Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH.
The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH.
J Nutr. 2019 May 1;149(5):804-815. doi: 10.1093/jn/nxy319.
The influence of long-term dietary patterns on weight gain and the underlying potential biological mechanisms are not fully understood.
We prospectively examined the association of changes in 2 empirical hypothesis-oriented dietary patterns (insulinemic and inflammatory) and weight gain over 24 y at 4-y intervals.
We followed 54,397 women in the Nurses' Health Study and 33,043 men in the Health Professionals Follow-Up Study (1986-2010), and computed the empirical dietary index for hyperinsulinemia (EDIH) and empirical dietary inflammatory pattern (EDIP) scores from food frequency questionnaires administered every 4 y. Both scores are weighted sums of 18 food groups, which characterize dietary insulinemic or inflammatory potential based on plasma levels of insulin response or inflammatory biomarkers. We used multivariable-adjusted linear regression to examine 4-y changes in the dietary scores and weight change within the same period.
The mean baseline body mass index (BMI, in kg/m2) was 25.4. Compared with participants who made minimal dietary changes (quintile 3) over 6 4-y periods; participants who changed their diets toward lower insulinemic or inflammatory potential (quintile 1) gained significantly less weight (in kilograms per 4 y) independent of total energy intake, BMI, physical activity, and smoking status: EDIH: -0.65 (95% CI: -0.73, -0.57), EDIP: -0.29 (-0.37, -0.21) among women; and EDIH: -0.60 (-0.71, -0.49), EDIP: -0.19 (-0.27, -0.07) among men. In contrast, those who changed their diets toward higher insulinemic or inflammatory potential (quintile 5) gained significantly more weight: EDIH: 0.43 (0.36, 0.51), EDIP: 0.15 (0.07, 0.23) among women; and EDIH: 0.49 (0.38, 0.59), EDIP: 0.22 (0.11, 0.33) among men (P-trend < 0.0001 for all comparisons). Associations were stronger among individuals who were overweight or obese, younger, less physically active, and had never smoked.
High dietary insulinemic and inflammatory potential is associated with substantial long-term weight gain in adult men and women independent of total energy intake. Dietary patterns with low insulinemic and inflammatory potential may aid in weight gain prevention.
长期饮食模式对体重增加的影响以及潜在的生物学机制尚不完全清楚。
我们前瞻性地研究了两种经验性假设导向的饮食模式（胰岛素和炎症）变化与 4 年间隔 24 年体重增加的关系。
我们对参加护士健康研究的 54397 名女性和参加健康专业人员随访研究的 33043 名男性进行了随访（1986-2010 年），并根据每 4 年进行一次的食物频率问卷计算了高胰岛素血症经验性饮食指数（EDIH）和经验性饮食炎症模式（EDIP）评分。这两个评分都是基于胰岛素反应或炎症生物标志物的血浆水平来衡量饮食胰岛素或炎症潜力的 18 种食物组的加权和。我们使用多变量调整线性回归来检查饮食评分在 6 个 4 年期间的变化和同期体重变化。
平均基线体重指数（BMI，kg/m2）为 25.4。与饮食变化最小的参与者（五分位数 3）相比；饮食向胰岛素或炎症潜力较低的方向变化（五分位数 1）的参与者体重增加明显较少（每 4 年增加 0.65 公斤），而不考虑总能量摄入、BMI、体力活动和吸烟状况：EDIH：-0.65（95%CI：-0.73，-0.57），EDIP：-0.29（-0.37，-0.21）在女性中；EDIH：-0.60（-0.71，-0.49），EDIP：-0.19（-0.27，-0.07）在男性中。相比之下，饮食向胰岛素或炎症潜力较高的方向变化（五分位数 5）的参与者体重增加明显更多：EDIH：0.43（0.36，0.51），EDIP：0.15（0.07，0.23）在女性中；EDIH：0.49（0.38，0.59），EDIP：0.22（0.11，0.33）在男性中（所有比较的 P 趋势<0.0001）。在超重或肥胖、年轻、体力活动较少和从不吸烟的个体中，相关性更强。
高胰岛素血症和炎症饮食潜力与成年男女的长期体重增加密切相关，而与总能量摄入无关。胰岛素和炎症潜力低的饮食模式可能有助于预防体重增加。
