EPIC-Oxford: benefits and risks of plant-based diets

植物性饮食，包括很少或不包括来自动物来源的食物，可能对健康和环境都有好处。现有证据支持这种饮食在减少与饮食有关的温室气体排放和其他环境影响方面具有实质性优势，但对健康的证据很少，可能既有益处也有风险。例如，植物性饮食所特有的低饱和脂肪摄入量和高纤维摄入量可能会降低患某些心血管和胃肠道疾病的风险，但高质量蛋白质、一些维生素和钙的低摄入量可能会增加患某些类型的中风和骨折等疾病的风险。为了解决这一证据上的差距，我们的目标是加强和扩展英国一项成熟的纵向人口研究，为研究植物性饮食的健康益处和风险建立世界上最翔实的资源。EPIC-Oxford队列研究有65000名参与者，他们生活在英国各地，该研究于30年前开始招募，目标是对素食者进行抽样，50%的参与者不吃肉。这个资源有关于饮食的详细信息，一个大型生物库（收集储存的血液样本），以及与所有医院入院、癌症诊断和死亡的NHS数据集的全面联系，使其在世界上独一无二的研究植物性饮食对健康的长期影响。我们的目标是通过对所有幸存的参与者进行重新调查来增强现有资源，并通过招募8万名新参与者来扩大现有资源，以增加统计能力和遵循接近100%植物性饮食（即纯素食，或任何动物产品的摄入量非常低）的人数，以及改善资源的种族多样性。我们还将扩大生物库，根据饮食组、年龄、性别和种族，再从5000名参与者中收集血液样本，以进一步研究植物性饮食对身体功能的影响。我们已经完成了一项试点研究，招募了6000名新参与者，其中3000人是植物性的，这证明了我们基于互联网的招募方法的成功和成本效益，并使我们能够完善我们的饮食问卷，并获得这些人的食物和营养摄入量的最新信息。为了使提议的新EPIC-Oxford资源广泛访问，我们将把我们收集的饮食和生活方式数据转移到英国纵向联系联盟（UK LLC）可信的研究环境。然后，英国有限责任公司将扩展链接到所有NHS数据集，提供英国各地参与者诊断出的疾病和病症的详细信息，并管理对其他研究人员分析资源的访问。通过创建这一资源，这项研究将首次提供强有力的证据，证明植物性饮食的长期益处和风险，以及确定的任何风险是否可以减轻。

Plant-based diets, which include little or no food from animal sources, might have benefits for both health and the environment. The available evidence supports substantial advantages for such diets in reducing diet-related greenhouse gas emissions and other environmental impacts, but the evidence for health is sparse and there may be both benefits and risks. For example, the low intakes of saturated fat and high intakes of fibre characteristic of plant-based diets may reduce risks for some cardiovascular and gastrointestinal diseases, but the low intakes of high quality protein, some vitamins and calcium might increase risks for conditions such as some types of stroke, and bone fractures. To address this gap in the evidence we aim to enhance and extend a mature longitudinal population study in the UK to establish the world's most informative resource for studying the health benefits and risks of plant-based diets. The EPIC-Oxford cohort, which has 65,000 participants living throughout the UK, was initiated 30 years ago with recruitment targeted to oversample people following vegetarian diets, and 50% of the participants do not eat meat. This resource has detailed information on diet, a large biobank (collection of stored blood samples), and comprehensive linkage to NHS datasets on all hospital admissions, cancer diagnoses and deaths, making it unique in the world for research on the long-term health impacts of plant-based diets. We aim to enhance the existing resource by a resurvey of all surviving participants, and to extend it by recruitment of 80,000 new participants to increase statistical power and the number of people following close to 100% plant-based diets (i.e. vegan, or very low intakes of any animal products), as well as to improve the ethnic diversity of the resource. We will also extend the biobank, collecting blood samples from a further 5,000 participants selected with regard to diet group, age, gender and ethnicity, to enable further research on the impacts of plant-based diets on the functioning of the body. We have completed a pilot study recruiting 6,000 new participants, 3,000 plant-based, which has demonstrated the success and cost-effectiveness of our internet-based recruitment method, and allowed us to refine our dietary questionnaire and obtain up-to-date information on the food and nutrient intakes of these people. To make the proposed new EPIC-Oxford resource widely accessible, we will transfer the data we collect on diet and lifestyle to the UK Longitudinal Linkage Consortium (UK LLC) trusted research environment. The UK LLC will then extend the linkage to all NHS datasets providing details of diseases and conditions diagnosed in participants throughout the UK, and manage access to the resource for analyses by other researchers. The research made possible by creating this resource will provide, for the first time, robust evidence on the long-term benefits and risks of plant-based diets, and on whether any risks identified can be mitigated.