Dietary patterns and the risk of CVD and all-cause mortality in older British men
Dietary patterns and the risk of CVD and all-cause mortality in older British men
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DOI：
10.1017/s0007114516003147
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发表时间：
2016-10-01
影响因子：
3.6
通讯作者：
Wannamethee, S. Goya
中科院分区：
文献类型：
--
作者：
Atkins, Janice L.;Whincup, Peter H.;Wannamethee, S. Goya
饮食模式是心血管疾病发病率和死亡率的主要危险因素;然而，很少有研究在老年人中研究这种关系。我们研究了来自英国区域心脏研究的3226名年龄在60-79岁的英国老年男性的饮食模式与CVD风险和全因死亡率之间的前瞻性关联，这些老年男性在基线时没有CVD。基线FFQ数据用于生成34个食物组。主成分分析确定的饮食模式，分为四分位数，与较高的四分位数代表较高的坚持饮食模式。考克斯比例风险检验了饮食模式与全因死亡率和心血管结局风险之间的关系。我们确定了三种可解释的饮食模式：“高脂肪/低纤维”（红肉、肉制品、白色面包、炸土豆、鸡蛋含量高）、“谨慎”（家禽、鱼、水果、蔬菜、豆类、意大利面、大米、全麦面包、鸡蛋、橄榄油含量高）和“高糖”（饼干、布丁、巧克力、糖果、甜果酱、早餐谷物含量高）。在11年的随访中，发生了899例死亡，316例心血管疾病相关死亡，569例心血管疾病事件和301例冠心病事件。调整混杂因素后，“高脂肪/低纤维”饮食模式仅与全因死亡风险增加相关（最高与最低四分位数;风险比1.44; 95%CI 1.13，1.84）。坚持“高糖”饮食与CVD和CHD事件风险增加的边缘显著趋势相关。“谨慎”饮食并没有显示出心血管结局或死亡率的显著趋势。避免“高脂肪/低纤维”和“高糖”饮食成分可能会降低老年人心血管事件和全因死亡率的风险。
Dietary patterns are a major risk factor for cardiovascular morbidity and mortality; however, few studies have examined this relationship in older adults. We examined prospective associations between dietary patterns and the risk of CVD and all-cause mortality in 3226 older British men, aged 60-79 years and free from CVD at baseline, from the British Regional Heart Study. Baseline FFQ data were used to generate thirty-four food groups. Principal component analysis identified dietary patterns that were categorised into quartiles, with higher quartiles representing higher adherence to the dietary pattern. Cox proportional hazards examined associations between dietary patterns and risk of all-cause mortality and cardiovascular outcomes. We identified three interpretable dietary patterns: 'high fat/low fibre' (high in red meat, meat products, white bread, fried potato, eggs), 'prudent' (high in poultry, fish, fruits, vegetables, legumes, pasta, rice, wholemeal bread, eggs, olive oil) and 'high sugar' (high in biscuits, puddings, chocolates, sweets, sweet spreads, breakfast cereals). During 11 years of follow-up, 899 deaths, 316 CVD-related deaths, 569 CVD events and 301 CHD events occurred. The 'high-fat/low-fibre' dietary pattern was associated with an increased risk of all-cause mortality only, after adjustment for confounders (highest v. lowest quartile; hazard ratio 1.44; 95% CI 1.13, 1.84). Adherence to a 'high-sugar' diet was associated with a borderline significant trend for an increased risk of CVD and CHD events. The 'prudent' diet did not show a significant trend with cardiovascular outcomes or mortality. Avoiding 'high-fat/low-fibre' and 'high-sugar' dietary components may reduce the risk of cardiovascular events and all-cause mortality in older adults.