Objectives To assess the health impacts and environmental consequences of adherence to national dietary recommendations (the Eatwell Guide (EWG)) in the UK.
Design and setting A secondary analysis of multiple observational studies in the UK.
Participants Adults from the European Prospective Investigation into Cancer - Oxford(EPIC-Oxford), UK Biobank and Million Women Study, and adults and children aged 5 and over from the National Diet and Nutrition Survey (NDNS).
Primary and secondary outcome measures risk of total mortality from Cox proportional hazards regression models, total greenhouse gas emissions (GHGe) and blue water footprint (WF) associated with very low (0-2 recommendations), low (3-4 recommendations) or intermediate-to-high (5-9 recommendations) adherence to EWG recommendations.
Results Less than 0.1% of the NDNS sample adhere to all nine EWG recommendations and 30.6% adhere to at least five recommendations. Compared with very low adherence to EWG recommendations, intermediate-to-high adherence was associated with a reduced risk of mortality (risk ratio (RR): 0.93; 99% CI: 0.90 to 0.97) and -1.6 kg CO2eq/day (95% CI: -1.5 to -1.8), or 30% lower dietary GHGe. Dietary WFs were similar across EWG adherence groups. Of the individual Eatwell guidelines, adherence to the recommendation on fruit and vegetable consumption was associated with the largest reduction in total mortality risk: an RR of 0.90 (99% CI: 0.88 to 0.93). Increased adherence to the recommendation on red and processed meat consumption was associated with the largest decrease in environmental footprints (-1.48 kg CO2eq/day, 95% CI: -1.79 to 1.18 for GHGe and -22.5 L/day, 95% CI: -22.7 to 22.3 for blue WF).
Conclusions The health and environmental benefits of greater adherence to EWG recommendations support increased government efforts to encourage improved diets in the UK that are essential for the health of people and the planet in the Anthropocene.
Mediating mechanisms linking anthropometric, lifestyle and dietary risk factors with cancer risk
The mediating mechanisms linking anthropometric and lifestyle risk factors with cancer development and survival remain unclear. We aim to investigate the potential mediating roles of metabolic factors (including biomarkers and intermediate conditions and diseases) on the association between risk factors (e.g. fat mass, diet, physical activity) and subsequent cancer diagnosis, death and survival by cancer type. The proposed project aims to understand the mechanisms that underpin the association of risk factors with cancer development and progression, which is consistent with UK Biobank's mission of health-related research that is in the interest of the public good. In the first stage of this project we will run prospective analyses to assess the associations of potential risk factors with risk of, and death from, specific cancers. If there are sufficient cases and available information on tumour characteristics, we will split tumours into subtypes. We will also assess the association between the potential risk factors and each of the possible mediators, as well as the prospective associations between the mediators and cancer risk. Finally, we will estimate the mediation effects of the individual mediators in the associations between risk factors and cancer risk. We intend to include all participants of the UK Biobank cohort.
|Lead investigator:||Dr Aurora Perez-Cornago|
|Lead institution:||University of Oxford|