背景:关于谷物类型与死亡率的关联以及生活方式对这种关联的调节作用知之甚少。这项研究旨在评估中国老年人中谷物类型和生活方式与全因死亡率的单一或联合关联。
方法:数据来自1998年至2018年的中国纵向健康长寿调查(CLHLS)。年龄≥65岁的受试者符合资格。谷物的类型包括小麦,总大米,和粗粮。生活方式是通过吸烟获得的,酒精消费,身体活动,和饮食模式。全因死亡率是主要结果。
结果:这项研究包括30275名参与者,平均年龄为87±11岁,记录了在平均4.8年随访期间的19261例死亡。与小麦相比,在那些有健康和中等生活方式的人中,总水稻与13%(HR:0.87,95%CI0.80,0.93)和6%(HR:0.94,95%CI0.90,1.00)较低的死亡风险相关,分别,和粗粮与14%(HR:0.86,95%CI0.74,1.00)和12%(HR:0.88,95%CI0.79,0.97)的死亡风险降低相关,分别。同时,小麦和粗粮摄入量的每SD增加与10%(HR:1.10,95%CI1.03,1.18)和25%(HR:1.25,95%CI1.08,1.44)的死亡率相关。女性死亡率高于13%(HR:1.13,95%CI1.08,1.19)和29%(HR:1.29,95%CI1.17,1.44),男性死亡率高于13%(HR:1.29,95%CI1.17,1.44)。此外,观察到总谷物摄入量与全因死亡率的U形关联(非线性P=0.002),观察到稻米总摄入量与全因死亡率呈J形关联(非线性P=0.003)。
结论:特定类型的谷物和生活方式与全因死亡率单独或共同相关。与小麦相比,对于生活方式相对健康的参与者,总大米和粗粮是高级谷物。水稻总量的摄入与全因死亡率呈剂量-反应关系。因此,在老年人中,应鼓励中等摄入量的大米总量和健康的生活方式相结合。
Little is known on the association of types of grains with mortality and the moderating effect of lifestyle on this association. This study aims to evaluate the single or joint associations of types of grains and lifestyle with all-cause mortality among Chinese older adults.
Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018. Subjects aged ≥ 65 years were eligible. The types of grains included wheat, total rice, and coarse cereals. Lifestyle was derived using smoking, alcohol consumption, physical activity, and dietary pattern. All-cause mortality was the primary outcome.
This study included 30275 participants with a mean age 87 ± 11 years and documented 19261 deaths during a mean follow-up of 4.8 years. Compared to wheat, in those with healthy and intermediate lifestyle, total rice was associated with a 13% (HR: 0.87, 95% CI 0.80, 0.93) and 6% (HR: 0.94, 95% CI 0.90, 1.00) lower risk of mortality, respectively, and coarse cereals were associated with a 14% (HR: 0.86, 95% CI 0.74, 1.00) and 12% (HR: 0.88, 95% CI 0.79, 0.97) lower risk of mortality, respectively. Meanwhile, an increase per SD in intakes of wheat and coarse cereals was associated with a 10% (HR: 1.10, 95% CI 1.03, 1.18) and 25% (HR: 1.25, 95% CI 1.08, 1.44) higher mortality rate in those with healthy lifestyle, and a 13% (HR: 1.13, 95% CI 1.08, 1.19) and 29% (HR: 1.29, 95% CI 1.17, 1.44) higher mortality in females but not males. In addition, a U-shaped association of intake of total grains with all- cause mortality was observed (P for non-linearity = 0.002), and a J-shaped association of intake of total rice with all- cause mortality was observed (P for non-linearity = 0.003).
Specific types of grains and lifestyle were separately or jointly associated with all-cause mortality. Compared to wheat, total rice and coarse cereals were advanced grains for participants with a relatively healthy lifestyle. Intake of total rice was related to all-cause mortality in a dose-response manner. Therefore, a combination of intermediate intake of total rice and healthy lifestyle should be encouraged in older adults.