85545 名澳大利亚老年人饮食质量和身体活动与心血管疾病和死亡率的关系：一项纵向研究。
The association of diet quality and physical activity with cardiovascular disease and mortality in 85,545 older Australians: A longitudinal study.
机构信息
Sydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006, Australia; Charles Perkins Centre, the University of Sydney, Camperdown, NSW 2006, Australia.
Sydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006, Australia; Sydney Local Health District, Camperdown, NSW 2050, Australia.
出版信息
J Sport Health Sci. 2024 Nov;13(6):841-850. doi: 10.1016/j.jshs.2024.05.011. Epub 2024 May 28.
BACKGROUND
A quality diet and an active lifestyle are both important cornerstones of cardiovascular disease (CVD) prevention. However, despite their interlinked effects on metabolic health, the 2 behaviors are rarely considered jointly, particularly within the context of CVD prevention. We examined the independent, interactive, and joint associations of diet and physical activity with CVD hospitalization, CVD mortality, and all-cause mortality.
METHODS
CVD-free Australian participants aged 45-74 years (n = 85,545) reported physical activity, diet, sociodemographic, and lifestyle characteristics at baseline (2006-2009) and follow-up (2012-2015), and data were linked to hospitalization and death registries (03/31/2019 for CVD hospitalization and all-cause mortality and 12/08/2017 for CVD mortality). Diet quality was categorized as low, medium, and high based on meeting dietary recommendations. Physical activity was operationalized as (a) total moderate-to-vigorous physical activity (MVPA) as per guidelines, and (b) the composition of MVPA as the ratio of vigorous-intensity physical activity (VPA) to total MVPA. We used a left-truncated cause-specific Cox proportional hazards model using time-varying covariates.
RESULTS
During a median of 10.7 years of follow-up, 6576 participants were admitted to the hospital for CVD and 6581 died from all causes (876 from CVD during 9.3 years). A high-quality diet was associated with a 17% lower risk of all-cause mortality than a low-quality diet, and the highest MVPA category (compared with the lowest) was associated with a 44% and 48% lower risk of CVD and all-cause mortality, respectively. Multiplicative interactions between diet and physical activity were non-significant. For all outcomes, the lowest risk combinations involved a high-quality diet and the highest MVPA categories. Accounting for total MVPA, some VPA was associated with further risk reduction of CVD hospitalization and all-cause mortality.
CONCLUSION
For CVD prevention and longevity, one should adhere to both a healthy diet and an active lifestyle and incorporate some VPA when possible.
背景
健康饮食和积极生活方式都是预防心血管疾病（CVD）的重要基石。然而，尽管这两种行为对代谢健康有着相互关联的影响，但很少将它们同时考虑在内，特别是在 CVD 预防的背景下。我们研究了饮食和身体活动与 CVD 住院、CVD 死亡率和全因死亡率的独立、交互和联合关联。
方法
无 CVD 的澳大利亚参与者年龄在 45-74 岁之间（n=85545），在基线（2006-2009 年）和随访（2012-2015 年）时报告了身体活动、饮食、社会人口统计学和生活方式特征，并将数据与住院和死亡登记处（2019 年 3 月 31 日用于 CVD 住院和全因死亡率，2017 年 12 月 8 日用于 CVD 死亡率）相关联。根据饮食建议，饮食质量被分为低、中、高。身体活动被操作化为（a）按照指南进行的总中度至剧烈体力活动（MVPA），以及（b）MVPA 的组成，即剧烈强度体力活动（VPA）与总 MVPA 的比例。我们使用时间变化协变量的左截断特定原因 Cox 比例风险模型。
结果
在中位数为 10.7 年的随访期间，有 6576 名参与者因 CVD 住院，有 6581 名参与者死于各种原因（9.3 年内有 876 人死于 CVD）。高质量的饮食与低质量饮食相比，全因死亡率降低 17%，最高的 MVPA 类别（与最低类别相比）分别降低 CVD 和全因死亡率 44%和 48%。饮食和身体活动之间的乘法交互作用不显著。对于所有结果，风险最低的组合涉及高质量饮食和最高的 MVPA 类别。考虑到总 MVPA，一些 VPA 与进一步降低 CVD 住院和全因死亡率相关。
结论
为了预防 CVD 和长寿，人们应该坚持健康的饮食和积极的生活方式，并尽可能地融入一些 VPA。
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