National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China.
Department of Epidemiology, School of Public Health, Harbin Medical University, China.
J Clin Endocrinol Metab. 2022 Jun 16;107(7):e3066-e3075. doi: 10.1210/clinem/dgac069.
This study aims to investigate whether food intake time across 3 meals is associated with long-term survival among the people with diabetes.
This study included 4642 diabetic patients participating in the National Health and Nutrition Examination Survey from 2003 to 2014. Food consumed across a day including the forenoon, afternoon, and evening was divided into quantiles based on their distribution. Cox proportional hazards regression models were used to analyze the survival relationship between food intakes time and mortality.
In the forenoon, compared to the participants in the lowest quantile of potato and starchy vegetable, participants in the highest quantile had lower mortality risk of cardiovascular disease (CVD) [hazard ratio (HR)potato = 0.46, 95% CI 0.24-0.89; HRstarchy-vegetable = 0.32, 95% CI 0.15-0.72]. In the afternoon, participants who consumed whole grain had lower mortality of CVD (HRwhole grain = 0.67, 95% CI 0.48-0.95). In the evening, the highest quantile of dark vegetable and milk intake is related to lower mortality risk of CVD (HRdark vegetable = 0.55, 95% CI 0.35-0.87; HRmilk = 0.56, 95% CI 0.36-0.88) and all-cause mortality (HRmilk = 0.71, 95% CI 0.54-0.92), whereas participants in the highest quantile of intakes of processed meat are more likely to die due to CVD (HRprocessed-meat = 1.74, 95% CI 1.07-2.82). Isocalorically switching 0.1 serving potato or starchy vegetable consumed in the afternoon or evening to the forenoon, 0.1 serving dark vegetable consumed in the afternoon to the evening, and 0.1 serving whole grain consumed in the forenoon to the afternoon reduced the risk of CVD mortality.
Higher intake of potato or starchy vegetable in forenoon, whole grain in the afternoon, and dark vegetable and milk in the evening and lower intake of processed meat in the evening was associated with better long-term survival in people with diabetes.
本研究旨在探讨糖尿病患者一日三餐的进食时间与长期生存的关系。
本研究纳入了 2003 年至 2014 年参加全国健康与营养调查的 4642 名糖尿病患者。根据分布情况,将一天中摄入的食物(包括上午、下午和晚上)分为若干个定量。使用 Cox 比例风险回归模型分析食物摄入时间与死亡率之间的生存关系。
在上午,与摄入最低土豆和淀粉类蔬菜定量的参与者相比,摄入最高定量的参与者患心血管疾病(CVD)的死亡率较低[土豆的风险比(HR)=0.46,95%CI 0.24-0.89;淀粉类蔬菜的 HR=0.32,95%CI 0.15-0.72]。在下午,摄入全谷物的参与者患 CVD 的死亡率较低(HRwhole grain=0.67,95%CI 0.48-0.95)。在晚上,摄入深色蔬菜和牛奶的最高定量与 CVD 死亡率降低相关(HRdark vegetable=0.55,95%CI 0.35-0.87;HRmilk=0.56,95%CI 0.36-0.88)和全因死亡率(HRmilk=0.71,95%CI 0.54-0.92),而摄入加工肉类最高定量的参与者更有可能死于 CVD(HRprocessed-meat=1.74,95%CI 1.07-2.82)。将下午或晚上摄入的 0.1 份土豆或淀粉类蔬菜、下午摄入的 0.1 份深色蔬菜转换到上午、将上午摄入的 0.1 份全谷物转换到下午,可降低 CVD 死亡风险。
糖尿病患者上午摄入较多的土豆或淀粉类蔬菜、下午摄入全谷物、晚上摄入深色蔬菜和牛奶、晚上摄入较少的加工肉类,与长期生存状况较好相关。