JAMA子刊:低碳水vs低脂饮食,谁更健康?不在形式,在质量!
创作:szx 审核:szx 03月01日
  • 纳入37233名美国成年人,在297768人-年的随访期间,发生4866例死亡;
  • 总体的低碳水化合物饮食(LCD)分数与低脂饮食(LFD)分数与总死亡率无显著关联;
  • 根据高质量碳水化合物、动物蛋白及饱和脂肪酸摄入量计算不健康LCD分数/LFD分数,根据低质量碳水化合物、植物蛋白及不饱和脂肪酸摄入量计算健康LCD分数/LFD分数;
  • 不健康LCD及不健康LFD与更高的死亡率相关,健康LCD及健康LFD与更低的死亡率相关。
主编推荐语
szx
JAMA Internal Medicine上发表的一项前瞻性队列研究,对近4万名美国成年人进行多年随访后发现,摄入健康的低脂饮食或健康的低碳水化合物饮食(健康的定义为摄入更多的高质量碳水化合物、植物蛋白及不饱和脂肪酸),与更低的死亡率显著相关。
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Association of Low-Carbohydrate and Low-Fat Diets With Mortality Among US Adults

低碳水化合物与低脂饮食与美国成年人死亡率的关联

10.1001/jamainternmed.2019.6980

01-21, Article

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Importance : It is crucial to incorporate quality and types of carbohydrate and fat when investigating the associations of low-fat and low-carbohydrate diets with mortality.
Objective : To investigate the associations of low-carbohydrate and low-fat diets with total and cause-specific mortality among US adults.
Design, Setting, and Participants: This prospective cohort study used data from the US National Health and Nutrition Examination Survey from 1999 to 2014 from 37 233 adults 20 years or older with 24-hour dietary recall data. Data were analyzed from July 5 to August 27, 2019.
Exposures : Overall, unhealthy, and healthy low-carbohydrate-diet and low-fat-diet scores based on the percentage of energy as total and subtypes of carbohydrate, fat, and protein.
Main Outcomes and Measures : All-cause mortality from baseline until December 31, 2015, linked to National Death Index mortality data.
Results : A total of 37 233 US adults (mean [SD] age, 49.7 [18.3] years; 19 598 [52.6%] female) were included in the present analysis. During 297 768 person-years of follow-up, 4866 total deaths occurred. Overall low-carbohydrate-diet and low-fat-diet scores were not associated with total mortality. The multivariable-adjusted hazard ratios for total mortality per 20-percentile increase in dietary scores were 1.07 (95% CI, 1.02-1.11; P = .01 for trend) for unhealthy low-carbohydrate-diet score, 0.91 (95% CI, 0.87-0.95; P < .001 for trend) for healthy low-carbohydrate-diet score, 1.06 (95% CI, 1.01-1.12; P = .04 for trend) for unhealthy low-fat-diet score, and 0.89 (95% CI, 0.85-0.93; P < .001 for trend) for healthy low-fat-diet score. The associations remained similar in the stratification and sensitivity analyses.
Conclusions and Relevance: In this study, overall low-carbohydrate-diet and low-fat-diet scores were not associated with total mortality. Unhealthy low-carbohydrate-diet and low-fat-diet scores were associated with higher total mortality, whereas healthy low-carbohydrate-diet and low-fat-diet scores were associated with lower total mortality. These findings suggest that the associations of low-carbohydrate and low-fat diets with mortality may depend on the quality and food sources of macronutrients.

First Authors:
Zhilei Shan

Correspondence Authors:
Zhilei Shan

All Authors:
Zhilei Shan,Yanjun Guo,Frank B Hu,Liegang Liu,Qibin Qi

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