Emi Nor Aishah, Gan Wan Ying, Mohd Shariff Zalilah, Anuar Zaini Azriyanti, Shamsuddin Nurainul Hana, Appukutty Mahenderan, Appannah Geeta
1Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor Malaysia.
2Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Nutr Metab (Lond). 2020 Apr 7;17:28. doi: 10.1186/s12986-020-00447-x. eCollection 2020.
This study aimed to identify a dietary pattern (DP) characterised mainly by high intakes of free sugar and other nutrients hypothesised to be associated with obesity such as dietary energy density (DED), percentage of energy from total fat and fibre density in adolescents from three southern states of Peninsular Malaysia, and its associations with cardiometabolic risk factors.
This is a cross-sectional study among 335 adolescents who provided both dietary information assessed using a validated food frequency questionnaire (FFQ) and biochemical parameters including lipid profile, blood glucose, serum insulin and homeostatic model assessment-insulin resistance (HOMA-IR). Anthropometric measurements included weight (kg), height (cm) and waist circumference (cm), while body mass index (BMI) in kg/m was estimated, respectively. Reduced rank regression (RRR) identified a DP with percentage of energy from sugar and total fat, DED and fibre density intake as response variables.
The identified 'high sugar, high fibre, high DED and low fat' DP was characterised by high intakes of sugar-sweetened beverages, fruits, sweets and low intakes of meat and cereal. Adolescents in the highest tertile of the identified DP had about 3.0 (OR = 2.7; 95%CI: 1.3, 5.6) and 2.0 (OR = 1.9; 95%CI: 1.0, 3.5) times higher odds of having dyslipideamia or elevated total cholesterol and LDL-cholesterol level, respectively compared to adolescents in the lowest tertile DP after adjusting for sex, school location, maternal education, physical activity, dietary misreporting and BMI z-score. This DP was not significantly associated with overweight and obesity.
Higher adherence to a DP characterised mainly by free sugars and DED was associated with greater odds of having dyslipideamia, elevated total cholesterol and LDL-cholesterol levels in Malaysian adolescents.
本研究旨在确定一种饮食模式（DP），其主要特征是游离糖和其他被认为与肥胖相关的营养素（如饮食能量密度（DED）、总脂肪能量百分比和纤维密度）的高摄入量，该饮食模式存在于马来西亚半岛南部三个州的青少年中，并研究其与心脏代谢危险因素的关联。
这是一项横断面研究，研究对象为335名青少年，他们提供了使用经过验证的食物频率问卷（FFQ）评估的饮食信息以及包括血脂谱、血糖、血清胰岛素和稳态模型评估-胰岛素抵抗（HOMA-IR）在内的生化参数。人体测量包括体重（kg）、身高（cm）和腰围（cm），同时分别估算体重指数（BMI，单位为kg/m²）。降秩回归（RRR）以糖和总脂肪的能量百分比、DED和纤维密度摄入量作为响应变量，确定了一种饮食模式。
所确定的“高糖、高纤维、高DED和低脂肪”饮食模式的特点是含糖饮料、水果、甜食的摄入量高，而肉类和谷物的摄入量低。在调整了性别、学校位置、母亲教育程度、身体活动、饮食误报和BMI z评分后，处于所确定饮食模式最高三分位数的青少年患血脂异常或总胆固醇和低密度脂蛋白胆固醇水平升高的几率分别比处于最低三分位数饮食模式的青少年高约3.0倍（OR = 2.7；95%CI：1.3，5.6）和2.0倍（OR = 1.9；95%CI：1.0，3.5）。这种饮食模式与超重和肥胖无显著关联。
在马来西亚青少年中，更高程度地遵循主要以游离糖和DED为特征的饮食模式与患血脂异常、总胆固醇和低密度脂蛋白胆固醇水平升高的几率增加有关。
