Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain.
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.
Mayo Clin Proc. 2022 Nov;97(11):2005-2015. doi: 10.1016/j.mayocp.2022.06.008.
To investigate the associations of a healthful plant-based diet index (hPDI) and an unhealthful plant-based diet index (uPDI) with all-cause and cardiovascular disease (CVD) mortality in Spanish adults.
We analyzed data from 11,825 individuals 18 years of age or older, representative of the Spanish population, recruited between 2008 and 2010 and followed-up to 2020. Food consumption was collected at baseline using a validated dietary history, which served to calculate two plant-based diet indices based on 18 major food groups (range, 18-90 points). For (1) hPDI only the consumption of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, and tea/coffee) received positive scores; whereas for (2) uPDI, only the consumption of less healthy plant foods (fruit juices, sugar-sweetened beverages, refined grains, potatoes, and sweets/desserts) received positive scores. Multivariable-adjusted Cox models were used to estimate HRs and their 95% CIs.
After a median follow-up of 10.9 and 9.8 years, 699 all-cause and 157 CVD deaths were ascertained, respectively. Each 10-point increase in hPDI was associated with 14% lower risk of all-cause death (HR, 0.86; 95% CI, 0.74 to 0.99), and 37% lower risk of CVD death (HR, 0.63; 95% CI, 0.46 to 0.85). No significant associations were found for uPDI.
Higher adherence to an hPDI diet, but not to a uPDI, was associated with lower all-cause and CVD mortality. This suggests that the quality of the plant food consumed is paramount to achieve diet-related benefits in mortality.
clinicaltrials.gov Identifier: NCT02804672.
研究健康植物性饮食指数（hPDI）和不健康植物性饮食指数（uPDI）与西班牙成年人全因和心血管疾病（CVD）死亡率的关联。
我们分析了 2008 年至 2010 年期间招募的、年龄在 18 岁及以上的、代表西班牙人口的 11825 名个体的数据，并随访至 2020 年。基线时使用经过验证的饮食史收集食物消耗情况，根据 18 种主要食物组（范围 18-90 分）计算出两种植物性饮食指数。（1）对于 hPDI，仅健康植物性食物（全谷物、水果、蔬菜、坚果、豆类、植物油和茶/咖啡）的消耗可获得正分；而（2）对于 uPDI，仅较少健康植物性食物（果汁、含糖饮料、精制谷物、土豆和甜食/甜点）的消耗可获得正分。使用多变量调整的 Cox 模型来估计 HRs 及其 95%置信区间。
在中位数为 10.9 年和 9.8 年的随访后，分别确定了 699 例全因死亡和 157 例 CVD 死亡。hPDI 每增加 10 分，全因死亡风险降低 14%（HR，0.86；95%CI，0.74 至 0.99），CVD 死亡风险降低 37%（HR，0.63；95%CI，0.46 至 0.85）。而 uPDI 则没有明显关联。
较高的 hPDI 饮食依从性与全因和 CVD 死亡率降低相关，而不是 uPDI。这表明所消耗的植物性食物的质量对实现与死亡率相关的饮食益处至关重要。
clinicaltrials.gov 标识符：NCT02804672。
