Protein foods from animal sources, incident cardiovascular disease and all-cause mortality: a substitution analysis.
Protein foods from animal sources, incident cardiovascular disease and all-cause mortality: a substitution analysis.
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动物源性蛋白质食品、心血管疾病事件和全因死亡率：替代分析。
DOI：
10.1093/ije/dyaa205
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发表时间：
2021
影响因子：
7.7
通讯作者：
VanHorn,Linda
中科院分区：
文献类型：
--
作者：
Zhong,VictorW;Allen,NorrinaB;Greenland,Philip;Carnethon,MercedesR;Ning,Hongyan;Wilkins,JohnT;Lloyd-Jones,DonaldM;VanHorn,Linda
背景富含蛋白质的食物是人类饮食的主要组成部分，并且在营养成分和健康影响方面具有高度异质性。设计用于疾病预防的健康饮食需要仔细考虑用更健康的蛋白质食品替代不健康的蛋白质食品。方法这是对 29,682 名美国参与者的六项前瞻性队列研究进行的汇总分析。数据收集于 1985 年至 2016 年。调整后的风险比 (HR) 和 30 年绝对风险差 (ARD) 计算了同时用不同数量的其他动物或植物蛋白食品替代一种或多种动物蛋白食品与心血管疾病 (CVD) 事件和全因死亡率之间的关联。结果用坚果、全谷物、豆类或鱼类替代鸡蛋、加工肉类、未加工的红肉或家禽与较低的 CVD 事件和全因死亡率风险相关。根据不同的替代量（从每周一份到每天一份）和同时替代的蛋白质食物的不同数量（从一份到四份不等），估计范围在 1%：HR，0.99 [95% 置信区间 (CI)，0.98–1.00] 和 54%：HR，0.46 (0.35–0.60) 之间，相对范围内的风险较低，在 0.3% 之间：ARD， -0.29%（-0.48%至-0.05%）和14.0%：ARD，-13.96%（-17.29%至-9.96%）绝对风险较低。结论坚果、全谷物、豆类和鱼类似乎是比鸡蛋、加工肉类、未加工红肉和家禽更健康的蛋白质来源，可预防心血管疾病和过早死亡。 CVD 事件和全因死亡率风险降低的幅度是由动物蛋白食品替代量和数量决定的。
BackgroundProtein-rich foods are major parts of the human diet and are highly heterogeneous in nutrient composition and health effects. Designing healthy diets for disease prevention requires careful consideration of substituting unhealthier protein foods with healthier protein foods.MethodsThis was a pooled analysis of six prospective cohort studies of 29 682 US participants. Data were collected in 1985–2016. Adjusted hazard ratios (HRs) and 30-year absolute risk differences (ARDs) were calculated for the associations between simultaneous substitution of one or more animal protein foods with other animal or plant protein foods at various amounts, and incident cardiovascular disease (CVD) and all-cause mortality.ResultsSubstituting eggs, processed meat, unprocessed red meat or poultry with nuts, whole grains, legumes or fish was associated with lower risks of incident CVD and all-cause mortality. According to different substitution amounts (varying from one serving per week to one serving per day) and different numbers of protein foods being simultaneously substituted (varying from one to four), estimates ranged between 1%: HR, 0.99 [95% confidence interval (CI), 0.98–1.00], and 54%: HR, 0.46 (0.35–0.60), lower risks on the relative scale and between 0.3%: ARD, -0.29% (-0.48% to -0.05%), and 14.0%: ARD, -13.96% (-17.29% to -9.96%) lower risks on the absolute scale.ConclusionsNuts, whole grains, legumes and fish appeared to be healthier protein sources than eggs, processed meat, unprocessed red meat and poultry for preventing incident CVD and premature death. The magnitude of lower risk for incident CVD and all-cause mortality was driven by amount and number of animal protein foods substituted.