Liang Shan, Wang Li, Wu Xiaoli, Hu Xu, Wang Tao, Jin Feng
Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
Key Laboratory of Microbial Physiological and Metabolic Engineering, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.
Front Nutr. 2023 Jan 9;9:957688. doi: 10.3389/fnut.2022.957688. eCollection 2022.
The highly processed western diet is substituting the low-processed traditional diet in the last decades globally. Increasing research found that a diet with poor quality such as western diet disrupts gut microbiota and increases the susceptibility to various neurological and mental disorders, while a balanced diet regulates gut microbiota and prevents and alleviates the neurological and mental disorders. Yet, there is limited research on the association between the disease burden expanding of neurological and mental disorders with a dietary transition.
We compared the disability-adjusted life-years (DALYs) trend by age for neurological and mental disorders in China, in the United States of America (USA), and across the world from 1990 to 2019, evaluated the dietary transition in the past 60 years, and analyzed the association between the burden trend of the two disorders with the changes in diet composition and food production.
We identified an age-related upward pattern in disease burden in China. Compared with the USA and the world, the Chinese neurological and mental disorders DALY percent was least in the generation over 75 but rapidly increased in younger generations and surpassed the USA and/or the world in the last decades. The age-related upward pattern in Chinese disease burdens had not only shown in the presence of cardiovascular diseases, neoplasms, and diabetes mellitus but also appeared in the presence of depressive disorders, Parkinson's disease, Alzheimer's disease and other dementias, schizophrenia, headache disorders, anxiety disorders, conduct disorders, autism spectrum disorders, and eating disorders, successively. Additionally, the upward trend was associated with the dramatic dietary transition including a reduction in dietary quality and food production sustainability, during which the younger generation is more affected than the older. Following the increase in total calorie intake, alcohol intake, ratios of animal to vegetal foods, and poultry meat to pulses, the burdens of the above diseases continuously rose. Then, following the rise of the ratios of meat to pulses, eggs to pulses, and pork to pulses, the usage of fertilizers, the farming density of pigs, and the burdens of the above disease except diabetes mellitus were also ever-increasing. Even the usage of pesticides was positively correlated with the burdens of Parkinson's disease, schizophrenia, cardiovascular diseases, and neoplasms. Contrary to China, the corresponding burdens of the USA trended to reduce with the improvements in diet quality and food production sustainability.
Our results suggest that improving diet quality and food production sustainability might be a promising way to stop the expanding burdens of neurological and mental disorders.
在过去几十年里，全球范围内高度加工的西方饮食正在取代低加工的传统饮食。越来越多的研究发现，像西方饮食这种质量较差的饮食会破坏肠道微生物群，并增加患各种神经和精神疾病的易感性，而均衡饮食则能调节肠道微生物群，并预防和缓解神经和精神疾病。然而，关于神经和精神疾病疾病负担的扩大与饮食转变之间的关联研究有限。
我们比较了1990年至2019年中国、美国以及全球范围内按年龄划分的神经和精神疾病伤残调整生命年（DALYs）趋势，评估了过去60年的饮食转变，并分析了这两种疾病的负担趋势与饮食结构和食物生产变化之间的关联。
我们在中国发现了疾病负担随年龄增长而上升的模式。与美国和全球相比，中国神经和精神疾病的伤残调整生命年百分比在75岁以上人群中最低，但在年轻一代中迅速增加，并在过去几十年中超过了美国和/或全球水平。中国疾病负担随年龄增长而上升的模式不仅出现在心血管疾病、肿瘤和糖尿病患者中，还依次出现在抑郁症患者、帕金森病患者、阿尔茨海默病和其他痴呆症患者、精神分裂症患者、头痛症患者、焦虑症患者、品行障碍患者、自闭症谱系障碍患者和饮食失调患者中。此外，这种上升趋势与剧烈的饮食转变有关，包括饮食质量下降和食物生产可持续性降低，在此期间年轻一代比年长一代受到的影响更大。随着总热量摄入、酒精摄入量、动物性食物与植物性食物的比例以及禽肉与豆类比例的增加，上述疾病的负担持续上升。然后，随着肉类与豆类、鸡蛋与豆类以及猪肉与豆类比例的上升，化肥使用量、猪的养殖密度以及除糖尿病外上述疾病的负担也不断增加。甚至农药使用量也与帕金森病、精神分裂症、心血管疾病和肿瘤的负担呈正相关。与中国相反，美国相应的负担随着饮食质量和食物生产可持续性的改善而趋于下降。
我们的结果表明，改善饮食质量和食物生产可持续性可能是阻止神经和精神疾病负担不断扩大的一个有前景的方法。
