营养充足与美国成年人死亡率降低有关。

Nutrient Adequacy Is Associated with Reduced Mortality in US Adults.

机构信息

Department of Food Science and Nutrition, Jeju National University, Jeju City, Jeju, South Korea.

Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA.

出版信息

J Nutr. 2021 Oct 1;151(10):3214-3222. doi: 10.1093/jn/nxab240.

DOI:10.1093/jn/nxab240

PMID:34383909

Abstract

BACKGROUND

Americans are underconsuming essential nutrients while overconsuming several nutrients, including sodium, saturated fat, and added sugars. Suboptimal nutrition may be linked with mortality risk; however, few studies have evaluated the associations of underconsumed and overconsumed nutrients in a comprehensive manner among the US population.

OBJECTIVES

This study investigated the association between nutrient intake through diet and mortality focusing on adequacy, moderation, and macronutrient quality in US adults.

METHODS

Based on the 1999-2010 NHANES, 20,602 adults aged ≥30 y were followed up until December 2015. Nutrient intake was assessed using a 1-d 24-h dietary recall. Adequacy of major underconsumed nutrients in the United States was evaluated using the RDA (percent of RDA) or Adequate Intake (percent of AI). Overconsumed nutrients for which moderation is needed were assessed based on various dietary recommendations. Macronutrient quality was evaluated using the ratio of carbohydrates to dietary fiber, essential amino acids, and EPA + DHA. The association between nutrient intake and mortality was evaluated using Cox proportional hazards regression analysis.

RESULTS

Higher intakes of vitamin E, magnesium, iron, dietary fiber, and potassium relative to the RDA/AI were associated with lower all-cause mortality. High intake of vitamin A (tertile 3: ≥80.1% of RDA) was associated with lower mortality from cardiovascular disease (CVD; HR: 0.75; 95% CI: 0.57, 0.99) and cancer (HR: 0.76; 95% CI: 0.62, 0.94), and high intake of calcium (tertile 3: ≥87.8% of RDA) was inversely associated with cancer mortality (HR: 0.72; 95% CI: 0.56, 0.93). Higher intakes of essential amino acids and EPA + DHA evaluated as quartiles were inversely associated with all-cause and CVD mortality.

CONCLUSIONS

These findings suggest that higher intakes of underconsumed nutrients and improving macronutrient quality are associated with lower risk of CVD and cancer deaths in US adults.

摘要

背景

美国人在摄入必需营养素方面存在不足，而在摄入钠、饱和脂肪和添加糖等多种营养素方面却存在过量。营养状况不佳可能与死亡风险有关；然而，很少有研究全面评估美国人群中摄入不足和摄入过量的营养素之间的关联。

目的

本研究通过饮食评估营养素摄入与美国成年人死亡率之间的关系，重点关注充足性、适度性和宏量营养素质量。

方法

基于 1999-2010 年 NHANES 数据，对 20602 名年龄≥30 岁的成年人进行了随访，随访至 2015 年 12 月。采用 1 天 24 小时膳食回顾法评估营养素摄入。采用 RDA（RDA 的百分比）或 AI（AI 的百分比）评估美国主要摄入不足营养素的充足性。根据各种饮食建议，评估需要适度摄入的过量营养素。使用碳水化合物与膳食纤维、必需氨基酸和 EPA+DHA 的比值来评估宏量营养素质量。采用 Cox 比例风险回归分析评估营养素摄入与死亡率之间的关系。

结果

与 RDA/AI 相比，维生素 E、镁、铁、膳食纤维和钾的摄入量较高与全因死亡率降低相关。维生素 A 摄入量较高（第三四分位：≥RDA 的 80.1%）与心血管疾病（CVD；HR：0.75；95%CI：0.57，0.99）和癌症（HR：0.76；95%CI：0.62，0.94）死亡率降低相关，钙摄入量较高（第三四分位：≥RDA 的 87.8%）与癌症死亡率降低相关（HR：0.72；95%CI：0.56，0.93）。必需氨基酸和 EPA+DHA 的摄入量较高（按四分位数评估）与全因和 CVD 死亡率降低相关。