Center for Community Health and Health Equity, Brigham and Women's Hospital, Boston, Mass.
Am J Med. 2013 Dec;126(12):1059-67.e1-4. doi: 10.1016/j.amjmed.2013.07.023. Epub 2013 Oct 15.
Dietary fiber may decrease the risk of cardiovascular disease and associated risk factors. We examined trends in dietary fiber intake among diverse US adults between 1999 and 2010, and investigated associations between dietary fiber intake and cardiometabolic risks including metabolic syndrome, cardiovascular inflammation, and obesity.
Our cross-sectional analysis included 23,168 men and nonpregnant women aged 20+ years from the 1999-2010 National Health and Nutrition Examination Survey. We used weighted multivariable logistic regression models to estimate predicted marginal risk ratios and 95% confidence intervals for the risks of having the metabolic syndrome, inflammation, and obesity associated with quintiles of dietary fiber intake.
Consistently, dietary fiber intake remained below recommended adequate intake levels for total fiber defined by the Institute of Medicine. Mean dietary fiber intake averaged 15.7-17.0 g. Mexican Americans (18.8 g) consumed more fiber than non-Hispanic whites (16.3 g) and non-Hispanic blacks (13.1 g). Comparing the highest with the lowest quintiles of dietary fiber intake, adjusted predicted marginal risk ratios (95% confidence interval) for the metabolic syndrome, inflammation, and obesity were 0.78 (0.69-0.88), 0.66 (0.61-0.72), and 0.77 (0.71-0.84), respectively. Dietary fiber was associated with lower levels of inflammation within each racial and ethnic group, although statistically significant associations between dietary fiber and either obesity or metabolic syndrome were seen only among whites.
Low dietary fiber intake from 1999-2010 in the US, and associations between higher dietary fiber and a lower prevalence of cardiometabolic risks suggest the need to develop new strategies and policies to increase dietary fiber intake.
膳食纤维可能降低心血管疾病和相关风险因素的风险。我们研究了 1999 年至 2010 年期间不同美国成年人膳食纤维摄入量的趋势,并调查了膳食纤维摄入量与代谢综合征、心血管炎症和肥胖等心血管代谢风险之间的关联。
我们的横断面分析包括 1999-2010 年全国健康和营养调查中 20 岁及以上的 23168 名男性和非孕妇。我们使用加权多变量逻辑回归模型来估计与膳食纤维摄入量五分位数相关的代谢综合征、炎症和肥胖风险的预测边际风险比和 95%置信区间。
一致地,膳食纤维摄入量仍低于医学研究所定义的总纤维推荐充足摄入量。平均膳食纤维摄入量为 15.7-17.0 克。墨西哥裔美国人(18.8 克)的纤维摄入量高于非西班牙裔白人(16.3 克)和非西班牙裔黑人(13.1 克)。与膳食纤维摄入量最低五分位数相比,最高五分位数的调整后预测边际风险比(95%置信区间)分别为代谢综合征、炎症和肥胖的 0.78(0.69-0.88)、0.66(0.61-0.72)和 0.77(0.71-0.84)。膳食纤维与每个种族和族裔群体的炎症水平降低有关,尽管仅在白人群体中观察到膳食纤维与肥胖或代谢综合征之间存在统计学显著关联。
1999 年至 2010 年美国膳食纤维摄入量低,以及膳食纤维摄入量较高与心血管代谢风险较低之间的关联表明,需要制定新的策略和政策来增加膳食纤维摄入量。