National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, 150081, P.R. China.
J Clin Endocrinol Metab. 2021 Jun 16;106(7):e2480-e2490. doi: 10.1210/clinem/dgab288.
Emerging evidence suggests that not only the quantity but also the quality and food sources of macronutrients plays an important role in CVD. However, limited studies have examined the association of meal timing of different quality of macronutrients with CVD risk.
This study aimed to examine the association of subtypes of macronutrient consumption at dinner vs breakfast with cardiovascular diseases (CVD).
A total of 27 911 participants from the National Health and Nutrition Examination Survey (2003-2016) were included. The differences of subtypes of macronutrients at dinner vs breakfast (Δratio) were categorized into quintiles. Multiple logistic regression models and isocaloric substitution effects of subtypes were performed.
After adjustment of a variety of covariates, participants in the highest quintile of the Δratio of low-quality carbohydrates had a higher risk of angina (odds ratio [OR] = 1.63; 95% CI, 1.16-2.29) (Pfor trend = .007) and heart attack (OR = 1.47; 95% CI, 1.13-1.93) (Pfor trend = .068) compared with the lowest quintile. The highest quintile of the Δratio of animal protein had a higher risk of coronary heart disease (OR = 1.44; 95% CI, 1.06-1.95) (Pfor trend = .014) and angina (OR = 1.44; 95% CI, 1.01-2.07) (Pfor trend = .047). For the Δratio of unsaturated fatty acid (USFA), the highest quintile of the Δratio of USFA was related to lower stroke risk (OR = 0.76; 95% CI, 0.58-0.99) (Pfor trend = .049). Isocaloric substitution of low-quality carbohydrates/animal protein by high-quality carbohydrates/plant protein at dinner reduced CVD risk by around 10%.
This study indicated that overconsumption of low-quality carbohydrates and animal protein at dinner rather than breakfast was significantly associated with higher CVD risk and USFA consumption at dinner related to lower CVD risk among US adults. Substitution of low-quality carbohydrates or animal protein by high-quality carbohydrates or plant protein at dinner could reduce CVD risk.
新出现的证据表明，宏量营养素的数量、质量和食物来源对心血管疾病（CVD）都有重要影响。然而，有限的研究已经检查了不同质量的宏量营养素的用餐时间与 CVD 风险之间的关联。
本研究旨在研究晚餐与早餐时不同宏量营养素摄入类型与心血管疾病（CVD）的关系。
本研究共纳入 27911 名来自国家健康和营养检查调查（2003-2016 年）的参与者。晚餐与早餐时（Δ比值）的宏量营养素亚类的差异分为五组。采用多因素逻辑回归模型和亚类的等热量替代效应。
在调整了多种协变量后，与最低五分位数相比，低质量碳水化合物的Δ比值最高五分位数的心绞痛风险较高（比值比[OR] = 1.63；95%置信区间[CI]，1.16-2.29）（P 趋势= 0.007）和心脏病发作（OR = 1.47；95%CI，1.13-1.93）（P 趋势= 0.068）。动物蛋白的Δ比值最高五分位数与冠心病（OR = 1.44；95%CI，1.06-1.95）（P 趋势= 0.014）和心绞痛（OR = 1.44；95%CI，1.01-2.07）（P 趋势= 0.047）的风险较高有关。对于不饱和脂肪酸（USFA）的Δ比值，USFA 的 Δ比值最高五分位数与较低的中风风险相关（OR = 0.76；95%CI，0.58-0.99）（P 趋势= 0.049）。晚餐时用高质量碳水化合物/植物蛋白代替低质量碳水化合物/动物蛋白可使 CVD 风险降低约 10%。
本研究表明，晚餐时过度摄入低质量碳水化合物和动物蛋白而非早餐与更高的 CVD 风险显著相关，而晚餐时 USFA 的摄入与美国成年人较低的 CVD 风险相关。晚餐时用高质量碳水化合物或植物蛋白代替低质量碳水化合物或动物蛋白可降低 CVD 风险。
