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[大学生论坛]:在美国,人们死于心脏病,中风及二型糖尿病与饮食因素的关系

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mj. 发表于 2019-1-3 23:05:13 | 显示全部楼层 |阅读模式
本帖最后由 mj. 于 2019-1-3 23:27 编辑

Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States
在美国,人们死于心脏病,中风及二型糖尿病饮食因素的关系

Abstract 摘要

IMPORTANCE—In the United States, national associations of individual dietary factors with specific cardiometabolic diseases are not well established.
背景——在美国国内,关于个体间饮食因素与特定心脏代谢类疾病的联系的研究没有得到完全建立。

OBJECTIVE—To estimate associations of intake of 10 specific dietary factors with mortality due to heart disease, stroke, and type 2 diabetes (cardiometabolic mortality) among US adults.
目的——评估美国成人摄入10种特定种类食品与他们因心脏病,中风及二型糖尿病(心脏代谢类致死因素)而死亡的联系。

DESIGN, SETTING, AND PARTICIPANTS—A comparative risk assessment model incorporated data and corresponding uncertainty on population demographics and dietary habits from National Health and Nutrition Examination Surveys (1999–2002: n = 8104; 2009–2012: n = 8516); estimated associations of diet and disease from meta-analyses of prospective studies and clinical trials with validity analyses to assess potential bias; and estimated disease-specific national mortality from the National Center for Health Statistics.
实验设计,场景,受试者——一个比较风险评估模型,结合数据及同比不确定性在国家卫生营养评定研究下的人口统计学和饮食习惯(1999–2002: n = 8104; 2009–2012: n = 8516);从多元分析的角度和多变量临床试验分析测量偏置电压,评估了饮食和疾病的联系;评估国家卫生统计中心公示的特定疾病的国内死亡率。

EXPOSURES—Consumption of 10 foods/nutrients associated with cardiometabolic diseases: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugarsweetened beverages (SSBs), polyunsaturated fats, seafood omega-3 fats, and sodium.
暴露因素——摄入10种与心脏代谢类疾病有关食物/营养物质:水果,蔬菜,坚果/植物种子,全谷物,未加工红肉,加工肉类,含糖饮料,多元不饱和脂肪,海鲜中的ω-3脂肪酸以及钠元素。

MAIN OUTCOMES AND MEASURES—Estimated absolute and percentage mortality due to heart disease, stroke, and type 2 diabetes in 2012. Disease-specific and demographic-specific (age, sex, race, and education) mortality and trends between 2002 and 2012 were also evaluated.
主要预后指标——评估2012年由心脏病,中风,二型糖尿病导致的死亡数及死亡率。同时评估202年至2012年间特定疾病和特定人口学特征(年龄,性别,种族及受教育程度)下的死亡率和发展趋势。

RESULTS—In 2012, 702 308 cardiometabolic deaths occurred in US adults, including 506 100 from heart disease (371 266 coronary heart disease, 35 019 hypertensive heart disease, and 99 815 other cardiovascular disease), 128 294 from stroke (16 125 ischemic, 32 591 hemorrhagic, and 79 578 other), and 67 914 from type 2 diabetes. Of these, an estimated 318 656 (95% uncertainty interval [UI], 306 064–329 755; 45.4%) cardiometabolic deaths per year were associated with suboptimal intakes—48.6% (95% UI, 46.2%–50.9%) of cardiometabolic deaths in men and 41.8% (95% UI, 39.3%–44.2%) in women; 64.2% (95% UI, 60.6%–67.9%) at younger ages (25–34 years) and 35.7% (95% UI, 33.1%–38.1%) at older ages (≥75 years); 53.1% (95% UI, 51.6%– 54.8%) among blacks, 50.0% (95% UI, 48.2%–51.8%) among Hispanics, and 42.8% (95% UI, 40.9%–44.5%) among whites; and 46.8% (95% UI, 44.9%–48.7%) among lower-, 45.7% (95% UI, 44.2%–47.4%) among medium-, and 39.1% (95% UI, 37.2%–41.2%) among higher-educated individuals. The largest numbers of estimated diet-related cardiometabolic deaths were related to high sodium (66 508 deaths in 2012; 9.5% of all cardiometabolic deaths), low nuts/seeds (59 374; 8.5%), high processed meats (57 766; 8.2%), low seafood omega-3 fats (54 626; 7.8%), low vegetables (53 410; 7.6%), low fruits (52 547; 7.5%), and high SSBs (51 694; 7.4%). Between 2002 and 2012, population-adjusted US cardiometabolic deaths per year decreased by 26.5%. The greatest decline was associated with insufficient polyunsaturated fats (−20.8% relative change [95% UI, −18.5% to −22.8%]), nuts/seeds (−18.0% [95% UI, −14.6% to −21.0%]), and excess SSBs (−14.5% [95% UI, −12.0% to −16.9%]). The greatest increase was associated with unprocessed red meats (+14.4% [95% UI, 9.1%–19.5%]).
结果——2012年,美国成人中有702308例死于心脏代谢疾病,包括506100例心脏病(471266例冠心病,35019例高血压及99815例其他心血管疾病),128294例中风(16125例缺血性中风,32591例出血性中风,79578例其他中风),以及67914例死于二型糖尿病。 数据显示,每年318656例(95%置信区间,306064–329 755; 45.4%)心脏代谢死亡与次优的饮食行为有关——男性中有48.6% (95%置信区间,46.2%–50.9%)死于心脏代谢,而女性中有41.8% (95%置信区间39.3%–44.2%);年轻人(25–34 岁)中有64.2% (95%置信区间,60.6%–67.9%),而老年人(≥75岁)中有35.7% (95%置信区间,33.1%–38.1%) ;黑人中有 53.1% (95%置信区间,51.6%– 54.8%) ,拉美裔有 50.0% (95%置信区间,48.2%–51.8%),白人中有42.8% (95%置信区间,40.9%–44.5%); 低教育程度人群中有46.8% (95%置信区间, 44.9%–48.7%),中等教育程度人群中有 45.7% (95%置信区间,44.2%–47.4%),高等教育程度人群中有 39.1% (95%置信区间,37.2%–41.2%)。据评估,饮食方面导致死于心脏代谢疾病的最多是由于钠元素摄入过多(2012年有66 508 例死亡; 9.5% 死于各种心脏代谢疾病),坚果/植物种摄入过少(59 374; 8.5%),加工肉类摄入过多(57 766; 8.2%),海鲜中的ω-3脂肪酸摄入过少(54 626; 7.8%),蔬菜摄入过少(53 410; 7.6%),水果摄入过少(52 547; 7.5%)以及含糖饮料摄入过多(51 694; 7.4%)等因素。在2002年至2012年间,经历人口规模调整的美国每年心脏代谢病死亡率降低了26.5%。其中最显著的降低与多元不饱和脂肪酸(−20.8% 相对变化 [95% 置信区间, −18.5% 至 −22.8%])摄入量不足和含糖饮料(−14.5% [95%置信区间, −12.0% 至 −16.9%])摄入过量有关。其中最显著的增加与摄入未加工肉类(+14.4% [95% 置信区间, 9.1%–19.5%])有关。

CONCLUSIONS AND RELEVANCE—Dietary factors were estimated to be associated with a substantial proportion of deaths from heart disease, stroke, and type 2 diabetes. These results should help identify priorities, guide public health planning, and inform strategies to alter dietary habits and improve health.
结论及意义——据评估,大部分死于心脏病,中风与二型糖尿病的原因与饮食因素与有关。这些结果能帮助辨别优先治疗人群,引导公共卫生规划以及告知人们改变饮食习惯和提高身体健康的策略。


来源:Journal of the American Medicine Association, JAMA
作者:Renata Micha, RD, PhD, Jose L. Peñalvo, PhD, Frederick Cudhea, PhD, Fumiaki Imamura, PhD, Colin D. Rehm, PhD, and Dariush Mozaffarian, MD, DrPH
翻译:陈美娟
发表时间:2017.3.7
JAMA. 2017 March 07; 317(9): 912–924. doi:10.1001/jama.2017.0947.

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