Institute of Epidemiology, University of Kiel, Kiel, Germany.
Department of Cardiology and Cardiac Surgery, University of Warmia and Mazury, Olsztyn, Poland.
Am J Clin Nutr. 2020 Aug 1;112(2):354-363. doi: 10.1093/ajcn/nqaa119.
Better adherence to plant-based diets has been linked to lower risk of metabolic diseases but the effect on abdominal fat distribution and liver fat content is unclear.
We aimed to examine the association between different plant-based diet indices and measures of abdominal fat distribution and liver fat content.
In a population-based sample of 578 individuals from Northern Germany (57% male, median age 62 y), diet was assessed with a validated FFQ and an overall, a healthy, and an unhealthy plant-based diet index were derived. Participants underwent MRI to assess volumes of visceral and subcutaneous abdominal adipose tissue and liver signal intensity (LSI), a measure of liver fat content. Fatty liver disease (FLD) was defined as log LSI ≥3.0. Cross-sectional associations of the plant-based diet indices with visceral and subcutaneous abdominal fat volumes, LSI, and FLD were assessed in linear and logistic regression analyses. The most comprehensive model adjusted for age, sex, education, smoking, alcohol, physical activity, energy intake, diabetes, hyperlipidemia, and BMI.
Higher overall and healthy plant-based diet indices both revealed statistically significant associations with lower visceral and subcutaneous abdominal adipose tissue volumes and with lower odds of FLD in multivariable-adjusted models without BMI. Upon additional adjustment for BMI, only the association of the healthy plant-based diet with visceral adipose tissue remained statistically significant (per 10-point higher healthy plant-based diet index, percentage change in visceral adipose tissue: -4.9%, 95% CI: -8.6%, -2.0%). None of the plant-based diet indices was associated with LSI. The unhealthy plant-based diet index was unrelated to any of the abdominal or liver fat parameters.
Adherence to healthy plant-based diets was associated with lower visceral adipose tissue. None of the other examined associations remained statistically significant after adjustment for BMI.
更好地坚持植物性饮食与较低的代谢性疾病风险相关,但对腹部脂肪分布和肝脂肪含量的影响尚不清楚。
本研究旨在探讨不同植物性饮食指数与腹部脂肪分布和肝脂肪含量指标之间的关系。
在德国北部的一个基于人群的样本中,共纳入 578 名参与者(57%为男性,中位年龄 62 岁),采用验证过的 FFQ 评估饮食情况,并由此得出整体、健康和不健康的植物性饮食指数。参与者接受 MRI 检查,以评估内脏和皮下腹部脂肪组织的体积以及肝脏信号强度(LSI),后者是肝脂肪含量的衡量指标。脂肪肝疾病(FLD)定义为 log LSI≥3.0。采用线性和逻辑回归分析评估植物性饮食指数与内脏和皮下腹部脂肪体积、LSI 和 FLD 的横断面关联。最全面的模型调整了年龄、性别、教育程度、吸烟、饮酒、体力活动、能量摄入、糖尿病、高脂血症和 BMI。
在多变量调整模型中,整体和健康的植物性饮食指数均与内脏和皮下腹部脂肪体积减少以及 FLD 患病风险降低呈统计学显著相关,且不包含 BMI。在进一步调整 BMI 后,仅健康植物性饮食与内脏脂肪组织的关联仍具有统计学意义(健康植物性饮食指数每增加 10 分,内脏脂肪组织的百分比变化为-4.9%,95%CI:-8.6%,-2.0%)。任何一种植物性饮食指数都与 LSI 无关。不健康的植物性饮食指数与任何腹部或肝脏脂肪参数均无关。
健康的植物性饮食依从性与较低的内脏脂肪组织相关。在调整 BMI 后,其余的关联均不再具有统计学意义。