Damsgaard Camilla T, Biltoft-Jensen Anja, Tetens Inge, Michaelsen Kim F, Lind Mads V, Astrup Arne, Landberg Rikard
Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark;
National Food Institute, Technical University of Denmark, Søborg, Denmark.
J Nutr. 2017 May;147(5):816-824. doi: 10.3945/jn.116.244624. Epub 2017 Mar 29.
Whole-grain consumption seems to be cardioprotective in adults, but evidence in children is limited. We investigated whether intakes of total whole grain and dietary fiber as well as specific whole grains were associated with fat mass and cardiometabolic risk profile in children. We collected cross-sectional data on parental education, puberty, diet by 7-d records, and physical activity by accelerometry and measured anthropometry, fat mass index by dual-energy X-ray absorptiometry, and blood pressure in 713 Danish children aged 8-11 y. Fasting blood samples were obtained and analyzed for alkylresorcinols, biomarkers of whole-grain wheat and rye intake, HDL and LDL cholesterol, triacylglycerols, insulin, and glucose. Linear mixed models included puberty, parental education, physical activity, and intakes of energy, fruit and vegetables, saturated fat, and n-3 (ω-3) polyunsaturated fatty acids. Median (IQR) whole-grain and dietary fiber intakes were 52 g/d (35-72 g/d) and 17 g/d (14-22 g/d), respectively. Fourteen percent of children were overweight or obese and most had low-risk cardiometabolic profiles. Dietary whole-grain and fiber intakes were not associated with fat mass index but were inversely associated with serum insulin [both < 0.01; e.g., with 0.68 pmol/L (95% CI: 0.26, 1.10 pmol/L) lower insulin · g whole grain · MJ]. Whole-grain oat intake was inversely associated with fat mass index, systolic blood pressure, and LDL cholesterol (all < 0.05) as well as insulin ( = 0.003), which also tended to be inversely associated with whole-grain rye intake ( = 0.11). Adjustment for fat mass index did not change the associations. The C17-to-C21 alkylresorcinol ratio, reflecting whole-grain rye to wheat intake, was inversely associated with insulin ( < 0.001). Higher whole-grain intake was associated with lower serum insulin independently of fat mass in 8- to 11-y-old Danish children. Whole-grain oat intake was linked to an overall protective cardiometabolic profile, and whole-grain rye intake was marginally associated with lower serum insulin. This supports whole grains as healthy dietary components in childhood. This trial was registered at clinicaltrials.gov as NCT01577277.
食用全谷物似乎对成年人有心脏保护作用,但在儿童中的证据有限。我们调查了儿童摄入的总全谷物、膳食纤维以及特定全谷物是否与脂肪量和心脏代谢风险状况相关。我们收集了关于父母教育程度、青春期、通过7天饮食记录得出的饮食情况以及通过加速度计测量的身体活动情况的横断面数据,并测量了713名8至11岁丹麦儿童的人体测量数据、通过双能X射线吸收法测量的脂肪量指数以及血压。采集空腹血样并分析其中的烷基间苯二酚(全谷物小麦和黑麦摄入量的生物标志物)、高密度脂蛋白和低密度脂蛋白胆固醇、三酰甘油、胰岛素和葡萄糖。线性混合模型纳入了青春期、父母教育程度、身体活动以及能量、水果和蔬菜、饱和脂肪和n-3(ω-3)多不饱和脂肪酸的摄入量。全谷物和膳食纤维的摄入量中位数(四分位间距)分别为52克/天(35 - 72克/天)和17克/天(14 - 22克/天)。14%的儿童超重或肥胖,且大多数儿童的心脏代谢风险状况处于低风险。饮食中的全谷物和膳食纤维摄入量与脂肪量指数无关,但与血清胰岛素呈负相关[两者均P < 0.01;例如,每克全谷物每兆焦耳能量摄入使胰岛素降低0.68皮摩尔/升(95%置信区间:0.26,1.10皮摩尔/升)]。全谷物燕麦的摄入量与脂肪量指数、收缩压和低密度脂蛋白胆固醇呈负相关(均P < 0.05)以及与胰岛素呈负相关(P = 0.003),全谷物黑麦摄入量也往往与之呈负相关(P = 0.11)。对脂肪量指数进行调整后,这些关联并未改变。反映全谷物黑麦与小麦摄入量的C17至C21烷基间苯二酚比值与胰岛素呈负相关(P < 0.001)。在8至11岁的丹麦儿童中,较高的全谷物摄入量与较低的血清胰岛素水平相关,且独立于脂肪量。全谷物燕麦的摄入量与总体心脏代谢保护状况相关,全谷物黑麦的摄入量与较低的血清胰岛素水平有微弱关联。这支持了全谷物作为儿童健康饮食成分的观点。该试验已在clinicaltrials.gov上注册,注册号为NCT01577277。