RT Journal Article
T1 Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study.
A1 Hanley-Cook, Giles T
A1 Huybrechts, Inge
A1 Biessy, Carine
A1 Remans, Roseline
A1 Kennedy, Gina
A1 Deschasaux-Tanguy, Mélanie
A1 Murray, Kris A
A1 Touvier, Mathilde
A1 Skeie, Guri
A1 Kesse-Guyot, Emmanuelle
A1 Argaw, Alemayehu
A1 Casagrande, Corinne
A1 Nicolas, Geneviève
A1 Vineis, Paolo
A1 Millett, Christopher J
A1 Weiderpass, Elisabete
A1 Ferrari, Pietro
A1 Dahm, Christina C
A1 Bueno-de-Mesquita, H Bas
A1 Sandanger, Torkjel M
A1 Ibsen, Daniel B
A1 Freisling, Heinz
A1 Ramne, Stina
A1 Jannasch, Franziska
A1 van der Schouw, Yvonne T
A1 Schulze, Matthias B
A1 Tsilidis, Konstantinos K
A1 Tjønneland, Anne
A1 Ardanaz, Eva
A1 Bodén, Stina
A1 Cirera, Lluís
A1 Gargano, Giuliana
A1 Halkjær, Jytte
A1 Jakszyn, Paula
A1 Johansson, Ingegerd
A1 Katzke, Verena
A1 Masala, Giovanna
A1 Panico, Salvatore
A1 Rodriguez-Barranco, Miguel
A1 Sacerdote, Carlotta
A1 Srour, Bernard
A1 Tumino, Rosario
A1 Riboli, Elio
A1 Gunter, Marc J
A1 Jones, Andrew D
A1 Lachat, Carl
AB 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. 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  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.
YR 2021
FD 2021-10-18
LK https://hdl.handle.net/10668/24674
UL https://hdl.handle.net/10668/24674
LA en
DS RISalud
RD Apr 18, 2025