目标:非传染性慢性疾病(NCDs),如肥胖,2型糖尿病,心脏病,在传统饮食和生活方式的非西方人群中,癌症很少见。随着人口向工业化饮食和生活方式过渡,非传染性疾病发展。
目的:我们进行了系统的文献综述,以研究饮食和生活方式转变对非传染性疾病的影响。
方法:我们确定了22个经历了营养转变的人群,其中11个有足够的数据。其中,我们选择了四个不同地理位置的人口,饮食和生活方式经历了饮食和生活方式的转变,并探讨了饮食变化与健康结果之间的关系。我们排除了特征与选定人群重叠或数据不足等复杂因素的人群,子组,不同时期不同的学习方法。选定的人口是也门犹太人,托克劳人,Tanushimaru日本人,和马赛。我们还审查了来自七个排除群体的过渡数据(Pima,纳瓦霍人,澳大利亚原住民,南非纳塔尔印第安人和祖鲁语使用者,因纽特人,和Hadza)来评估偏见。
结果:代替动物饱和脂肪(SFA)的三组(也门犹太人,Maasai)或具有精制碳水化合物的植物(托克劳)具有负面的健康结果(例如,肥胖增加,糖尿病,心脏病)。也门过渡后SFA消费量减少>40%,但男性的BMI增加19%,糖尿病增加约40倍。托克劳人减少了脂肪,大幅降低SFA,糖摄入量增加:肥胖和糖尿病上升。Tanushimaruans过渡到更多的脂肪和更少的碳水化合物,并使用更多的抗高血压药物;中风和乳腺癌下降,而心脏病稳定。马赛人过渡到低脂肪,SFA和更高的碳水化合物,并增加了BMI和糖尿病。在其他七个种群中观察到类似的模式。
结论:与负面健康结果(尤其是肥胖和糖尿病)最密切相关的营养素类别是糖(也门犹太人和托克劳人增加了600-650%)和精制碳水化合物(马赛人,总碳水化合物在男性中增加了39%,在女性中增加了362%),而卡路里增加与这些疾病的相关性较低。在11个人口中,非传染性疾病与精制碳水化合物的增加有关,而不是与卡路里的增加有关,活动减少或其他因素,但不能归因于SFA或总脂肪消耗。
OBJECTIVE: Non-communicable chronic diseases (NCDs) such as obesity, type 2 diabetes, heart disease, and cancer were rare among non-western populations with traditional diets and lifestyles. As populations transitioned toward industrialized diets and lifestyles, NCDs developed.
OBJECTIVE: We performed a systematic literature
review to examine the effects of diet and lifestyle transitions on NCDs.
METHODS: We identified 22 populations that underwent a nutrition transition, eleven of which had sufficient data. Of these, we chose four populations with diverse geographies, diets and lifestyles who underwent a dietary and lifestyle transition and explored the relationship between dietary changes and health outcomes. We excluded populations with features overlapping with selected populations or with complicating factors such as inadequate data, subgroups, and different study methodologies over different periods. The selected populations were Yemenite Jews, Tokelauans, Tanushimaru Japanese, and Maasai. We also
review transition data from seven excluded populations (Pima, Navajo, Aboriginal Australians, South African Natal Indians and Zulu speakers, Inuit, and Hadza) to assess for bias.
RESULTS: The three groups that replaced saturated fats (SFA) from animal (Yemenite Jews, Maasai) or plants (Tokelau) with refined carbohydrates had negative health outcomes (e.g., increased obesity, diabetes, heart disease). Yemenites reduced SFA consumption by >40% post-transition but men\'s BMI increased 19% and diabetes increased ~40-fold. Tokelauans reduced fat, dramatically reduced SFA, and increased sugar intake: obesity and diabetes rose. The Tanushimaruans transitioned to more fats and less carbohydrates and used more anti-hypertensive medications; stroke and breast cancer declined while heart disease was stable. The Maasai transitioned to lower fat, SFA and higher carbohydrates and had increased BMI and diabetes. Similar patterns were observed in the seven other populations.
CONCLUSIONS: The nutrient category most strongly associated with negative health outcomes - especially obesity and diabetes - was sugar (increased 600-650% in Yemenite Jews and Tokelauans) and refined carbohydrates (among Maasai, total carbohydrates increased 39% in men and 362% in women), while increased calories was less strongly associated with these disorders. Across 11 populations, NCDs were associated with increased refined carbohydrates more than increased calories, reduced activity or other factors, but cannot be attributed to SFA or total fat consumption.