The Department of Cardiovascular Medicine, The University of Tokyo, Japan; The Department of Advanced Cardiology, The University of Tokyo, Japan.
The Department of Cardiovascular Medicine, The University of Tokyo, Japan.
Atherosclerosis. 2021 Mar;320:79-85. doi: 10.1016/j.atherosclerosis.2021.01.022. Epub 2021 Jan 27.
Epidemiological evidence on the relationship between eating behaviors, including breakfast skipping, late night dinner, and bedtime snacking, and cardiovascular disease (CVD) events among the general population is scarce. We sought to explore the association of eating behaviors with subsequent CVD using a nationwide epidemiological database.
Medical records of 1,941,125 individuals without prior history of CVD were extracted from the Japan Medical Data Center contracting with more than 60 insurers from multiple regions in Japan, mainly including employed working-age individuals. Skipping breakfast <3 times per week, late night dinner <3 times per week, and bedtime snacking <3 times per week were defined as optimal eating behaviors. Median age was 45 (interquartile range 39-53) years, and 1,138,676 were men. Median follow-up period was 978 (interquartile range 481-1790) days. Among them, 948,805 individuals (48.9%) had optimal eating behaviors, whereas 647,383 individuals (33.4%), 283,017 individuals (14.6%), and 61,920 individuals (3.2%) had single, double, and triple non-optimal eating behaviors, respectively. Individuals with non-optimal eating behaviors were younger and more likely to be men. Obesity and high waist circumference were more commonly observed in those with non-optimal eating behaviors. Multivariable Cox regression analysis showed that, compared with no non-optimal eating behavior, having non-optimal eating behaviors would have higher risk of myocardial infarction, angina pectoris, stroke, and heart failure. However, the dose-response relationship was not clear in the association between the number of non-optimal eating behaviors and incident CVD. Multivariable Cox regression analysis after multiple imputation for missing values also showed the association between non-optimal eating behaviors and incident CVD.
Using a nationwide epidemiological database, we found a possible relationship between eating behaviors including skipping breakfast, late night dinner, and bedtime snacking, and subsequent cardiovascular events among the general population, suggesting the potential importance of maintaining optimal eating behaviors for the primordial and primary CVD prevention in the general population.
关于饮食习惯（包括不吃早餐、深夜晚餐和睡前吃零食）与普通人群心血管疾病（CVD）事件之间关系的流行病学证据还很缺乏。我们旨在利用全国性的流行病学数据库探讨这些饮食习惯与随后 CVD 之间的关联。
从与日本多个地区的 60 多家保险公司签订合同的日本医疗数据中心提取了 1941125 名无 CVD 既往史的个体的医疗记录，这些个体主要包括有工作的适龄人群。每周不吃早餐<3 次、每周深夜晚餐<3 次和睡前吃零食<3 次被定义为最佳饮食习惯。中位年龄为 45 岁（四分位距 39-53 岁），其中 1138676 名为男性。中位随访期为 978 天（四分位距 481-1790 天）。其中，948805 人（48.9%）具有最佳饮食习惯，而 647383 人（33.4%）、283017 人（14.6%）和 61920 人（3.2%）分别存在单一、双重和三重非最佳饮食习惯。具有非最佳饮食习惯的个体更年轻且更可能为男性。肥胖和高腰围在非最佳饮食习惯者中更为常见。多变量 Cox 回归分析显示，与没有非最佳饮食习惯者相比，具有非最佳饮食习惯者发生心肌梗死、心绞痛、卒中和心力衰竭的风险更高。然而，在非最佳饮食习惯数量与 CVD 事件发生之间的关联中，剂量-反应关系并不明显。对缺失值进行多次插补后的多变量 Cox 回归分析也显示了非最佳饮食习惯与 CVD 事件之间的关联。
使用全国性的流行病学数据库，我们发现普通人群中包括不吃早餐、深夜晚餐和睡前吃零食在内的饮食习惯与随后发生心血管事件之间可能存在关联，这提示了在普通人群中保持最佳饮食习惯对一级和二级 CVD 预防的潜在重要性。
Zotero 插件