Grimes Carley A, Riddell Lynn J, Campbell Karen J, He Feng J, Nowson Caryl A
1School of Exercise and Nutrition Sciences,Centre for Physical Activity and Nutrition Research,Deakin University,Burwood,VIC 3125,Australia.
2Centre for Environmental and Preventative Medicine,Wolfson Institute of Preventative Medicine,Queen Mary University of London,London EC1M 6BQ,UK.
Br J Nutr. 2016 Mar 28;115(6):1071-9. doi: 10.1017/S0007114515005243. Epub 2016 Jan 26.
Emerging evidence indicates that dietary Na may be linked to obesity; however it is unclear whether this relationship is independent of energy intake (EI). The aim of this study was to assess the association between Na intake and measures of adiposity, including BMI z score, weight category and waist:height ratio (WHtR), in a sample of Australian schoolchildren. This was a cross-sectional study of schoolchildren aged 4-12 years. Na intake was assessed via one 24-h urine collection. BMI was converted to age- and sex-specific z scores, and WHtR was used to define abdominal obesity. In children aged ≥8 years, EI was determined via one 24-h dietary recall. Of the 666 children with valid urine samples 55 % were male (average age 9·3 (sd 1·8) years). In adjusted models an additional 17 mmol/d of Na was associated with a 0·10 higher BMI z score (95 % CI 0·07, 0·13), a 23 % (OR 1·23; 95 % CI 1·16, 1·31) greater risk of being overweight/obese and a 15 % (OR 1·15; 95 % CI 1·09, 1·23) greater risk of being centrally obese. In the subsample of 8-12-year-old children (n 458), adjustment for EI did not markedly alter the associations between Na and adiposity outcomes. Using a robust measure of daily Na intake we found a positive association between Na intake and obesity risk in Australian schoolchildren, which could not be explained by total energy consumption. To determine whether this is a causal relationship, longitudinal studies, with high-quality measures of Na and EI, are required.
新出现的证据表明，饮食中的钠可能与肥胖有关；然而，这种关系是否独立于能量摄入（EI）尚不清楚。本研究的目的是评估澳大利亚学童样本中钠摄入量与肥胖指标之间的关联，这些指标包括体重指数z评分、体重类别和腰高比（WHtR）。这是一项针对4至12岁学童的横断面研究。通过一次24小时尿液收集来评估钠摄入量。体重指数被转换为年龄和性别特异性z评分，并使用腰高比来定义腹型肥胖。在8岁及以上的儿童中，通过一次24小时饮食回顾来确定能量摄入。在666名有有效尿液样本的儿童中，55%为男性（平均年龄9·3（标准差1·8）岁）。在调整模型中，钠摄入量每增加17 mmol/d，体重指数z评分就会高出0·10（95%置信区间0·07，0·13），超重/肥胖风险增加23%（比值比1·23；95%置信区间1·16，1·31），中心性肥胖风险增加15%（比值比1·15；95%置信区间1·09，1·23）。在8至12岁儿童的子样本（n = 458）中，但对能量摄入进行调整后，并未显著改变钠与肥胖指标之间的关联。通过对每日钠摄入量的可靠测量，我们发现澳大利亚学童的钠摄入量与肥胖风险之间存在正相关，这无法用总能量消耗来解释。若要确定这是否为因果关系，则需要开展纵向研究，并对钠和能量摄入进行高质量测量。
