{"title":"坚果消费与死亡风险之间的关系:韩国一项为期 20 年的队列研究,根据健康相关变量进行分层分析。","authors":"Hye Ran Shin, Jihye Kim, SuJin Song","doi":"10.1186/s12937-024-01019-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although nuts are a well-known healthy food group, the relationship between nut consumption and mortality remains unclear, particularly among Asians. This prospective cohort study examined the association between nut consumption and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality in Korean adults.</p><p><strong>Methods: </strong>Data from two cohorts (the Ansan-Ansung and Health-Examinees) from the Korean Genome and Epidemiology Study were used. A total of 114,140 individuals aged 40-79 years were included in the data analyses. Nut consumption was assessed using a validated semi-quantitative food frequency questionnaire and categorized into four groups: non-consumers, less than 1 serving/week, 1-2 servings/week, and 2 or more servings/week (one serving was 15 g of nuts). Mortality outcomes were determined based on the 2001-2021 death records from Statistics Korea. Cox proportional hazard regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across nut consumption categories. A stratified subgroup analysis by health-related variables was also performed.</p><p><strong>Results: </strong>During a mean follow-up of 12.3 years, 4,559 deaths were recorded. After adjusting for covariates, the HR for all-cause mortality was 0.877 (95% CI = 0.772-0.996, p for trend = 0.006) in individuals with a nut consumption of 2 or more servings/week compared with that in non-consumers. Multivariable HRs for CVD mortality were 0.800 (95% CI = 0.681-0.939) in individuals consuming less than 1 serving/week, 0.656 (95% CI = 0.469-0.918) in those consuming 1-2 servings/week, and 1.009 (95% CI = 0.756-1.347) in those consuming 2 or more servings/week compared with that in non-consumers (p for trend = 0.080). No association was observed between nut consumption and cancer mortality. Stratified analysis identified significant interactions in the association between nut consumption and all-cause mortality by age, body mass index, and physical activity.</p><p><strong>Conclusions: </strong>Nut consumption was linearly associated with the reduced risk of all-cause mortality and showed a non-linear dose-response relationship with CVD mortality in Koreans, but had no association with cancer mortality. The effects of nut consumption, which have been inadequately investigated in this population, varied across different subgroups. These findings suggest that incorporating nuts into the diet should be encouraged for long-term health of Korean adults.</p>","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439287/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between nut consumption and mortality risk: a 20-year cohort study in Korea with a stratified analysis by health-related variables.\",\"authors\":\"Hye Ran Shin, Jihye Kim, SuJin Song\",\"doi\":\"10.1186/s12937-024-01019-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although nuts are a well-known healthy food group, the relationship between nut consumption and mortality remains unclear, particularly among Asians. This prospective cohort study examined the association between nut consumption and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality in Korean adults.</p><p><strong>Methods: </strong>Data from two cohorts (the Ansan-Ansung and Health-Examinees) from the Korean Genome and Epidemiology Study were used. A total of 114,140 individuals aged 40-79 years were included in the data analyses. Nut consumption was assessed using a validated semi-quantitative food frequency questionnaire and categorized into four groups: non-consumers, less than 1 serving/week, 1-2 servings/week, and 2 or more servings/week (one serving was 15 g of nuts). Mortality outcomes were determined based on the 2001-2021 death records from Statistics Korea. Cox proportional hazard regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across nut consumption categories. A stratified subgroup analysis by health-related variables was also performed.</p><p><strong>Results: </strong>During a mean follow-up of 12.3 years, 4,559 deaths were recorded. After adjusting for covariates, the HR for all-cause mortality was 0.877 (95% CI = 0.772-0.996, p for trend = 0.006) in individuals with a nut consumption of 2 or more servings/week compared with that in non-consumers. Multivariable HRs for CVD mortality were 0.800 (95% CI = 0.681-0.939) in individuals consuming less than 1 serving/week, 0.656 (95% CI = 0.469-0.918) in those consuming 1-2 servings/week, and 1.009 (95% CI = 0.756-1.347) in those consuming 2 or more servings/week compared with that in non-consumers (p for trend = 0.080). No association was observed between nut consumption and cancer mortality. Stratified analysis identified significant interactions in the association between nut consumption and all-cause mortality by age, body mass index, and physical activity.</p><p><strong>Conclusions: </strong>Nut consumption was linearly associated with the reduced risk of all-cause mortality and showed a non-linear dose-response relationship with CVD mortality in Koreans, but had no association with cancer mortality. The effects of nut consumption, which have been inadequately investigated in this population, varied across different subgroups. 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引用次数: 0
摘要
背景:虽然坚果是众所周知的健康食品,但坚果消费与死亡率之间的关系仍不清楚,尤其是在亚洲人中。这项前瞻性队列研究考察了韩国成年人食用坚果与全因、心血管疾病(CVD)和癌症死亡风险之间的关系:研究使用了韩国基因组与流行病学研究中两个队列(安山安星队列和健康受试者队列)的数据。共有 114140 名 40-79 岁的人被纳入数据分析。坚果食用量通过有效的半定量食物频率问卷进行评估,并分为四组:非食用者、每周少于 1 份、每周 1-2 份和每周 2 份或以上(1 份为 15 克坚果)。死亡率结果是根据韩国统计局 2001-2021 年的死亡记录确定的。采用考克斯比例危险回归分析法计算不同坚果摄入量类别的死亡率危险比(HRs)和95%置信区间(CIs)。此外,还根据健康相关变量进行了分层分组分析:在平均 12.3 年的随访期间,共记录了 4,559 例死亡。在对协变量进行调整后,与不食用坚果者相比,每周食用 2 份或更多坚果者的全因死亡率 HR 为 0.877(95% CI = 0.772-0.996,趋势 p = 0.006)。与非食用者相比,每周食用不到 1 份坚果的人心血管疾病死亡率的多变量 HR 值为 0.800(95% CI = 0.681-0.939),每周食用 1-2 份坚果的人心血管疾病死亡率的多变量 HR 值为 0.656(95% CI = 0.469-0.918),每周食用 2 份或更多坚果的人心血管疾病死亡率的多变量 HR 值为 1.009(95% CI = 0.756-1.347)(趋势 p = 0.080)。未观察到坚果食用量与癌症死亡率之间存在关联。分层分析发现,坚果摄入量与全因死亡率之间的关系在年龄、体重指数和体力活动方面存在明显的相互作用:结论:食用坚果与韩国人全因死亡风险的降低呈线性关系,与心血管疾病死亡率呈非线性剂量反应关系,但与癌症死亡率没有关系。对韩国人食用坚果的影响还没有进行充分的研究,不同的亚群对食用坚果的影响也不尽相同。这些研究结果表明,为了韩国成年人的长期健康,应鼓励在饮食中加入坚果。
Association between nut consumption and mortality risk: a 20-year cohort study in Korea with a stratified analysis by health-related variables.
Background: Although nuts are a well-known healthy food group, the relationship between nut consumption and mortality remains unclear, particularly among Asians. This prospective cohort study examined the association between nut consumption and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality in Korean adults.
Methods: Data from two cohorts (the Ansan-Ansung and Health-Examinees) from the Korean Genome and Epidemiology Study were used. A total of 114,140 individuals aged 40-79 years were included in the data analyses. Nut consumption was assessed using a validated semi-quantitative food frequency questionnaire and categorized into four groups: non-consumers, less than 1 serving/week, 1-2 servings/week, and 2 or more servings/week (one serving was 15 g of nuts). Mortality outcomes were determined based on the 2001-2021 death records from Statistics Korea. Cox proportional hazard regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across nut consumption categories. A stratified subgroup analysis by health-related variables was also performed.
Results: During a mean follow-up of 12.3 years, 4,559 deaths were recorded. After adjusting for covariates, the HR for all-cause mortality was 0.877 (95% CI = 0.772-0.996, p for trend = 0.006) in individuals with a nut consumption of 2 or more servings/week compared with that in non-consumers. Multivariable HRs for CVD mortality were 0.800 (95% CI = 0.681-0.939) in individuals consuming less than 1 serving/week, 0.656 (95% CI = 0.469-0.918) in those consuming 1-2 servings/week, and 1.009 (95% CI = 0.756-1.347) in those consuming 2 or more servings/week compared with that in non-consumers (p for trend = 0.080). No association was observed between nut consumption and cancer mortality. Stratified analysis identified significant interactions in the association between nut consumption and all-cause mortality by age, body mass index, and physical activity.
Conclusions: Nut consumption was linearly associated with the reduced risk of all-cause mortality and showed a non-linear dose-response relationship with CVD mortality in Koreans, but had no association with cancer mortality. The effects of nut consumption, which have been inadequately investigated in this population, varied across different subgroups. These findings suggest that incorporating nuts into the diet should be encouraged for long-term health of Korean adults.
期刊介绍:
Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered.
Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies.
In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.