补充营养援助计划（Supplemental Nutrition Assistance Program，SNAP）受助人的饮食炎症水平升高为精准公共卫生干预提供了目标。
Elevated Dietary Inflammation Among Supplemental Nutrition Assistance Program Recipients Provides Targets for Precision Public Health Intervention.
机构信息
Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio; Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, Cleveland, Ohio; Ronin Institute, Montclair, New Jersey.
Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, Cleveland, Ohio; Dissemination and Training Division of the Veterans Health Administration, National Center for PTSD, Menlo Park, California.
出版信息
Am J Prev Med. 2021 Aug;61(2):192-200. doi: 10.1016/j.amepre.2021.02.007. Epub 2021 May 11.
INTRODUCTION
The Supplemental Nutrition Assistance Program was designed to prevent food insecurity among low-income Americans and has been linked to improvements in pregnancy health, long-term child development, and criminal recidivism. However, the pursuit of food security does not ensure nutritional sufficiency, and the program has not improved diet quality or cardiometabolic mortality (i.e., heart disease, stroke, diabetes). In this study, longitudinal cohort data are used to identify by Supplemental Nutrition Assistance Program status the proinflammatory characteristics that predispose to chronic disease.
METHODS
Between 2015 and 2018, annual 24-hour dietary recalls were conducted with 409 residents from low-income, urban neighborhoods in Columbus and Cleveland, Ohio (statistical analysis started in 2019). The Dietary Inflammatory Index was calculated. It provides empirically validated estimates of the internal inflammation that each diet should produce; higher Dietary Inflammatory Index scores have been associated with elevated inflammatory biomarkers. Finally, associations between Supplemental Nutrition Assistance Program and Dietary Inflammatory Index were evaluated, and dietary components that differed by Supplemental Nutrition Assistance Program status were identified.
RESULTS
Supplemental Nutrition Assistance Program recipients had higher Dietary Inflammatory Index scores (+0.40, 95% CI=0.09, 0.70) and a consistently lower intake of 4 anti-inflammatory nutrients (dietary fiber, β-carotene, magnesium, vitamin E) than nonrecipients. Vitamin D intake did not differ by Supplemental Nutrition Assistance Program status but was well below the Recommended Daily Allowance in this sample.
CONCLUSIONS
Supplemental Nutrition Assistance Program recipients had elevated Dietary Inflammatory Index scores, implying higher diet-driven inflammation. This was due, in part, to low intake of 4 anti-inflammatory food components, which were higher yet still nutritionally insufficient among nonrecipients. Findings highlight specific nutritional targets for improving public health through dietary change.
简介
补充营养援助计划旨在防止美国低收入人群面临粮食不安全问题，该计划与改善妊娠健康、儿童长期发育和减少犯罪再犯率有关。然而，追求粮食安全并不能确保营养充足，该计划也没有改善饮食质量或心血管代谢死亡率（即心脏病、中风和糖尿病）。在这项研究中，使用纵向队列数据确定了补充营养援助计划状况下导致慢性病的促炎特征。
方法
2015 年至 2018 年，对俄亥俄州哥伦布和克利夫兰的低收入城市社区的 409 名居民进行了年度 24 小时膳食回忆调查（统计分析于 2019 年开始）。计算了饮食炎症指数。它提供了每个饮食应产生的内部炎症的经验验证估计值；较高的饮食炎症指数与升高的炎症生物标志物有关。最后，评估了补充营养援助计划与饮食炎症指数之间的关联，并确定了因补充营养援助计划状况而异的饮食成分。
结果
补充营养援助计划的接受者饮食炎症指数得分较高（+0.40，95%CI=0.09，0.70），且始终摄入较少的 4 种抗炎营养素（膳食纤维、β-胡萝卜素、镁、维生素 E）。维生素 D 的摄入量不因补充营养援助计划的状况而异，但在该样本中，维生素 D 的摄入量远低于推荐的每日摄入量。
结论
补充营养援助计划的接受者饮食炎症指数较高，这意味着饮食引起的炎症更高。这部分是由于 4 种抗炎食物成分的摄入量较低，而非接受者的摄入量虽较高，但仍营养不足。这些发现突出了通过饮食改变改善公共健康的具体营养目标。
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