饮食指南依从性改善与代谢综合征的负相关关系：首尔代谢综合征管理项目
Inverse association of improved adherence to dietary guidelines with metabolic syndrome: the Seoul Metabolic Syndrome Management program.
作者信息
Ham Dongwoo, Cho YoungYun, Park Mi-Suk, Park Yun-Sug, Kim Sun-Young, Seol Hye-Min, Park Yoo Mi, Woo Sunok, Joung Hyojee, Lim Do-Sun
机构信息
Institute of Health and Environment, Seoul National University, Seoul 08826, Korea.
Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea.
出版信息
Nutr Res Pract. 2020 Dec;14(6):621-636. doi: 10.4162/nrp.2020.14.6.621. Epub 2020 Apr 27.
BACKGROUND/OBJECTIVES: The Seoul Metabolic Syndrome Management (SMESY) program is a 1-yr lifestyle modification program targeting metabolic syndrome (MetS) in Seoul residents. This study investigated the associations between adherence to dietary guidelines and MetS among the SMESY program participants.
SUBJECTS/METHODS: Data of 54,385 participants aged 20-64 yrs who completed the SMESY program in 2015, had information on adherence to dietary guidelines, and were not medicated for diabetes, hypertension, or dyslipidemia were analyzed. Participants underwent MetS screening and completed a lifestyle questionnaire including adherence to 10 dietary guidelines before and after participation. Participants were classified according to the number of MetS risk factors at baseline (MetS group, ≥ 3; risk group, 1-2; healthy group, none). Adherence to dietary guidelines was determined from the number of "yes" responses regarding the fulfillment of each guideline on ≥ 5 days/week. Multiple logistic regression was used to evaluate associations between newly diagnosed MetS and changes in adherence to dietary guidelines.
RESULTS
In the MetS group, MetS prevalence decreased after the SMESY program (men, -41.9%p; women, -48.7%p), and all risk factors were significantly improved ( < 0.0001). All groups exhibited improved adherence to all dietary guidelines after participation ( < 0.0001). In the MetS group with positively changed adherence scores, the MetS prevalence decreased by -44.1%p for men and -49.5%p for women, whereas the prevalence in those with negative changes decreased by -38.1%p for men and -48.6%p for women. In the risk group, those with positively changed adherence scores had significantly decreased odds ratios (ORs) for newly diagnosed MetS compared with those with negative changes (OR, 0.70; 95% confidence interval [CI], 0.61-0.80 for men; OR, 0.88; 95% CI, 0.79-0.99 for women).
CONCLUSIONS
The SMESY program may effectively reduce the risk of MetS among adults with risk factors by improving adherence to dietary guidelines.
背景/目的：首尔代谢综合征管理（SMESY）项目是一项针对首尔居民代谢综合征（MetS）的为期1年的生活方式改善项目。本研究调查了SMESY项目参与者中饮食指南依从性与MetS之间的关联。
对象/方法：分析了2015年完成SMESY项目、有饮食指南依从性信息且未接受糖尿病、高血压或血脂异常药物治疗的54385名20 - 64岁参与者的数据。参与者接受了MetS筛查，并完成了一份生活方式问卷，包括参与前后对10条饮食指南的依从情况。参与者根据基线时MetS风险因素的数量进行分类（MetS组，≥3个；风险组，1 - 2个；健康组，无）。饮食指南依从性根据每周≥5天满足每条指南的“是”回答数量来确定。采用多因素逻辑回归评估新诊断的MetS与饮食指南依从性变化之间的关联。
结果
在MetS组中，SMESY项目后MetS患病率下降（男性，-41.9%；女性，-48.7%），所有风险因素均显著改善（<0.0001）。所有组在参与后对所有饮食指南的依从性均有所改善（<0.0001）。在饮食指南依从性得分呈正向变化的MetS组中，男性MetS患病率下降了-44.1%，女性下降了-49.5%，而得分呈负向变化的人群中，男性患病率下降了-38.1%，女性下降了-48.6%。在风险组中，饮食指南依从性得分呈正向变化的人群与得分呈负向变化的人群相比，新诊断MetS的比值比（OR）显著降低（男性：OR = 0.70；95%置信区间[CI]，0.61 - 0.80；女性：OR = 0.88；95% CI，0.79 - 0.99）。
结论
SMESY项目可能通过提高饮食指南依从性有效降低有风险因素的成年人患MetS的风险。
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