School of Public Health, Loma Linda University, Loma Linda, CA, USA.
School of Medicine, Loma Linda University, Loma Linda, CA, USA.
Am J Clin Nutr. 2022 Jun 7;115(6):1589-1601. doi: 10.1093/ajcn/nqac043.
Both ultra-processed foods and animal-derived foods have been associated with mortality in some studies.
We aimed to examine the association of 2 dietary factors (ultra-processed foods and animal-based foods), adjusted for each other, with all-cause mortality.
The setting is an observational prospective cohort study in North America, recruited from Seventh-day Adventist churches, comprised of 95,597 men and women, yielding an analytic sample of 77,437 participants after exclusions. The exposure of interest was diet measured by FFQ, in particular 2 dietary factors: 1) proportion of dietary energy from ultra-processed foods (other processing levels and specific substitutions in some models) and 2) proportion of dietary energy from animal-based foods (red meat, poultry, fish, and eggs/dairy separately in some models). The main outcome was all-cause mortality. Mortality data through 2015 were obtained from the National Death Index. Analyses used proportional hazards regression.
There were 9293 deaths. In mutually adjusted continuous linear models of both dietary factors (ultra-processed and animal-based foods), the HR for the 90th compared with the 10th percentile of the proportion of dietary energy from ultra-processed food was 1.14 (95% CI: 1.07, 1.21, comparing 47.7% with 12.1% dietary energy), whereas for animal-based food intake (meats, dairy, eggs) it was 1.01 (95% CI: 0.95, 1.07, comparing 25.0% with 0.4% dietary energy). There was no evidence of interaction (P = 0.36). Among animal-based foods, only red meat intake was associated with mortality (HR: 1.14; 95% CI: 1.08, 1.22, comparing 6.2% with 0% dietary energy).
Greater consumption of ultra-processed foods was associated with higher all-cause mortality in this health-conscious Adventist population with many vegetarians. The total of animal-based food consumption (meat, dairy, eggs) was not associated with mortality, but higher red meat intake was. These findings suggest that high consumption of ultra-processed foods may be an important indicator of mortality.
一些研究表明，超加工食品和动物源性食品都与死亡率有关。
我们旨在研究 2 种饮食因素（超加工食品和动物源性食品）相互调整后与全因死亡率的关系。
本研究为观察性前瞻性队列研究，在北美招募，来自基督复临安息日会教堂，包括 95597 名男性和女性，排除后得出 77437 名参与者的分析样本。研究的暴露因素是通过 FFQ 测量的饮食，特别是 2 种饮食因素：1）超加工食品（其他加工水平和某些模型中的特定替代品）所摄入的能量占总膳食能量的比例；2）动物源性食品（红肉类、家禽类、鱼类和蛋类/乳制品）所摄入的能量占总膳食能量的比例。主要结局是全因死亡率。通过国家死亡索引获得 2015 年以前的死亡率数据。分析采用比例风险回归。
共有 9293 人死亡。在超加工食品（ultra-processed foods）和动物源性食品（animal-based foods）的两种饮食因素的相互调整连续线性模型中，与超加工食品能量摄入占总膳食能量的第 10 百分位相比，第 90 百分位的 HR 为 1.14（95%CI：1.07，1.21，比较 47.7%与 12.1%的膳食能量），而动物源性食物（肉类、奶制品、蛋类）的 HR 为 1.01（95%CI：0.95，1.07，比较 25.0%与 0.4%的膳食能量）。没有交互作用的证据（P=0.36）。在动物源性食品中，只有红肉类的摄入量与死亡率有关（HR：1.14；95%CI：1.08，1.22，比较 6.2%与 0%的膳食能量）。
在这个有健康意识的复临安息日会人群中，有很多素食者，超加工食品的消费与全因死亡率的升高有关。动物源性食品的总摄入量（肉类、奶制品、蛋类）与死亡率无关，但较高的红肉类摄入量与死亡率有关。这些发现表明，超加工食品的高摄入量可能是死亡率的一个重要指标。
