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Reaching and maintaining higher dietary diversity is associated with decreased risk of all-cause mortality: A longitudinal study from the China Health and Nutrition Survey
It is generally believed that higher dietary diversity is associated with better health status. The dietary diversity of individuals may change with age; however, evidence on the trajectory of change in the long-term and whether it is related to all-cause mortality is still scant. In this study, we...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549334/ https://www.ncbi.nlm.nih.gov/pubmed/36225878 http://dx.doi.org/10.3389/fnut.2022.947290 |
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author | Qu, Xiaochen Na, Xiaona Yang, Jiaqi Yu, Haoran Chen, Aiwen Zhao, Ai |
author_facet | Qu, Xiaochen Na, Xiaona Yang, Jiaqi Yu, Haoran Chen, Aiwen Zhao, Ai |
author_sort | Qu, Xiaochen |
collection | PubMed |
description | It is generally believed that higher dietary diversity is associated with better health status. The dietary diversity of individuals may change with age; however, evidence on the trajectory of change in the long-term and whether it is related to all-cause mortality is still scant. In this study, we used data from the China Health and Nutrition Survey (CHNS) collected in five follow-ups between 2004 and 2015 to explore the association between changes in dietary diversity scores (DDS) and all-cause mortality, as well as the dynamic change in DDS with age. In total, 6,737 subjects (aged between 30 and 60 at enrollment) were included in the analysis. Latent Class Trajectory Modeling (LCTM) was used to explore the different trajectories of DDS changes among participants. Four classes were identified: class 1 with the lowest average DDS (3.0) that showed a gradual decline during the follow-ups; class 2 with relatively low DDS (4.0) that experienced slight growth; class 3 with medium DDS (5.2) that also demonstrated similar growth rate to class 2; and class 4 with the highest DDS (6.7) maintained at a high level. Cox proportional hazards regression models were applied to investigate the association between the DDS trajectories and the risk of death. Only class 4, which was characterized by the highest and stable DDS, had significant reduced risk of all-cause mortality of 71.0% (hazard ratio [HR]: 0.29; 95% confidence interval [CI]: 0.10–0.83), 68% (HR: 0.32; 95% CI: 0.11–0.89), and 66.0% (HR: 0.34; 95% CI: 0.12–0.94), compared to classes 1, 2, and 3, respectively, while the first three classes showed no significant inter-class differences. When considering the average DDS during the study period, each point of increase in DDS corresponded to a 22% reduced risk of mortality (HR: 0.78; 95% CI: 0.69–0.89). In summary, reaching and maintaining a higher DDS was associated with a decreased risk of all-cause mortality. Therefore, promoting diversified eating and increasing the accessibility of varieties of foods should be paid more attention from policymakers and be more emphasized in dietary guidelines. |
format | Online Article Text |
id | pubmed-9549334 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95493342022-10-11 Reaching and maintaining higher dietary diversity is associated with decreased risk of all-cause mortality: A longitudinal study from the China Health and Nutrition Survey Qu, Xiaochen Na, Xiaona Yang, Jiaqi Yu, Haoran Chen, Aiwen Zhao, Ai Front Nutr Nutrition It is generally believed that higher dietary diversity is associated with better health status. The dietary diversity of individuals may change with age; however, evidence on the trajectory of change in the long-term and whether it is related to all-cause mortality is still scant. In this study, we used data from the China Health and Nutrition Survey (CHNS) collected in five follow-ups between 2004 and 2015 to explore the association between changes in dietary diversity scores (DDS) and all-cause mortality, as well as the dynamic change in DDS with age. In total, 6,737 subjects (aged between 30 and 60 at enrollment) were included in the analysis. Latent Class Trajectory Modeling (LCTM) was used to explore the different trajectories of DDS changes among participants. Four classes were identified: class 1 with the lowest average DDS (3.0) that showed a gradual decline during the follow-ups; class 2 with relatively low DDS (4.0) that experienced slight growth; class 3 with medium DDS (5.2) that also demonstrated similar growth rate to class 2; and class 4 with the highest DDS (6.7) maintained at a high level. Cox proportional hazards regression models were applied to investigate the association between the DDS trajectories and the risk of death. Only class 4, which was characterized by the highest and stable DDS, had significant reduced risk of all-cause mortality of 71.0% (hazard ratio [HR]: 0.29; 95% confidence interval [CI]: 0.10–0.83), 68% (HR: 0.32; 95% CI: 0.11–0.89), and 66.0% (HR: 0.34; 95% CI: 0.12–0.94), compared to classes 1, 2, and 3, respectively, while the first three classes showed no significant inter-class differences. When considering the average DDS during the study period, each point of increase in DDS corresponded to a 22% reduced risk of mortality (HR: 0.78; 95% CI: 0.69–0.89). In summary, reaching and maintaining a higher DDS was associated with a decreased risk of all-cause mortality. Therefore, promoting diversified eating and increasing the accessibility of varieties of foods should be paid more attention from policymakers and be more emphasized in dietary guidelines. Frontiers Media S.A. 2022-09-26 /pmc/articles/PMC9549334/ /pubmed/36225878 http://dx.doi.org/10.3389/fnut.2022.947290 Text en Copyright © 2022 Qu, Na, Yang, Yu, Chen and Zhao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Nutrition Qu, Xiaochen Na, Xiaona Yang, Jiaqi Yu, Haoran Chen, Aiwen Zhao, Ai Reaching and maintaining higher dietary diversity is associated with decreased risk of all-cause mortality: A longitudinal study from the China Health and Nutrition Survey |
title | Reaching and maintaining higher dietary diversity is associated with decreased risk of all-cause mortality: A longitudinal study from the China Health and Nutrition Survey |
title_full | Reaching and maintaining higher dietary diversity is associated with decreased risk of all-cause mortality: A longitudinal study from the China Health and Nutrition Survey |
title_fullStr | Reaching and maintaining higher dietary diversity is associated with decreased risk of all-cause mortality: A longitudinal study from the China Health and Nutrition Survey |
title_full_unstemmed | Reaching and maintaining higher dietary diversity is associated with decreased risk of all-cause mortality: A longitudinal study from the China Health and Nutrition Survey |
title_short | Reaching and maintaining higher dietary diversity is associated with decreased risk of all-cause mortality: A longitudinal study from the China Health and Nutrition Survey |
title_sort | reaching and maintaining higher dietary diversity is associated with decreased risk of all-cause mortality: a longitudinal study from the china health and nutrition survey |
topic | Nutrition |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549334/ https://www.ncbi.nlm.nih.gov/pubmed/36225878 http://dx.doi.org/10.3389/fnut.2022.947290 |
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