Liu Ruru, Mi Baibing, Zhao Yaling, Li Qiang, Dang Shaonong, Yan Hong
Department of Epidemiology and Biostatistics, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
Department of Disinfection, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi Province, China.
BMJ Nutr Prev Health. 2021 Jan 13;4(1):80-89. doi: 10.1136/bmjnph-2020-000165. eCollection 2021.
The association between dietary carbohydrate consumption and blood pressure (BP) is controversial. The present study aimed to evaluate the possible gender-specific association of carbohydrate across the whole BP distribution.
Cross-sectional survey including 2241 rural adults was conducted in northwestern China in 2010. BP was measured by trained medical personnel. Dietary information was collected by semiquantitative Food-Frequency Questionnaire. Multivariate quantile regression model was used to estimate the association between total carbohydrates consumption and systolic BP (SBP) and diastolic BP (DBP) at different quantiles. Gender-specific β coefficient and its 95% CI was calculated.
The average carbohydrate intake was 267.4 (SD 112.0) g/day in males and 204.9 (SD 90.7) g/day in females, with only 10.6% of males and 6.5% females consumed at least 65% of total energy from carbohydrates. And more than 80% carbohydrates were derived from refined grains. In females, increased total carbohydrates intake was associated with adverse SBP and DBP. An additional 50 g carbohydrates per day was positively associated with SBP at low and high quantiles (10th-20th and 60th-80th) and with DBP almost across whole distribution (30th-90th), after adjusting for age, fortune index, family history of hypertension, body mass index, physical activity level, alcohol intake and smoke, energy, two nutrient principal components, protein and sodium intake. Both relatively low and high carbohydrate intake were associated with increased SBP, with minimum level observed at 130-150 g carbohydrate intake per day from restricted cubic splines. However, no significant associations were observed in males.
Higher total carbohydrates consumption might have an adverse impact on both SBP and DBP in Chinese females but not males. Additionally, the positive association varies across distribution of BP quantiles. Further research is warranted to validate these findings and clarify the causality.
膳食碳水化合物摄入量与血压(BP)之间的关联存在争议。本研究旨在评估碳水化合物在整个血压分布范围内可能存在的性别特异性关联。
2010年在中国西北部对2241名农村成年人进行了横断面调查。血压由经过培训的医务人员测量。膳食信息通过半定量食物频率问卷收集。采用多变量分位数回归模型估计不同分位数下总碳水化合物摄入量与收缩压(SBP)和舒张压(DBP)之间的关联。计算了性别特异性β系数及其95%置信区间。
男性平均碳水化合物摄入量为267.4(标准差112.0)克/天,女性为204.9(标准差90.7)克/天,只有10.6%的男性和6.5%的女性碳水化合物摄入量至少占总能量的65%。超过80%的碳水化合物来自精制谷物。在女性中,总碳水化合物摄入量增加与不良的收缩压和舒张压相关。在调整年龄、财富指数、高血压家族史、体重指数、身体活动水平、酒精摄入量和吸烟情况、能量、两种营养主成分、蛋白质和钠摄入量后,每天额外摄入50克碳水化合物与低和高分位数(第10 - 20百分位数和第60 - 80百分位数)的收缩压呈正相关,并且几乎在整个分布范围(第30 - 90百分位数)与舒张压呈正相关。碳水化合物摄入量相对较低和较高均与收缩压升高相关,从受限立方样条曲线观察到每天碳水化合物摄入量为130 - 150克时收缩压水平最低。然而,在男性中未观察到显著关联。
较高的总碳水化合物摄入量可能对中国女性的收缩压和舒张压有不良影响,但对男性没有。此外,这种正相关在血压分位数分布中有所不同。有必要进行进一步研究以验证这些发现并阐明因果关系。