School of Behavioural and Health Sciences, Australian Catholic University, East Melbourne, VIC 3002, Australia.
Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC 3010, Australia.
Nutrients. 2020 Mar 18;12(3):799. doi: 10.3390/nu12030799.
We examined whether energy and macronutrient intake from different meals was associated with changes in cardiometabolic risk (CMR) factors in children. CMR score (CMRS) was computed by summing Z-scores of waist circumference, the average of systolic and diastolic blood pressure, fasting glucose, high-density lipoprotein cholesterol (multiplying by -1), and triglycerides. We included 5517 children aged 6-13 years from six major cities in China. Five meal patterns were identified according to energy intake: balanced, breakfast dominant, lunch dominant, dinner dominant, and snack dominant patterns. These patterns were not significantly associated with changes in CMR factors. Carbohydrate intake (% energy) at lunch was positively associated with the change in CMRS (beta coefficient (95% CI): (0.777 (0.509, 1.046) in quintile 5 versus quintile 1). A positive association between carbohydrate intake at dinner and change in CMRS was observed. High protein intake at both lunch and dinner was associated with a favorable change in CMRS. Moderate fat intake at lunch was associated with a lower increase in CMRS. Meal patterns driven by energy were not significantly associated with CMR factors; however, a low carbohydrate-high protein-moderate fat lunch and low carbohydrate-high protein dinner were associated with favorable changes in CMRS in children.
我们研究了不同餐次的能量和宏量营养素摄入与儿童心血管代谢风险（CMR）因素变化的关系。CMR 评分（CMRS）通过计算腰围 Z 分数、收缩压和舒张压的平均值、空腹血糖、高密度脂蛋白胆固醇（乘以-1）和甘油三酯的 Z 分数之和得出。我们纳入了来自中国六个主要城市的 5517 名 6-13 岁的儿童。根据能量摄入，确定了五种膳食模式：均衡、早餐主导、午餐主导、晚餐主导和零食主导模式。这些模式与 CMR 因素的变化没有显著相关性。午餐的碳水化合物摄入量（占能量的百分比）与 CMRS 的变化呈正相关（五分位数 5 与五分位数 1 相比，β系数（95%CI）：（0.777（0.509，1.046））。晚餐的碳水化合物摄入量与 CMRS 的变化呈正相关。午餐和晚餐的高蛋白摄入量与 CMRS 的有利变化相关。午餐时适量的脂肪摄入与 CMRS 升高幅度较低有关。以能量为驱动的膳食模式与 CMR 因素没有显著相关性；然而，低碳水化合物-高蛋白-适量脂肪的午餐和低碳水化合物-高蛋白的晚餐与儿童 CMRS 的有利变化相关。
