1Diabetes and Cardiovascular Disease - Genetic Epidemiology,Department of Clinical Sciences in Malmö,Lund University,SE-205 02, Malmö,Sweden.
2Research Group in Nutritional Epidemiology,Department of Clinical Sciences in Malmö,Lund University,SE-205 02, Malmö,Sweden.
Br J Nutr. 2018 May;119(10):1168-1176. doi: 10.1017/S000711451800079X.
The aim of this study was to derive dietary patterns associated with cardio-metabolic traits and to examine whether these predict prospective changes in these traits and incidence of the metabolic syndrome (iMetS). Subjects from the Malmö Diet and Cancer Study cardiovascular cohort without cardio-metabolic disease and related drug treatments at baseline (n 4071; aged 45-67 years, 40 % men) were included. We applied reduced rank regression on thirty-eight foods to derive patterns that explain variation in response variables measured at baseline (waist circumference, TAG, HDL- and LDL-cholesterol, systolic and diastolic blood pressure, fasting glucose and insulin). Patterns were examined in relation to change in cardio-metabolic traits and iMetS in subjects who were re-examined after 16·7 years (n 2704). Two dietary patterns ('Western' and 'Drinker') were retained and explained 3·2 % of the variation in response variables. The 'Western' dietary pattern was inversely associated with HDL-cholesterol and positively with all other response variables (both at baseline and follow-up), but there was no association with LDL at follow-up. After adjustment for potential confounders, the 'Western' dietary pattern was associated with higher risk of iMetS (hazard ratio Q4 v. Q1: 1·47; 95 % CI 1·23, 1·77; P trend=1·5×10-5). The 'Drinker' dietary pattern primarily explained variation in HDL and was not associated with iMetS. In conclusion, this study supports current food-based dietary guidelines suggesting that a 'Western' dietary pattern with high intakes of sugar-sweetened beverages and red and processed meats and low intakes of wine, cheese, vegetables and high-fibre foods is associated with detrimental effects on cardio-metabolic health.
本研究旨在确定与心血管代谢特征相关的饮食模式，并研究这些模式是否可以预测这些特征的前瞻性变化和代谢综合征（iMetS）的发生。本研究纳入了无心血管代谢疾病且基线时无相关药物治疗的马尔默饮食与癌症研究心血管队列中的受试者（n 4071；年龄 45-67 岁，40%为男性）。我们应用降秩回归对 38 种食物进行分析，以确定解释基线时测量的反应变量（腰围、TAG、HDL-和 LDL-胆固醇、收缩压和舒张压、空腹血糖和胰岛素）变异的模式。在经过 16.7 年再次检查的受试者中（n 2704），我们检查了这些模式与心血管代谢特征和 iMetS 的变化之间的关系。保留了两种饮食模式（“西方”和“饮酒者”），它们解释了反应变量变化的 3.2%。“西方”饮食模式与 HDL-胆固醇呈负相关，与所有其他反应变量（基线和随访时均如此）呈正相关，但与 LDL 无相关性。在调整潜在混杂因素后，“西方”饮食模式与 iMetS 风险增加相关（Q4 与 Q1 的危险比：1.47；95%CI 1.23，1.77；P 趋势=1.5×10-5）。“饮酒者”饮食模式主要解释了 HDL 的变化，与 iMetS 无关。总之，本研究支持当前基于食物的饮食指南，即高糖饮料、红肉和加工肉以及低酒、奶酪、蔬菜和高纤维食物的“西方”饮食模式与心血管代谢健康的不良影响有关。
