Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, No 22 Qixiangtai Road, Tianjin, 300070, China.
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
J Transl Med. 2023 Feb 6;21(1):88. doi: 10.1186/s12967-023-03927-9.
Little is known on the association of types of grains with mortality and the moderating effect of lifestyle on this association. This study aims to evaluate the single or joint associations of types of grains and lifestyle with all-cause mortality among Chinese older adults.
Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018. Subjects aged ≥ 65 years were eligible. The types of grains included wheat, total rice, and coarse cereals. Lifestyle was derived using smoking, alcohol consumption, physical activity, and dietary pattern. All-cause mortality was the primary outcome.
This study included 30275 participants with a mean age 87 ± 11 years and documented 19261 deaths during a mean follow-up of 4.8 years. Compared to wheat, in those with healthy and intermediate lifestyle, total rice was associated with a 13% (HR: 0.87, 95% CI 0.80, 0.93) and 6% (HR: 0.94, 95% CI 0.90, 1.00) lower risk of mortality, respectively, and coarse cereals were associated with a 14% (HR: 0.86, 95% CI 0.74, 1.00) and 12% (HR: 0.88, 95% CI 0.79, 0.97) lower risk of mortality, respectively. Meanwhile, an increase per SD in intakes of wheat and coarse cereals was associated with a 10% (HR: 1.10, 95% CI 1.03, 1.18) and 25% (HR: 1.25, 95% CI 1.08, 1.44) higher mortality rate in those with healthy lifestyle, and a 13% (HR: 1.13, 95% CI 1.08, 1.19) and 29% (HR: 1.29, 95% CI 1.17, 1.44) higher mortality in females but not males. In addition, a U-shaped association of intake of total grains with all- cause mortality was observed (P for non-linearity = 0.002), and a J-shaped association of intake of total rice with all- cause mortality was observed (P for non-linearity = 0.003).
Specific types of grains and lifestyle were separately or jointly associated with all-cause mortality. Compared to wheat, total rice and coarse cereals were advanced grains for participants with a relatively healthy lifestyle. Intake of total rice was related to all-cause mortality in a dose-response manner. Therefore, a combination of intermediate intake of total rice and healthy lifestyle should be encouraged in older adults.
关于谷物类型与死亡率的关系以及生活方式对此关联的调节作用，目前所知甚少。本研究旨在评估谷物类型和生活方式单独或联合与中国老年人全因死亡率的关系。
数据来自于 1998 年至 2018 年的中国老年人健康长寿纵向研究（CLHLS）。年龄≥65 岁的受试者符合条件。谷物类型包括小麦、总大米和粗粮。生活方式是通过吸烟、饮酒、身体活动和饮食模式来确定的。全因死亡率是主要结局。
本研究纳入了 30275 名平均年龄为 87±11 岁的参与者，在平均 4.8 年的随访期间记录了 19261 例死亡。与小麦相比，在生活方式健康和中等的人群中，总大米与死亡率分别降低 13%（HR：0.87，95%CI 0.80，0.93）和 6%（HR：0.94，95%CI 0.90，1.00），粗粮与死亡率分别降低 14%（HR：0.86，95%CI 0.74，1.00）和 12%（HR：0.88，95%CI 0.79，0.97）。同时，在生活方式健康的人群中，每增加一个 SD 的小麦和粗粮摄入量，死亡率分别增加 10%（HR：1.10，95%CI 1.03，1.18）和 25%（HR：1.25，95%CI 1.08，1.44），而在女性中，这种关系更为明显，死亡率分别增加 13%（HR：1.13，95%CI 1.08，1.19）和 29%（HR：1.29，95%CI 1.17，1.44），但在男性中则不然。此外，总谷物摄入量与全因死亡率呈 U 型关联（非线性 P 值=0.002），总大米摄入量与全因死亡率呈 J 型关联（非线性 P 值=0.003）。
特定类型的谷物和生活方式分别或共同与全因死亡率相关。与小麦相比，总大米和粗粮是生活方式相对健康人群的优质谷物。总大米摄入量与全因死亡率呈剂量反应关系。因此，应鼓励老年人摄入适量的总大米并保持健康的生活方式。
