidence intervals (95% CI) of mortality for each quartile of the potato intake, with the lowest quartile (Q1 - with the lowest intake) used as a reference. In the meta-analysis we used adjusted Cox regression to determine the risk ratio (RR) and 95% CI, as well as random effects models and generic inverse variance methods to synthesize quantitative and pooled data, followed by a leave-one-out method for sensitivity analysis.
Among 24,856 participants included, 3433 deaths occurred during the mean follow-up of 6.4 years. In multivariate adjusted models, total (42%), CVD (65%), cerebrovascular (26%) and cancer (52%) mortality risk was greater in individuals with higher potato consumption than those with the lowest intake ( < 0.001 for all comparisons). However, this link disappeared after adjustment for confounding factors. Results from pooling current prospective studies revealed a non-significant association between total (RR = 1.25, 0.98-1.60, = 0.066), CVD (RR = 0.99, 0.90-1.08, = 0.845) and stroke mortality (RR = 0.94, 0.85-1.03, = 0.214) with potato consumption. Individuals with a higher potato intake had a less favorable profile of cardiometabolic factors, including greater waist circumference (97.2 vs. 99.5 cm, < 0.001) and a less favorable profile of systolic and diastolic blood pressure, levels of triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C) and TG/HDL-C ratio ( < 0.001 for all comparisons).
Our results revealed no significant effects of potato intake on long-term mortality rates, whereas higher potato consumption was adversely related to cardiometabolic risk factors. These findings should be taken into consideration for public health strategies, establishing the position for potatoes in the food pyramid.
食用土豆对死亡率、心血管(CV)及心脏代谢风险因素的长期影响在很大程度上仍不明确。利用1999 - 2010年美国国家健康与营养检查调查(NHANES),我们评估了土豆摄入量对全因死亡率和特定病因(心血管疾病(CVD)、脑血管疾病和癌症)死亡率的长期影响,随后在一项系统评价和队列研究的荟萃分析中对结果进行了验证,该荟萃分析调查了土豆消费与全因及特定病因死亡的汇总关联。
在NHANES中确定了截至2011年12月31日的生命状态。应用Cox比例风险模型来确定土豆摄入量每四分位数的死亡率风险比(HRs)和95%置信区间(95%CI),以最低四分位数(Q1 - 摄入量最低)作为参考。在荟萃分析中,我们使用调整后的Cox回归来确定风险比(RR)和95%CI,以及随机效应模型和通用逆方差方法来综合定量和汇总数据,随后采用逐一剔除法进行敏感性分析。
在纳入的24,856名参与者中,在平均6.4年的随访期间发生了3433例死亡。在多变量调整模型中,土豆摄入量较高的个体的全因(42%)、CVD(65%)、脑血管(26%)和癌症(52%)死亡率风险高于摄入量最低的个体(所有比较均P < 0.001)。然而,在对混杂因素进行调整后,这种关联消失了。汇总当前前瞻性研究的结果显示,土豆消费与全因死亡率(RR = 1.25,0.98 - 1.60,P = 0.066)、CVD死亡率(RR = 0.99,0.90 - 1.08,P = 0.845)和中风死亡率(RR = 0.94,0.85 - 1.03,P = 0.214)之间无显著关联。土豆摄入量较高的个体的心脏代谢因素状况较差,包括腰围更大(97.2对99.5 cm,P < 0.001),收缩压和舒张压、甘油三酯(TG)水平、高密度脂蛋白胆固醇(HDL - C)以及TG/HDL - C比值的状况也较差(所有比较均P < 0.001)。
我们的结果显示土豆摄入量对长期死亡率无显著影响,而较高的土豆消费量与心脏代谢风险因素呈负相关。在制定公共卫生策略、确定土豆在食物金字塔中的地位时应考虑这些发现。