Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea.
Facultad de Enfermería, Pontificia Universidad Católica del Ecuador, Quito 170525, Ecuador.
Nutrients. 2021 May 27;13(6):1834. doi: 10.3390/nu13061834.
The associations of lifestyle and environment with metabolic syndrome (MetS) and cardiovascular disease have recently resulted in increased attention in research. This study aimed to examine interactive associations among carbohydrate and fat intake, physical environment (i.e., elevation and humidity), lifestyle, and MetS among Ecuadorian adults. We used data from the Ecuador National Health and Nutrition Survey 2012 (ENSANUT-ECU), with a total of 6023 participants aged 20 to 60 years included in this study. Logistic regression was used to determine the association of status of carbohydrate and fat intake, low-carbohydrate high-fat diet (LCHF) and medium-carbohydrate and fat (MCF) diet with MetS, where the high-carbohydrate low-fat (HCLF) diet was used as a reference. Women with LCHF and MCF diets showed lower prevalence of increased blood pressure (OR = 0.34, 95% CI: 0.19-0.59; OR = 0.50, 95% CI: 0.32-0.79, respectively). Women with MCF diet also showed lower prevalence of elevated fasting glucose (OR = 0.58, 95% CI: 0.37-0.91). Moreover, there were negative associations between MetS and reduced HDL cholesterol in women with MCF diet residing in low relative humidity (OR = 0.66, 95% CI: 0.45-0.98) and in women with LCHF diet residing at a high elevation (OR = 0.37, 95% CI: 0.16-0.86). Additionally, higher prevalence of increased waist circumference was observed in men with both MFC and LCHF diets who were physically inactive (OR = 1.89, 95% CI: 1.12-3.20; OR = 2.34, 95% CI: 1.19-4.60, respectively) and residing in high relative humidity (OR = 1.90, 95% CI: 1.08-2.89; OR = 2.63, 95% CI: 1.32-5.28, respectively). Our findings suggest that LCHF intake is associated with lower blood pressure, while MCF intake is associated with lower blood pressure and fasting glucose in Ecuadorian women. Furthermore, the associations of carbohydrate and fat intake with prevalence of MetS can be modified by physical activity, relative humidity, and elevation. The obtained outcomes may provide useful information for health programs focusing on dietary intake and lifestyle according to physical environment of the population to promote health and prevent metabolic diseases.
生活方式和环境与代谢综合征（MetS）和心血管疾病的关联最近引起了研究的关注。本研究旨在探讨厄瓜多尔成年人碳水化合物和脂肪摄入、身体环境（即海拔和湿度）、生活方式和 MetS 之间的交互关联。我们使用了 2012 年厄瓜多尔国家健康和营养调查（ENSANUT-ECU）的数据，其中共有 6023 名 20 至 60 岁的参与者纳入本研究。使用逻辑回归来确定碳水化合物和脂肪摄入、低碳水化合物高脂肪饮食（LCHF）和中碳水化合物和脂肪饮食（MCF）与 MetS 的关联，其中高碳水化合物低脂肪饮食（HCLF）作为参考。LCHF 和 MCF 饮食的女性患高血压的比例较低（OR=0.34，95%CI：0.19-0.59；OR=0.50，95%CI：0.32-0.79）。MCF 饮食的女性空腹血糖升高的比例也较低（OR=0.58，95%CI：0.37-0.91）。此外，在居住在相对湿度较低地区的 MCF 饮食女性（OR=0.66，95%CI：0.45-0.98）和居住在高海拔地区的 LCHF 饮食女性（OR=0.37，95%CI：0.16-0.86）中，MetS 与降低高密度脂蛋白胆固醇呈负相关。此外，在不活跃的男性中，MFC 和 LCHF 饮食都与较高的腰围增加患病率相关（OR=1.89，95%CI：1.12-3.20；OR=2.34，95%CI：1.19-4.60），且居住在高相对湿度地区（OR=1.90，95%CI：1.08-2.89；OR=2.63，95%CI：1.32-5.28）。我们的研究结果表明，LCHF 摄入与较低的血压有关，而 MCF 摄入与厄瓜多尔女性较低的血压和空腹血糖有关。此外，碳水化合物和脂肪摄入与 MetS 患病率的关联可能受到身体活动、相对湿度和海拔的影响。获得的结果可能为根据人群的身体环境提供有关饮食摄入和生活方式的健康计划提供有用信息，以促进健康和预防代谢疾病。
