全球健康饮食指数的时间趋势及其与心血管、肾脏和代谢疾病的关联：基于全球和个体视角的综合分析

Temporal trends in the planetary health diet index and its association with cardiovascular, kidney, and metabolic diseases: A comprehensive analysis from global and individual perspectives.

作者信息

Tang Haoxian, Zhang Xuan, Luo Nan, Huang Jingtao, Yang Qinglong, Lin Hanyuan, Lin Mengyue, Wu Shiwan, Wen Jiasheng, Hong Jianan, Chen Pan, Jiang Liwen, Chen Yequn, Tan Xuerui

机构信息

Shantou University Medical College, Shantou, Guangdong, China; Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.

Shantou University Medical College, Shantou, Guangdong, China; Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.

出版信息

J Nutr Health Aging. 2025 May;29(5):100520. doi: 10.1016/j.jnha.2025.100520. Epub 2025 Feb 21.

DOI:10.1016/j.jnha.2025.100520

PMID:39985957

Abstract

BACKGROUND

Diet plays a critical role in human health and environmental sustainability, particularly in cardiovascular, kidney, and metabolic (CKM) diseases. However, the variations in the Planetary Health Diet Index (PHDI) across populations, regions, and over time, as well as its association with CKM disease burdens, remain insufficiently explored.

METHODS

We assessed PHDI scores using data from 185 countries (1990-2018) from the Global Dietary Database, examining demographic characteristics and temporal trends. The Global Burden of Disease Study was used to evaluate the associations between PHDI and CKM disease burdens, including incidence, prevalence, mortality, and disability-adjusted life years. CKM syndrome was defined by the American Heart Association. Individual-level data from the National Health and Nutrition Examination Survey (NHANES) were also used to assess the impact of PHDI on CKM risks and mortality.

RESULTS

From 1990 to 2018, while overall PHDI scores remained relatively stable between sexes, the composition of PHDI scores shifted across different age groups. In 2018, the mean PHDI score was 42.80 (95% uncertainty interval [UI] 42.49-46.50) for males and 44.65 (95% UI 44.53-47.82) for females. Higher PHDI scores were observed among females, older adults, urban residents, individuals with higher education, and those from South Asia. Globally, consumption of red/processed meat, saturated oils/trans fats, and added sugars substantially exceeded the EAT-Lancet Commission's reference values. Higher PHDI scores were generally associated with lower CKM disease burdens, although these associations varied by disease subtype. In individual-level analysis, including 45,460 NHANES participants (weighted mean age: 47.21 years, 51.4% female), each 10-point increase in PHDI was linked to a 13.7% reduction in stage 3/4 CKM syndrome risk, an 11.1% reduction in stage 4 CKM syndrome risk, and lower incidences and mortality rates for cardiovascular diseases, metabolic diseases, and chronic kidney disease.

CONCLUSIONS

From 1990 to 2018, significant changes occurred in the components of the PHDI, with notable variations by demographics and region. Higher PHDI scores may reduce CKM disease burdens, warranting further investigation into specific disease subtypes.

摘要

背景

饮食在人类健康和环境可持续性方面起着关键作用，尤其是在心血管、肾脏和代谢（CKM）疾病方面。然而，全球健康饮食指数（PHDI）在不同人群、地区以及不同时间的变化，及其与CKM疾病负担的关联，仍未得到充分研究。

方法

我们使用全球饮食数据库中185个国家（1990 - 2018年）的数据评估PHDI得分，研究人口统计学特征和时间趋势。全球疾病负担研究用于评估PHDI与CKM疾病负担之间的关联，包括发病率、患病率、死亡率和伤残调整生命年。CKM综合征由美国心脏协会定义。来自美国国家健康和营养检查调查（NHANES）的个体层面数据也用于评估PHDI对CKM风险和死亡率的影响。

结果

从1990年到2018年，虽然总体PHDI得分在性别之间保持相对稳定，但PHDI得分的构成在不同年龄组之间发生了变化。2018年，男性的平均PHDI得分为42.80（95%不确定区间[UI] 42.49 - 46.50），女性为44.65（95% UI 44.53 - 47.82）。在女性、老年人、城市居民、受过高等教育的人群以及来自南亚的人群中观察到较高的PHDI得分。在全球范围内，红肉/加工肉、饱和油/反式脂肪和添加糖的消费量大大超过了《柳叶刀》委员会的参考值。较高的PHDI得分通常与较低的CKM疾病负担相关，尽管这些关联因疾病亚型而异。在个体层面分析中，包括45460名NHANES参与者（加权平均年龄：47.21岁，51.4%为女性），PHDI每增加10分，3/4期CKM综合征风险降低13.7%，4期CKM综合征风险降低11.1%，心血管疾病、代谢疾病和慢性肾脏病的发病率和死亡率也降低。