Fereidouni Sahar, Hejazi Najmeh, Homayounfar Reza, Farjam Mojtaba
Student Research Committee, School of Nutrition and Food Sciences Shiraz University of Medical Sciences Shiraz Iran.
Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences Shiraz University of Medical Sciences Shiraz Iran.
Food Sci Nutr. 2022 Dec 23;11(3):1563-1571. doi: 10.1002/fsn3.3197. eCollection 2023 Mar.
Dietary intake is a determining factor in the morbidity and mortality of chronic disorders. However, not many documents have investigated this relationship. The aim of this study was to evaluate the associations of the Mediterranean dietary score (MDS), Alternative Healthy Eating Index (AHEI), Dietary Inflammatory Index (DII), DASH score, and dietary acid load with cardiovascular disease (CVD) mortality. A total of 2158 CVD patients (mean age of 54.73 ± 8.62 years) from the Fasa cohort study, Iran, participated in the current study. DII, AHEI, MDS, DASH, and dietary acid load (NEAP score) were computed using a validated 125-item Food Frequency Questionnaire (FFQ). Cox regression analyses were used to determine HRs and 95% CIs. During a follow-up of 3 years, we documented 59 CVD deaths. After adjusting for relevant confounders (age, gender, family history of CVD, smoking, physical activity, alcohol intake, and HTN) in the final model, we found that higher DII scores and dietary acid load were significantly related to increased mortality due to CVD (HR = 1.11; 95% CI = 1.01-1.24; and HR = 1.02; 95% CI = 1.01-1.03). However, the DASH score was insignificantly associated with decreased CVD mortality by 20.4% (HR = 0.79; 95% CI = 0.57-1.09). There was no significant relationship among AHEI score, MDS, and CVD mortality. This study showed that increasing dietary acidity and the use of inflammatory food compounds could contribute to CVD mortality. Also, adherence to the DASH diet may be associated with reduced CVD mortality.
饮食摄入是慢性疾病发病率和死亡率的一个决定性因素。然而，并没有很多文献对这种关系进行研究。本研究的目的是评估地中海饮食评分（MDS）、替代健康饮食指数（AHEI）、饮食炎症指数（DII）、得舒饮食评分（DASH）和饮食酸负荷与心血管疾病（CVD）死亡率之间的关联。来自伊朗法萨队列研究的总共2158名CVD患者（平均年龄54.73±8.62岁）参与了本研究。使用经过验证的125项食物频率问卷（FFQ）计算DII、AHEI、MDS、DASH和饮食酸负荷（净内源性酸度产生评分，NEAP评分）。采用Cox回归分析来确定风险比（HR）和95%置信区间（CI）。在3年的随访期间，我们记录了59例CVD死亡病例。在最终模型中对相关混杂因素（年龄、性别、CVD家族史、吸烟、身体活动、酒精摄入和高血压）进行调整后，我们发现较高的DII评分和饮食酸负荷与CVD导致的死亡率增加显著相关（HR = 1.11；95%CI = 1.01 - 1.24；以及HR = 1.02；95%CI = 1.01 - 1.03）。然而，DASH评分与CVD死亡率降低20.4%无显著关联（HR = 0.79；95%CI = 0.57 - 1.09）。AHEI评分、MDS与CVD死亡率之间无显著关系。本研究表明，饮食酸度增加和食用炎症性食物成分可能会导致CVD死亡率上升。此外，坚持得舒饮食可能与降低CVD死亡率有关。
