說明:

1. 背景:

由於肉類產品代表西方飲食中蛋白質的主要來源,肉類的攝取量是否會顯著導致致命的疾病負擔,此研究結果具有重要的臨床和公共健康的影響。

2. 目的:

目的是研究非常低的肉類攝取量(小於每週)是否有助於提高壽命。

3. 設計:

我們回顧6個前瞻性族群研究的數據和報告從復臨健康研究(Adventist Health Study) 中的長期素食者壽命的新發現。

4. 結果:

我們對6項研究的審查中發現以下趨勢:

14項研究中顯示非常低的肉類攝取量顯著下降死亡的風險,第5項研究中沒有顯著減少死亡風險,在第6項研究中兩者幾乎沒有關聯;

22低肉類攝取量顯著降低死亡風險的研究中也指出,以這樣的飲食堅持持續時間較長者(≥20年),除造成的死亡風險顯著下降以外,其預期壽命顯著了增加3.6年(95%信賴區間
1.4-5.8 年)
;

3)非常低肉類攝取的保護效應似乎在第九十年後衰減。

一些素食者中生存優勢的變異,在調整干擾因素包括(1)素食主義者的定義,(2)測量誤差,(3)年齡分佈,(4)健康志願者的作用,以及(5)攝入特定植物的食物後,可能是由於研究之間的素食者顯著差異所造成。

5. 結論:

從成人在北美和歐洲目前的前瞻性隊列的數據提高了,其中包括一個非常低的肉類攝入一種生活方式的模式具有更大的長壽相關的可能性。

評論:

1. 到底素食是不是比較健康,這是一個常被民眾關心的話題。此篇回顧性的研究回答了部分的答案,也就是說: 多數的研究發現少吃肉類,可能提升預期的壽命。但仍有少數的研究發現兩者不相關。如此大的差異,應該與研究的族群彼此間的變異有關。因此民眾如果要了解自己最佳的飲食方式,應該可以從一些健康檢查的數據中找到蛛絲馬跡,另外是否罹患一些與飲食相關的疾病,也是參考的指標。

2015-11-6 http://1690.tw

參考文獻:

1. Pramil N Singh, Joan Sabaté, and Gary E Fraser. Does low meat consumption increase life expectancy in humans? Am J Clin Nutr 2003;78(suppl):526S–32S

TABLE 1

Studies that related very low intake of all meats to all-cause mortality1

Cohort

Reference

Length of follow-up

Description of very-low-meat-intake group

Description of high-meat-intake group

Adjusted mortality ratio (95% CI)2

Method of control for confounding

1NR, not given in the published report.
2Very-low-meat-intake group compared with high-meat-intake group.
3Vegetarian was not defined further on the questionnaire for this study. Subsequent validity studies indicated that 66% of those indicating themselves as vegetarian consumed no meat or fish.
4Vegetarian was defined as zero or occasional intake of meat or fish as reported on a food-frequency questionnaire for this study.

y

Oxford Vegetarian Study (UK) Appleby et al (15, 16)

12

Zero meat intake (n = 6000) Meateater (n = 5000)

0.80 (0.65, 0.99)

Age, smoking, BMI, social class

22

Zero meat intake (n = 6000) Meateater (n = 5000)

1.01 (0.89, 1.14)

Age, smoking, BMI, social class
Health Food Shoppers Study (UK) Key et al (17)

17

Vegetarian (n = 4627)3 Nonvegetarian (n = 6144)

1.04 (0.93, 1.16)

Age, sex, smoking
Germans Chang-Claude et al (18, 19)

11

Vegetarian (1904)4 General population

0.44 (0.36, 0.53) for men; 0.53 (0.44, 0.64) for women

Age
Adventist Mortality Study (US) Kahn et al (22), Singh (1)

26

Zero meat intake (n = 7918) Meat eaten once or more per wk (n = 6958)

0.88 (0.82, 0.93)

Age, sex, education, and BMI by multivariate adjustment; ever-smokers, alcohol users, and those with baseline chronic disease excluded from analysis
Adventist Health Study (US) Fraser (20), Singh (1), Fraser and Shavlik (21)

12

Zero meat intake (n = 7191) Meat eaten once or more per wk (n = 7463)

0.85 (0.76, 0.94)

Age, sex, education, BMI, physical activity by multivariate adjustment; ever-smokers, alcohol users, and those with baseline chronic illness excluded from analysis
Italians Fortes et al (23)

5

Meat eaten less than once per wk (NR) Meat eaten more than once per wk (NR)

0.55 (0.28, 1.10)

Age, sex, education, BMI, smoking, cognitive function, chronic diseases

TABLE 2

Studies that examined the relation between duration of very low intake of all meats and subsequent risk of all-cause mortality among vegetarians

Cohort

Long-duration group

Short-duration group

Length of subsequent follow-up

Age-adjusted mortality ratio (95% CI)1

Multivariate mortality ratio (95% CI)1

1Long-duration group compared with short-duration group.
2Adjusted for age, sex, physical activity, BMI, and adherence to vegetarianism.
3Adjusted for age, sex, physical activity, BMI by multivariate adjustment; ever-smokers, alcohol users, and those with chronic diseases at baseline were excluded.

y

German vegetarians (18,19) Very low meat intake for ≥20 y (n = 1259) Very low meat intake for <20 y (n = 645)

11

0.69 (0.49, 0.98)

0.71 (0.49, 1.02)2

Seventh-day Adventist vegetarians (1) Zero meat intake for 17 y (n = 1906) Zero meat intake for <17 y (n = 265)

12

0.64 (0.48, 0.85)

0.70 (0.51,


FIGURE 1.

Cumulative survival, smoothed instantaneous hazards (26), and life expectancies (LE; reference 27) for long-term vegetarians (zero intake of all meats) and short-term vegetarians in the Adventist Studies. Long-term vegetarians reported zero meat intake for 17 y of the follow-up; short-term vegetarians reported zero meat intake for < 17 y of the follow-up. 1Significant 3.6-y difference (Z test given in reference 27) in life expectancy between long-term and short-term vegetarians (95% CI: 1.4, 5.8).

原文摘要:

Background:

Since meat products represent a major source of protein in the Western diet, findings on whether meat intake significantly contributes to the burden of fatal disease have important clinical and public health implications.

Objective:

The objective was to examine whether a very low meat intake (less than weekly) contributes to greater longevity.

Design:

We reviewed data from 6 prospective cohort studies and report new findings on the life expectancy of long-term vegetarians from the Adventist Health Study.

Results:

Our review of the 6 studies found the following trends:

1) a very low meat intake was associated with a significant decrease in risk of death in 4 studies, a nonsignificant decrease in risk of death in the fifth study, and virtually no association in the sixth study;

2) 2 of the studies in which a low meat intake significantly decreased mortality risk also indicated that a longer duration (≥ 2 decades) of adherence to this diet contributed to a significant decrease in mortality risk and a significant 3.6-y (95% CI: 1.4, 5.8 y) increase in life expectancy; and

3) The protective effect of a very low meat intake seems to attenuate after the ninth decade. Some of the variation in the survival advantage in vegetarians may have been due to marked differences between studies in adjustment for confounders, the definition of vegetarian, measurement error, age distribution, the healthy volunteer effect, and intake of specific plant foods by the vegetarians.

Conclusion:

Current prospective cohort data from adults in North America and Europe raise the possibility that a lifestyle pattern that includes a very low meat intake is associated with greater longevity.


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