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對植物性飲食的依從性影響2型糖尿病風險

創作:vicky: 審核:何才高:
2021-03-09

①對192,567名受試者進行2,955,350人-年的隨訪,期間共記錄12,627例2型糖尿病;

②每4年通過總體植物性飲食指數(PDI)、健康PDI (hPDI)和不健康PDI(uPDI)評估植物性飲食的依從性;

③與指數相對穩定(±3%)者相比,4年內PDI和hPDI下降幅度*(>10%)者在隨后4年內的糖尿病風險增加了12-23%,而在4年內PDI和hPDI每增加10%,糖尿病風險降低7-9%;

④uPDI變化與糖尿病風險無關;

⑤體重變化可解釋6.0-35.6%的PDI及hPDI變化與糖尿病風險的關聯。


關鍵詞
主編推薦語
近期Diabetes Care上發表的一項前瞻性隊列研究,對近20萬人進行超過10年隨訪后發現,提高對植物性飲食及健康植物性飲食的依從性可降低患2型糖尿病的風險,而降低對這種飲食的依從性則會帶來更高的2型糖尿病風險。同一團隊在2016年發表的類似研究(doi:10.1371/journal.pmed.1002039),對健康的植物性飲食和不健康的植物性飲食(包括甜食和飲料)進行了區分,并探討了它們與2型糖尿病發病率之間的關系。本文與2016年的不同之處,強調了“從現在改變依然可以獲益”,而*的美國膳食指南也指出:It is never too late to make improvements。
延伸導讀

本研究的原文信息和鏈接出處,以及相關解讀和評論文章。歡迎讀者朋友們推薦!
 Diabetes Care [IF:16.019]
Changes in Plant-Based Diet Indices and Subsequent Risk of Type 2 Diabetes in Women and Men: Three U.S. Prospective Cohorts
植物性飲食指數改變及其對男性和女性2型糖尿病的影響:三項美國前瞻性隊列
10.2337/dc20-1636
01-13, Article
Abstract:
OBJECTIVE: We evaluated the associations between changes in plant-based diets and subsequent risk of type 2 diabetes.
RESEARCH DESIGN AND METHODS: We prospectively followed 76,530 women in the Nurses’ Health Study (NHS) (1986–2012), 81,569 women in NHS II (1991–2017), and 34,468 men in the Health Professionals Follow-up Study (1986–2016). Adherence to plant-based diets was assessed every 4 years with the overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs). We pooled results of the three cohorts using meta-analysis.

RESULTS: We documented 12,627 cases of type 2 diabetes during 2,955,350 person-years of follow-up. After adjustment for initial BMI and initial and 4-year changes in alcohol intake, smoking, physical activity, and other factors, compared with participants whose indices remained relatively stable (±3%), participants with the largest decrease (>10%) in PDI and hPDI over 4 years had a 12–23% higher diabetes risk in the subsequent 4 years (pooled HR, PDI 1.12 [95% CI 1.05, 1.20], hPDI 1.23 [1.16, 1.31]). Each 10% increment in PDI and hPDI over 4 years was associated with a 7–9% lower risk (PDI 0.93 [0.91, 0.95], hPDI 0.91 [0.87, 0.95]). Changes in uPDI were not associated with diabetes risk. Weight changes accounted for 6.0–35.6% of the associations between changes in PDI and hPDI and diabetes risk.

CONCLUSIONS: Improving adherence to overall and healthful plant-based diets was associated with a lower risk of type 2 diabetes, whereas decreased adherence to such diets was associated with a higher risk.

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