Adherence to international dietary recommendations in association with all-cause mortality and fatal and non-fatal cardiovascular disease risk: a prospective analysis of UK Biobank participants

BMC Medicine

Aurora Perez-Cornago¹  Carmen Piernas²  Susan A. Jebb²  Maryam Kebbe³  Min Gao⁴ 

[1] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK;Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, OX2 6GG, Oxford, UK;Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, OX2 6GG, Oxford, UK;Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA;Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, OX2 6GG, Oxford, UK;School of Public Health, Peking University Health Science Center, Beijing, China;

关键词: Cardiovascular diseases;    Diet;    Mortality;    Dietary recommendations;    Cohort study;   

DOI  :  10.1186/s12916-021-02011-7

来源: Springer

【 摘 要 】

BackgroundInternational dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the pooled health effects of adherence to international dietary recommendations. We investigated associations between total adherence to the World Health Organization (WHO) dietary recommendations for saturated fats, free sugars, fibre, and fruits and vegetables and all-cause mortality and fatal and non-fatal CVD.MethodsWe included participants from the UK Biobank cohort recruited in 2006–2010, which provided at least two valid 24-h dietary assessments. We defined adherence to dietary recommendations as ≤ 10% saturated fats, ≤ 10% free sugars, ≥ 25 g/day fibre, and ≥ 5 servings of fruits and vegetables/day. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD. In cross-sectional analyses, multivariable linear regression was used to examine associations with cardiometabolic risk factors.ResultsAmong 115,051 participants (39–72 years), only 29.7%, 38.5%, 22.3%, and 9.5% met 0, 1, 2, or 3–4 recommendations, respectively. There was a lower risk of all-cause mortality among participants meeting more dietary recommendations (Ptrend < 0.001), with a significantly lower risk among participants meeting 2: HR 0.91 (95% confidence interval [CI] 0.85–0.97) and 3–4: HR 0.79 (95% CI 0.71–0.88) recommendations. There was no trend with CVD risk, but a significantly lower risk of fatal CVD with 3–4 recommendations: HR 0.78 (95% CI 0.61–0.98). Meeting more recommendations resulted in significant cross-sectional trends (Ptrend < 0.001) towards lower body fat, waist circumference, LDL cholesterol, apolipoprotein B, triglycerides, alkaline phosphatase, gamma glutammyltransferase, and hs-CRP, but higher glucose and aspartate aminotransferase.ConclusionsMeeting dietary recommendations is associated with additive reductions in premature mortality. Motivating and supporting people to adhere to dietary guidelines may help extend years of healthy life expectancy.

【 授权许可】

CC BY