Evaluation of Dietary Patterns and All-Cause Mortality: A Systematic Review.
Evaluation of Dietary Patterns and All-Cause Mortality: A Systematic Review.
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DOI：
10.1001/jamanetworkopen.2021.22277
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发表时间：
2021-08-02
影响因子：
13.8
通讯作者：
Heymsfield SB
中科院分区：
文献类型：
--
作者：
English LK;Ard JD;Bailey RL;Bates M;Bazzano LA;Boushey CJ;Brown C;Butera G;Callahan EH;de Jesus J;Mattes RD;Mayer-Davis EJ;Novotny R;Obbagy JE;Rahavi EB;Sabate J;Snetselaar LG;Stoody EE;Van Horn LV;Venkatramanan S;Heymsfield SB
饮食结构和全因死亡率之间有什么联系？在这项对1项随机临床试验和152项关于饮食模式和全因死亡率的观察性研究的系统综述中，有证据表明，成年人和老年人增加蔬菜、水果、豆类、坚果、全谷物、不饱和植物油、鱼和瘦肉或家禽(如果包括肉类)的消费与降低全因死亡率相关。这些健康模式包括相对较低的红肉和加工肉类、高脂肪乳制品和精制碳水化合物或糖果的摄入量。这篇综述发现，营养密集型食物的饮食模式与降低各种原因导致的死亡风险有关。2020年饮食指南咨询委员会对现有的饮食与健康研究进行了系统的审查，为当前的美国人饮食指南提供了信息。该委员会回答了这个公共卫生问题：饮食模式与全因死亡率(ACM)之间有什么联系？以确定饮食模式与ACM之间的联系。在委员会制定的分析框架和预定义的纳入和排除标准的指导下，美国农业部的营养证据系统审查(NESR)小组搜索了PubMed、Cochrane中央受控试验登记和Embase，并对结果进行了双重筛选，以确定在2000年1月1日至2019年10月4日发表的文章。这些研究评估了2岁及以上参与者的饮食模式和ACM。Nesr团队从纳入的研究中提取数据并评估偏倚风险。委员会成员综合证据，制定结论声明，并对支持结论声明的证据的强度进行分级。共有1项随机临床试验和152项观察性研究纳入综述。研究纳入了来自人类发展指数高或非常高的28个国家的成年人和老年人(基线年龄为17-84岁)；53项研究来自美国。大多数研究都设计得很好，使用了严格的方法，有低或中等的偏倚风险。精确度、直接性和概括性在整个证据中得到了证明。所有研究的结果都高度一致。有证据表明，成年人和老年人的饮食模式包括较高的蔬菜、水果、豆类、坚果、全谷物、不饱和植物油、鱼和瘦肉或家禽(如果包括肉类)的摄入量与ACM的风险降低相关。这些健康模式在红色和加工肉类、高脂肪乳制品和精制碳水化合物或糖果中也相对较低。其中一些饮食模式还包括适量摄入酒精饮料。基于带有混杂因素的附加分析的结果普遍证实了主要发现的稳健性。在这项系统性综述中，食用营养密集的饮食模式与降低各种原因导致的死亡风险有关。根据现有的饮食和营养研究，这篇系统性综述描述了与有益结果相关的食物、饮料和食物类别的组合。
What is the association between dietary patterns consumed and all-cause mortality? In this systematic review of 1 randomized clinical trial and 152 observational studies on dietary patterns and all-cause mortality, evidence demonstrated that dietary patterns characterized by increased consumption of vegetables, fruits, legumes, nuts, whole grains, unsaturated vegetable oils, fish, and lean meat or poultry (when meat was included) among adults and older adults were associated with decreased risk of all-cause mortality. These healthy patterns consisted of relatively low intake of red and processed meat, high-fat dairy, and refined carbohydrates or sweets. This review found that a dietary pattern with nutrient-dense foods was associated with reduced risk of death from all causes. The 2020 Dietary Guidelines Advisory Committee conducted a systematic review of existing research on diet and health to inform the current Dietary Guidelines for Americans. The committee answered this public health question: what is the association between dietary patterns consumed and all-cause mortality (ACM)? To ascertain the association between dietary patterns consumed and ACM. Guided by an analytical framework and predefined inclusion and exclusion criteria developed by the committee, the US Department of Agriculture’s Nutrition Evidence Systematic Review (NESR) team searched PubMed, the Cochrane Central Register of Controlled Trials, and Embase and dual-screened the results to identify articles that were published between January 1, 2000, and October 4, 2019. These studies evaluated dietary patterns and ACM in participants aged 2 years and older. The NESR team extracted data from and assessed risk of bias in included studies. Committee members synthesized the evidence, developed conclusion statements, and graded the strength of the evidence supporting the conclusion statements. A total of 1 randomized clinical trial and 152 observational studies were included in the review. Studies enrolled adults and older adults (aged 17-84 years at baseline) from 28 countries with high or very high Human Development Index; 53 studies originated from the US. Most studies were well designed, used rigorous methods, and had low or moderate risks of bias. Precision, directness, and generalizability were demonstrated across the body of evidence. Results across studies were highly consistent. Evidence suggested that dietary patterns in adults and older adults that involved higher consumption of vegetables, fruits, legumes, nuts, whole grains, unsaturated vegetable oils, fish, and lean meat or poultry (when meat was included) were associated with a decreased risk of ACM. These healthy patterns were also relatively low in red and processed meat, high-fat dairy, and refined carbohydrates or sweets. Some of these dietary patterns also included intake of alcoholic beverages in moderation. Results based on additional analyses with confounding factors generally confirmed the robustness of main findings. In this systematic review, consuming a nutrient-dense dietary pattern was associated with reduced risk of death from all causes. This systematic review describes the combinations of foods, beverages, and food groups that were associated with beneficial outcomes, according to existing research on diet and nutrition.
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