Abstract
Objective: Although dietary preferences influence chronic diseases, few studies have linked dietary preferences to mortality risk, particularly in large cohorts. To investigate the relationship between dietary preferences and mortality risk (all-cause, cancer, and cardiovascular disease [CVD]) in a large adult cohort. Methods A cohort of 1,160,312 adults (mean age 62.48±9.55) from the Shenzhen Healthcare Big Data Cohort (SHBDC) was analyzed. Hazard ratios (HRs) for mortality were estimated using the Cox proportional hazards model. Results The study identified 12,308 all-cause deaths, of which 3,865 (31.4%) were cancer-related and 3,576 (29.1%) were attributed to CVD. Compared with a mixed diet of meat and vegetables, a mainly meat-based diet (hazard ratio [HR] = 1.13; 95% confidence interval [CI] 1.02, 1.27), and a mainly vegetarian (HR = 0.87; 95% CI: 0.78, 0.97) substantially raised the risk of all-cause death; Oil preference (HR=0.57; 95% CI: 0.40, 0.83) and sugar preference (HR = 0.58; 95% CI: 0.41, 0.83) significantly reduced the risk of all-cause death; a mainly vegetarian (HR = 0.77; 95% CI: 0.62, 0.97) reduced the risk of CVD death. Furthermore, there was a stronger correlation between mortality risk and dietary preference in the > 65 age range. Conclusion A meat-based diet was associated with an increased risk of all-cause mortality, whereas a mainly vegetarian diet was linked to a reduced risk. Preferences for oil and sugar were also associated with lower all-cause mortality risk; however, these findings should be interpreted with caution.
Generated Summary
This study investigates the relationship between dietary preferences and mortality risk in a large adult cohort from the Shenzhen Healthcare Big Data Cohort (SHBDC). The study employs a prospective cohort design, analyzing data from 1,160,312 adults with an average age of 62.48 years. The research aims to determine how different dietary patterns (meat-based, vegetarian, and preferences for oil and sugar) correlate with all-cause, cancer, and cardiovascular disease (CVD) mortality. Cox proportional hazards models were used to estimate hazard ratios (HRs) for mortality based on dietary preferences, adjusting for various covariates like age, sex, and lifestyle factors. The findings are expected to contribute to the understanding of diet-related mortality risks and provide evidence to inform public health policies and dietary recommendations.
Key Findings & Statistics
- The study analyzed data from 1,160,312 adults.
- 12,308 all-cause deaths were identified during the study period.
- 3,865 of the deaths were cancer-related (31.4%).
- 3,576 deaths were attributed to CVD (29.1%).
- Compared to a mixed diet of meat and vegetables, a mainly meat-based diet was associated with an increased risk of all-cause death (HR = 1.13; 95% CI: 1.02, 1.27).
- A mainly vegetarian diet was associated with a reduced risk of all-cause death (HR = 0.87; 95% CI: 0.78, 0.97).
- Oil preference was associated with reduced risk (HR=0.57; 95% CI: 0.40, 0.83).
- Sugar preference was associated with reduced risk (HR = 0.58; 95% CI: 0.41, 0.83).
- A mainly vegetarian diet was associated with a reduced risk of CVD death (HR = 0.77; 95% CI: 0.62, 0.97).
- In the age group of >65, the correlation between mortality risk and dietary preference was stronger.
- The study included 7,189 (58.38%) males and 5,119 (41.61%) females who died.
- The follow-up time was (25.16 ± 27.66) months for the cancer death analysis group.
- The follow-up time was (25.16 ± 28.06) months for the CVD death analysis group.
- During the study, there were 3,865 cancer-related deaths, 3,576 CVD-related deaths, and 12,308 all-cause deaths.
- The mean age of participants was 62.48 years.
- In men, the mainly meat-based diet resulted in a higher risk of all-cause mortality (HR = 1.20; 95% CI: 1.08, 1.34) and cancer mortality (HR = 1.21; 95% CI: 1.00, 1.48).
- In the age group of 65 years or older, the mainly meat-based diet was significantly associated with higher risks of all-cause mortality (HR = 1.28; 95% CI: 1.14, 1.45), cancer mortality (HR = 1.38; 95% CI: 1.12, 1.72), and CVD mortality (HR=1.27; 95% CI: 1.02, 1.58).
Other Important Findings
- A meat-based diet was associated with an increased risk of all-cause mortality.
- A mainly vegetarian diet was linked to a reduced risk of all-cause mortality and CVD mortality.
- Preferences for oil and sugar were associated with lower all-cause mortality risk.
- The association between dietary patterns and mortality outcomes was more prominent in the older age group (≥ 65 years).
- In sex-stratified analysis, among men, salt preference, oil preference, and sugar preference were significantly associated with lower all-cause mortality.
- Among women, only mainly vegetarian showed a significant protective effect on all-cause mortality.
- Significant interactions were observed between sex and both the mainly vegetarian and salt preference, indicating differential effects by sex.
Limitations Noted in the Document
- The study’s reliance on self-reported dietary data may have introduced recall bias and inaccurate classification of dietary preferences.
- The follow-up period was relatively short, potentially limiting the observation of long-term effects of dietary patterns.
- Some potential confounders may not have been fully identified or measured, which could affect the results.
- The study design, which is cross-sectional, may limit the ability to establish causality between dietary preferences and mortality outcomes.
- The study used simplified questionnaires for dietary data collection.
Conclusion
The study’s findings highlight the significant impact of dietary preferences on mortality risk in a large cohort of adults in Shenzhen. The results show that a meat-based diet is associated with an increased risk of mortality from all causes, whereas a vegetarian diet is linked to a reduced risk, particularly among older adults. Preferences for oil and sugar also showed protective effects. These findings are consistent with previous studies and possible mechanisms include inflammatory responses, oxidative stress, and increased saturated fat intake caused by red and processed meats. Stratified analysis revealed that the effects of dietary patterns on mortality risk were heterogeneous across different sexes and age groups. Dietary recommendations should be personalized. The study suggests that the elderly may be more sensitive to adverse dietary factors. The implications of this research support the development of public health policies and dietary recommendations and provide solid evidence for public health policies. Therefore, the study recommends that personalized dietary recommendations should be formulated.