Mortality in vegetarians and comparable nonvegetarians in the United Kingdom.
Mortality in vegetarians and comparable nonvegetarians in the United Kingdom.
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DOI：
10.3945/ajcn.115.119461
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发表时间：
2016-01
期刊：
影响因子：
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通讯作者：
Key TJ
中科院分区：
文献类型：
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作者：
Appleby PN;Crowe FL;Bradbury KE;Travis RC;Key TJ
背景：素食者和其他不吃肉的人被观察到比吃肉的人在一些慢性病上的发病率更低，但尚不清楚这是否转化为更低的死亡率。目的：这项研究的目的是描述英国大规模队列中素食者和可比非素食者的死亡率。设计：该研究对两项前瞻性研究的数据进行了汇总分析，包括60,310名居住在英国的人，包括18,431名经常吃肉的人(他们平均每周吃5次肉≥)，13,039名低肉食者(不经常吃肉)，8,516名吃鱼的人(吃鱼而不吃肉)，以及20,324名素食者(包括2228名不吃任何动物性食物的素食主义者)。使用COX比例风险模型估计了18种常见死因中每种常见死因按饮食分组的死亡率。结果：在100万年的随访期中，有5294例患者在90岁之前死亡。总体(全因)死亡率在节食组之间无显著差异：低肉食者、鱼食者和素食者与正常肉食者相比，小时比分别为0.93(95%CI：0.86，1.00)、0.96(95%CI：0.86，1.06)和1.02(95%CI：0.94，1.1)；风险的P-异质性=0.082。与经常吃肉的人相比，死于循环系统疾病的风险有显著差异[吃鱼的人更高(HR：1.22；95%CI：1.02，1.46)]；恶性肿瘤[吃鱼的人更低(HR：0.82；95%CI：0.70，0.97)]，包括胰腺癌[少吃肉的人和素食者更低(HR：0.55；95%CI：0.36，0.86和HR：0.48；[95%CI：0.28，0.82]和淋巴/造血组织癌[在素食者中较低(HR：0.50；95%CI：0.32，0.79)]；呼吸系统疾病[在低肉食者中较低(HR：0.70；95%CI：0.53，0.92)]；以及所有其他原因[在低肉食者中较低(HR：0.74；95%CI：0.56，0.99)]。对体重指数的进一步调整使这些关联基本保持不变。结论：英国的素食者和类似的非素食者的全因死亡率相似。在具体死因方面发现的差异值得进一步调查。
Background: Vegetarians and others who do not eat meat have been observed to have lower incidence rates than meat eaters of some chronic diseases, but it is unclear whether this translates into lower mortality. Objective: The purpose of this study was to describe mortality in vegetarians and comparable nonvegetarians in a large United Kingdom cohort. Design: The study involved a pooled analysis of data from 2 prospective studies that included 60,310 persons living in the United Kingdom, comprising 18,431 regular meat eaters (who ate meat ≥5 times/wk on average), 13,039 low (less-frequent) meat eaters, 8516 fish eaters (who ate fish but not meat), and 20,324 vegetarians (including 2228 vegans who did not eat any animal foods). Mortality by diet group for each of 18 common causes of death was estimated with the use of Cox proportional hazards models. Results: There were 5294 deaths before age 90 in >1 million y of follow-up. There was no significant difference in overall (all-cause) mortality between the diet groups: HRs in low meat eaters, fish eaters, and vegetarians compared with regular meat eaters were 0.93 (95% CI: 0.86, 1.00), 0.96 (95% CI: 0.86, 1.06), and 1.02 (95% CI: 0.94, 1.10), respectively; P-heterogeneity of risks = 0.082. There were significant differences in risk compared with regular meat eaters for deaths from circulatory disease [higher in fish eaters (HR: 1.22; 95% CI: 1.02, 1.46)]; malignant cancer [lower in fish eaters (HR: 0.82; 95% CI: 0.70, 0.97)], including pancreatic cancer [lower in low meat eaters and vegetarians (HR: 0.55; 95% CI: 0.36, 0.86 and HR: 0.48; 95% CI: 0.28, 0.82, respectively)] and cancers of the lymphatic/hematopoietic tissue [lower in vegetarians (HR: 0.50; 95% CI: 0.32, 0.79)]; respiratory disease [lower in low meat eaters (HR: 0.70; 95% CI: 0.53, 0.92)]; and all other causes [lower in low meat eaters (HR: 0.74; 95% CI: 0.56, 0.99)]. Further adjustment for body mass index left these associations largely unchanged. Conclusions: United Kingdom–based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation.