Gribbin Sarah, Enticott Joanne, Hodge Allison M, Moran Lisa, Thong Eleanor, Joham Anju, Zaman Sarah
Monash Cardiovascular Research Centre, Monash University School of Clinical Sciences at Monash Health, Melbourne, Victoria, Australia.
Monash Centre for Health Research and Implementation, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
Heart. 2022 May 25;108(12):932-939. doi: 10.1136/heartjnl-2021-319654.
Conflicting evidence surrounds the effect of dietary macronutrient intake (fat, carbohydrate and protein) on cardiovascular disease (CVD), particularly in women.
Women (aged 50-55 years) were recruited into the Australian Longitudinal Study on Women's Health. Women were divided into quintiles according to their carbohydrate and saturated fat intake as a percentage of total energy intake (TEI). The primary endpoint was new-onset CVD (heart disease/stroke). Secondary endpoints included all-cause mortality, incident hypertension, obesity and/or diabetes mellitus. Multivariate logistic regression models assessed for associations with the primary and secondary endpoints, with adjustment for confounders.
A total of 9899 women (mean age 52.5±1.5 years) were followed for 15 years, with 1199 incident CVD and 470 deaths. On multivariable analysis, higher carbohydrate intake was associated with lower CVD risk (p<0.01), with the lowest CVD risk for quintile 3 (41.0%-44.3% energy as carbohydrate) versus quintile 1 (<37.1% energy as carbohydrate) (OR 0.56, 95% CI 0.35 to 0.91, p=0.02). There was no significant association between carbohydrate intake and mortality (p=0.69) or between saturated fat intake and CVD (p=0.29) or mortality (p=0.25). Both increasing saturated fat and carbohydrate intake were significantly inversely associated with hypertension, diabetes mellitus and obesity (p<0.01 for all).
In middle-aged Australian women, moderate carbohydrate intake (41.0%-44.3% of TEI) was associated with the lowest risk of CVD, without an effect on total mortality. Increasing saturated fat intake was not associated with CVD or mortality and instead correlated with lower rates of diabetes, hypertension and obesity.
关于膳食常量营养素摄入量（脂肪、碳水化合物和蛋白质）对心血管疾病（CVD）的影响，证据相互矛盾，尤其是在女性中。
招募年龄在50 - 55岁的女性参与澳大利亚女性健康纵向研究。根据碳水化合物和饱和脂肪摄入量占总能量摄入量（TEI）的百分比，将女性分为五个五分位数组。主要终点是新发心血管疾病（心脏病/中风）。次要终点包括全因死亡率、新发高血压、肥胖症和/或糖尿病。多变量逻辑回归模型评估与主要和次要终点的关联，并对混杂因素进行调整。
共对9899名女性（平均年龄52.5±1.5岁）进行了15年的随访，有1199例心血管疾病发病和470例死亡。多变量分析显示，较高的碳水化合物摄入量与较低的心血管疾病风险相关（p<0.01），五分位数组3（碳水化合物能量占比为41.0% - 44.3%）的心血管疾病风险最低，与五分位数组1（碳水化合物能量占比<37.1%）相比（比值比0.56，95%置信区间0.35至0.91，p = 0.02）。碳水化合物摄入量与死亡率之间无显著关联（p = 0.69），饱和脂肪摄入量与心血管疾病（p = 0.29）或死亡率（p = 0.25）之间也无显著关联。饱和脂肪和碳水化合物摄入量的增加均与高血压、糖尿病和肥胖症显著负相关（所有p<0.01）。
在澳大利亚中年女性中，适度的碳水化合物摄入量（占TEI的41.0% - 44.3%）与最低的心血管疾病风险相关，且对总死亡率无影响。饱和脂肪摄入量的增加与心血管疾病或死亡率无关，反而与较低的糖尿病、高血压和肥胖症发生率相关。
