Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
J Nutr. 2020 Mar 1;150(3):560-567. doi: 10.1093/jn/nxz262.
Although the general importance of diet quality in the prevention of unintentional weight gain is known, it is unknown whether its influence is age or sex dependent.
The aim of this study was to investigate whether the strength of the association between diet quality and 4-y weight change was modified by age and sex.
From the Dutch population-based Lifelines Cohort, 85,618 nonobese adult participants (age 18-93 y), recruited between 2006 and 2013, were included in the study. At baseline, diet was assessed with a 110-item food-frequency questionnaire. The Lifelines Diet Score, based on international evidence for diet-disease relations at the food group level, was calculated to assess diet quality. For analyses, the score was divided in quintiles (Qs). Body weight was objectively measured at baseline and after a median follow-up of 44 mo (25th-75th percentile: 35-51 mo). In between, body weight was self-reported twice. Linear mixed models were used to investigate the association between diet quality and weight change by sex and in 6 age categories (18-29, 30-39, 40-49, 50-59, 60-69, and ≥70 y).
Mean 4-y weight change decreased over age categories. Confounder-adjusted linear mixed models showed that the association between diet quality and weight change was modified by sex (P-interaction = 0.001). In women, the association was also modified by age (P-interaction = 0.001). Poor diet quality was most strongly associated with weight gain in the youngest men [Q1 compared with Q5: +0.33 kg/y (95% CI: 0.10, 0.56)] and women [+0.22 kg/y (95% CI: 0.07, 0.37)]. In contrast, in women aged ≥70 y, poor diet quality was associated with greater weight loss [-0.44 kg/y (95% CI: -0.84, -0.05)].
Poor diet quality was related to higher weight gain, especially in young adults. Oppositely, among women aged ≥70 y, poor diet quality was related to higher weight loss. Therefore, a healthful diet is a promising target for undesirable weight changes in both directions.
尽管人们已经认识到饮食质量在预防意外体重增加方面的重要性，但目前尚不清楚这种影响是否与年龄或性别有关。
本研究旨在探讨饮食质量与 4 年体重变化之间的关联强度是否受年龄和性别影响。
本研究纳入了荷兰基于人群的 Lifelines 队列研究中的 85618 名非肥胖成年参与者（年龄 18-93 岁），这些参与者于 2006 年至 2013 年间招募入组。在基线时，使用包含 110 个食物项目的食物频率问卷评估饮食情况。基于国际上有关饮食与疾病关系的证据，我们计算了 Lifelines 饮食评分，以评估饮食质量。为了分析，我们将评分分为五分位数（Qs）。在基线时和中位数随访 44 个月（25 至 75 百分位数：35-51 个月）期间，我们使用客观测量方法测量了体重。在此期间，我们还两次记录了参与者的自报体重。我们使用线性混合模型，按性别和 6 个年龄类别（18-29、30-39、40-49、50-59、60-69 和≥70 岁），分析饮食质量与体重变化之间的关系。
4 年体重变化均值随年龄类别而降低。经混杂因素调整的线性混合模型显示，饮食质量与体重变化之间的关系受到性别的影响（P 交互=0.001）。在女性中，这种关系也受到年龄的影响（P 交互=0.001）。在最年轻的男性（Q1 与 Q5 相比：+0.33kg/y（95%CI：0.10，0.56））和女性（+0.22kg/y（95%CI：0.07，0.37））中，较差的饮食质量与体重增加的关联最强。相比之下，在≥70 岁的女性中，较差的饮食质量与体重减轻相关[-0.44kg/y（95%CI：-0.84，-0.05）]。
较差的饮食质量与体重增加有关，尤其是在年轻成年人中。相反，在≥70 岁的女性中，较差的饮食质量与体重减轻有关。因此，健康饮食是控制体重向两个方向变化的一个有前途的目标。
