遵循 EAT-柳叶刀饮食与前瞻性 NutriNet-Santé 队列癌症和心血管结局风险的关系。
Association between adherence to the EAT-Lancet diet and risk of cancer and cardiovascular outcomes in the prospective NutriNet-Santé cohort.
机构信息
Sorbonne Paris Nord University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France.
Department of Public Health, Avicenne Hospital, Bobigny, France.
出版信息
Am J Clin Nutr. 2022 Oct 6;116(4):980-991. doi: 10.1093/ajcn/nqac208.
BACKGROUND
The EAT-Lancet commission proposed, in 2019, a planetary, healthy, and universal dietary pattern. However, this diet has rarely been studied in relation to various health outcomes.
OBJECTIVES
We aimed to prospectively estimate the association between the EAT-Lancet diet and cancer and cardiovascular disease (CVD) risk.
METHODS
The study was conducted in participants of the NutriNet-Santé cohort (2009-2021). The endpoints were the incident outcomes (cancer and CVDs and mortality from these diseases), combined and separately. Adherence to the EAT-Lancet diet was estimated using the EAT-Lancet Diet Index (ELD-I) modeled as quintiles (Qs). Multivariable Cox proportional hazard models were used to estimate HRs and 95% CIs, adjusted for potential confounders and moderators.
RESULTS
A total of 62,382 subjects were included; 2475 cases of cancer and 786 cases of cardiovascular events occurred during a median follow-up of 8.1 y. The sample was 76% female, the mean ± SD age at inclusion was 51.0 ± 10.2 y. The ELD-I ranged from -162 to 332 points with a mean ± SD score of 45.4 ± 25.6 points. In multivariable models, no significant association between the EAT-Lancet diet and the risk of cancer and CVD combined, and separately, was observed. Alcohol consumption was an effect modifier of the association. A significant association was observed among low drinkers (HRQ5vs.Q1: 0.86; 95% CI: 0.73, 1.02; P-trend = 0.02). A higher ELD-I was significantly associated with a lower risk of overall cancer only among females (HRQ5vs.Q1: 0.89; 95% CI: 0.75, 1.05; P-trend = 0.03). Both associations were largely attenuated by BMI.
CONCLUSIONS
Contrary to our hypothesis, our results documented significant associations between adherence to the EAT-Lancet diet and incidence of cancer only in some subgroups, and no association with CVD.This trial was registered at clinicaltrials.gov as NCT03335644.
背景
EAT 饮食与柳叶刀委员会在 2019 年提出了一种行星健康且普遍适用的饮食模式。然而，这种饮食与各种健康结果的关系很少被研究。
目的
我们旨在前瞻性估计 EAT 饮食与癌症和心血管疾病（CVD）风险之间的关联。
方法
该研究在 NutriNet-Santé 队列（2009-2021 年）的参与者中进行。终点是癌症和 CVD 事件的发生情况（以及这些疾病的死亡率），并将其合并和单独进行分析。EAT 饮食的依从性使用 EAT-Lancet 饮食指数（ELD-I）进行评估，该指数以五分位数（Qs）建模。多变量 Cox 比例风险模型用于估计 HRs 和 95%CI，调整了潜在的混杂因素和调节剂。
结果
共纳入 62382 名受试者；在中位随访 8.1 年期间，发生了 2475 例癌症和 786 例心血管事件。样本中 76%为女性，入组时的平均年龄±标准差为 51.0±10.2 岁。ELD-I 范围为-162 至 332 分，平均得分±标准差为 45.4±25.6 分。在多变量模型中，未观察到 EAT 饮食与癌症和 CVD 风险的组合以及单独的风险之间存在显著关联。饮酒量是这种关联的一个效应修饰因子。在低饮酒者中观察到显著关联（HRQ5vs.Q1：0.86；95%CI：0.73，1.02；P-trend=0.02）。在女性中，较高的 ELD-I 与整体癌症风险降低显著相关（HRQ5vs.Q1：0.89；95%CI：0.75，1.05；P-trend=0.03）。这两个关联在很大程度上都被 BMI 所削弱。
结论
与我们的假设相反，我们的结果记录了仅在某些亚组中，EAT 饮食的依从性与癌症发生率之间存在显著关联，而与 CVD 没有关联。该试验在 clinicaltrials.gov 上注册为 NCT03335644。
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