对代表 EAT-Lancet 参考膳食的七种不同评分与三个队列中的死亡率、中风和温室气体排放的系统性评估

IF 24.1 1区 医学 Q1 ENVIRONMENTAL SCIENCES Lancet Planetary Health Pub Date : 2024-06-01 DOI:10.1016/S2542-5196(24)00094-9
Anna Stubbendorff BSc , Dalia Stern PhD , Ulrika Ericson PhD , Emily Sonestedt PhD , Elinor Hallström PhD , Yan Borné PhD , Prof Martin Lajous ScD , Prof Nita G Forouhi FFPH , Prof Anja Olsen PhD , Christina C Dahm PhD , Daniel B Ibsen PhD
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引用次数: 0

摘要

将 EAT-Lancet 参考膳食转化为可用于评估健康和环境影响的膳食评分采用了不同的方法。我们的目的是比较不同的 EAT-Lancet 膳食评分,并估计它们与全因死亡率、中风发病率和温室气体排放的关系。我们进行了系统性回顾(PROSPERO,CRD42021286597),以确定代表 EAT-Lancet 参考饮食坚持情况的不同评分。然后,我们对饮食依从性评分进行了定性比较,包括其根据 EAT-Lancet 参考饮食建议对个体进行分组的能力,并对三个不同队列中饮食评分与健康和环境结果数据的关联进行了定量评估:丹麦饮食、癌症和健康队列(DCH;n=52452)、瑞典马尔默饮食和癌症队列(MDC;n=20973)以及墨西哥教师队列(MTC;n=30151)。DCH 和 MTC 采用食物频率问卷调查法,MDC 采用改良饮食史法评估饮食摄入量,我们以此计算 EAT-Lancet 饮食评分,并评估评分与全因死亡率和中风危险的关系。在 MDC 中,对每位参与者的膳食温室气体排放值进行了汇总,我们利用这些值来预测与每个评分系统中不同的膳食依从性评分相关的温室气体排放。在我们的研究中,确定了七种饮食评分(Knuppel 等人,2019 年;Trijsburg 等人,2020 年;Cacau 等人,2021 年;Hanley-Cook 等人,2021 年;Kesse-Guyot 等人,2021 年;Stubbendorff 等人,2022 年;Colizzi 等人,2023 年)。七项评分中的两项(Stubbendorff 和 Colizzi)在根据 EAT-Lancet 参考膳食建议对不同队列的参与者进行分组时最为一致,评分越高(膳食依从性越高),死亡率风险越低(在 DCH 和 MDC 中),中风发病风险越低(在 DCH 和 MDC 中,Stubbendorff 评分与中风发病风险相关;在 DCH 中,Colizzi 评分与中风发病风险相关),在 MDC 中,温室气体排放预测值越低。我们的结论是,代表 EAT-Lancet 参考饮食的七个不同评分在构建、解释以及与疾病和气候相关结果的关系方面存在差异。在我们的评估中,有两个评分通常表现良好。鉴于公共卫生和环境政策依赖于这些估计值,未来的研究应仔细考虑使用哪种膳食评分,最好使用多种评分来评估估计值的稳健性。
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A systematic evaluation of seven different scores representing the EAT–Lancet reference diet and mortality, stroke, and greenhouse gas emissions in three cohorts

Different approaches have been used for translation of the EAT–Lancet reference diet into dietary scores that can be used to assess health and environmental impact. Our aim was to compare the different EAT–Lancet diet scores, and to estimate their associations with all-cause mortality, stroke incidence, and greenhouse gas emissions. We did a systematic review (PROSPERO, CRD42021286597) to identify different scores representing adherence to the EAT–Lancet reference diet. We then qualitatively compared the diet adherence scores, including their ability to group individuals according the EAT–Lancet reference diet recommendations, and quantitatively assessed the associations of the diet scores with health and environmental outcome data in three diverse cohorts: the Danish Diet, Cancer and Health Cohort (DCH; n=52 452), the Swedish Malmö Diet and Cancer Cohort (MDC; n=20 973), and the Mexican Teachers’ Cohort (MTC; n=30 151). The DCH and MTC used food frequency questionnaires and the MDC used a modified diet history method to assess dietary intake, which we used to compute EAT–Lancet diet scores and evaluate the associations of scores with hazard of all-cause mortality and stroke. In the MDC, dietary greenhouse gas emission values were summarised for every participant, which we used to predict greenhouse gas emissions associated with varying diet adherence scores on each scoring system. In our review, seven diet scores were identified (Knuppel et al, 2019; Trijsburg et al, 2020; Cacau et al, 2021; Hanley-Cook et al, 2021; Kesse-Guyot et al, 2021; Stubbendorff et al, 2022; and Colizzi et al, 2023). Two of the seven scores (Stubbendorff and Colizzi) were among the most consistent in grouping participants according to the EAT–Lancet reference diet recommendations across cohorts, and higher scores (greater diet adherence) were associated with decreased risk of mortality (in the DCH and MDC), decreased risk of incident stroke (in the DCH and MDC for the Stubbendorff score; and in the DCH for the Colizzi score), and decreased predicted greenhouse gas emissions in the MDC. We conclude that the seven different scores representing the EAT–Lancet reference diet had differences in construction, interpretation, and relation to disease and climate-related outcomes. Two scores generally performed well in our evaluation. Future studies should carefully consider which diet score to use and preferably use multiple scores to assess the robustness of estimations, given that public health and environmental policy rely on these estimates.

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来源期刊
CiteScore
28.40
自引率
2.30%
发文量
272
审稿时长
8 weeks
期刊介绍: The Lancet Planetary Health is a gold Open Access journal dedicated to investigating and addressing the multifaceted determinants of healthy human civilizations and their impact on natural systems. Positioned as a key player in sustainable development, the journal covers a broad, interdisciplinary scope, encompassing areas such as poverty, nutrition, gender equity, water and sanitation, energy, economic growth, industrialization, inequality, urbanization, human consumption and production, climate change, ocean health, land use, peace, and justice. With a commitment to publishing high-quality research, comment, and correspondence, it aims to be the leading journal for sustainable development in the face of unprecedented dangers and threats.
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