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全球宏量营养素供应与特定年龄死亡率的关系。

Global associations between macronutrient supply and age-specific mortality.

机构信息

Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia;

School of Life and Environmental Sciences, University of Sydney, Sydney, NSW 2006, Australia.

出版信息

Proc Natl Acad Sci U S A. 2020 Dec 1;117(48):30824-30835. doi: 10.1073/pnas.2015058117. Epub 2020 Nov 16.

Abstract

Animal experiments have demonstrated that energy intake and the balance of macronutrients determine life span and patterns of age-specific mortality (ASM). Similar effects have also been detected in epidemiological studies in humans. Using global supply data and 1,879 life tables from 103 countries, we test for these effects at a macrolevel: between the nutrient supplies of nations and their patterns of ASM. We find that macronutrient supplies are strong predictors of ASM even after correction for time and economic factors. Globally, signatures of undernutrition are evident in the effects of low supply on life expectancy at birth and high mortality across ages, even as recently as 2016. However, in wealthy countries, the effects of overnutrition are prominent, where high supplies particularly from fats and carbohydrates are predicted to lead to high levels of mortality. Energy supplied at around 3,500 kcal/cap/d minimized mortality across ages. However, we show that the macronutrient composition of energy supply that minimizes mortality varies with age. In early life, 40 to 45% energy from each of fat and carbohydrate and 16% from protein minimizes mortality. In later life, replacing fat with carbohydrates to around 65% of total energy and reducing protein to 11% is associated with the lowest level of mortality. These results, particularly those regarding fats, accord both with experimental data from animals and within-country epidemiological studies on the association between macronutrient intake and risk of age-related chronic diseases.

摘要

动物实验已经证明,能量摄入和宏量营养素的平衡决定了寿命和特定年龄死亡率(ASM)的模式。在人类的流行病学研究中也检测到了类似的影响。利用全球供应数据和来自 103 个国家的 1,879 份生命表,我们在宏观层面上检验了这些影响:在国家的营养素供应和其 ASM 模式之间。我们发现,即使在考虑了时间和经济因素的情况下,宏量营养素的供应仍然是 ASM 的强有力预测指标。在全球范围内,低供应对出生时预期寿命和各年龄段高死亡率的影响明显表明存在营养不足的迹象,即使在最近的 2016 年也是如此。然而,在富裕国家,营养过剩的影响更为突出,高脂肪和碳水化合物等高供应预计会导致高死亡率。提供约 3500 千卡/人/天的能量可以最大限度地降低各年龄段的死亡率。然而,我们表明,最大限度降低死亡率的能量供应的宏量营养素组成因年龄而异。在生命早期,来自脂肪和碳水化合物的能量各占 40%至 45%,蛋白质占 16%,可以最大限度地降低死亡率。在生命后期,用碳水化合物代替脂肪,使其占总能量的 65%左右,并将蛋白质减少到 11%,与最低的死亡率相关。这些结果,特别是关于脂肪的结果,与动物实验数据和国内关于宏量营养素摄入与年龄相关的慢性疾病风险之间的关联的流行病学研究都一致。

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