Adherence to international dietary recommendations in association with all-cause mortality and fatal and non-fatal cardiovascular disease risk: a prospective analysis of UK Biobank participants

International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the po...

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Published inBMC medicine Vol. 19; no. 1; p. 134
Main Authors Kebbe, Maryam, Gao, Min, Perez-Cornago, Aurora, Jebb, Susan A, Piernas, Carmen
Format Journal Article
LanguageEnglish
Published England BioMed Central Ltd 23.06.2021
BioMed Central
BMC
Subjects
Age
Alkaline phosphatase
Apolipoprotein B
Aspartate aminotransferase
Biobanks
Biological Specimen Banks
Biomarkers
Blood pressure
Body fat
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - prevention & control
Cholesterol
Cohort analysis
Cohort study
Confidence intervals
Cross-Sectional Studies
Diabetes
Diagnosis
Diet
Diet therapy
Dietary guidelines
Dietary recommendations
Energy
Ethnicity
Fats
Fruits
Glucose
Guidelines
Health risks
Heart diseases
Hospitals
Humans
Interactive computer systems
Life expectancy
Life span
Lipids
Lipoproteins
Low density lipoprotein
Metabolism
Mortality
Nutrients
Nutrition
Questionnaires
Requirements
Risk analysis
Risk Factors
Sociodemographics
Statistical analysis
Statistical models
Sugar
Triglycerides
United Kingdom - epidemiology
Vegetables
United Kingdom
England
Scotland
United Kingdom > UK
Wales
Dietary recommendations
Diet
Cardiovascular diseases
Cohort study
Mortality
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Abstract International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the pooled health effects of adherence to international dietary recommendations. We investigated associations between total adherence to the World Health Organization (WHO) dietary recommendations for saturated fats, free sugars, fibre, and fruits and vegetables and all-cause mortality and fatal and non-fatal CVD. We included participants from the UK Biobank cohort recruited in 2006-2010, which provided at least two valid 24-h dietary assessments. We defined adherence to dietary recommendations as ≤ 10% saturated fats, ≤ 10% free sugars, ≥ 25 g/day fibre, and ≥ 5 servings of fruits and vegetables/day. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD. In cross-sectional analyses, multivariable linear regression was used to examine associations with cardiometabolic risk factors. Among 115,051 participants (39-72 years), only 29.7%, 38.5%, 22.3%, and 9.5% met 0, 1, 2, or 3-4 recommendations, respectively. There was a lower risk of all-cause mortality among participants meeting more dietary recommendations (P < 0.001), with a significantly lower risk among participants meeting 2: HR 0.91 (95% confidence interval [CI] 0.85-0.97) and 3-4: HR 0.79 (95% CI 0.71-0.88) recommendations. There was no trend with CVD risk, but a significantly lower risk of fatal CVD with 3-4 recommendations: HR 0.78 (95% CI 0.61-0.98). Meeting more recommendations resulted in significant cross-sectional trends (P < 0.001) towards lower body fat, waist circumference, LDL cholesterol, apolipoprotein B, triglycerides, alkaline phosphatase, gamma glutammyltransferase, and hs-CRP, but higher glucose and aspartate aminotransferase. Meeting dietary recommendations is associated with additive reductions in premature mortality. Motivating and supporting people to adhere to dietary guidelines may help extend years of healthy life expectancy.
AbstractList Background International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the pooled health effects of adherence to international dietary recommendations. We investigated associations between total adherence to the World Health Organization (WHO) dietary recommendations for saturated fats, free sugars, fibre, and fruits and vegetables and all-cause mortality and fatal and non-fatal CVD. Methods We included participants from the UK Biobank cohort recruited in 2006-2010, which provided at least two valid 24-h dietary assessments. We defined adherence to dietary recommendations as [less than or equai to] 10% saturated fats, [less than or equai to] 10% free sugars, [greater than or equai to] 25 g/day fibre, and [greater than or equai to] 5 servings of fruits and vegetables/day. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD. In cross-sectional analyses, multivariable linear regression was used to examine associations with cardiometabolic risk factors. Results Among 115,051 participants (39-72 years), only 29.7%, 38.5%, 22.3%, and 9.5% met 0, 1, 2, or 3-4 recommendations, respectively. There was a lower risk of all-cause mortality among participants meeting more dietary recommendations (P.sub.trend < 0.001), with a significantly lower risk among participants meeting 2: HR 0.91 (95% confidence interval [CI] 0.85-0.97) and 3-4: HR 0.79 (95% CI 0.71-0.88) recommendations. There was no trend with CVD risk, but a significantly lower risk of fatal CVD with 3-4 recommendations: HR 0.78 (95% CI 0.61-0.98). Meeting more recommendations resulted in significant cross-sectional trends (P.sub.trend < 0.001) towards lower body fat, waist circumference, LDL cholesterol, apolipoprotein B, triglycerides, alkaline phosphatase, gamma glutammyltransferase, and hs-CRP, but higher glucose and aspartate aminotransferase. Conclusions Meeting dietary recommendations is associated with additive reductions in premature mortality. Motivating and supporting people to adhere to dietary guidelines may help extend years of healthy life expectancy. Keywords: Cardiovascular diseases, Diet, Mortality, Dietary recommendations, Cohort study
International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the pooled health effects of adherence to international dietary recommendations. We investigated associations between total adherence to the World Health Organization (WHO) dietary recommendations for saturated fats, free sugars, fibre, and fruits and vegetables and all-cause mortality and fatal and non-fatal CVD. We included participants from the UK Biobank cohort recruited in 2006-2010, which provided at least two valid 24-h dietary assessments. We defined adherence to dietary recommendations as ≤ 10% saturated fats, ≤ 10% free sugars, ≥ 25 g/day fibre, and ≥ 5 servings of fruits and vegetables/day. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD. In cross-sectional analyses, multivariable linear regression was used to examine associations with cardiometabolic risk factors. Among 115,051 participants (39-72 years), only 29.7%, 38.5%, 22.3%, and 9.5% met 0, 1, 2, or 3-4 recommendations, respectively. There was a lower risk of all-cause mortality among participants meeting more dietary recommendations (P < 0.001), with a significantly lower risk among participants meeting 2: HR 0.91 (95% confidence interval [CI] 0.85-0.97) and 3-4: HR 0.79 (95% CI 0.71-0.88) recommendations. There was no trend with CVD risk, but a significantly lower risk of fatal CVD with 3-4 recommendations: HR 0.78 (95% CI 0.61-0.98). Meeting more recommendations resulted in significant cross-sectional trends (P < 0.001) towards lower body fat, waist circumference, LDL cholesterol, apolipoprotein B, triglycerides, alkaline phosphatase, gamma glutammyltransferase, and hs-CRP, but higher glucose and aspartate aminotransferase. Meeting dietary recommendations is associated with additive reductions in premature mortality. Motivating and supporting people to adhere to dietary guidelines may help extend years of healthy life expectancy.
Abstract Background International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the pooled health effects of adherence to international dietary recommendations. We investigated associations between total adherence to the World Health Organization (WHO) dietary recommendations for saturated fats, free sugars, fibre, and fruits and vegetables and all-cause mortality and fatal and non-fatal CVD. Methods We included participants from the UK Biobank cohort recruited in 2006–2010, which provided at least two valid 24-h dietary assessments. We defined adherence to dietary recommendations as ≤ 10% saturated fats, ≤ 10% free sugars, ≥ 25 g/day fibre, and ≥ 5 servings of fruits and vegetables/day. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD. In cross-sectional analyses, multivariable linear regression was used to examine associations with cardiometabolic risk factors. Results Among 115,051 participants (39–72 years), only 29.7%, 38.5%, 22.3%, and 9.5% met 0, 1, 2, or 3–4 recommendations, respectively. There was a lower risk of all-cause mortality among participants meeting more dietary recommendations ( P trend < 0.001), with a significantly lower risk among participants meeting 2: HR 0.91 (95% confidence interval [CI] 0.85–0.97) and 3–4: HR 0.79 (95% CI 0.71–0.88) recommendations. There was no trend with CVD risk, but a significantly lower risk of fatal CVD with 3–4 recommendations: HR 0.78 (95% CI 0.61–0.98). Meeting more recommendations resulted in significant cross-sectional trends ( P trend < 0.001) towards lower body fat, waist circumference, LDL cholesterol, apolipoprotein B, triglycerides, alkaline phosphatase, gamma glutammyltransferase, and hs-CRP, but higher glucose and aspartate aminotransferase. Conclusions Meeting dietary recommendations is associated with additive reductions in premature mortality. Motivating and supporting people to adhere to dietary guidelines may help extend years of healthy life expectancy.
International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the pooled health effects of adherence to international dietary recommendations. We investigated associations between total adherence to the World Health Organization (WHO) dietary recommendations for saturated fats, free sugars, fibre, and fruits and vegetables and all-cause mortality and fatal and non-fatal CVD. We included participants from the UK Biobank cohort recruited in 2006-2010, which provided at least two valid 24-h dietary assessments. We defined adherence to dietary recommendations as [less than or equai to] 10% saturated fats, [less than or equai to] 10% free sugars, [greater than or equai to] 25 g/day fibre, and [greater than or equai to] 5 servings of fruits and vegetables/day. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD. In cross-sectional analyses, multivariable linear regression was used to examine associations with cardiometabolic risk factors. Among 115,051 participants (39-72 years), only 29.7%, 38.5%, 22.3%, and 9.5% met 0, 1, 2, or 3-4 recommendations, respectively. There was a lower risk of all-cause mortality among participants meeting more dietary recommendations (P.sub.trend < 0.001), with a significantly lower risk among participants meeting 2: HR 0.91 (95% confidence interval [CI] 0.85-0.97) and 3-4: HR 0.79 (95% CI 0.71-0.88) recommendations. There was no trend with CVD risk, but a significantly lower risk of fatal CVD with 3-4 recommendations: HR 0.78 (95% CI 0.61-0.98). Meeting more recommendations resulted in significant cross-sectional trends (P.sub.trend < 0.001) towards lower body fat, waist circumference, LDL cholesterol, apolipoprotein B, triglycerides, alkaline phosphatase, gamma glutammyltransferase, and hs-CRP, but higher glucose and aspartate aminotransferase. Meeting dietary recommendations is associated with additive reductions in premature mortality. Motivating and supporting people to adhere to dietary guidelines may help extend years of healthy life expectancy.
BACKGROUNDInternational dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the pooled health effects of adherence to international dietary recommendations. We investigated associations between total adherence to the World Health Organization (WHO) dietary recommendations for saturated fats, free sugars, fibre, and fruits and vegetables and all-cause mortality and fatal and non-fatal CVD.METHODSWe included participants from the UK Biobank cohort recruited in 2006-2010, which provided at least two valid 24-h dietary assessments. We defined adherence to dietary recommendations as ≤ 10% saturated fats, ≤ 10% free sugars, ≥ 25 g/day fibre, and ≥ 5 servings of fruits and vegetables/day. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD. In cross-sectional analyses, multivariable linear regression was used to examine associations with cardiometabolic risk factors.RESULTSAmong 115,051 participants (39-72 years), only 29.7%, 38.5%, 22.3%, and 9.5% met 0, 1, 2, or 3-4 recommendations, respectively. There was a lower risk of all-cause mortality among participants meeting more dietary recommendations (Ptrend < 0.001), with a significantly lower risk among participants meeting 2: HR 0.91 (95% confidence interval [CI] 0.85-0.97) and 3-4: HR 0.79 (95% CI 0.71-0.88) recommendations. There was no trend with CVD risk, but a significantly lower risk of fatal CVD with 3-4 recommendations: HR 0.78 (95% CI 0.61-0.98). Meeting more recommendations resulted in significant cross-sectional trends (Ptrend < 0.001) towards lower body fat, waist circumference, LDL cholesterol, apolipoprotein B, triglycerides, alkaline phosphatase, gamma glutammyltransferase, and hs-CRP, but higher glucose and aspartate aminotransferase.CONCLUSIONSMeeting dietary recommendations is associated with additive reductions in premature mortality. Motivating and supporting people to adhere to dietary guidelines may help extend years of healthy life expectancy.
Abstract Background International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the pooled health effects of adherence to international dietary recommendations. We investigated associations between total adherence to the World Health Organization (WHO) dietary recommendations for saturated fats, free sugars, fibre, and fruits and vegetables and all-cause mortality and fatal and non-fatal CVD. Methods We included participants from the UK Biobank cohort recruited in 2006–2010, which provided at least two valid 24-h dietary assessments. We defined adherence to dietary recommendations as ≤ 10% saturated fats, ≤ 10% free sugars, ≥ 25 g/day fibre, and ≥ 5 servings of fruits and vegetables/day. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD. In cross-sectional analyses, multivariable linear regression was used to examine associations with cardiometabolic risk factors. Results Among 115,051 participants (39–72 years), only 29.7%, 38.5%, 22.3%, and 9.5% met 0, 1, 2, or 3–4 recommendations, respectively. There was a lower risk of all-cause mortality among participants meeting more dietary recommendations (P trend < 0.001), with a significantly lower risk among participants meeting 2: HR 0.91 (95% confidence interval [CI] 0.85–0.97) and 3–4: HR 0.79 (95% CI 0.71–0.88) recommendations. There was no trend with CVD risk, but a significantly lower risk of fatal CVD with 3–4 recommendations: HR 0.78 (95% CI 0.61–0.98). Meeting more recommendations resulted in significant cross-sectional trends (P trend < 0.001) towards lower body fat, waist circumference, LDL cholesterol, apolipoprotein B, triglycerides, alkaline phosphatase, gamma glutammyltransferase, and hs-CRP, but higher glucose and aspartate aminotransferase. Conclusions Meeting dietary recommendations is associated with additive reductions in premature mortality. Motivating and supporting people to adhere to dietary guidelines may help extend years of healthy life expectancy.
Background International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the pooled health effects of adherence to international dietary recommendations. We investigated associations between total adherence to the World Health Organization (WHO) dietary recommendations for saturated fats, free sugars, fibre, and fruits and vegetables and all-cause mortality and fatal and non-fatal CVD. Methods We included participants from the UK Biobank cohort recruited in 2006–2010, which provided at least two valid 24-h dietary assessments. We defined adherence to dietary recommendations as ≤ 10% saturated fats, ≤ 10% free sugars, ≥ 25 g/day fibre, and ≥ 5 servings of fruits and vegetables/day. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD. In cross-sectional analyses, multivariable linear regression was used to examine associations with cardiometabolic risk factors. Results Among 115,051 participants (39–72 years), only 29.7%, 38.5%, 22.3%, and 9.5% met 0, 1, 2, or 3–4 recommendations, respectively. There was a lower risk of all-cause mortality among participants meeting more dietary recommendations (Ptrend < 0.001), with a significantly lower risk among participants meeting 2: HR 0.91 (95% confidence interval [CI] 0.85–0.97) and 3–4: HR 0.79 (95% CI 0.71–0.88) recommendations. There was no trend with CVD risk, but a significantly lower risk of fatal CVD with 3–4 recommendations: HR 0.78 (95% CI 0.61–0.98). Meeting more recommendations resulted in significant cross-sectional trends (Ptrend < 0.001) towards lower body fat, waist circumference, LDL cholesterol, apolipoprotein B, triglycerides, alkaline phosphatase, gamma glutammyltransferase, and hs-CRP, but higher glucose and aspartate aminotransferase. Conclusions Meeting dietary recommendations is associated with additive reductions in premature mortality. Motivating and supporting people to adhere to dietary guidelines may help extend years of healthy life expectancy.
ArticleNumber 134
Audience Academic
Author Piernas, Carmen
Kebbe, Maryam
Gao, Min
Perez-Cornago, Aurora
Jebb, Susan A
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Issue 1
Keywords Dietary recommendations
Diet
Cardiovascular diseases
Cohort study
Mortality
Language English
License Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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Snippet International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary...
Abstract Background International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated...
Background International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor...
BACKGROUNDInternational dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor...
Abstract Background International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated...
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SubjectTerms Age
Alkaline phosphatase
Apolipoprotein B
Aspartate aminotransferase
Biobanks
Biological Specimen Banks
Biomarkers
Blood pressure
Body fat
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - prevention & control
Cholesterol
Cohort analysis
Cohort study
Confidence intervals
Cross-Sectional Studies
Diabetes
Diagnosis
Diet
Diet therapy
Dietary guidelines
Dietary recommendations
Energy
Ethnicity
Fats
Fruits
Glucose
Guidelines
Health risks
Heart diseases
Hospitals
Humans
Interactive computer systems
Life expectancy
Life span
Lipids
Lipoproteins
Low density lipoprotein
Metabolism
Mortality
Nutrients
Nutrition
Questionnaires
Requirements
Risk analysis
Risk Factors
Sociodemographics
Statistical analysis
Statistical models
Sugar
Triglycerides
United Kingdom - epidemiology
Vegetables
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Title Adherence to international dietary recommendations in association with all-cause mortality and fatal and non-fatal cardiovascular disease risk: a prospective analysis of UK Biobank participants
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