中国65岁及以上老年人植物性饮食与死亡的关系  

The relationship between a plant-based diet and death in the elderly aged 65 and over in China

作　　者：郑淼 毛学韫 朱飞云 陈如程[1] 郑卫军[1] ZHENG Miao;MAO Xueyun;ZHU Feiyun;CHEN Rucheng;ZHENG Weijun(Department of Medical Statistics,School of Public Health,Zhejiang Chinese Medical University,Hangzhou 310053,China)

机构地区：[1]浙江中医药大学公共卫生学院医学统计教研室,杭州310053

出　　处：《中华疾病控制杂志》2023年第6期633-638,644,共7页Chinese Journal of Disease Control & Prevention

基　　金：浙江省自然科学基金(LR20H260001)。

摘　　要：目的探讨老年人植物性饮食与死亡之间的关系。方法基于中国老年健康和家庭幸福调查(Chinese Longitudinal Healthy Longevity and Happy Family Study,CLHLS-HF)数据,分析15300份样本在2008―2018年随访调查资料。以植物性饮食指数(plant-based diet index,PDI)、不健康的植物性饮食指数(unhealthy plant-based diet index,UPDI)作为评估植物性饮食情况的指标,分别按五分位数分组,分为Q1、Q2、Q3、Q4、Q5共5组。采取Cox回归分析构建模型,研究PDI、UPDI对于65岁及以上老年人死亡的影响。结果调整人口学特征、健康行为和基础疾病混杂因素后,PDI与死亡存在统计学关联(P<0.001),以Q1为对照组,Q3(HR=0.900,95%CI:0.832~0.974)、Q4(HR=0.872,95%CI:0.804~0.947)、Q5组(HR=0.779,95%CI:0.715~0.850)人群死亡风险分别减少10.00%、12.80%、22.10%,Q2组差异无统计学意义;UPDI与死亡存在统计学关联(P<0.001),相较Q1组,Q3(HR=1.182,95%CI:1.080~1.294)、Q4(HR=1.206,95%CI:1.101~1.321)、Q5组(HR=1.210,95%CI:1.104~1.327)人群死亡风险分别增加18.20%、20.60%、21.00%,Q2组差异无统计学意义。随着PDI分数的上升,人群死亡风险呈下降的趋势;随着UPDI分数的上升,人群死亡风险呈上升的趋势(均P趋势<0.001)。结论基于CLHLS-HF人群可知,减少植物性食物尤其是健康的植物性食物摄入频率会增加老年人死亡的风险。Objective To investigate the relationship between a plant-based diet and death in the elderly population.Methods Based on the data of the Chinese Longitudinal Healthy Longevity and Happy Family Study(CLHLS-HF),this study analyzed the follow-up survey data of 15300 samples from 2008 to 2018.The plant-based diet index(PDI)and unhealthy plant-based diet index(UPDI)were used as indicators to evaluate the plant-based diet,which was grouped according to the quintile and divided into five groups:Q1,Q2,Q3,Q4,and Q5.A Cox survival analysis was used to construct a model to study the effects of PDI and UPDI on the death of individuals aged 65 years and above.Results After adjusting for confounding factors such as demographic characteristics,health behaviors,and underlying diseases,a statistically significant association was found between PDI and death(P<0.001).Compared with Q1(control group),Q3(HR=0.900,95%CI:0.832-0.974),Q4(HR=0.872,95%CI:0.804-0.947),and Q5(HR=0.779,95%CI:0.715-0.850)reduced the risk of death by 10.00%,12.80%,22.10%,respectively,while Q2 was not statistically significant.The UPDI was statistically associated with death(P<0.001),with Q3(HR=1.182,95%CI:1.080-1.294),Q4(HR=1.206,95%CI:1.101-1.321),and Q5(HR=1.210,95%CI:1.104-1.327)increased the risk of death by 18.20%,20.60%,and 21.00%,respectively,compared with Q1.And Q2 was not statistically significant.With the increase in PDI,the mortality risk of the population showed a downward trend;with the decrease in UPDI score,the mortality risk of the population showed an upward trend(Ptrend<0.001).Conclusion Based on the CLHLS-HF population,a reduced intake of plant foods,especially healthy ones,increases the mortality risk in the elderly.

关 键 词：植物性饮食 植物性饮食指数 不健康的植物性饮食指数 老年人 死亡 中国老年健康和家庭幸福调查 

分 类 号：R181[医药卫生—流行病学]