Chen Hsin-Jen, Wang Youfa, Cheskin Lawrence J
Institute and Department of Public Health, National Yang-Ming University, Taipei, Taiwan; Global Obesity Prevention Center at Johns Hopkins, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Global Obesity Prevention Center at Johns Hopkins, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Systems-Oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY.
Ann Epidemiol. 2016 Aug;26(8):527-533. doi: 10.1016/j.annepidem.2016.06.006. Epub 2016 Jun 15.
This study examined longitudinal relationship between baseline daily eating frequency and all-cause and cardiovascular disease (CVD) mortality among U.S. adults.
The Third National Health and Nutrition Examination Survey (1988-1992) participants were followed through 2006. Nonpregnant adults >17 years old (n = 6884) whose dietary recall was of good quality and had fasted at least 8 hours before physical examinations were eligible for this analysis. Frequency of eating was derived from 24-hour dietary recalls. Main outcomes included all-cause and CVD mortality during follow-up, based on National Death Index data.
During follow-up (median time: 176 months), 1280 subjects died, 503 of them from CVD. Adults reporting eating ≥6 times/day had a lower hazard ratio for CVD mortality than those reporting eating 4 times/day (hazard ratio = 0.68; 95% confidence interval, 0.43-1.08; test for trend, P = .011). The gradient of CVD mortality risk by eating frequency was significant for the groups with ≥2500 kcal of total energy intake (test for trend, P = .037).
Eating frequency was inversely associated with CVD mortality, which was especially marked for people reporting high total energy intake. Nevertheless, public health recommendations should be cautious, as eating frequency was positively associated with total energy intake, which could promote weight gain.
本研究探讨了美国成年人基线每日进食频率与全因死亡率和心血管疾病（CVD）死亡率之间的纵向关系。
对第三次全国健康和营养检查调查（1988 - 1992年）的参与者进行随访至2006年。年龄大于17岁的非孕妇成年人（n = 6884），其饮食回忆质量良好且在体检前至少禁食8小时，符合本分析的条件。进食频率来自24小时饮食回忆。主要结局包括基于国家死亡指数数据的随访期间全因死亡率和CVD死亡率。
在随访期间（中位时间：176个月），1280名受试者死亡，其中503人死于CVD。报告每天进食≥6次的成年人CVD死亡率的风险比低于报告每天进食4次的成年人（风险比 = 0.68；95%置信区间，0.43 - 1.08；趋势检验，P = 0.011）。对于总能量摄入≥2500千卡的人群，按进食频率划分的CVD死亡风险梯度具有显著性（趋势检验，P = 0.037）。
进食频率与CVD死亡率呈负相关，这在报告总能量摄入较高的人群中尤为明显。然而，由于进食频率与总能量摄入呈正相关，可能会促进体重增加，因此公共卫生建议应谨慎制定。
