Song SuJin, Song Won O, Song YoonJu
Department of Food and Nutrition, Hannam University, Daejeon, Republic of Korea.
Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA.
J Clin Lipidol. 2017 Mar-Apr;11(2):338-347.e3. doi: 10.1016/j.jacl.2017.01.016. Epub 2017 Feb 6.
A high prevalence of metabolic syndrome along with increasing rates of low high-density lipoprotein cholesterol (HDL-C) and elevated triglycerides (TGs) is shown in Korean adults. Little is known about the associations between macronutrient intake and lipid abnormalities in the Asian population, whose major energy source is carbohydrates.
We examined the associations of dietary carbohydrate and fat intakes with lipid abnormalities in Korean adults.
A total of 14,301 adults (5715 men and 8586 women) aged ≥30 years with no diagnosis and treatment for diabetes, hypertension, or dyslipidemia were selected from the 2008 to 2012 Korea National Health and Nutrition Examination Survey data. From the 24-hour recall data, dietary carbohydrate and fat intakes were estimated. Multivariate logistic regression was used to estimate odds ratios for lipid abnormalities, that is, elevated total cholesterol (TC), low HDL-C, high TC to HDL-C ratio, elevated non-HDL-C, elevated LDL cholesterol (LDL-C), and elevated TG across quintiles of dietary carbohydrate and fat intakes.
Percentage of energy from carbohydrate was positively associated with elevated TG and low HDL-C but inversely associated with elevated TC and elevated LDL-C in both men and women. Energy-adjusted carbohydrate intake also showed a positive association with low HDL-C. Dietary fat intakes had the opposite associations with lipid abnormalities than results for carbohydrate.
High carbohydrate diet is undesirable with regard to increased TG and reduced HDL-C despite the benefit for LDL-C. Dietary strategies emphasizing appropriate macronutrient intakes by the type of lipid abnormalities are recommended for the prevention of cardiovascular disease in Korean adults.
韩国成年人中代谢综合征的高患病率以及低高密度脂蛋白胆固醇(HDL-C)和甘油三酯(TG)升高的比率不断上升。在以碳水化合物为主要能量来源的亚洲人群中,关于宏量营养素摄入与脂质异常之间的关联知之甚少。
我们研究了韩国成年人饮食中碳水化合物和脂肪摄入量与脂质异常之间的关联。
从2008年至2012年韩国国家健康与营养检查调查数据中选取了14301名年龄≥30岁、未被诊断和治疗过糖尿病、高血压或血脂异常的成年人(5715名男性和8586名女性)。根据24小时回顾性数据估算饮食中碳水化合物和脂肪的摄入量。使用多因素逻辑回归来估计脂质异常的比值比,即总胆固醇(TC)升高、HDL-C降低、TC与HDL-C比值升高、非HDL-C升高、低密度脂蛋白胆固醇(LDL-C)升高以及饮食中碳水化合物和脂肪摄入量五分位数范围内的TG升高。
碳水化合物提供的能量百分比与TG升高和HDL-C降低呈正相关,但与男性和女性的TC升高和LDL-C升高呈负相关。能量调整后的碳水化合物摄入量也与HDL-C降低呈正相关。饮食中脂肪摄入量与脂质异常的关联与碳水化合物的结果相反。
尽管高碳水化合物饮食对LDL-C有益,但就TG升高和HDL-C降低而言是不理想的。建议针对韩国成年人预防心血管疾病采取根据脂质异常类型强调适当宏量营养素摄入的饮食策略。