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dc.contributorUniversitat Ramon Llull. Facultat de Ciències de la Salut Blanquerna
dc.contributor.authorHanley-Cook, Giles T.
dc.contributor.authorHuybrechts, Inge
dc.contributor.authorBiessy, Carine
dc.contributor.authorRemans, Roseline
dc.contributor.authorKennedy, Gina
dc.contributor.authorDeschasaux-Tanguy, Mélanie
dc.contributor.authorMurray, Kris A.
dc.contributor.authorTouvier, Mathilde
dc.contributor.authorSkeie, Guri
dc.contributor.authorKesse-Guyot, Emmanuelle
dc.contributor.authorArgaw, Alemayehu
dc.contributor.authorCasagrande, Corinne
dc.contributor.authorNicolas, Geneviève
dc.contributor.authorVineis, Paolo
dc.contributor.authorMillett, Christopher J.
dc.contributor.authorWeiderpass, Elisabete
dc.contributor.authorFerrari, Pietro
dc.contributor.authorDahm, Christina C.
dc.contributor.authorBueno de Mesquita, H. Bas
dc.contributor.authorSandanger, Torkjel M.
dc.contributor.authorIbsen, Daniel B.
dc.contributor.authorFreisling, Heinz
dc.contributor.authorRamne, Stina
dc.contributor.authorJannasch, Franziska
dc.contributor.authorvan der Schouw, Yvonne T.
dc.contributor.authorSchulze, Matthias B.
dc.contributor.authorTsilidis, Konstantinos K.
dc.contributor.authorTjønneland, Anne
dc.contributor.authorArdanaz, Eva
dc.contributor.authorBodén, Stina
dc.contributor.authorCirera, Lluís
dc.contributor.authorGargano, Giuliana
dc.contributor.authorHalkjær, Jytte
dc.contributor.authorJakszyn, Paula
dc.contributor.authorJohansson, Ingegerd
dc.contributor.authorKatzke, Verena Andrea
dc.contributor.authorMasala, Giovanna
dc.contributor.authorPanico, Salvatore
dc.contributor.authorRodríguez-Barranco, Miguel
dc.contributor.authorSacerdote, Carlotta
dc.contributor.authorSrour, Bernard
dc.contributor.authorTumino, Rosario
dc.contributor.authorRiboli, Elio
dc.contributor.authorGunter, Marc J.
dc.contributor.authorJones, Andrew D.
dc.contributor.authorLachat, Carl
dc.date.accessioned2022-11-22T17:09:08Z
dc.date.accessioned2023-07-12T12:05:01Z
dc.date.available2022-11-22T17:09:08Z
dc.date.available2023-07-12T12:05:01Z
dc.date.created2021-02-24
dc.date.issued2021-10-18
dc.identifier.urihttp://hdl.handle.net/20.500.14342/719
dc.description.abstractBackground 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.eng
dc.format.extent23 p.cat
dc.language.isoengcat
dc.publisherPublic Library of Science (PLoS)cat
dc.relation.ispartofPLoS Medicine, 2021, 18(10): e1003834cat
dc.rightsAttribution 4.0 International
dc.rights© L'autor/a
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceRECERCAT (Dipòsit de la Recerca de Catalunya)
dc.subject.otherAlimentaciócat
dc.subject.otherBiodiversitatcat
dc.subject.otherDietèticacat
dc.subject.otherMortalitat -- Europacat
dc.titleFood biodiversity and total and cause-specific mortality in 9 European countries: an analysis of a prospective cohort studycat
dc.typeinfo:eu-repo/semantics/articlecat
dc.typeinfo:eu-repo/semantics/publishedVersioncat
dc.rights.accessLevelinfo:eu-repo/semantics/openAccess
dc.embargo.termscapcat
dc.subject.udc613
dc.identifier.doihttps://doi.org/10.1371/journal.pmed.1003834cat


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