School of Health Sciences, Wuhan University, Wuhan City, Hubei Province, Wuhan, China; Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
School of Health Sciences, Wuhan University, Wuhan City, Hubei Province, Wuhan, China.
Am J Prev Med. 2020 Feb;58(2):294-301. doi: 10.1016/j.amepre.2019.09.004. Epub 2019 Nov 15.
Evidence on the combined effect of fruit and vegetable intake and total fat intake on hypertension is scarce. This study aimed to explore the relationship among fruit and vegetable intake, fat intake, and hypertension risk among Chinese adults.
Individuals who participated in the China Health and Nutrition Survey (2004, 2006, 2009, and 2011) and were free of hypertension at baseline (n=4,368) were categorized into quartiles (Q1, lowest; Q4, highest) according to their dietary fruit and vegetable intake and fat intake. Generalized estimation equation models, adjusted for confounders, were used to explore the relationship of fat intake with hypertension and systolic and diastolic blood pressure among all adults and within quartiles of fruit and vegetable intake. Data analyses were performed in 2018.
A total of 1,086 adults developed hypertension during follow-up. In the total population, the OR of the highest quartile of fat intake was 1.40 (95% CI=1.12, 1.75) compared with the lowest. Among individuals with low fruit and vegetable intake, the odds of hypertension for those in Q3 (OR=1.97, 95% CI=1.37, 2.83) and Q4 (OR=1.81, 95% CI=1.14, 2.90) of fat intake, compared with individuals in Q1, were even higher than for the overall sample. For each 50-gram increase in FI per day, the ORs of hypertension increased from fat intake Q1 to Q4 among all respondents and those with low fruit and vegetable intake, but not among those with high fruit and vegetable intake. Systolic blood pressure increased by 1.08 mm Hg (95% CI=0.03, 2.13) per 50-gram fat intake per day increment in the fruit and vegetable intake Q1 group, whereas the association was not significant in the fruit and vegetable intake Q2-Q4 groups.
Fruit and vegetable intake modifies the relationship between fat intake and hypertension, whereby high fruit and vegetable intake may offset the detrimental effect of fat intake on hypertension. Increased fruit and vegetable intake and controlled fat intake are recommended to prevent hypertension in Chinese adults.
关于水果和蔬菜摄入量与总脂肪摄入量对高血压的综合影响的证据很少。本研究旨在探讨中国成年人的水果和蔬菜摄入量、脂肪摄入量与高血压风险之间的关系。
参加中国健康与营养调查（2004 年、2006 年、2009 年和 2011 年）且基线时无高血压的个体（n=4368）根据其饮食中水果和蔬菜摄入量以及脂肪摄入量分为四分位数（Q1，最低；Q4，最高）。使用广义估计方程模型，在调整混杂因素后，来探讨所有成年人中以及在水果和蔬菜摄入量四分位数范围内的脂肪摄入量与高血压以及收缩压和舒张压之间的关系。数据分析于 2018 年进行。
在随访期间共有 1086 名成年人发生高血压。在总人群中，与最低四分位数相比，最高四分位数的脂肪摄入量的比值比为 1.40（95%置信区间=1.12，1.75）。在水果和蔬菜摄入量低的人群中，与最低四分位数相比，第三四分位数（比值比=1.97，95%置信区间=1.37，2.83）和第四四分位数（比值比=1.81，95%置信区间=1.14，2.90）的脂肪摄入量与高血压的相关性甚至更高。对于每天增加 50 克 FI，在所有受访者以及水果和蔬菜摄入量低的人群中，随着脂肪摄入量从四分位数 Q1 增加到 Q4，高血压的比值比增加，但在水果和蔬菜摄入量高的人群中则不然。在水果和蔬菜摄入量 Q1 组中，每天每增加 50 克脂肪摄入，收缩压增加 1.08 毫米汞柱（95%置信区间=0.03，2.13），而在水果和蔬菜摄入量 Q2-Q4 组中，这种关联不显著。
水果和蔬菜摄入量可调节脂肪摄入量与高血压之间的关系，高水果和蔬菜摄入量可能抵消脂肪摄入量对高血压的有害影响。建议增加水果和蔬菜摄入量并控制脂肪摄入量，以预防中国成年人的高血压。
