Zazpe Itziar, Sánchez-Taínta Ana, Santiago Susana, de la Fuente-Arrillaga Carmen, Bes-Rastrollo Maira, Martínez J Alfredo, Martínez-González Miguel Ángel
Department of Preventive Medicine and Public Health, School of Medicine-Clínica Universidad de Navarra, University of Navarra, Irunlarrea 1, Pamplona 31008, Navarra, Spain.
Department of Nutrition and Food Sciences and Physiology, University of Navarra, Navarra, Spain.
Br J Nutr. 2014 Jun 14;111(11):2000-9. doi: 10.1017/S0007114513004364. Epub 2014 Mar 25.
Epidemiological research confirms that the prevalence of suboptimal micronutrient intakes across Europe is an emerging concern in terms of public health. The aim of the present study was to investigate the association between a new index of carbohydrate (CHO) quality and micronutrient intake adequacy in the 'Seguimiento Universidad de Navarra (SUN)' cohort. The baseline assessment extended from 1999 to March 2012. We assessed 16,841 participants who completed a validated 136-item semi-quantitative FFQ at baseline. We created a new index to evaluate CHO quality for the following four criteria: dietary fibre intake; glycaemic index; whole grains:total grains ratio; solid CHO:total CHO ratio. The subjects were classified into quintiles according to this index. We evaluated the intakes of Zn, I, Se, Fe, Ca, K, P, Mg, Cr and vitamins B1, B2, B3, B6, B12, C, A, D, E and folic acid. The probability of intake adequacy was evaluated using the estimated average requirement cut-point approach and the probabilistic approach. Logistic regression analysis was used to assess the nutritional adequacy according to the CHO quality index (CQI). Participants in the highest quintile of CQI were found to have the lowest prevalence of inadequacy. A higher quality of CHO intake was found to be associated with a lower risk of nutritional inadequacy in comparison with the lowest quintile of CQI (adjusted OR 0·06, 95 % CI 0·02, 0·16; P for trend < 0·001). A higher CQI was found to be strongly associated with better micronutrient intake adequacy in the young Mediterranean cohort, stressing the importance of focusing nutritional education not only on CHO quantity, but also on quality.
流行病学研究证实，从公共卫生角度来看，欧洲微量营养素摄入不足的普遍情况正成为一个新的关注点。本研究的目的是在“纳瓦拉大学跟踪研究（SUN）”队列中，调查一种新的碳水化合物（CHO）质量指数与微量营养素摄入充足率之间的关联。基线评估时间跨度为1999年至2012年3月。我们评估了16841名在基线时完成了一份经验证的136项半定量食物频率问卷的参与者。我们创建了一个新指数，根据以下四个标准评估CHO质量：膳食纤维摄入量；血糖生成指数；全谷物与总谷物的比例；固体CHO与总CHO的比例。根据该指数将受试者分为五等份。我们评估了锌、碘、硒、铁、钙、钾、磷、镁、铬以及维生素B1、B2、B3、B6、B12、C、A、D、E和叶酸的摄入量。使用估计平均需求量切点法和概率法评估摄入充足的概率。采用逻辑回归分析根据CHO质量指数（CQI）评估营养充足情况。发现CQI最高五分位数的参与者摄入不足的患病率最低。与CQI最低五分位数相比，CHO摄入质量较高与营养不足风险较低相关（调整后的比值比为0.06，95%置信区间为0.02至0.16；趋势P值<0.001）。在年轻的地中海队列中，较高的CQI与更好的微量营养素摄入充足情况密切相关，这突出了营养教育不仅要关注CHO的量，还要关注其质量的重要性。
