Wu Feitong, Wills Karen, Laslett Laura L, Oldenburg Brian, Jones Graeme, Winzenberg Tania
1Menzies Institute for Medical Research,University of Tasmania,17 Liverpool Street, Hobart, TAS 7000,Australia.
2School of Population and Global Health,University of Melbourne,235 Bouverie Street, Carlton, VIC 3053,Australia.
Br J Nutr. 2017 Oct;118(8):598-606. doi: 10.1017/S0007114517002483. Epub 2017 Oct 9.
Influences of dietary patterns on musculoskeletal health are poorly understood in middle-aged women. This cross-sectional analysis from a cohort of 347 women (aged 36-57 years) aimed to examine associations between dietary patterns and musculoskeletal health outcomes in middle-aged women. Diet was measured by the Cancer Council of Victoria FFQ. Total body bone mineral content (TB BMC), femoral neck and lumbar spine bone density (dual-energy X-ray absorptiometry), lower limbs muscle strength (LMS) and balance tests (timed up and go test, step test, functional reach test (FRT) and lateral reach test) were also measured. Exploratory factor analysis was used to identify dietary patterns and scores for each pattern generated using factor loadings with absolute values ≥0·20. Associations between food pattern scores and musculoskeletal outcomes were assessed using multivariable linear regression. Three dietary patterns were identified: 'Healthy' (high consumption of a plant-based diet - vegetables, legumes, fruit, tomatoes, nuts, snacks, garlic, whole grains and low intake of high-fat dairy products), 'high protein, high fat' (red meats, poultry, processed meats, potatoes, cruciferous and dark-yellow vegetables, fish, chips, spirits and high-fat dairy products) and 'Processed foods' (high intakes of meat pies, hamburgers, beer, sweets, fruit juice, processed meats, snacks, spirits, pizza and low intake of cruciferous vegetables). After adjustment for confounders, Healthy pattern was positively associated with LMS, whereas Processed foods pattern was inversely associated with TB BMC and FRT. The associations were not significant after accounting for multiple comparisons. There were no associations with any other outcomes. These results suggest that maintaining a healthy diet could contribute to bone acquisition, muscle strength and balance in adult life. However, while they provide some support for further investigating dietary strategies for prevention of age-related loss of muscle and deterioration in balance, the exploratory nature of the analyses means that confirmation in longitudinal studies and/or trials with pre-specified hypotheses is needed.
中年女性的饮食模式对肌肉骨骼健康的影响尚不清楚。这项对347名年龄在36至57岁之间的女性队列进行的横断面分析旨在研究中年女性的饮食模式与肌肉骨骼健康结果之间的关联。饮食通过维多利亚癌症理事会食物频率问卷进行测量。还测量了全身骨矿物质含量（TB BMC）、股骨颈和腰椎骨密度（双能X线吸收法）、下肢肌肉力量（LMS）和平衡测试（计时起立行走测试、台阶测试、功能性伸展测试（FRT）和侧向伸展测试）。探索性因素分析用于确定饮食模式，并使用绝对值≥0·20的因素负荷为每种模式生成分数。使用多变量线性回归评估食物模式分数与肌肉骨骼结果之间的关联。确定了三种饮食模式：“健康”（以植物性饮食为主——蔬菜、豆类、水果、西红柿、坚果、零食、大蒜、全谷物，高脂肪乳制品摄入量低）、“高蛋白、高脂肪”（红肉、家禽、加工肉类、土豆、十字花科和深黄色蔬菜、鱼类、薯条、烈酒和高脂肪乳制品）和“加工食品”（肉馅饼、汉堡包、啤酒、糖果、果汁、加工肉类、零食、烈酒、披萨摄入量高，十字花科蔬菜摄入量低）。在对混杂因素进行调整后，“健康”模式与LMS呈正相关，而“加工食品”模式与TB BMC和FRT呈负相关。在考虑多重比较后，这些关联不显著。与任何其他结果均无关联。这些结果表明，保持健康的饮食可能有助于成年人的骨骼获取、肌肉力量和平衡。然而，虽然它们为进一步研究预防与年龄相关的肌肉流失和平衡恶化的饮食策略提供了一些支持，但分析的探索性意味着需要在纵向研究和/或有预先设定假设的试验中进行确认。
