Perraud Elie, Wang Juhui, Salomé Marion, Huneau Jean-François, Lapidus Nathanaël, Mariotti François
Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, Paris, France.
Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP Sorbonne Université, Public Health Department, Saint-Antoine Hospital, Paris, France.
Front Nutr. 2022 Jun 28;9:924526. doi: 10.3389/fnut.2022.924526. eCollection 2022.
Diets higher in plants are associated with lower risks of chronic diseases. However, animal foods, which are rich in protein, are also rich in some important minerals and vitamins. Using data from a representative survey in France (INCA3, = 1,125), we used path analyses as a mediation-like approach to decipher the importance of plant and animal proteins in the relationship between the plant-based diet index (PDI) and diet quality. We used three types of diet quality scores, namely, nutrient security, positive nutrient adequacy, and long-term mortality risk of four diet-related diseases (i.e., coronary heart disease, stroke, type 2 diabetes, and colorectal cancer). We identified positive and negative mediations, i.e., changes in plant/animal protein intake that are associated with changes in PDI, and favor or limit the association with the diet quality score. The PDI was positively associated with the risk of long-term mortality but not significantly with nutrient adequacy or nutrient security. A positive mediation by plant protein was found for all diet quality scores (specific indirect effects (SIEs) ranging from 0.04 to 0.10 SD). Conversely, the association between PDI and nutrient adequacy (but not nutrient security) was negatively mediated by animal protein intake (SIE: -0.06 SD). In further detailed models, the association between PDI and diet quality was mainly positively mediated by protein foods from the fruit-vegetables-legumes group (0.01 SD for the nutrient security and 0.02 SD for the nutrient adequacy) and whole grains (0.02 SD for the nutrient adequacy). Our data suggest that the positive impact of plant-based diets on diet quality is largely driven by higher intakes of plant protein foods, especially from fruits-vegetables-legumes and whole grains. Conversely, lower animal protein intake tends to limit the positive impact of plant-based diets on overall positive nutrient adequacy but not security. Protein sources appear critical to healthy plant-based diets.
植物性食物占比更高的饮食与较低的慢性病风险相关。然而，富含蛋白质的动物性食物也富含一些重要的矿物质和维生素。利用来自法国一项代表性调查（INCA3，n = 1125）的数据，我们采用路径分析这种类似中介效应的方法来解读植物蛋白和动物蛋白在植物性饮食指数（PDI）与饮食质量关系中的重要性。我们使用了三种饮食质量评分，即营养安全性、正向营养素充足性以及四种与饮食相关疾病（即冠心病、中风、2型糖尿病和结直肠癌）的长期死亡风险。我们识别出了正向和负向中介效应，即植物/动物蛋白摄入量的变化与PDI的变化相关，并促进或限制与饮食质量评分的关联。PDI与长期死亡风险呈正相关，但与营养素充足性或营养安全性无显著关联。对于所有饮食质量评分，均发现植物蛋白存在正向中介效应（特定间接效应（SIEs）范围为0.04至0.10标准差）。相反，动物蛋白摄入量对PDI与营养素充足性（而非营养安全性）之间的关联存在负向中介效应（SIE：-0.06标准差）。在进一步的详细模型中，PDI与饮食质量之间的关联主要由果蔬-豆类组的蛋白质食物（营养安全性为0.01标准差，营养素充足性为0.02标准差）和全谷物（营养素充足性为0.02标准差）正向中介。我们的数据表明，植物性饮食对饮食质量的积极影响很大程度上是由植物蛋白食物的较高摄入量驱动的，尤其是来自果蔬-豆类和全谷物的植物蛋白。相反，较低的动物蛋白摄入量往往会限制植物性饮食对总体正向营养素充足性的积极影响，但不会影响营养安全性。蛋白质来源对于健康的植物性饮食似乎至关重要。
