Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study

Background: Food biodiversity, encompassing the variety of plants, animals, and other organisms consumed as food and drink, has intrinsic potential to underpin diverse, nutritious diets and improve Earth system resilience. Dietary species richness (DSR), which is recommended as a crosscutting measur...

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Autores: Hanley-Cook, Giles T., Huybrechts, Inge, Biessy, Carine, Remans, Roseline, Kennedy, Gina, Deschasaux-Tanguy, Mélanie, Murray, Kris A., Touvier, Mathilde, Skeie, Guri, Kesse-Guyot, Emmanuelle, Argaw, Alemayehu, Casagrande, Corinne, Nicolas, Geneviève, Vineis, Paolo, Millett, Christopher J., Weiderpass, Elisabete, Ferrari, Pietro, Dahm, Christina C., Bueno de Mesquita, H. Bas, Sandanger, Torkjel M., Ibsen, Daniel B., Freisling, Heinz, Ramne, Stina, Jannasch, Franziska, Van Der Schouw, Yvonne T., Schulze, Matthias B., Tsilidis, Konstantinos K., Tjønneland, Anne, Ardanaz, Eva, Bodén, Stina, Cirera, Lluís, Gargano, Giuliana, Halkjær, Jytte, Jakszyn, Paula, Johansson, Ingegerd, Katzke, Verena, Masala, Giovanna, Panico, Salvatore, Rodriguez Barranco, Miguel, Sacerdote, Carlotta, Srour, Bernard, Tumino, Rosario, Riboli, Elio, Gunter, Marc J., Jones, Andrew D., Lachat, Carl
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/181057
Acceso en línea:https://hdl.handle.net/2445/181057
Access Level:acceso abierto
Palabra clave:Biodiversitat
Nutrició
Comorbiditat
Biodiversity
Nutrition
Comorbidity
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dc.title.none.fl_str_mv Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study
title Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study
spellingShingle Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study
Hanley-Cook, Giles T.
Biodiversitat
Nutrició
Comorbiditat
Biodiversity
Nutrition
Comorbidity
title_short Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study
title_full Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study
title_fullStr Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study
title_full_unstemmed Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study
title_sort Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study
dc.creator.none.fl_str_mv Hanley-Cook, Giles T.
Huybrechts, Inge
Biessy, Carine
Remans, Roseline
Kennedy, Gina
Deschasaux-Tanguy, Mélanie
Murray, Kris A.
Touvier, Mathilde
Skeie, Guri
Kesse-Guyot, Emmanuelle
Argaw, Alemayehu
Casagrande, Corinne
Nicolas, Geneviève
Vineis, Paolo
Millett, Christopher J.
Weiderpass, Elisabete
Ferrari, Pietro
Dahm, Christina C.
Bueno de Mesquita, H. Bas
Sandanger, Torkjel M.
Ibsen, Daniel B.
Freisling, Heinz
Ramne, Stina
Jannasch, Franziska
Van Der Schouw, Yvonne T.
Schulze, Matthias B.
Tsilidis, Konstantinos K.
Tjønneland, Anne
Ardanaz, Eva
Bodén, Stina
Cirera, Lluís
Gargano, Giuliana
Halkjær, Jytte
Jakszyn, Paula
Johansson, Ingegerd
Katzke, Verena
Masala, Giovanna
Panico, Salvatore
Rodriguez Barranco, Miguel
Sacerdote, Carlotta
Srour, Bernard
Tumino, Rosario
Riboli, Elio
Gunter, Marc J.
Jones, Andrew D.
Lachat, Carl
author Hanley-Cook, Giles T.
author_facet Hanley-Cook, Giles T.
Huybrechts, Inge
Biessy, Carine
Remans, Roseline
Kennedy, Gina
Deschasaux-Tanguy, Mélanie
Murray, Kris A.
Touvier, Mathilde
Skeie, Guri
Kesse-Guyot, Emmanuelle
Argaw, Alemayehu
Casagrande, Corinne
Nicolas, Geneviève
Vineis, Paolo
Millett, Christopher J.
Weiderpass, Elisabete
Ferrari, Pietro
Dahm, Christina C.
Bueno de Mesquita, H. Bas
Sandanger, Torkjel M.
Ibsen, Daniel B.
Freisling, Heinz
Ramne, Stina
Jannasch, Franziska
Van Der Schouw, Yvonne T.
Schulze, Matthias B.
Tsilidis, Konstantinos K.
Tjønneland, Anne
Ardanaz, Eva
Bodén, Stina
Cirera, Lluís
Gargano, Giuliana
Halkjær, Jytte
Jakszyn, Paula
Johansson, Ingegerd
Katzke, Verena
Masala, Giovanna
Panico, Salvatore
Rodriguez Barranco, Miguel
Sacerdote, Carlotta
Srour, Bernard
Tumino, Rosario
Riboli, Elio
Gunter, Marc J.
Jones, Andrew D.
Lachat, Carl
author_role author
author2 Huybrechts, Inge
Biessy, Carine
Remans, Roseline
Kennedy, Gina
Deschasaux-Tanguy, Mélanie
Murray, Kris A.
Touvier, Mathilde
Skeie, Guri
Kesse-Guyot, Emmanuelle
Argaw, Alemayehu
Casagrande, Corinne
Nicolas, Geneviève
Vineis, Paolo
Millett, Christopher J.
Weiderpass, Elisabete
Ferrari, Pietro
Dahm, Christina C.
Bueno de Mesquita, H. Bas
Sandanger, Torkjel M.
Ibsen, Daniel B.
Freisling, Heinz
Ramne, Stina
Jannasch, Franziska
Van Der Schouw, Yvonne T.
Schulze, Matthias B.
Tsilidis, Konstantinos K.
Tjønneland, Anne
Ardanaz, Eva
Bodén, Stina
Cirera, Lluís
Gargano, Giuliana
Halkjær, Jytte
Jakszyn, Paula
Johansson, Ingegerd
Katzke, Verena
Masala, Giovanna
Panico, Salvatore
Rodriguez Barranco, Miguel
Sacerdote, Carlotta
Srour, Bernard
Tumino, Rosario
Riboli, Elio
Gunter, Marc J.
Jones, Andrew D.
Lachat, Carl
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Biodiversitat
Nutrició
Comorbiditat
Biodiversity
Nutrition
Comorbidity
topic Biodiversitat
Nutrició
Comorbiditat
Biodiversity
Nutrition
Comorbidity
description Background: Food biodiversity, encompassing the variety of plants, animals, and other organisms consumed as food and drink, has intrinsic potential to underpin diverse, nutritious diets and improve Earth system resilience. Dietary species richness (DSR), which is recommended as a crosscutting measure of food biodiversity, has been positively associated with the micronutrient adequacy of diets in women and young children in low- and middle-income countries (LMICs). However, the relationships between DSR and major health outcomes have yet to be assessed in any population. Methods and findings: We examined the associations between DSR and subsequent total and cause-specific mortality among 451,390 adults enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) study (1992 to 2014, median follow-up: 17 years), free of cancer, diabetes, heart attack, or stroke at baseline. Usual dietary intakes were assessed at recruitment with country-specific dietary questionnaires (DQs). DSR of an individual's yearly diet was calculated based on the absolute number of unique biological species in each (composite) food and drink. Associations were assessed by fitting multivariable-adjusted Cox proportional hazards regression models. In the EPIC cohort, 2 crops (common wheat and potato) and 2 animal species (cow and pig) accounted for approximately 45% of self-reported total dietary energy intake [median (P10-P90): 68 (40 to 83) species consumed per year]. Overall, higher DSR was inversely associated with all-cause mortality rate. Hazard ratios (HRs) and 95% confidence intervals (CIs) comparing total mortality in the second, third, fourth, and fifth (highest) quintiles (Qs) of DSR to the first (lowest) Q indicate significant inverse associations, after stratification by sex, age, and study center and adjustment for smoking status, educational level, marital status, physical activity, alcohol intake, and total energy intake, Mediterranean diet score, red and processed meat intake, and fiber intake [HR (95% CI): 0.91 (0.88 to 0.94), 0.80 (0.76 to 0.83), 0.69 (0.66 to 0.72), and 0.63 (0.59 to 0.66), respectively; PWald < 0.001 for trend]. Absolute death rates among participants in the highest and lowest fifth of DSR were 65.4 and 69.3 cases/10,000 person-years, respectively. Significant inverse associations were also observed between DSR and deaths due to cancer, heart disease, digestive disease, and respiratory disease. An important study limitation is that our findings were based on an observational cohort using self-reported dietary data obtained through single baseline food frequency questionnaires (FFQs); thus, exposure misclassification and residual confounding cannot be ruled out. Conclusions: In this large Pan-European cohort, higher DSR was inversely associated with total and cause-specific mortality, independent of sociodemographic, lifestyle, and other known dietary risk factors. Our findings support the potential of food (species) biodiversity as a guiding principle of sustainable dietary recommendations and food-based dietary guidelines.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/181057
url https://hdl.handle.net/2445/181057
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pmed.1003834
PLOS Medicine, 2021, vol. 18, num. 10
https://doi.org/10.1371/journal.pmed.1003834
dc.rights.none.fl_str_mv cc by (c) Hanley-Cook, Giles T. et al, 2021
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Hanley-Cook, Giles T. et al, 2021
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort studyHanley-Cook, Giles T.Huybrechts, IngeBiessy, CarineRemans, RoselineKennedy, GinaDeschasaux-Tanguy, MélanieMurray, Kris A.Touvier, MathildeSkeie, GuriKesse-Guyot, EmmanuelleArgaw, AlemayehuCasagrande, CorinneNicolas, GenevièveVineis, PaoloMillett, Christopher J.Weiderpass, ElisabeteFerrari, PietroDahm, Christina C.Bueno de Mesquita, H. BasSandanger, Torkjel M.Ibsen, Daniel B.Freisling, HeinzRamne, StinaJannasch, FranziskaVan Der Schouw, Yvonne T.Schulze, Matthias B.Tsilidis, Konstantinos K.Tjønneland, AnneArdanaz, EvaBodén, StinaCirera, LluísGargano, GiulianaHalkjær, JytteJakszyn, PaulaJohansson, IngegerdKatzke, VerenaMasala, GiovannaPanico, SalvatoreRodriguez Barranco, MiguelSacerdote, CarlottaSrour, BernardTumino, RosarioRiboli, ElioGunter, Marc J.Jones, Andrew D.Lachat, CarlBiodiversitatNutricióComorbiditatBiodiversityNutritionComorbidityBackground: Food biodiversity, encompassing the variety of plants, animals, and other organisms consumed as food and drink, has intrinsic potential to underpin diverse, nutritious diets and improve Earth system resilience. Dietary species richness (DSR), which is recommended as a crosscutting measure of food biodiversity, has been positively associated with the micronutrient adequacy of diets in women and young children in low- and middle-income countries (LMICs). However, the relationships between DSR and major health outcomes have yet to be assessed in any population. Methods and findings: We examined the associations between DSR and subsequent total and cause-specific mortality among 451,390 adults enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) study (1992 to 2014, median follow-up: 17 years), free of cancer, diabetes, heart attack, or stroke at baseline. Usual dietary intakes were assessed at recruitment with country-specific dietary questionnaires (DQs). DSR of an individual's yearly diet was calculated based on the absolute number of unique biological species in each (composite) food and drink. Associations were assessed by fitting multivariable-adjusted Cox proportional hazards regression models. In the EPIC cohort, 2 crops (common wheat and potato) and 2 animal species (cow and pig) accounted for approximately 45% of self-reported total dietary energy intake [median (P10-P90): 68 (40 to 83) species consumed per year]. Overall, higher DSR was inversely associated with all-cause mortality rate. Hazard ratios (HRs) and 95% confidence intervals (CIs) comparing total mortality in the second, third, fourth, and fifth (highest) quintiles (Qs) of DSR to the first (lowest) Q indicate significant inverse associations, after stratification by sex, age, and study center and adjustment for smoking status, educational level, marital status, physical activity, alcohol intake, and total energy intake, Mediterranean diet score, red and processed meat intake, and fiber intake [HR (95% CI): 0.91 (0.88 to 0.94), 0.80 (0.76 to 0.83), 0.69 (0.66 to 0.72), and 0.63 (0.59 to 0.66), respectively; PWald < 0.001 for trend]. Absolute death rates among participants in the highest and lowest fifth of DSR were 65.4 and 69.3 cases/10,000 person-years, respectively. Significant inverse associations were also observed between DSR and deaths due to cancer, heart disease, digestive disease, and respiratory disease. An important study limitation is that our findings were based on an observational cohort using self-reported dietary data obtained through single baseline food frequency questionnaires (FFQs); thus, exposure misclassification and residual confounding cannot be ruled out. Conclusions: In this large Pan-European cohort, higher DSR was inversely associated with total and cause-specific mortality, independent of sociodemographic, lifestyle, and other known dietary risk factors. Our findings support the potential of food (species) biodiversity as a guiding principle of sustainable dietary recommendations and food-based dietary guidelines.Public Library of Science (PLoS)2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/181057Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1371/journal.pmed.1003834PLOS Medicine, 2021, vol. 18, num. 10https://doi.org/10.1371/journal.pmed.1003834cc by (c) Hanley-Cook, Giles T. et al, 2021http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1810572026-05-27T06:46:51Z
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