Inverse association between Paleolithic Diet Fraction and mortality and incidence of cardiometabolic disease in the prospective Malmö Diet and Cancer Study.

Cardiometabolic disease Cohort study Diet HR hazard ratio ICD International Classification of Diseases Mortality Paleolithic Diet Fraction

Journal

European journal of nutrition
ISSN: 1436-6215
Titre abrégé: Eur J Nutr
Pays: Germany
ID NLM: 100888704

Informations de publication

Date de publication:
11 Dec 2023
Historique:
received: 09 03 2023
accepted: 08 11 2023
medline: 11 12 2023
pubmed: 11 12 2023
entrez: 11 12 2023
Statut: aheadofprint

Résumé

Paleolithic Diet Fraction (PDF) estimates how large a portion of the absolute dietary intake stems from food groups included in the Paleolithic diet. In randomized controlled trials higher PDFs have been associated with healthier levels of cardiometabolic risk markers. Our aim was to build upon these findings by examining associations between PDF and mortality and incidence of cardiometabolic disease in the prospective Malmö Diet and Cancer Study. PDF was calculated from an interview-based, modified diet history method, and associations were estimated by using multivariable Cox proportional hazards regression. The examined cohort consisted of 24,104 individuals (44-74 years, 63% women) without previous coronary events, diabetes, or stroke at baseline (1992-1996). A total of 10,092 individuals died during a median follow-up of 18 years. Median PDF was 40% (0-90%). The adjusted hazard ratios (HR) for PDF as a continuous variable (from 0 to 100%) were for risk of death from all causes 0.55 [95% CI 0.45, 0.66], tumor 0.68 [95% CI 0.49, 0.93], cardiovascular 0.55 [95% CI 0.39, 0.78], respiratory 0.44 [95% CI 0.21, 0.90], neurological 0.26 [95% CI 0.11, 0.60], digestive, 0.10 [95% CI 0.03, 0.30], and other diseases 0.64 [95% CI 0.41, 1.00]. The corresponding HR for risk of coronary event was 0.61 [95% 0.43, 0.86], for ischemic stroke it was 0.73 [95% 0.48, 1.09] and for type 2 diabetes it was 0.82 [95% 0.61, 1.10]. Observational data suggest an inverse association between PDF and all-cause as well as cause-specific mortality and incidence of cardiometabolic disease.

Identifiants

pubmed: 38078965
doi: 10.1007/s00394-023-03279-6
pii: 10.1007/s00394-023-03279-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s).

Références

Eaton SB, Konner M (1985) Paleolithic nutrition. A consideration of its nature and current implications. N Engl J Med 312:283–289. https://doi.org/10.1056/NEJM198501313120505
doi: 10.1056/NEJM198501313120505 pubmed: 2981409
Lindeberg S, Cordain L, Eaton SB (2003) Biological and clinical potential of a palaeolithic diet. J Nutr Environ Med 13:149–160. https://doi.org/10.1080/13590840310001619397
doi: 10.1080/13590840310001619397
Manheimer EW, van Zuuren EJ, Fedorowicz Z, Pijl H (2015) Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis12. Am J Clin Nutr 102:922–932. https://doi.org/10.3945/ajcn.115.113613
doi: 10.3945/ajcn.115.113613 pubmed: 26269362 pmcid: 4588744
Ghaedi E, Mohammadi M, Mohammadi H et al (2019) Effects of a Paleolithic Diet on cardiovascular disease risk factors: a systematic review and meta-analysis of randomized controlled trials. Adv Nutr 10:634–646. https://doi.org/10.1093/advances/nmz007
doi: 10.1093/advances/nmz007 pubmed: 31041449 pmcid: 6628854
Rydhög B, Granfeldt Y, Frassetto L et al (2019) Assessing compliance with Paleolithic diet by calculating Paleolithic Diet Fraction as the fraction of intake from Paleolithic food groups. Clin Nutr Exp 25:29–35. https://doi.org/10.1016/j.yclnex.2019.03.002
doi: 10.1016/j.yclnex.2019.03.002
Rydhög B, Granfeldt Y, Sundquist K, Jönsson T (2021) Paleolithic diet fraction in post hoc data analysis of a randomized cross-over study comparing Paleolithic diet with diabetes diet. Clin Nutr Open Sci 38:73–80. https://doi.org/10.1016/j.nutos.2021.07.001
doi: 10.1016/j.nutos.2021.07.001
Mårtensson A, Stomby A, Tellström A et al (2021) Using a Paleo ratio to assess adherence to Paleolithic dietary recommendations in a randomized controlled trial of individuals with type 2 diabetes. Nutrients 13:969. https://doi.org/10.3390/nu13030969
doi: 10.3390/nu13030969 pubmed: 33802738 pmcid: 8002510
Whalen KA, Judd S, McCullough ML et al (2017) Paleolithic and mediterranean diet pattern scores are inversely associated with all-cause and cause-specific mortality in adults. J Nutr 147:612–620. https://doi.org/10.3945/jn.116.241919
doi: 10.3945/jn.116.241919 pubmed: 28179490 pmcid: 5368578
Manjer J, Carlsson S, Elmståhl S et al (2001) The Malmö diet and cancer study: representativity, cancer incidence and mortality in participants and non-participants. Eur J Cancer Prev 10:489–499. https://doi.org/10.1097/00008469-200112000-00003
doi: 10.1097/00008469-200112000-00003 pubmed: 11916347
Wirfält E, Sonestedt E (2016) The modified diet history methodology of the Malmö Diet and Cancer cohort
Callmer E, Riboli E, Saracci R et al (1993) Dietary assessment methods evaluated in the Malmö food study. J Intern Med 233:53–57. https://doi.org/10.1111/j.1365-2796.1993.tb00648.x
doi: 10.1111/j.1365-2796.1993.tb00648.x pubmed: 8429287
Wirfält E, Mattisson I, Johansson U et al (2002) A methodological report from the Malmö Diet and Cancer study: development and evaluation of altered routines in dietary data processing. Nutr J 1:3. https://doi.org/10.1186/1475-2891-1-3
doi: 10.1186/1475-2891-1-3 pubmed: 12537595 pmcid: 149436
Elmståhl S, Riboli E, Lindgärde F et al (1996) The Malmö Food Study: the relative validity of a modified diet history method and an extensive food frequency questionnaire for measuring food intake. Eur J Clin Nutr 50:143–151
pubmed: 8654327
Riboli E, Elmståhl S, Saracci R et al (1997) The Malmö Food Study: validity of two dietary assessment methods for measuring nutrient intake. Int J Epidemiol 26(Suppl 1):S161–S173. https://doi.org/10.1093/ije/26.suppl_1.s161
doi: 10.1093/ije/26.suppl_1.s161 pubmed: 9126544
(2014) Nordic Nutrition Recommendations 2012 : Integrating nutrition and physical activity. Nordisk Ministerråd
Bergwall S, Acosta S, Ramne S et al (2021) Leisure-time physical activities and the risk of cardiovascular mortality in the Malmö diet and Cancer study. BMC Public Health 21:1948. https://doi.org/10.1186/s12889-021-11972-6
doi: 10.1186/s12889-021-11972-6 pubmed: 34702239 pmcid: 8549319
Hanas R, John G, International HBA1c Consensus Committee (2010) 2010 consensus statement on the worldwide standardization of the hemoglobin A1C measurement. Diabetes Care 33:1903–1904. https://doi.org/10.2337/dc10-0953
Hoelzel W, Weykamp C, Jeppsson J-O et al (2004) IFCC reference system for measurement of hemoglobin A1c in human blood and the national standardization schemes in the United States, Japan, and Sweden: a method-comparison study. Clin Chem 50:166–174. https://doi.org/10.1373/clinchem.2003.024802
doi: 10.1373/clinchem.2003.024802 pubmed: 14709644
WHO Consultation on Obesity (1999: Geneva S, Organization WH (2000) Obesity : preventing and managing the global epidemic : report of a WHO consultation. 252 p.
Vittinghoff E (2012) Regression methods in biostatistics: linear, logistic, survival, and repeated measures models, 2nd edn. Springer, New York
doi: 10.1007/978-1-4614-1353-0
Whalen KA, McCullough M, Flanders WD et al (2014) Paleolithic and Mediterranean diet pattern scores and risk of incident, sporadic colorectal adenomas. Am J Epidemiol 180:1088–1097. https://doi.org/10.1093/aje/kwu235
doi: 10.1093/aje/kwu235 pubmed: 25326623 pmcid: 4239795
Bonaccio M, Di Castelnuovo A, Costanzo S et al (2021) Association of a traditional Mediterranean diet and non-Mediterranean dietary scores with all-cause and cause-specific mortality: prospective findings from the Moli-sani Study. Eur J Nutr 60:729–746. https://doi.org/10.1007/s00394-020-02272-7
doi: 10.1007/s00394-020-02272-7 pubmed: 32440732
Cheng E, Um CY, Prizment A et al (2018) Associations of evolutionary-concordance diet, Mediterranean Diet, and evolutionary-concordance lifestyle pattern scores with all-cause and cause-specific mortality. Br J Nutr. https://doi.org/10.1017/S0007114518003483
doi: 10.1017/S0007114518003483 pubmed: 30560736 pmcid: 6581641
Tsivgoulis G, Judd S, Letter AJ et al (2013) Adherence to a Mediterranean diet and risk of incident cognitive impairment. Neurology 80:1684–1692. https://doi.org/10.1212/WNL.0b013e3182904f69
doi: 10.1212/WNL.0b013e3182904f69 pubmed: 23628929 pmcid: 3716473
González-Padilla E, Tao Z, Sánchez-Villegas A et al (2022) Association between adherence to Swedish dietary guidelines and mediterranean diet and risk of stroke in a Swedish population. Nutrients 14:1253. https://doi.org/10.3390/nu14061253
doi: 10.3390/nu14061253 pubmed: 35334910 pmcid: 8954837
Vieyra G, Hankinson SE, Oulhote Y et al (2023) Dietary patterns and urinary phthalate exposure among postmenopausal women of the Women’s Health Initiative. Environ Res 216:114727. https://doi.org/10.1016/j.envres.2022.114727
doi: 10.1016/j.envres.2022.114727 pubmed: 36356671
Bonaccio M, Costanzo S, Di Castelnuovo A et al (2023) Increased adherence to a mediterranean diet is associated with reduced low-grade inflammation after a 12.7-Year period: results from the Moli-sani study. J Acad Nutr Diet 123:783-795.e7. https://doi.org/10.1016/j.jand.2022.12.005
doi: 10.1016/j.jand.2022.12.005 pubmed: 36549563
Hirahatake KM, Jiang L, Wong ND et al (2019) Diet quality and cardiovascular disease risk in postmenopausal women with type 2 diabetes mellitus: The Women’s Health initiative. J Am Heart Assoc 8:e013249. https://doi.org/10.1161/JAHA.119.013249
doi: 10.1161/JAHA.119.013249 pubmed: 31533514 pmcid: 6806027
Bonaccio M, Di Castelnuovo A, Ruggiero E et al (2022) Joint association of food nutritional profile by Nutri-Score front-of-pack label and ultra-processed food intake with mortality: Moli-sani prospective cohort study. BMJ. https://doi.org/10.1136/bmj-2022-070688
doi: 10.1136/bmj-2022-070688 pubmed: 36450651 pmcid: 9430377
Shikany JM, Safford MM, Soroka O et al (2021) Mediterranean diet score, dietary patterns, and risk of sudden cardiac death in the REGARDS study. JAHA 10:e019158. https://doi.org/10.1161/JAHA.120.019158
doi: 10.1161/JAHA.120.019158 pubmed: 34189926 pmcid: 8403280
Cheng E, Um CY, Prizment AE et al (2018) Evolutionary concordance lifestyle- and diet- and mediterranean diet-pattern scores and risk of incident colorectal cancer in Iowa women. Cancer Epidemiol Biomarkers Prev 27:1195–1202. https://doi.org/10.1158/1055-9965.EPI-17-1184
doi: 10.1158/1055-9965.EPI-17-1184 pubmed: 30108096 pmcid: 6170696
Bonaccio M, Bonanni AE, Di Castelnuovo A et al (2012) Low income is associated with poor adherence to a Mediterranean diet and a higher prevalence of obesity: cross-sectional results from the Moli-sani study. BMJ Open 2:e001685. https://doi.org/10.1136/bmjopen-2012-001685
doi: 10.1136/bmjopen-2012-001685 pubmed: 23166131 pmcid: 3533017
Stubbendorff A, Sonestedt E, Ramne S et al (2022) Development of an EAT-Lancet index and its relation to mortality in a Swedish population. Am J Clin Nutr 115:705–716. https://doi.org/10.1093/ajcn/nqab369
doi: 10.1093/ajcn/nqab369 pubmed: 34791011
Mursu J, Steffen LM, Meyer KA et al (2013) Diet quality indexes and mortality in postmenopausal women: the Iowa Women’s Health Study1234. Am J Clin Nutr 98:444–453. https://doi.org/10.3945/ajcn.112.055681
doi: 10.3945/ajcn.112.055681 pubmed: 23783291 pmcid: 3712553
Sohouli MH, Baniasadi M, Hernández-Ruiz Á et al (2023) Associations of the Paleolithic diet pattern scores and the risk of breast cancer among adults: a case-control study. Nutr Cancer 75:256–264. https://doi.org/10.1080/01635581.2022.2108466
doi: 10.1080/01635581.2022.2108466 pubmed: 35938520
Penley MJ, Byrd DA, Bostick RM (2022) Associations of evolutionary-concordance diet and lifestyle pattern scores with incident, sporadic colorectal adenoma in a pooled case-control study. Nutr Cancer 74:2075–2087. https://doi.org/10.1080/01635581.2021.2002919
doi: 10.1080/01635581.2021.2002919 pubmed: 35102803 pmcid: 10041860
Shah S, Mahamat-Saleh Y, Hajji-Louati M et al (2023) Palaeolithic diet score and risk of breast cancer among postmenopausal women overall and by hormone receptor and histologic subtypes. Eur J Clin Nutr. https://doi.org/10.1038/s41430-023-01267-x
doi: 10.1038/s41430-023-01267-x pubmed: 36726032
Whalen KA, McCullough ML, Flanders WD et al (2016) Paleolithic and Mediterranean diet pattern scores are inversely associated with biomarkers of inflammation and oxidative balance in adults123. J Nutr 146:1217–1226. https://doi.org/10.3945/jn.115.224048
doi: 10.3945/jn.115.224048 pubmed: 27099230 pmcid: 4877627
de la OV, Zazpe I, Goni L, et al (2022) A score appraising Paleolithic diet and the risk of cardiovascular disease in a Mediterranean prospective cohort. Eur J Nutr 61:957–971. https://doi.org/10.1007/s00394-021-02696-9
Wong MMH, Grech A, Louie JCY (2020) Dietary patterns and cardiovascular disease in Australian adults: Findings from the 2011–12 Australian Health Survey. Nutr Metab Cardiovasc Dis 30:738–748. https://doi.org/10.1016/j.numecd.2020.02.002
doi: 10.1016/j.numecd.2020.02.002 pubmed: 32139253
Shah S, MacDonald C-J, El Fatouhi D et al (2021) The associations of the Palaeolithic diet alone and in combination with lifestyle factors with type 2 diabetes and hypertension risks in women in the E3N prospective cohort. Eur J Nutr 60:3935–3945. https://doi.org/10.1007/s00394-021-02565-5
doi: 10.1007/s00394-021-02565-5 pubmed: 33909140
Frączek B, Pięta A, Burda A et al (2021) Paleolithic diet-effect on the health status and performance of athletes? Nutrients 13:1019. https://doi.org/10.3390/nu13031019
doi: 10.3390/nu13031019 pubmed: 33801152 pmcid: 8004139
Liang S, Mijatovic J, Li A et al (2022) Dietary patterns and non-communicable disease biomarkers: a network meta-analysis and nutritional geometry approach. Nutrients 15:76. https://doi.org/10.3390/nu15010076
doi: 10.3390/nu15010076 pubmed: 36615733 pmcid: 9824098
Stomby A, Otten J, Ryberg M et al (2017) A paleolithic diet with and without combined aerobic and resistance exercise increases functional brain responses and hippocampal volume in subjects with type 2 diabetes. Front Aging Neurosci 9:391. https://doi.org/10.3389/fnagi.2017.00391
doi: 10.3389/fnagi.2017.00391 pubmed: 29255413 pmcid: 5722796
Gyorkos A, Baker MH, Miutz LN et al (2019) Carbohydrate-restricted diet and exercise increase brain-derived neurotrophic factor and cognitive function: a randomized crossover trial. Cureus 11:e5604. https://doi.org/10.7759/cureus.5604
doi: 10.7759/cureus.5604 pubmed: 31700717 pmcid: 6822553
Irish AK, Erickson CM, Wahls TL et al (2017) Randomized control trial evaluation of a modified Paleolithic dietary intervention in the treatment of relapsing-remitting multiple sclerosis: a Pilot study. Degener Neurol Neuromuscul Dis 7:1–18. https://doi.org/10.2147/DNND.S116949
doi: 10.2147/DNND.S116949 pubmed: 30050374 pmcid: 6053098
Konijeti GG, Kim N, Lewis JD et al (2017) Efficacy of the autoimmune protocol diet for inflammatory bowel disease. Inflamm Bowel Dis 23:2054–2060. https://doi.org/10.1097/MIB.0000000000001221
doi: 10.1097/MIB.0000000000001221 pubmed: 28858071
Schnorr SL, Candela M, Rampelli S et al (2014) Gut microbiome of the Hadza hunter-gatherers. Nat Commun 5:3654. https://doi.org/10.1038/ncomms4654
doi: 10.1038/ncomms4654 pubmed: 24736369
Barone M, Turroni S, Rampelli S et al (2019) Gut microbiome response to a modern Paleolithic diet in a Western lifestyle context. PLoS ONE 14:e0220619. https://doi.org/10.1371/journal.pone.0220619
doi: 10.1371/journal.pone.0220619 pubmed: 31393934 pmcid: 6687155
Cordain L, Eaton SB, Sebastian A et al (2005) Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr 81:341–354. https://doi.org/10.1093/ajcn.81.2.341
doi: 10.1093/ajcn.81.2.341 pubmed: 15699220
Jönsson T, Granfeldt Y, Erlanson-Albertsson C et al (2010) A paleolithic diet is more satiating per calorie than a mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab (Lond) 7:85. https://doi.org/10.1186/1743-7075-7-85
doi: 10.1186/1743-7075-7-85 pubmed: 21118562
Kuipers RS, Luxwolda MF, Dijck-Brouwer DAJ et al (2010) Estimated macronutrient and fatty acid intakes from an East African Paleolithic diet. Br J Nutr 104:1666–1687. https://doi.org/10.1017/S0007114510002679
doi: 10.1017/S0007114510002679 pubmed: 20860883
Nagel G, Zoller D, Ruf T et al (2007) Long-term reproducibility of a food-frequency questionnaire and dietary changes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heidelberg cohort. Br J Nutr 98:194–200. https://doi.org/10.1017/S0007114507691636
doi: 10.1017/S0007114507691636 pubmed: 17367573
Jankovic N, Steppel MT, Kampman E et al (2014) Stability of dietary patterns assessed with reduced rank regression; the Zutphen Elderly Study. Nutr J 13:30. https://doi.org/10.1186/1475-2891-13-30
doi: 10.1186/1475-2891-13-30 pubmed: 24690194 pmcid: 4021363
Cheng Y-J, Chen Z-G, Wu S-H et al (2021) Body mass index trajectories during mid to late life and risks of mortality and cardiovascular outcomes: results from four prospective cohorts. EClinicalMedicine 33:100790. https://doi.org/10.1016/j.eclinm.2021.100790
doi: 10.1016/j.eclinm.2021.100790 pubmed: 33778436 pmcid: 7985466
Schnohr P (2003) Changes in leisure-time physical activity and risk of death: an observational study of 7,000 men and women. Am J Epidemiol 158:639–644. https://doi.org/10.1093/aje/kwg207
doi: 10.1093/aje/kwg207 pubmed: 14507599
Public Health Agency of Sweden Physical activity (self-reported) by age, sex and year. In: The National Public Health Survey. http://fohm-app.folkhalsomyndigheten.se/Folkhalsodata/pxweb/en/A_Folkhalsodata/A_Folkhalsodata__B_HLV__aLevvanor__aadLevvanorfysak/hlv1fysaald.px/table/tableViewLayout1/ . Accessed 5 Oct 2023
Boström G (2006) Chapter 9: Habits of life and health. Scand J Public Health 34:199–228. https://doi.org/10.1080/14034950600677287
Backman H, Vanfleteren L, Lindberg A et al (2020) Decreased COPD prevalence in Sweden after decades of decrease in smoking. Respir Res 21:283. https://doi.org/10.1186/s12931-020-01536-4
doi: 10.1186/s12931-020-01536-4 pubmed: 33115506 pmcid: 7594463
Raninen J, Agahi N (2020) Trends in older people’s drinking habits, Sweden 2004–2017. Nordic Stud Alcohol Drugs 37:459–469. https://doi.org/10.1177/1455072520954336
doi: 10.1177/1455072520954336

Auteurs

Björn Rydhög (B)

Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, Jan Waldenströms Gata 35, CRC, Hus 28 Plan 11, 205 02, Malmö, Sweden. bjorn.rydhog@med.lu.se.

Pedro Carrera-Bastos (P)

Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, Jan Waldenströms Gata 35, CRC, Hus 28 Plan 11, 205 02, Malmö, Sweden.

Yvonne Granfeldt (Y)

Department of Food Technology, Engineering and Nutrition, Lund University, Lund, Sweden.

Kristina Sundquist (K)

Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, Jan Waldenströms Gata 35, CRC, Hus 28 Plan 11, 205 02, Malmö, Sweden.

Emily Sonestedt (E)

Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.

Peter M Nilsson (PM)

Internal Medicine-Epidemiology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.

Tommy Jönsson (T)

Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, Jan Waldenströms Gata 35, CRC, Hus 28 Plan 11, 205 02, Malmö, Sweden.

Classifications MeSH