单独及联合生活方式因素的旧石器饮食与 E3N 前瞻性队列中女性 2 型糖尿病和高血压风险的关联。
The associations of the Palaeolithic diet alone and in combination with lifestyle factors with type 2 diabetes and hypertension risks in women in the E3N prospective cohort.
机构信息
Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm U1018, "Exposome, Heredity, Cancer, and Health" Team, CESP, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.
Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg.
出版信息
Eur J Nutr. 2021 Oct;60(7):3935-3945. doi: 10.1007/s00394-021-02565-5. Epub 2021 Apr 28.
PURPOSE
Patterns of change from the traditional Palaeolithic lifestyle to the modern lifestyle may partly explain the epidemic proportions of non-communicable diseases (NCDs). We investigated to what extent adherence to the Palaeolithic diet (PD) and the Palaeolithic-like lifestyle was associated with type 2 diabetes (T2D) and hypertension risks.
METHODS
A study of 70,991 women from the E3N (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale) cohort, followed up for nearly 20 years. There were 3292 incident T2D and 12,504 incident hypertension cases that were validated. Dietary data were collected at baseline in 1993 via a food frequency questionnaire. The PD score and the Palaeolithic-like lifestyle score (PD, physical activity, smoking status, and body mass index [BMI]) were derived and considered in quintiles. Multivariable Cox regression models were employed to estimate hazard ratios (HR) and 95% confidence intervals (CI) for incident T2D and hypertension.
RESULTS
In the fully adjusted models, a 1-SD increase of the PD score was associated with 4% and 3% lower risks of T2D and hypertension, respectively. Those in the highest versus the lowest quintile of the score had HR (95% CI) of 0.88 (0.79, 0.98) and 0.91 (0.86, 0.96) for T2D and hypertension, respectively (P-trend < 0.0001). Associations were stronger for the Palaeolithic-like lifestyle score; in the fully adjusted model, a 1-SD increase of the score was associated with 19% and 6% lower risks of T2D and hypertension, respectively. Risks lowered successively with each increase in quintile; those in the highest versus the lowest quintile had HR (95% CI) of 0.58 (0.52, 0.65) and 0.85 (0.80, 0.90) for T2D and hypertension, respectively (P-trend < 0.0001).
CONCLUSIONS
Our data suggest that adhering to a PD based on fruit, vegetables, lean meats, fish, and nuts, and incorporating a Palaeolithic-like lifestyle could be promising options to prevent T2D and hypertension.
目的
从传统旧石器时代生活方式向现代生活方式的变化模式可能部分解释了非传染性疾病（NCD）的流行程度。我们研究了遵守旧石器时代饮食（PD）和类似旧石器时代的生活方式与 2 型糖尿病（T2D）和高血压风险的关联程度。
方法
对 E3N（法国女性教育全国互助会队列研究）队列中的 70991 名女性进行了一项研究，随访时间近 20 年。有 3292 例确诊的 T2D 和 12504 例确诊的高血压病例。1993 年通过食物频率问卷收集了基线时的饮食数据。根据 PD 得分和类似旧石器时代的生活方式得分（PD、体育活动、吸烟状况和体重指数 [BMI]），将 PD 得分和类似旧石器时代的生活方式得分分为五分位数。使用多变量 Cox 回归模型估计 T2D 和高血压的发病率风险比（HR）和 95%置信区间（CI）。
结果
在完全调整的模型中，PD 得分每增加 1 个标准差，T2D 和高血压的风险分别降低 4%和 3%。得分最高组与最低组相比，T2D 和高血压的 HR（95%CI）分别为 0.88（0.79，0.98）和 0.91（0.86，0.96）（P 趋势<0.0001）。类似旧石器时代的生活方式得分的相关性更强；在完全调整的模型中，得分每增加 1 个标准差，T2D 和高血压的风险分别降低 19%和 6%。风险随着五分位数的增加而依次降低；得分最高组与最低组相比，T2D 和高血压的 HR（95%CI）分别为 0.58（0.52，0.65）和 0.85（0.80，0.90）（P 趋势<0.0001）。
结论
我们的数据表明，遵循以水果、蔬菜、瘦肉、鱼和坚果为基础的 PD，并采用类似旧石器时代的生活方式，可能是预防 T2D 和高血压的有前途的选择。
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