健康饮食模式通过降低低度炎症与降低炎症性肠病风险相关：一项大型前瞻性队列研究的证据
Healthy eating patterns associated with reduced risk of inflammatory bowel disease by lowering low-grade inflammation: evidence from a large prospective cohort study.
作者信息
Xia Bin, Li Yan, Hu Linmin, Xie Peng, Mi Ningning, Lv Liyuan, Liang Zixin, Sun Yuxuan, Li Ying, Jiang Xiaodong, Liu Guinan, Feng Yuanyuan, Zhu Yingxin, Zhan Bo, He Qiangsheng, Lei Pingguang, Qi Jian, Wang Pengpeng, Yuan Jinqiu
机构信息
Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, 518107, China.
Chinese Health Risk Management Collaboration (CHRIMAC), Shenzhen, Guangdong, China.
出版信息
BMC Med. 2024 Dec 18;22(1):589. doi: 10.1186/s12916-024-03809-x.
BACKGROUND
Limited epidemiological evidence exists regarding the role of healthy eating patterns in reducing the risk of Crohn's disease (CD) and ulcerative colitis (UC). This study aimed to investigate the association between adherence to four established healthy eating patterns and subsequent CD or UC risk, and further examined whether these associations are linked to anti-inflammatory mechanisms.
METHODS
We conducted a prospective cohort study of 197,391 participants from the UK Biobank who completed at least one dietary questionnaire and were free from inflammatory bowel disease or cancer at baseline. Four dietary patterns were assessed, including Alternate Mediterranean Diet (AMED), Healthy Eating Index 2015 (HEI-2015), Healthful Plant-based Diet Index (HPDI), and EAT-Lancet. Cox proportional models with restricted cubic splines were applied to explore the associations. The potential role of low-grade inflammation in these associations was examined through mediation analysis.
RESULTS
During 2,193,436 person-years follow-up, 260 CD and 601 UC cases were identified. Higher AMED and HEI-2015 scores were associated with a reduced risk of CD but no UC, with no evidence against nonlinearity. These associations remained consistent across multiple sensitive and subgroup analyses. For dietary components, the fruits and monounsaturated fatty acids: saturated fatty acids ratio in AMED, and total fruits, total protein foods and fatty acid in HEI-2015 were linked to a decreased CD risk. Both diets were also associated with lower plasma inflammation biomarkers. Mediation analysis indicated that 7.66% and 13.40% of the reductions in CD risk attributed to AMED and HEI-2015 diets, respectively, were mediated by low-grade inflammation scores.
CONCLUSIONS
Higher adherence to AMED and HEI-2015 might significantly reduce CD risk, partly due to their anti-inflammatory properties.
背景
关于健康饮食模式在降低克罗恩病（CD）和溃疡性结肠炎（UC）风险方面的作用，流行病学证据有限。本研究旨在调查坚持四种既定健康饮食模式与后续患CD或UC风险之间的关联，并进一步研究这些关联是否与抗炎机制有关。
方法
我们对英国生物银行的197,391名参与者进行了一项前瞻性队列研究，这些参与者至少完成了一份饮食问卷，且在基线时无炎症性肠病或癌症。评估了四种饮食模式，包括交替地中海饮食（AMED）、2015年健康饮食指数（HEI - 2015）、健康植物性饮食指数（HPDI）和EAT - Lancet饮食。应用带有受限立方样条的Cox比例模型来探索这些关联。通过中介分析研究了低度炎症在这些关联中的潜在作用。
结果
在2,193,436人年的随访期间，共确定了260例CD病例和601例UC病例。较高的AMED和HEI - 2015得分与CD风险降低相关，但与UC风险无关，且无证据表明存在非线性关系。这些关联在多个敏感性和亚组分析中保持一致。对于饮食成分，AMED中的水果和单不饱和脂肪酸与饱和脂肪酸的比例，以及HEI - 2015中的总水果、总蛋白质食物和脂肪酸与CD风险降低有关。两种饮食还与较低的血浆炎症生物标志物相关。中介分析表明，分别归因于AMED和HEI - 2015饮食的CD风险降低中，有7.66%和13.40%是由低度炎症得分介导的。
结论
更高程度地坚持AMED和HEI - 2015可能会显著降低CD风险，部分原因是它们的抗炎特性。
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