Piernas Carmen, Gao Min, Jebb Susan A
Department of Biochemistry and Molecular Biology II, Center for Biomedical Research (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, Granada, Spain.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Proc Nutr Soc. 2022 Jun 29:1-8. doi: 10.1017/S0029665122001094.
Most current nutrition policies and dietary recommendations still reflect decades of research addressing the mechanism of action or health risks of individual nutrients. Yet, most high-income countries including the UK are far from reaching the dietary intakes which are recommended for good health. Food-based dietary patterns (DPs) can help target specific combinations of foods that are associated with disease risk, recognising the coexistence of multiple nutrients within foods and their potential synergistic effects. Reduced rank regression (RRR) has emerged as a useful exploratory approach which uses knowledge of the pathway from diet to disease to help identify DPs which are associated with disease risk in a particular population. Here we reviewed the literature with a focus on longitudinal cohort studies using RRR to derive DPs and reporting associations with non-communicable disease risk. We also illustrated the application of the RRR approach using data from the UK Biobank study, where we derived DPs that explained high variability in a set of nutrient response variables. The main DP was characterised by high intakes of chocolate and confectionery, butter and low-fibre bread, and low intakes of fresh fruit and vegetables and showed particularly strong associations with CVD, type 2 diabetes and all-cause mortality, which is consistent with previous studies that derived 'Western' or unhealthy DPs. These recent studies conducted in the UK Biobank population together with evidence from previous cohort studies contribute to the emerging evidence base to underpin food-based dietary advice for non-communicable disease prevention.
当前大多数营养政策和饮食建议仍反映了数十年来针对单一营养素的作用机制或健康风险所开展的研究。然而，包括英国在内的大多数高收入国家远未达到有益于健康的推荐饮食摄入量。基于食物的饮食模式（DPs）能够帮助确定与疾病风险相关的特定食物组合，认识到食物中多种营养素的共存及其潜在的协同作用。降秩回归（RRR）已成为一种有用的探索性方法，它利用从饮食到疾病的路径知识，来帮助识别与特定人群疾病风险相关的饮食模式。在此，我们回顾了相关文献，重点关注使用RRR得出饮食模式并报告与非传染性疾病风险关联的纵向队列研究。我们还利用英国生物银行研究的数据说明了RRR方法的应用，在该研究中，我们得出了解释一组营养反应变量中高变异性的饮食模式。主要的饮食模式特点是巧克力和糖果、黄油以及低纤维面包的摄入量高，而新鲜水果和蔬菜的摄入量低，并且与心血管疾病、2型糖尿病和全因死亡率的关联尤为强烈，这与之前得出“西方”或不健康饮食模式的研究一致。这些近期在英国生物银行人群中开展的研究，连同之前队列研究的证据，为基于食物的饮食建议以预防非传染性疾病提供了新出现的证据基础。
