Sorbonne Paris Nord (Paris 13) University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), SMBH Paris 13, 74 Rue Marcel Cachin, F-93017 Bobigny, France.
Public Health Department, Avicenne Hospital (AP-HP), Bobigny, France.
Public Health Nutr. 2021 Nov;24(16):5539-5549. doi: 10.1017/S1368980021002871. Epub 2021 Jul 2.
Dietary indexes measure the adherence of individuals to a set of nutritional recommendations. However, the health gains associated with adherence to various dietary indexes may vary. Our objective was to compare the magnitude of estimated avoided deaths by chronic diseases obtained by improving diet quality in the French population, measured by a variety of dietary indexes.
Simulation study based on observational data.
Weighted data from a French population-based cohort study.
In participants from the NutriNet-Santé cohort, we computed dietary scores reflecting the adherence to various recommendations (Medi-Lite, Healthy Diet Indicator (HDI), Programme National Nutrition Santé/National Nutrition and Health Program - Guidelines Score, Diet Quality Index (DQI), Alternative Healthy Eating Index (AHEI) and the modified Food Standards Agency nutrient profiling system dietary index (FSAm-NPS DI)). Quintiles of the food groups' consumption and dietary intakes were used as input in a simulation model (Preventable Risk Integrated ModEl (PRIME)), yielding the number of delayed or avoided deaths in nutrition-related non-communicable diseases, comparing between very high or very low nutritional quality of the diet and medium nutritional quality.
A modification of dietary intakes from medium quality to very low quality (i.e. from the middle quintile to the quintile with the lowest nutritional quality) was associated with an increased number of deaths ranging from 3485 (95 % uncertainty interval (CI) 4002, 2987) for HDI and 3379 (95 % CI 3881, 2894) for FSAm-NPS DI to 838 (95 % CI 1163, 523) for Medi-Lite. Conversely, a modification of dietary intakes from medium quality to very high quality was associated with a decrease in the number of deaths ranging from 1995 (95 % CI 1676, 2299) for Probability of Adequate Nutrient intake diet, 1986 (95 % CI 1565, 2361) for DQI-International, 1931 (95 % CI 1499, 2316) for FSAm-NPS DI and 858 (95 % CI 499, 1205) for HDI.
Our results provide some insights as the potential impact of following various dietary guidelines to reduce mortality from nutrition-related diseases.
饮食指数可衡量个体对一组营养建议的遵守程度。然而，不同饮食指数的遵守情况与健康获益可能存在差异。本研究旨在比较通过改善法国人群的饮食质量，用多种饮食指数衡量，所获得的与各种慢性病相关的估计避免死亡人数的差异。
基于观察数据的模拟研究。
加权数据来自法国基于人群的队列研究。
在 NutriNet-Santé 队列研究的参与者中，我们计算了反映对各种建议（Medi-Lite、健康饮食指数（HDI）、国家营养与健康计划/国家营养和健康计划-指南评分、饮食质量指数（DQI）、替代健康饮食指数（AHEI）和改良的食品标准局营养成分分类系统饮食指数（FSAm-NPS DI））的遵守程度的饮食评分。使用食物组摄入量的五分位数作为模拟模型（可预防风险综合模型（PRIME））的输入，从而比较饮食质量非常高或非常低与中等饮食质量时营养相关非传染性疾病的延迟或避免死亡人数。
从中等质量饮食向非常低质量饮食（即从中等五分位数改为营养质量最低的五分位数）的饮食摄入变化与死亡人数的增加相关，范围从 HDI 的 3485（95%置信区间（CI）：4002，2987）和 FSAm-NPS DI 的 3379（95%CI：3881，2894）到 Medi-Lite 的 838（95%CI：1163，523）。相反，从中等质量饮食向非常高质量饮食的饮食摄入变化与死亡人数的减少相关，范围从 Probability of Adequate Nutrient intake diet 的 1995（95%CI：1676，2299）、DQI-International 的 1986（95%CI：1565，2361）、FSAm-NPS DI 的 1931（95%CI：1499，2316）和 HDI 的 858（95%CI：499，1205）。
本研究结果为遵循各种饮食指南以降低与营养相关疾病相关的死亡率的潜在影响提供了一些见解。
