Millen Barbara E, Pencina Michael J, Kimokoti Ruth W, Zhu Lei, Meigs James B, Ordovas Jose M, D'Agostino Ralph B
Department of Family Medicine and the Graduate Medical Sciences Division, Boston University School of Medicine, Boston, MA, USA.
Am J Clin Nutr. 2006 Aug;84(2):434-41. doi: 10.1093/ajcn/84.1.434.
Diet is recognized as a key factor in the cause and management of the metabolic syndrome (MetS). However, policies to guide preventive clinical nutrition interventions of the condition are limited.
We examined the relation between dietary quality and incident MetS in adult women and identified foci for preventive nutrition interventions.
This was a prospective study of 300 healthy women (aged 30-69 y) in the Framingham Offspring-Spouse study who were free of MetS risk factors at baseline. The development of individual MetS traits and overall MetS status during 12 y of follow-up were compared in women by tertile of nutritional risk, based on intake of 19 nutrients. Multivariate logistic regression models considered age, smoking, physical activity, and menopausal status.
Baseline age-adjusted mean nutrient intake and ischemic heart disease risk profiles differed by tertile of nutritional risk. Women with higher nutritional risk profiles consumed more dietary lipids (total, saturated, and monounsaturated fats) and alcohol and less fiber and micronutrients; they had higher cigarette use and waist circumferences. Compared with women with the lowest nutritional risk, those in the highest tertile had a 2- to 3-fold risk of the development of abdominal obesity and overall MetS during 12 y of follow-up [odds ratio: 2.3 (95% CI: 1.2, 4.3) and 3.0 (95% CI: 1.2, 7.6), respectively].
Higher composite nutritional risk predicts the development of abdominal obesity and MetS during long-term follow-up in healthy women, independent of lifestyle and ischemic heart disease risk factors. Preventive nutrition interventions for obesity and MetS risk reduction should focus on the overall nutritional quality of women's dietary profiles.
饮食被认为是代谢综合征（MetS）病因及管理中的关键因素。然而，指导该病症预防性临床营养干预的政策有限。
我们研究了成年女性饮食质量与新发MetS之间的关系，并确定预防性营养干预的重点。
这是一项针对弗雷明汉后代-配偶研究中300名健康女性（年龄30 - 69岁）的前瞻性研究，这些女性在基线时无MetS风险因素。根据19种营养素的摄入量，将女性按营养风险三分位数分组，比较随访12年期间个体MetS特征及总体MetS状态的发展情况。多变量逻辑回归模型考虑了年龄、吸烟、身体活动和绝经状态。
按营养风险三分位数分组，基线年龄调整后的平均营养素摄入量及缺血性心脏病风险概况有所不同。营养风险较高的女性摄入更多的膳食脂质（总脂肪、饱和脂肪和单不饱和脂肪）和酒精，而膳食纤维和微量营养素摄入较少；她们的吸烟率和腰围更高。与营养风险最低的女性相比，最高三分位数组的女性在随访12年期间发生腹部肥胖和总体MetS的风险高出2至3倍[比值比分别为：2.3（95%置信区间：1.2, 4.3）和3.0（95%置信区间：1.2, 7.6）]。
较高的综合营养风险预示着健康女性在长期随访中会发生腹部肥胖和MetS，且独立于生活方式和缺血性心脏病风险因素。针对肥胖和降低MetS风险的预防性营养干预应关注女性饮食的整体营养质量。
