Adherence to a Healthy Diet According to the World Health Organization Guidelines and All-Cause Mortality in Elderly Adults From Europe and the United States
Adherence to a Healthy Diet According to the World Health Organization Guidelines and All-Cause Mortality in Elderly Adults From Europe and the United States
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DOI：
10.1093/aje/kwu229
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发表时间：
2014-11-15
影响因子：
5
通讯作者：
Feskens, Edith J.
中科院分区：
文献类型：
--
作者：
Jankovic, Nicole;Geelen, Anouk;Feskens, Edith J.
世界卫生组织（WHO）制定了健康饮食指南，以在全球范围内预防慢性病和推迟死亡。我们的目的是调查使用健康饮食指标（HDI）衡量的世卫组织指南与欧洲和美国老年男性和女性全因死亡率之间的关系。我们分析了11项前瞻性队列研究的396,391名参与者（42%为女性）的数据，这些参与者入组时年龄在60岁或以上（1988-2005年）。人类发展指数评分基于6种营养素和1种食物组，范围从0（最不健康的饮食）到70（最健康的饮食）。调整后的队列特定风险比通过Cox比例风险回归得出，随后使用随机效应荟萃分析进行汇总。在4,497,957人年的随访期间，发生了84,978例死亡。在队列中，HDI得分中位数从40到54分不等。对于HDI评分增加10点（代表遵守额外的世卫组织指南），男性和女性合并的合并调整风险比为0.90(95%置信区间（CI）： 0.87, 0.93)，男性为0.89 (95% CI: 0.85, 0.92)，女性为0.90 （95% CI: 0.85, 0.95）。这些估计转化为在60岁时预期寿命增加2年。在欧洲和美国，更严格地遵守世卫组织指南与老年男性和女性的寿命延长有关。
The World Health Organization (WHO) has formulated guidelines for a healthy diet to prevent chronic diseases and postpone death worldwide. Our objective was to investigate the association between the WHO guidelines, measured using the Healthy Diet Indicator (HDI), and all-cause mortality in elderly men and women from Europe and the United States. We analyzed data from 396,391 participants (42% women) in 11 prospective cohort studies who were 60 years of age or older at enrollment (in 1988-2005). HDI scores were based on 6 nutrients and 1 food group and ranged from 0 (least healthy diet) to 70 (healthiest diet). Adjusted cohort-specific hazard ratios were derived by using Cox proportional hazards regression and subsequently pooled using random-effects meta-analysis. During 4,497,957 person-years of follow-up, 84,978 deaths occurred. Median HDI scores ranged from 40 to 54 points across cohorts. For a 10-point increase in HDI score (representing adherence to an additional WHO guideline), the pooled adjusted hazard ratios were 0.90 (95% confidence interval (CI): 0.87, 0.93) for men and women combined, 0.89 (95% CI: 0.85, 0.92) for men, and 0.90 (95% CI: 0.85, 0.95) for women. These estimates translate to an increased life expectancy of 2 years at the age of 60 years. Greater adherence to the WHO guidelines is associated with greater longevity in elderly men and women in Europe and the United States.