背景:2019年,EAT-Lancet委员会提出了一种健康的饮食模式,随着食物浪费的减少和农业实践的改善,可以可持续地养活不断增长的全球人口。我们开发了行星健康饮食指数(PHDI)来量化对EAT-Lancet参考饮食的依从性。
目的:我们旨在评估美国3个前瞻性男性和女性队列中PHDI与总死亡率和特定原因死亡率之间的关联。
方法:我们追踪了来自护士健康研究(1986-2019)的66,692名女性,来自护士健康研究II(1989-2019)的92,438名女性,来自卫生专业人员随访研究(1986-2018)的47,274名男性,他们没有癌症,糖尿病,和基线时的主要心血管疾病。使用半定量食物频率问卷每4年计算一次PHDI。使用多变量比例风险模型计算风险比(HR)。
结果:随访期间,我们记录了31,330例女性死亡和23,206例男性死亡。当比较PHDI的最高和最低五分之一时,全因死亡率的合并多变量校正HR为0.77[95%置信区间(CI):0.75,0.80](P趋势<0.0001).PHDI与心血管疾病死亡风险较低相关(HR:0.86;95%CI:0.81,0.91),癌症(HR:0.90;95%CI:0.85,0.95),呼吸系统疾病(HR:0.53;95%CI:0.48,0.59),和神经退行性疾病(HR:0.72;95%CI:0.67,0.78)。在女性中,但不是男性,PHDI还与感染性疾病死亡风险较低显著相关(HR:0.62;95%CI:0.51,0.76).PHDI得分也与温室气体排放和其他环境影响成反比。
结论:在3个大型美国男性和女性前瞻性队列中,随访时间长达34年,较高的PHDI与较低的总死亡率和特定原因死亡率以及环境影响风险相关.
In 2019, the EAT-Lancet Commission proposed a healthy dietary pattern that, along with reductions in food waste and improved agricultural practices, could feed the increasing global population sustainably. We developed a Planetary Health Diet Index (PHDI) to quantify adherence to the EAT-Lancet reference diet.
We aimed to assess associations between PHDI and total and cause-specific mortality in 3 prospective cohorts of males and females in the United States.
We followed 66,692 females from the Nurses\' Health Study (1986-2019), 92,438 females from the Nurses\' Health Study II (1989-2019), and 47,274 males from the Health Professionals Follow-up Study (1986-2018) who were free of cancer, diabetes, and major cardiovascular diseases at baseline. The PHDI was calculated every 4 y using a semiquantitative food frequency questionnaire. Hazard ratios (HRs) were calculated using multivariable proportional-hazards models.
During follow-up, we documented 31,330 deaths among females and 23,206 among males. When comparing the highest with the lowest quintile of PHDI, the pooled multivariable-adjusted HRs were 0.77 [95% confidence interval (CI): 0.75, 0.80] for all-cause mortality (P-trend < 0.0001). The PHDI was associated with lower risk of deaths from cardiovascular diseases (HR: 0.86; 95% CI: 0.81, 0.91), cancer (HR: 0.90; 95% CI: 0.85, 0.95), respiratory diseases (HR: 0.53; 95% CI: 0.48, 0.59), and neurodegenerative diseases (HR: 0.72; 95% CI: 0.67, 0.78). In females, but not males, the PHDI was also significantly associated with a lower risk of deaths from infectious diseases (HR: 0.62; 95% CI: 0.51, 0.76). PHDI scores were also associated inversely with greenhouse gas emissions and other environmental impacts.
In 3 large United States-based prospective cohorts of males and females with up to 34 y of follow-up, a higher PHDI was associated with lower risk of total and cause-specific mortality and environment impacts.