Tanaka Shiori, Yoneoka Daisuke, Ishizuka Aya, Ueda Peter, Nakamura Keiji, Uneyama Hisayuki, Hayashi Naoki, Shibuya Kenji, Nomura Shuhei
Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
BMC Public Health. 2021 Apr 21;21(1):770. doi: 10.1186/s12889-021-10772-2.
Low vegetable intake is one of the key dietary risk factors known to be associated with a range of health problems, including cardiovascular diseases (CVDs), cancer, and diabetes and kidney diseases (DKDs). Using data from Japan's National Health and Nutrition Surveys and the Global Burden of Diseases study in 2017, this study aimed to forecast the impact of change in vegetable intake on disability-adjusted life years (DALYs) between 2017 and 2040 for three diseases.
We generated a three-component model of cause-specific DALYs, including changes in major behavioural and metabolic risk predictors, the socio-demographic index and an autoregressive integrated moving average model to project future DALY rates for 2017-2040 using the data between 1990 and 2016. Data on Vegetable consumption and risk predictors, and DALY rate were obtained from Japan's National Health and Nutrition Surveys and the Global Burden of Diseases Study in 2017. We also modelled three scenarios of better, moderate and worse cases to evaluate the impact of change in vegetable consumption on the DALY rates for three diseases (CVDs, cancer, and DKDs).
Projected mean vegetable intake in the total population showed a decreasing trend through 2040 to 237.7 g/day. A significant difference between the reference scenario and the better case scenario was observed with un-overlapped 95% prediction intervals of DALY rates in females aged 20-49 years (- 8.0%) for CVDs, the total population for cancer (- 5.6%), and in males (- 8.2%) and females (- 13.7%) for DKDs.
Our analysis indicates that increased vegetable consumption would have a significant reduction in the burdens of CVDs, cancer and DKDs in Japan. By estimating the disease burden attributable to low vegetable intake under different scenarios of future vegetable consumption, our study can inform the design of targeted interventions for public health challenges.
蔬菜摄入量低是已知的关键饮食风险因素之一,与一系列健康问题相关,包括心血管疾病(CVD)、癌症、糖尿病和肾脏疾病(DKD)。本研究利用日本全国健康与营养调查以及2017年全球疾病负担研究的数据,旨在预测2017年至2040年蔬菜摄入量变化对三种疾病的伤残调整生命年(DALY)的影响。
我们构建了一个特定病因DALY的三成分模型,包括主要行为和代谢风险预测因素的变化、社会人口指数以及自回归积分滑动平均模型,以利用1990年至2016年的数据预测2017年至2040年的未来DALY率。蔬菜消费和风险预测因素以及DALY率的数据来自日本全国健康与营养调查以及2017年全球疾病负担研究。我们还模拟了三种情景,即较好、中等和较差情景,以评估蔬菜消费变化对三种疾病(CVD、癌症和DKD)的DALY率的影响。
预计到2040年,总人口的蔬菜摄入量平均呈下降趋势,降至237.7克/天。在20 - 49岁女性中,CVD的DALY率(-8.0%)、癌症的总人口(-5.6%)以及DKD的男性(-8.2%)和女性(-13.7%)的参考情景与较好情景之间观察到显著差异,95%预测区间不重叠。
我们的分析表明,增加蔬菜消费将显著减轻日本CVD、癌症和DKD的负担。通过估计未来蔬菜消费不同情景下低蔬菜摄入量导致的疾病负担,我们的研究可为公共卫生挑战的针对性干预设计提供参考。