Unidad de Medicina Preventiva, Hospital Universitario Infanta Sofía, San Sebastian de los Reyes, Spain.
Menopause. 2012 Oct;19(10):1121-9. doi: 10.1097/gme.0b013e3182544925.
A healthy diet is particularly important during menopause, a period in which the risk of a number of health problems increases. This study analyzed diet quality as measured by two indices, namely, the Alternate Healthy Eating Index (AHEI) and the Alternate Mediterranean Diet (aMED) index, which measures adherence to a Mediterranean diet, and examined the factors associated with lower diet quality.
This was a cross-sectional study covering 3,564 women aged 45 to 68 years who underwent breast cancer screening at 7 centers (Corunna, Barcelona, Burgos, Palma de Mallorca, Pamplona, Valencia, and Zaragoza). Data on diet were collected using a food frequency questionnaire validated for the Spanish population. We calculated the AHEI out of a total of 80 points and the aMED out of a total of 9 points. Ordinal logistic regression models were fitted, taking diet quality (tertiles of the AHEI and the aMED) as dependent variables. The following were included in the final multivariate models as explanatory variables: sociodemographic characteristics, chronic diseases, and lifestyles that were associated with diet quality, with a P value <0.100 in an initial simple model (adjusted solely for calorie intake and screening center). Interaction between menopause status and the other explanatory variables was checked.
The median score for AHEI was 40 of a maximum of 80 points. Lower diet quality was registered by the youngest women (P for trend < 0.001), premenopausal and perimenopausal women (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.01-1.56; and OR, 1.48; CI, 1.20-1.83, respectively), obese women (OR, 1.18; CI, 0.99-1.41), those with a diagnosis of diabetes (OR, 1.35; CI, 1.01-1.79), smokers (OR, 1.41; CI, 1.21-1.66), and women reporting lower daily physical activity (OR, 1.31; CI, 1.12-1.53). Better diet quality was shown by women with higher education (OR, 0.74; CI, 0.62-0.88) and ex-smokers (OR, 0.82; CI, 0.69-0.98). Nulliparity was associated with higher AHEI scores, but only among premenopausal women (OR, 0.50; CI, 0.32-0.78). aMED index varied between 0 and 9 (median 5). Lower scores were associated with younger age (P for trend < 0.001), low socioeconomic level (OR, 1.13; CI, 0.96-1.33), lower educational level (P for trend = 0.008), and low level of daily physical activity (OR, 1.27, CI, 1.08-1.50).
The youngest women, the most sedentary women, and those who had a lower educational level and socioeconomic status registered worse diet quality. Ex-smokers and postmenopausal women obtained better scores, probably reflecting a keener concern about leading a healthy life.
在更年期期间，健康的饮食尤为重要，因为在此期间，许多健康问题的风险会增加。本研究分析了两种指数（即交替健康饮食指数（AHEI）和交替地中海饮食指数（aMED））所衡量的饮食质量，这两个指数分别衡量了对地中海饮食的遵守程度，并检查了与较低饮食质量相关的因素。
这是一项横断面研究，涵盖了 3564 名年龄在 45 至 68 岁之间的女性，她们在 7 个中心（科伦纳、巴塞罗那、布尔戈斯、帕尔马德马洛卡、潘普洛纳、巴伦西亚和萨拉戈萨）接受乳腺癌筛查。使用经过验证的西班牙人群的食物频率问卷收集饮食数据。我们计算了 AHEI 总分为 80 分，aMED 总分为 9 分。采用有序逻辑回归模型，将饮食质量（AHEI 和 aMED 的三分位数）作为因变量。以下是最终多变量模型中的解释变量：社会人口特征、慢性疾病和与饮食质量相关的生活方式，在初始简单模型中，这些变量与饮食质量相关（仅调整卡路里摄入量和筛查中心），P 值<0.100。检查了更年期状态与其他解释变量之间的相互作用。
AHEI 的中位数得分为 40 分（满分 80 分）。最年轻的女性（P<0.001）、绝经前和围绝经期女性（比值比[OR]，1.25；95%置信区间[CI]，1.01-1.56；和 OR，1.48；CI，1.20-1.83）、肥胖女性（OR，1.18；CI，0.99-1.41）、患有糖尿病的女性（OR，1.35；CI，1.01-1.79）、吸烟者（OR，1.41；CI，1.21-1.66）和报告日常体力活动较少的女性（OR，1.31；CI，1.12-1.53）的饮食质量较差。具有较高教育程度的女性（OR，0.74；CI，0.62-0.88）和戒烟者（OR，0.82；CI，0.69-0.98）的饮食质量更好。初产妇与较高的 AHEI 评分相关，但仅在绝经前女性中（OR，0.50；CI，0.32-0.78）。aMED 指数在 0 到 9 之间变化（中位数为 5）。较低的分数与较年轻的年龄（P<0.001）、较低的社会经济水平（OR，1.13；CI，0.96-1.33）、较低的教育水平（P<0.008）和较低的日常体力活动水平（OR，1.27，CI，1.08-1.50）相关。
最年轻的女性、最久坐不动的女性以及那些教育程度和社会经济地位较低的女性的饮食质量较差。戒烟者和绝经后女性的得分较好，这可能反映了她们对健康生活的更强烈关注。
