Cundiff David K, Wu Chunyi
Global Burden of Disease, Institute for Health Metrics and Evaluation, Long Beach, USA.
Statistics, Michigan Medicine, Ann Arbor, USA.
Cureus. 2023 Jun 6;15(6):e40061. doi: 10.7759/cureus.40061. eCollection 2023 Jun.
Background This article aimed to compare the EAT-Lancet Commission's "Planetary Health Diet" (PHD) with the Institute for Health Metrics and Evaluation (IHME) Global Burden of Disease Study 1990-2017 (GBD2017) dietary and other risk factor data. In the PHD/GBD comparison, we also intended to show the relevance of a new multiple regression analysis methodology with dietary and non-dietary risk factors (independent variables) for noncommunicable disease (NCD) deaths/100000/year in males and females 15-69 years old from 1990 to 2017 (NCDs, dependent variable). Methods We formatted worldwide GBD2017 dietary risk factors and NCD data on 1120 worldwide cohorts to obtain 7846 population-weighted cohorts. Each cohort represented about one million people, totaling about 7.8 billion people from 195 countries. With an empirically derived methodology, we compared the PHD animal- and plant-sourced food recommended ranges (kilocalories/day=KC/d) with optimal dietary ranges (KC/d) from GBD cohort data. Using GBD data subsets with low and high animal food consumption cohorts, our new GBD multiple regression formula derivation methodology equated risk factor formula coefficients to their population-attributable risk percents (PAR%s). Results We contrasted PHD recommendations for the available 14 dietary risk factors (KC/d means and ranges) with our GBD analysis methodology's optimal ranges for each dietary variable (KC/d mean and range): PHD beef, lamb, and pork mean: 30 KC/d (range: 0-60 KC/d)/GBD processed meat: 8.86 (1.69-16.03)+GBD red meat: 44.52 (20.37-68.68), PHD fish: 40 (0-143)/GBD: 19.68 (3.45-35.90), PHD whole milk or equivalents: 153 (0-306)/GBD: 40.00 (18.89-61.11), PHD poultry: 62 (0-124)/GBD: 56.10 (24.13-88.07), PHD eggs: 19 (0-37)/GBD: 19.42 (9.99-28.86), PHD: saturated oils 96 (0-96)/GBD added saturated fatty acids (SFA): 116.55 (104.04-129.07), PHD all added sugars: 120 (0-120)/GBD sugary beverages: 286.37 (256.99-315.76), PHD tubers or starchy vegetables: 39 (0-78)/GBD potatoes: 84.16 (75.75-92.58)+GBD sweet potatoes: 9.21 (4.05-14.37), PHD fruits: 126 (63-189)/GBD: 63.03 (21.61-113.71), PHD vegetables: 78.32 (9.48-196.14)/GBD: 85.05 (66.75-103.36), PHD nuts: 291 (0-437)/GBD nuts and seeds: 10.97 (5.95-15.98), PHD whole grains: 811 (811/811)/GBD: 56.14 (50.53-61.76), PHD legumes: 284 (0-379)/GBD: 59.93 (45.43-74.43), and total animal food PHD: (0/400)/GBD: 329.84 (212.49-447.19). Multiple regression low and high animal food subsets' (animal foods mean=147.09 KC/d versus animal foods mean=482.00 KC/d) formulas each with 28 dietary and non-dietary risk factors (independent variables) accounted for 52.53% and 28.83% of their respective total formula PAR%s with NCDs (dependent variable). Conclusions GBD data modeling supported many but not all the PHD dietary recommendations. GBD data suggested that the amount of consumption of animal foods was the dominant determinate of NCDs of countries globally. Adding to the univariate associations, multiple regression risk factor formulas with risk factor coefficients equated to their PAR%s further elucidated dietary influences on NCDs. This paper and the soon-to-be-released IHME GBD2021 (1990-2021) data should help inform the EAT-Lancet 2.0 Commission's work.
背景 本文旨在比较《柳叶刀 - 饮食与健康委员会》的“行星健康饮食”（PHD）与健康指标与评估研究所（IHME）的《1990 - 2017年全球疾病负担研究》（GBD2017）中的饮食及其他风险因素数据。在PHD/GBD比较中，我们还旨在展示一种新的多元回归分析方法与饮食和非饮食风险因素（自变量）对于1990年至2017年15 - 69岁男性和女性非传染性疾病（NCD）死亡率/10万/年（NCDs，因变量）的相关性。方法 我们对全球1120个队列的GBD2017饮食风险因素和NCD数据进行格式化处理，以获得7846个人口加权队列。每个队列代表约100万人，总计来自195个国家的约78亿人。通过一种经验推导的方法，我们将PHD中动物和植物源性食物的推荐范围（千卡/天 = KC/d）与GBD队列数据中的最佳饮食范围（KC/d）进行比较。利用动物食物消费量低和高的GBD数据子集，我们新的GBD多元回归公式推导方法将风险因素公式系数等同于其人群归因风险百分比（PAR%s）。结果 我们将PHD针对14种可用饮食风险因素的建议（KC/d均值和范围）与我们的GBD分析方法针对每个饮食变量的最佳范围（KC/d均值和范围）进行对比：PHD牛肉、羊肉和猪肉均值：30 KC/d（范围：0 - 60 KC/d）/GBD加工肉类：8.86（1.69 - 16.03）+ GBD红肉：44.52（20.37 - 68.68），PHD鱼类：40（0 - 143）/GBD：19.68（3.45 - 35.90），PHD全脂牛奶或等同物：153（0 - 306）/GBD：40.00（18.89 - 61.11），PHD家禽：62（0 - 124）/GBD：56.10（24.13 - 88.07），PHD鸡蛋：19（0 - 37）/GBD：19.42（9.99 - 28.86），PHD：饱和油96（0 - 96）/GBD添加饱和脂肪酸（SFA）：116.55（104.04 - 129.07），PHD所有添加糖：120（0 - 120）/GBD含糖饮料：286.37（256.99 - 315.76），PHD块茎或淀粉类蔬菜：39（0 - 78）/GBD土豆：84.16（75.75 - 92.58）+ GBD红薯：9.21（4.05 - 14.37），PHD水果：126（63 - 189）/GBD：63.03（21.61 - 113.71），PHD蔬菜：78.32（9.48 - 196.14）/GBD：85.05（66.75 - 103.36），PHD坚果：291（0 - 437）/GBD坚果和种子：10.97（5.95 - 15.98），PHD全谷物：811（811/811）/GBD：56.14（50.53 - 61.76），PHD豆类：284（0 - 379）/GBD：59.93（45.43 - 74.43），以及PHD总动物食物：（0/400）/GBD：329.84（212.49 - 447.19）。动物食物量低和高的多元回归子集（动物食物均值 = 147.09 KC/d与动物食物均值 = 482.00 KC/d）的公式，每个公式包含28个饮食和非饮食风险因素（自变量），分别占其各自含NCDs（因变量）的总公式PAR%s的52.53%和28.83%。结论 GBD数据建模支持了许多但并非所有的PHD饮食建议。GBD数据表明，动物食物的消费量是全球各国非传染性疾病的主要决定因素。除了单变量关联外，风险因素系数等同于其PAR%s的多元回归风险因素公式进一步阐明了饮食对非传染性疾病的影响。本文以及即将发布的IHME GBD2021（1990 - 2021）数据应有助于为《柳叶刀 - 饮食与健康委员会2.0》的工作提供信息。
