Abstract
Background: Whether mushroom consumption, which is rich in several bioactive compounds, including the crucial antioxidants ergothioneine and glutathione, is inversely associated with low all-cause and cause-specific mortality remains uncertain. This study aimed to prospectively investigate the association between mushroom consumption and all-cause and cause-specific mortality risk. Methods: Longitudinal analyses of participants from the Third National Health and Nutrition Examination Survey (NHANES III) extant data (1988–1994). Mushroom intake was assessed by a single 24-h dietary recall using the US Department of Agriculture food codes for recipe foods. All-cause and cause-specific mortality were assessed in all participants linked to the National Death Index mortality data (1988–2015). We used Cox proportional hazards regression models to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95% Cls) for all-cause and cause-specific mortality. Results: Among 15,546 participants included in the current analysis, the mean (SE) age was 44.3 (0.5) years. During a mean (SD) follow-up duration of 19.5 (7.4) years, a total of 5826 deaths were documented. Participants who reported consuming mushrooms had lower risk of all-cause mortality compared with those without mushroom intake (adjusted hazard ratio (HR) = 0.84; 95% CI: 0.73–0.98) after adjusting for demographic, major lifestyle factors, overall diet quality, and other dietary factors including total energy. When cause-specific mortality was examined, we did not observe any statistically significant associations with mushroom consumption. Consuming 1-serving of mushrooms per day instead of 1-serving of processed or red meats was associated with lower risk of all-cause mortality (adjusted HR = 0.65; 95% CI: 0.50-0.84). We also observed a dose-response relationship between higher mushroom consumption and lower risk of all-cause mortality (P-trend = 0.03). Conclusion: Mushroom consumption was associated with a lower risk of total mortality in this nationally representative sample of US adults. Keywords: Mushroom, Mortality risk, Diet, Prospective study, NHANES III
Generated Summary
This prospective cohort study used data from the Third National Health and Nutrition Examination Survey (NHANES III) (1988–1994) to investigate the association between mushroom consumption and all-cause and cause-specific mortality among American adults. The study assessed mushroom intake through a single 24-hour dietary recall and linked participants to the National Death Index (NDI) mortality data (1988–2015). Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for all-cause and cause-specific mortality. The study included 15,546 participants aged 18 or older. The main exposure was mushroom intake, and the outcomes were all-cause and cause-specific mortality. Covariates included demographic, lifestyle, and dietary factors. The research aimed to determine if mushroom consumption was inversely associated with mortality risk, considering its rich content of bioactive compounds like ergothioneine and glutathione.
Key Findings & Statistics
- The study included 15,546 participants, with a mean age of 44.3 ± 0.5 years.
- A total of 5826 deaths were documented during a mean follow-up of 19.5 ± 7.4 years.
- Participants consuming mushrooms had a lower risk of all-cause mortality (adjusted HR = 0.84; 95% CI: 0.73–0.98).
- The study found that the association between mushroom consumption and all-cause mortality remained statistically significant after adjusting for demographic, major lifestyle factors, overall diet quality, and other dietary factors, including total energy intake.
- The study observed a dose-response relationship between mushroom consumption and all-cause mortality (P-trend = 0.03).
- Consuming 1-serving of mushrooms per day instead of 1-serving of processed or red meats was associated with lower all-cause mortality risk (adjusted HR = 0.65; 95% CI: 0.50-0.84).
- Model 1, which adjusted for age and sex, showed an adjusted HR of 0.79 (95% CI: 0.67-0.92).
- Model 3, with further adjustments for BMI, physical activity, smoking, alcohol, and other dietary factors, yielded an adjusted HR of 0.84 (95% CI: 0.73-0.98).
- In cause-specific mortality analyses, adjusted HRs were as follows: cardiovascular disease (adjusted HR = 0.82; 95% CI: 0.56-1.21), cancer (adjusted HR = 0.77; 95% CI: 0.50-1.19), Alzheimer disease (adjusted HR = 0.90; 95% CI: 0.31-2.60), diabetes mellitus (adjusted HR = 0.32; 95% CI: 0.06-1.65), and other causes of mortality (adjusted HR = 0.93; 95% CI: 0.70-1.23).
- Substituting 1-serving/d of mushroom for red or processed meat: adjusted HR for all-cause mortality was 0.65 (95% CI: 0.50-0.84).
- The mean HEI-2000 score was higher among mushroom consumers compared to non-consumers (Table 1).
- The incidence rate for mushroom intake was 14.9 (12.8, 17.3) per 1000 person-years.
- In the sensitivity analyses, excluding 385 deaths in the first 2 years: adjusted HR = 0.82; 95%CI: 0.70-0.97.
Other Important Findings
- The study found that compared with individuals without mushroom intake, mushroom consumers were more likely to be from the South region of the US, non-Hispanic whites, and have higher education levels.
- The association between mushroom intake and all-cause mortality remained statistically significant after adjusting for potential confounders including ethnicity-race, region, place of residence, education, marital status, BMI, physical activity, total energy intake, and other dietary factors.
- The study found that greater mushroom consumption was associated with a lower risk of all-cause mortality.
Limitations Noted in the Document
- The study used a single 24-hour dietary recall, which may not capture long-term dietary patterns and could lead to misclassification.
- The assessment of mushroom consumption relied on USDA food codes for recipe foods, potentially leading to misclassification of exposure.
- The study did not differentiate between types of mushrooms.
- The observational nature of the study prevents establishing causality.
- The study did not include information on ergothioneine and glutathione intake.
Conclusion
The study’s findings demonstrate a significant inverse association between mushroom consumption and the risk of all-cause mortality in a nationally representative sample of US adults. This research suggests that incorporating mushrooms into the diet could be beneficial for public health, potentially lowering the risk of premature mortality. The study highlights that replacing red or processed meat with mushrooms may further reduce mortality risk, emphasizing the potential of dietary interventions in health outcomes. The results support and build upon existing knowledge regarding the health benefits of mushrooms, aligning with previous research that has shown their association with better nutrient intake and improved diet quality. The study’s findings are especially pertinent considering the role of mushrooms in containing antioxidants like ergothioneine and glutathione, which are known to combat oxidative stress and are linked to the prevention of chronic diseases. The study underscores the importance of understanding the potential of mushrooms in the context of broader dietary guidelines and public health recommendations. Further research is needed to replicate these findings and to explore the specific mechanisms and types of mushrooms that contribute most to the observed health benefits. The study suggests that there is a need for greater awareness of the health-promoting effects of mushrooms to improve health outcomes in the US population. The study emphasizes that mushrooms have low levels of energy, sodium, and fats and are high in fiber, vitamins, and minerals. The results reinforce the idea of mushrooms being considered as a significant food source with potential health benefits.