Institut national de santé publique du Québec, Québec, Canada; Population Research and Outcome Studies, University of Adelaide, South Australia, Australia.
Population Research and Outcome Studies, University of Adelaide, South Australia, Australia; Department of Nutrition and Foodborne Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
Clin Nutr. 2014 Jun;33(3):513-20. doi: 10.1016/j.clnu.2013.07.009. Epub 2013 Jul 22.
BACKGROUND & AIMS: Multimorbidity is a common health status. The impact of nutrition on the development of multimorbidity remains to be determined. The aim of this study is to determine the association between foods, macronutrients and micronutrients and the evolution of multimorbidity.
Data from 1020 Chinese who participated in the Jiangsu longitudinal Nutrition Study (JIN) were collected in 2002 (baseline) and 2007 (follow-up). Three-day weighted food records and status for 11 chronic diseases was determined using biomedical measures (hypertension, diabetes, hypercholesterolemia and anemia) or self-reports (coronary heart disease, asthma, stroke, cancer, fracture, arthritis and hepatitis). Participants were divided in six categories of stage of evolution of multimorbidity. Association of foods, macronutrients and micronutrients at baseline with stages in the evolution of multimorbidity were determined. Data were adjusted for age, sex, BMI, marital status, sedentary lifestyle, smoking status, annual income, education and energy intake.
The prevalence of multimorbidity increased from 14% to 34%. A high consumption of fruit and vegetables (p < 0.05) and grain products other than rice and wheat (p < 0.001) were associated with healthier stages in the evolution of multimorbidity. The consumption of grain products other than rice and wheat was highly correlated with dietary fibers (r = 0.77, p < 0.0001), iron (r = 0.46, p < 0.0001), magnesium (r = 0.49, p < 0.0001) and phosphorus (r = 0.57, p < 0.0001) intake which were also associated with healthier stages.
This study provides the first evidence of an association between nutrition and evolution towards multimorbidity. More precisely, greater consumption of fruits and vegetable and whole grain products consumption appear to lower the risk of multimorbidity.
多病共存是一种常见的健康状况。营养对多病共存发展的影响仍有待确定。本研究旨在确定食物、宏量营养素和微量营养素与多病共存演变之间的关联。
2002 年（基线）和 2007 年（随访）收集了参加江苏纵向营养研究（JIN）的 1020 名中国人的数据。使用生物医学测量（高血压、糖尿病、高胆固醇血症和贫血）或自我报告（冠心病、哮喘、中风、癌症、骨折、关节炎和肝炎）确定为期三天的加权食物记录和 11 种慢性疾病的状况。参与者分为多病共存演变的六个阶段类别。在基线时，确定食物、宏量营养素和微量营养素与多病共存演变阶段之间的关联。数据经过年龄、性别、BMI、婚姻状况、久坐生活方式、吸烟状况、年收入、教育程度和能量摄入的调整。
多病共存的患病率从 14%上升到 34%。高水果和蔬菜摄入量（p < 0.05）和除大米和小麦以外的谷物产品摄入量（p < 0.001）与多病共存演变的更健康阶段相关。除大米和小麦以外的谷物产品摄入量与膳食纤维（r = 0.77，p < 0.0001）、铁（r = 0.46，p < 0.0001）、镁（r = 0.49，p < 0.0001）和磷（r = 0.57，p < 0.0001）摄入高度相关，这些营养素也与更健康的阶段相关。
本研究首次提供了营养与向多病共存演变之间关联的证据。更具体地说，更多地食用水果和蔬菜以及全谷物产品似乎降低了多病共存的风险。
