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成人脑瘫患者的饮食质量:预防心血管疾病的一个可改变的风险因素。

Diet quality in adults with cerebral palsy: a modifiable risk factor for cardiovascular disease prevention.

作者信息

Brown Meagan C, Marciniak Christina M, Garrett Ariane M, Gaebler-Spira Deborah J

机构信息

Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.

Department of Physical Medicine and Rehabilitation, Feinberg Medical School, Northwestern University, Chicago, IL, USA.

出版信息

Dev Med Child Neurol. 2021 Oct;63(10):1221-1228. doi: 10.1111/dmcn.14913. Epub 2021 May 6.

Abstract

AIM

To assess diet quality and its relationship with cardiovascular health measures for adults with cerebral palsy (CP).

METHOD

A convenience sample of 45 adults with CP (26 females, 19 males; mean age 35y 10mo [SD 14y 9mo]). were recruited for this cross-sectional study. Demographic, medical, and Gross Motor Function Classification System (GMFCS) information were obtained through in-person visits. Participants completed two 24-hour dietary recalls using the Automated Self-Administered 24-hour Dietary Assessment Tool. Specific macronutrient intake was compared to 2015 to 2020 US Department of Agriculture (USDA) guidelines. Other data included body mass index (BMI), waist-to-hip ratio (WHR), blood pressure, and hemoglobin A1c (HgA1c;n=43).

RESULTS

Adults across GMFCS levels I to V were enrolled, 20 participants were in GMFCS levels IV or V. Mean calorie intake was 1777.91/day (SD 610.54), while sodium intake was 3261.75mg/day (SD 1484.92). Five participants met USDA vegetable and seven fruit guidelines. None met whole grain targets. Sixteen were overweight/obese by BMI. Sixteen participants without hypertension diagnoses had elevated blood pressure and nine had abnormal HgA1c without prediabetes/diabetes history. Percent calories from saturated fat was inversely associated with WHR in unadjusted and adjusted models (p=0.002 and p=0.003 respectively); all other dietary recommendations assessed (total calories, sodium, and sugar) were non-significant. Post hoc analyses were unchanged using 2020 to 2025 USDA guidelines.

INTERPRETATION

Assessment of nutrient intake and diet quality is feasible and warrants further study in adults with CP, as USDA guidelines are largely unmet. What this paper adds Adults with cerebral palsy (CP) do not meet US Department of Agriculture dietary quality recommendations. Prediabetes and hypertension may be common, but unrecognized, in adults with CP. Screening for nutrient intake and diet quality should be performed to facilitate nutritional counseling.

摘要

目的

评估脑瘫(CP)成人的饮食质量及其与心血管健康指标的关系。

方法

本横断面研究招募了45名CP成人的便利样本(26名女性,19名男性;平均年龄35岁10个月[标准差14岁9个月])。通过亲自走访获取人口统计学、医学和粗大运动功能分类系统(GMFCS)信息。参与者使用自动自填式24小时膳食评估工具完成两次24小时膳食回顾。将特定的宏量营养素摄入量与2015年至2020年美国农业部(USDA)指南进行比较。其他数据包括体重指数(BMI)、腰臀比(WHR)、血压和糖化血红蛋白(HgA1c;n = 43)。

结果

纳入了GMFCS I至V级的成人,20名参与者处于GMFCS IV或V级。平均卡路里摄入量为1777.91/天(标准差610.54),而钠摄入量为3261.75毫克/天(标准差1484.92)。5名参与者达到了USDA蔬菜指南,7名达到了水果指南。无人达到全谷物目标。16人根据BMI超重/肥胖。16名无高血压诊断的参与者血压升高,9名无糖尿病前期/糖尿病病史的参与者HgA1c异常。在未调整和调整模型中,饱和脂肪的卡路里百分比与WHR呈负相关(分别为p = 0.002和p = 0.003);评估的所有其他饮食建议(总卡路里、钠和糖)均无统计学意义。使用2020年至2025年USDA指南进行的事后分析结果不变。

解读

由于USDA指南大多未得到满足,对CP成人的营养摄入和饮食质量进行评估是可行的,值得进一步研究。本文补充内容:脑瘫(CP)成人未达到美国农业部的饮食质量建议。糖尿病前期和高血压在CP成人中可能很常见,但未被识别。应进行营养摄入和饮食质量筛查,以促进营养咨询。

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