Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Geelong, Victoria, 3125, Australia.
Nutr J. 2018 Feb 12;17(1):19. doi: 10.1186/s12937-018-0326-1.
Diet quality indices score dietary intakes against recommendations, whereas dietary patterns consider the pattern and combination of dietary intakes. Studies evaluating both methodologies in relation to cardiometabolic health in a nationally representative sample are limited. The aim of the present study was to investigate the relationship between diet quality, dietary patterns and markers of cardiometabolic health in Australian adults.
Dietary data, using two 24-h dietary recalls, were collected from adults in the cross-sectional Australian Health Survey 2011-2013 (n = 2121; 46.4 (SE 0.48) years). Diet quality was estimated using the Dietary Guideline Index (DGI). Dietary patterns (DPs), derived using reduced rank regression, were estimated using fiber density, SFA: PUFA and total sugars intake as intermediate markers. Multi-variable adjusted linear regression analyses were used to examine associations between diet quality and DPs and blood biomarkers, body mass index, waist circumference, diastolic and systolic blood pressure and an overall cardiometabolic risk score.
DGI was associated with lower glucose (coef - 0.009, SE 0.004; P-trend = 0.033), body mass index (coef - 0.017, SE 0.007; P-trend = 0.019) and waist circumference (coef - 0.014, SE 0.005; P-trend = 0.008). Two dietary patterns were derived: dietary pattern-1 was characterized by higher intakes of pome fruit and wholegrain bread, while dietary pattern-2 was characterized by higher intakes of added sugars and tropical fruit. Dietary pattern-1 was associated with lower body mass index (coef - 0.028, SE 0.007; P-trend< 0.001) and waist circumference (coef - 0.017, SE 0.005; P-trend = 0.001). There was a trend towards lower cardiometabolic risk score. Dietary pattern-2 was associated with lower HDL-cholesterol (coef - 0.026, SE 0.012; P-trend = 0.028). There was a trend towards lower diastolic blood pressure. No associations with other markers were observed.
Better diet quality and healthier dietary patterns were primarily associated with favorable anthropometric markers of cardiometabolic health. Findings support the need for comparison of whole-diet based methodologies that take into consideration the interactions between foods and nutrients. Longitudinal studies are warranted to better understand causal relationships between diet and cardiometabolic health.
饮食质量指数根据建议对饮食摄入量进行评分，而饮食模式则考虑饮食摄入量的模式和组合。在具有全国代表性的样本中，评估这两种方法与心血管代谢健康之间关系的研究有限。本研究的目的是调查澳大利亚成年人的饮食质量、饮食模式与心血管代谢健康标志物之间的关系。
使用两次 24 小时膳食回忆，从 2011-2013 年澳大利亚健康调查（n=2121；46.4（SE 0.48）岁）中的成年人收集饮食数据。使用饮食指南指数（DGI）来估计饮食质量。使用纤维密度、SFA：PUFA 和总糖摄入量作为中间标志物，使用降秩回归来估计饮食模式（DP）。使用多变量调整线性回归分析来检查饮食质量和 DP 与血液生物标志物、体重指数、腰围、舒张压和收缩压以及整体心血管代谢风险评分之间的关联。
DGI 与较低的血糖（系数-0.009，SE 0.004；P 趋势=0.033）、体重指数（系数-0.017，SE 0.007；P 趋势=0.019）和腰围（系数-0.014，SE 0.005；P 趋势=0.008）相关。得出了两种饮食模式：饮食模式-1 的特点是摄入更多的梨果和全麦面包，而饮食模式-2 的特点是摄入更多的添加糖和热带水果。饮食模式-1 与较低的体重指数（系数-0.028，SE 0.007；P 趋势<0.001）和腰围（系数-0.017，SE 0.005；P 趋势=0.001）相关。心血管代谢风险评分呈下降趋势。饮食模式-2 与较低的高密度脂蛋白胆固醇（系数-0.026，SE 0.012；P 趋势=0.028）相关。舒张压呈下降趋势。其他标志物未见相关性。
更好的饮食质量和更健康的饮食模式主要与心血管代谢健康的有利人体测量标志物相关。研究结果支持比较基于全饮食的方法，这些方法需要考虑食物和营养素之间的相互作用。需要进行纵向研究，以更好地了解饮食与心血管代谢健康之间的因果关系。
