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悉尼大学 Alistair Senior Caitlin Andrews 植物蛋白 寿命 Nature Communications
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Associations between national plant-based vs animal-based protein availability and population health outcomes Nature Communications
Introduction
In an era marked by the pressing need for decarbonization and environmental sustainability, global food systems, which contribute a third of all greenhouse gas emissions, are under increasing scrutiny1. Food systems are complex social-ecological networks that encompass all processes and infrastructure involved in feeding a population2. Many have argued that a reduction in the production of animal-based foods is key to achieving more sustainable food systems3, however, reduced production of animal-based foods is likely to result in a substitution of animal-based protein (ABP) for plant-based protein (PBP) and/or a reduction in total protein supplies within food systems4. For many populations, this transition therefore represents a substantial change in the nutritional environment. The capacity of post-transition PBP-rich nutritional environments to support the health of different demographics and age-classes has become a focus of debate5.
In general, the nutritional environment, encompassing factors such as the quality, quantity, and source of nutrients available for consumption, has been identified as a critical determinant of health and survivorship at different ages6. Malnutrition, including ‘undernutrition’, ‘overnutrition’ and imbalanced nutrition, are major risk factors for numerous age-related chronic diseases7, which remain the leading cause of death and age-related disability globally8. Furthermore, the health of older adults may be especially sensitive to the nutritional environment, as this demographic displays elevated risk of both under- and over-nutrition in a food-insecure environment9. At the other end of life, stunting or chronic malnutrition primarily occurs during the first 1000 days from conception due to insufficient maternal or child nutrition10. This often results from a food system that provides limited access to adequate and high-quality foods and is linked to an increased risk of death.
The availability of macronutrients, and particularly protein, at the national level is of interest when considering how nutritional environments affect health and survivorship as a function of age. There is abundant evidence that at the dietary level (i.e. below that of the nutritional environment) protein intake affects health. At the level of diet composition, recent reviews11,12 suggest that protein content, and, particularly, its amounts relative to the quantity of carbohydrate, plays a vital role in shaping age-related health outcomes. At the level of individual intakes, protein appears to exhibit a non-linear relationship with all-cause mortality, relative to total caloric intake in the diet, with both low and high protein intakes associated with increased mortality risk13,14. Furthermore, researchers have advocated for increases in protein intake recommendations for adults of all ages, but especially among older individuals15,16.
At the dietary level, the associations between protein and mortality also appear to vary depending on the source, with ABP potentially having a greater impact on mortality than PBP sources17,18. In particular, high intake of processed meats and—with less certainty—unprocessed red meats, has been linked to an increased risk of certain chronic diseases, including cardiovascular disease, type 2 diabetes, and some types of cancer19,20. On the other hand, plant protein sources, such as legumes, nuts, and whole grains, have been associated with a lower risk of chronic diseases and overall mortality18,21. Researchers have proposed that a predominantly plant-based diet is one of the key common denominators contributing to the extended vitality and longevity observed in long-lived communities, also known as “blue zones“22,23. These “blue zones,” including Okinawa, Japan; Ikaria, Greece; and Loma Linda, California; among others, have been found to have diets high in predominantly plant-based foods and low in animal-based protein. The differential associations of protein sources have been attributed to various dietary factors, such as nutrient composition and bioactive compounds24. While the exact causes remain the focus of ongoing work, there is sufficient evidence to suspect that transitioning from ABP to PBP sources can, at the very least, lead to a shift in the overall nutrient profile of the diet. The nutritional variation reflected in this shift may contribute to differences in health outcomes among humans.
A tool that can be used to parse the differential effects of nutrients and their interactions on outcomes of interest is the geometric framework for nutrition (GFN)25. The GFN is a comprehensive multi-dimensional framework that allows simultaneous examination of undernutrition, overnutrition, nutrient amounts, and compositions within a single framework. It enables insights into the combined macronutrient landscape associated with food environments, and identifies interactive relationships between nutritional components and response variables. The aim of the current study is to assess how the nutritional environment, with special reference to national per capita supplies of ABP and PBP, associates with patterns of age-specific mortality (ASM). Within this context, ASM emerges as an indicator of population-wide, and age-specific, health26. ASM serves as a standardised measure to assess the broader impact of nutritional environments on the morbidity of different age groups.
In this study, we used the GFN to investigate the associations between PBP versus ABP supplies on ASM using global demographic data. Our dataset comprises complete country- and year-specific entries from 101 different countries, spanning 1961–2018. We used data on macronutrient supply quantities available for human consumption from food balance sheets (FBS; see Methods for full explanation) compiled by the Food and Agriculture Organization of the United Nations (FAO). Specifically, these data reflect the average availability of food and nutrients at the national level, which are crucial for understanding the nutritional environment’s ability to support population health. This FBS supply data was combined with sex-specific mortality data (specifically, the proportion of individuals within a cohort that survive to each age) from life tables provided at the Human Mortality Database, economic statistics from the Maddison Project Database, and age, sex specific population estimates from the population division of the United Nations. We explored interactions between macronutrient supplies, time, country, and wealth, with statistical corrections to control for possible confounding by such factors. Using the best approximating model, we predicted the effects of ABP, PBP, fat and carbohydrate supplies on human life table parameters. Additionally, we considered age-specific macronutrient and energy availabilities for optimising survival over the human life course.
Results
Animal-based vs plant-based protein
The collated data comprised complete entries for macronutrient supplies from national food balance sheets (FBSs), survivorship at ages 5 and 60 ($ {l}_{5}\ and \ {l}_{60}\ , i.e., the proportion of a cohort still alive at ages 5 and 60) from national life tables, and gross domestic product per capita (GDP) across both sexes, for 101 countries. Briefly, per capita food supply data provided by FBSs refers to the average amount of food available for consumption per person within a nation for a given year, a foundational element of the nutritional environments contributing to health outcomes across different populations. Quantities of food items available for consumption are calculated based on the total quantities produced and imported, adjusting for any changes in stocks including exports. FBSs also give daily per capita supplies in terms of total energy, and specific energy sources, based on composition factors[27](https://www.nature.com/articles/s41467-025-58475-1#ref-CR27 "Food And Agriculture Organization The United Nation. Food Balance SHEETS - A Handbook. https://www.fao.org/4/X9892E/X9892e02.htm#P430_31575 (2001)."). Here we have analysed daily per capita protein supplies from animal and vegetal sources (i.e., animal-based protein and plant-based protein; ABP and PBP), as well as daily per capita supplies of total fat supplies and carbohydrate (note that carbohydrate was estimated as total available energy less energy from alcohol, ABP, PBP and fat). Our final dataset spanned from 1961 to 2018 with data from 4000 country-, year-, and sex-specific life tables. We begin by summarising the trends and global coverage of daily per capita protein supplies in our dataset. Figure [1A](https://www.nature.com/articles/s41467-025-58475-1#Fig1) and B show the ratio of ABP to PBP supplies across different countries in historic (1961–1990) and more recent (1991–2018) data, respectively. The geographic distribution of supplies shows a temporal trend towards convergence, where areas with higher ratios of ABP to PBP supplies in earlier years, such as northern America, north and west Europe, Argentina, Hong Kong, and New Zealand, tend to show a reduction in later years. In contrast, areas where supply is predominantly PBP in early years, including most parts of central and south America, Japan, South Korea, and Taiwan, show an increase in the ratio of ABP to PBP supplies during more recent years. Figure [1C](https://www.nature.com/articles/s41467-025-58475-1#Fig1) illustrates an average convergence of total ABP and PBP supply quantities, toward parity around the mid 1990’s and remaining relatively similar thereafter. Notably, the total protein supplies available within countries has tended to increase over time, largely attributable to increased ABP (Fig. [1C](https://www.nature.com/articles/s41467-025-58475-1#Fig1)). Within the data there is a positive association between total protein supplies and economic wealth, with a greater proportion of PBP to ABP where GDP is lower and the ratio of ABP to PBP increases up to GDP values of ~2011 12,000 per capita (Fig. 1D). Additionally, Fig. 1E and 1F show a greater proportion of PBP supplies relative to ABP where fat supplies are lower and carbohydrate supplies are higher, and vice versa.
Fig. 1: Summary of global protein supplies (kcal/capita/day) and correlations within the available data.
A Average log ratio of animal-based to plant-based protein supplies for each country, from 1961–1990, and B 1991 –2018, using all available data; grey shows an absence of data. (C) Supplies of plant- and animal-based protein as a function of year, D GDP per capita, (E) fat supplies (kcal/capita/day), and (F) carbohydrate supplies (kcal/capita/day). C–F The individual data points show the raw data values. The red, green, and blue smoothed lines represent the predicted values for ABP, PBP, and total protein, respectively, based on year (C), GDP (D), fat supplies (E), and carbohydrate supplies (F). Predictions were obtained using generalized additive mixed models, with random effects for countries. The shaded areas around the lines represent the 95% confidence intervals centred on these predictions. The smooth term significance is detailed in Supplementary Table 1 to Supplementary Table 12. GDP gross domestic product per capita (expressed in international-$ at 2011 prices). A, B Map data from Natural Earth, facilitated by rnaturalearth R package94.
Age-specific mortality
Using the model life table approach proposed by the World Health Organisation (WHO)28, a comprehensive picture of ASM in human populations can be built by taking survivorship to ages 5 ($ l\ 5) and 60 (\ l\ 60) as markers of early and late life survival, respectively. Hence, we assessed the \ l\ 5 and \ l\ 60 data using separate analyses. We further stratified the data into male and female survivorship, yielding four subsets for statistical modelling (i.e., \ l\ 5 male; \ l\ 60 male; \ l\ 5 female; \ l\ $60 female). Our primary tool was the generalised additive mixed model (GAMM). To each subset we fitted several models exploring a r ...
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Sydney University Charles Perkins Centre Alistair Senior Caitlin Andrews plant protein lifespan study news release
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Caitlin J. Andrews Alistair Senior Nature Communications plant protein animal protein author list
