Cordwell Amy, McClure Rebecca, Villani Anthony
School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia.
Br J Nutr. 2021 Jun 25:1-7. doi: 10.1017/S0007114521002324.
The relationship between adherence to a Mediterranean diet (MedDiet) and health-related quality of life (HRQoL) is unclear, particularly in vulnerable older adults. This cross-sectional analysis explored the association between adherence to a MedDiet and subscales of HRQoL in two independent cohorts of overweight and obese middle-aged to older adults with and without type 2 diabetes mellitus (T2DM). Both cohorts were community-dwelling (T2DM aged ≥ 50 years; non-T2DM aged ≥ 60 years) with a BMI ≥ 25 kg/m2. Adherence to a MedDiet was assessed using the Mediterranean Diet Adherence Screener, and HRQoL was determined using the 36-item short-form health survey. Multiple regression analysis was used to examine the association between adherence to a MedDiet and HRQoL subscales. A total of 152 middle-aged to older adults were included (T2DM: n 87, 71·2 (sd 8·2) years, BMI: 29·5 (sd 5·9) kg/m2; non-T2DM: n 65, 68·7 (sd 5·6) years, BMI: 33·7 (sd 4·9) kg/m2). Mean adherence scores for the entire cohort were 5·3 (sd 2·2) (T2DM cohort: 5·6(sd 2·3); non-T2DM cohort: 4·9 (sd 2·0)). In the adjusted model, using pooled data from both study cohorts, adherence to a MedDiet was significantly associated with the general health subscale of HRQoL (β = 0·223; 95 % CI 0·006, 0·044; P = 0·001). Similar findings were also observed in the T2DM cohort (β = 0·280; 95 % CI 0·007, 0·054; P = 0·001). However, no additional significant associations between adherence to a MedDiet and HRQoL subscales were observed. We showed that adherence to a MedDiet was positively associated with the general health subscale of HRQoL in middle-aged to older adults with T2DM. However, larger longitudinal data in older adults with a wider range of adherence scores, particularly higher adherence, are required to better understand the direction of this relationship.
坚持地中海饮食（MedDiet）与健康相关生活质量（HRQoL）之间的关系尚不清楚，尤其是在易受影响的老年人中。这项横断面分析探讨了在两个独立队列中，坚持MedDiet与超重和肥胖的中年至老年2型糖尿病（T2DM）患者及非T2DM患者HRQoL各子量表之间的关联。两个队列均为社区居住者（T2DM患者年龄≥50岁；非T2DM患者年龄≥60岁），体重指数（BMI）≥25kg/m²。使用地中海饮食依从性筛查工具评估对MedDiet的依从性，使用36项简短健康调查问卷确定HRQoL。采用多元回归分析来检验坚持MedDiet与HRQoL各子量表之间的关联。总共纳入了152名中年至老年成年人（T2DM组：n = 87，年龄71.2（标准差8.2）岁，BMI：29.5（标准差5.9）kg/m²；非T2DM组：n = 65，年龄68.7（标准差5.6）岁，BMI：33.7（标准差4.9）kg/m²）。整个队列的平均依从性得分是5.3（标准差2.2）（T2DM队列：5.6（标准差2.3）；非T2DM队列：4.9（标准差2.0））。在调整模型中，使用两个研究队列的汇总数据，坚持MedDiet与HRQoL的总体健康子量表显著相关（β = 0.223；95%置信区间0.006，0.044；P = 0.001）。在T2DM队列中也观察到了类似的结果（β = 0.280；95%置信区间0.007，0.054；P = 0.001）。然而，未观察到坚持MedDiet与HRQoL其他子量表之间存在额外的显著关联。我们发现，在患有T2DM的中年至老年成年人中，坚持MedDiet与HRQoL的总体健康子量表呈正相关。然而，需要更大规模的纵向数据，涵盖更广泛的依从性得分范围，尤其是更高的依从性，以便更好地理解这种关系的方向。
