Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in US Adults
Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in US Adults
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DOI：
10.1016/j.jacc.2017.05.047
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发表时间：
2017-07-25
影响因子：
24
通讯作者：
Hu, Frank B.
中科院分区：
文献类型：
--
作者：
Satija, Ambika;Bhupathiraju, Shilpa N.;Hu, Frank B.
背景技术推荐以植物为基础的饮食来预防冠心病(CHD)。然而，并非所有植物性食品都一定有益于健康。 目的 本研究旨在探讨植物性饮食指数与 CHD 发病率之间的关联。 方法 我们纳入了 NHS（护士健康研究）（1984 年至 2012 年）中的 73,710 名女性、NHS2（1991 年至 2013 年）中的 92,329 名女性以及卫生专业人员随访研究中的 43,259 名男性（1986年至2012年），基线时无慢性病。我们根据重复的半定量食物频率问卷数据创建了一个整体植物性饮食指数（PDI），为植物性食品分配正分，为动物性食品分配反向分数。我们还创建了一个健康的植物性饮食指数 (hPDI)，其中健康的植物性食品（全谷物、水果/蔬菜、坚果/豆类、油、茶/咖啡）获得正分，而不太健康的植物性食品（果汁/含糖饮料、精制谷物、土豆/薯条、糖果）和动物性食品获得相反的分数。为了创建不健康的 PDI (uPDI)，我们对不太健康的植物性食品给予正分，对动物和健康的植物性食品给予反向评分。 结果 在超过 4,833,042 人年的随访中，我们记录了 8,631 起 CHD 病例。在汇总多变量分析中，较高的 PDI 依从性与 CHD 独立呈负相关（比较极端十分位数的风险比 [HR]：0.92；95% 置信区间 [CI]：0.83 至 1.01；p 趋势 = 0.003）。 hDPI 的这种负相关性更强（HR：0.75；95% CI：0.68 至 0.83；p 趋势 < 0.001）。相反，uPDI 与 CHD 呈正相关（HR：1.32；95% CI：1.20 至 1.46；p 趋势 < 0.001）。 结论 富含健康植物性食品的植物性饮食指数摄入量较高与 CHD 风险显着降低相关，而强调不太健康植物性食品的植物性饮食指数与较高的 CHD 风险相关。 (C) 2017 年，美国心脏病学会基金会。
BACKGROUND Plant-based diets are recommended for coronary heart disease (CHD) prevention. However, not all plant foods are necessarily beneficial for health.OBJECTIVES This study sought to examine associations between plant-based diet indices and CHD incidence.METHODS We included 73,710 women in NHS (Nurses' Health Study) (1984 to 2012), 92,329 women in NHS2 (1991 to 2013), and 43,259 men in Health Professionals Follow-up Study (1986 to 2012), free of chronic diseases at baseline. We created an overall plant-based diet index (PDI) from repeated semiquantitative food-frequency questionnaire data, by assigning positive scores to plant foods and reverse scores to animal foods. We also created a healthful plant-based diet index (hPDI) where healthy plant foods (whole grains, fruits/vegetables, nuts/legumes, oils, tea/coffee) received positive scores, whereas less-healthy plant foods (juices/sweetened beverages, refined grains, potatoes/fries, sweets) and animal foods received reverse scores. To create an unhealthful PDI (uPDI), we gave positive scores to less-healthy plant foods and reverse scores to animal and healthy plant foods.RESULTS Over 4,833,042 person-years of follow-up, we documented 8,631 incident CHD cases. In pooled multivariable analysis, higher adherence to PDI was independently inversely associated with CHD (hazard ratio [HR] comparing extreme deciles: 0.92; 95% confidence interval [CI]: 0.83 to 1.01; p trend = 0.003). This inverse association was stronger for hDPI (HR: 0.75; 95% CI: 0.68 to 0.83; p trend < 0.001). Conversely, uPDI was positively associated with CHD (HR: 1.32; 95% CI: 1.20 to 1.46; p trend < 0.001).CONCLUSIONS Higher intake of a plant-based diet index rich in healthier plant foods is associated with substantially lower CHD risk, whereas a plant-based diet index that emphasizes less-healthy plant foods is associated with higher CHD risk. (C) 2017 by the American College of Cardiology Foundation.