Department of Medicine, Shiga University of Medical Science, Otsu, 520-2192, Japan.
Department of Public Health, Shiga University of Medical Science, Otsu, 520-2192, Japan.
Eur J Clin Nutr. 2020 Jan;74(1):67-76. doi: 10.1038/s41430-019-0424-y. Epub 2019 Apr 8.
BACKGROUND/OBJECTIVES: The association between carbohydrate intake and cardiovascular disease (CVD) risk has been investigated, but whether the quality of carbohydrate is more important than its amount is not known. We examined the associations between intake of dietary fibre (DF), carbohydrate, available carbohydrate, and starch with long-term CVD mortality in a Japanese population.
SUBJECTS/METHODS: We prospectively followed 8925 participants (3916 men and 5009 women) aged 30-79 years without CVD at baseline who participated in the National Nutrition Survey in Japan. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for CVD mortality by quartiles of exposure variables.
During 24 years of follow-up, 823 CVD deaths were observed. In men, the multivariable-adjusted HR for CVD mortality was lower in the highest quartile of DF intake (HR: 0.64; 95% CI: 0.47-0.87; P = 0.007) compared with the lowest quartile. This association was not significant in women. Multivariable-adjusted HR for total stroke mortality was lower in the highest quartile of DF intake (HR: 0.61; 95% CI: 0.38-0.98; P = 0.046) compared with the lowest quartile in women. Carbohydrate, available carbohydrate, and starch intake were not associated with CVD mortality.
Higher intake of DF was associated significantly with a lower risk of CVD mortality in men and lower risk of stroke mortality in women. Intake of carbohydrate, available carbohydrate, and starch were not associated with the risk of CVD mortality in men or women.
背景/目的:已经研究了碳水化合物摄入量与心血管疾病(CVD)风险之间的关联,但碳水化合物的质量是否比其数量更重要尚不清楚。我们在日本人群中研究了膳食纤维(DF)、碳水化合物、可利用碳水化合物和淀粉的摄入量与长期 CVD 死亡率之间的关系。
受试者/方法:我们前瞻性地随访了 8925 名年龄在 30-79 岁且基线时无 CVD 的参与者(男性 3916 名,女性 5009 名),他们参加了日本国家营养调查。使用 Cox 比例风险模型来估计暴露变量四分位数的 CVD 死亡率的多变量调整后的危险比(HR)及其 95%置信区间(CI)。
在 24 年的随访期间,观察到 823 例 CVD 死亡。在男性中,DF 摄入量最高四分位数的 CVD 死亡率的多变量调整 HR 低于最低四分位数(HR:0.64;95%CI:0.47-0.87;P=0.007)。在女性中,这种关联不显著。DF 摄入量最高四分位数的总卒中死亡率的多变量调整 HR 低于最低四分位数(HR:0.61;95%CI:0.38-0.98;P=0.046)。女性碳水化合物、可利用碳水化合物和淀粉的摄入量与 CVD 死亡率无关。
DF 摄入量较高与男性 CVD 死亡率降低和女性卒中死亡率降低显著相关。碳水化合物、可利用碳水化合物和淀粉的摄入量与男性或女性的 CVD 死亡率无关。