Colorectal Research Centre, Iran University of Medical Sciences, Tehran 1445613131, Iran.
Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia.
Nutrients. 2022 Jun 22;14(13):2577. doi: 10.3390/nu14132577.
(1) Background: Limited evidence from laboratory-based studies suggests that specific dietary macronutrients, particularly fat, can induce dyspeptic symptoms. Through a population-based study, we investigated the relationship between dietary macronutrients and dyspeptic symptoms and sought to determine macronutrient intake thresholds to predict or prevent dyspepsia and reduce symptoms in patients with dyspepsia. (2) Methods: A total of 4763 Iranian people were enrolled in this population-based, cross-sectional study. Uninvestigated dyspepsia (UD) and its symptoms, including postprandial fullness, early satiation, and epigastric pain, were evaluated using a modified Persian version of the Rome III criteria. The dietary intakes of participants were evaluated using a validated food−frequency questionnaire. Receiver operating characteristic (ROC) curve analysis was used to calculate threshold intakes of dietary macronutrients to prevent UD in the general population. The analysis was then repeated in those with UD to calculate intake thresholds for reducing UD symptoms. (3) Results: Early satiation occurred in 6.3% (n = 302), postprandial fullness in 8.0% (n = 384) and epigastric pain in 7.8% (n = 371) of participants. The prevalence of UD was 15.2%. Compared with individuals without UD, those with UD had a lower intake of carbohydrates (48.2% vs. 49.1%) and a higher intake of fats (38.3% vs. 37.4%), while protein and energy intakes did not differ. Higher dietary fat and protein intakes were associated with a higher prevalence of postprandial fullness and epigastric pain, respectively. Macronutrient intakes to predict UD in the general population were <49% of energy from carbohydrates, >14.7% from protein, and >37.7% from fats. Carbohydrate, protein, and fat intakes to prevent symptoms among those with UD were calculated to be >48.2%, <14.6%, and <38.6%, respectively. (4) Conclusion: Higher carbohydrate intake and lower fat or protein intakes were associated with a lower likelihood of UD. Prospective studies carefully manipulating dietary macronutrient composition are warranted to investigate the value of dietary changes to improve symptoms in people with UD.
（1）背景：有限的实验室研究证据表明，特定的膳食宏量营养素，特别是脂肪，会引起消化不良症状。通过一项基于人群的研究，我们调查了膳食宏量营养素与消化不良症状之间的关系，并试图确定宏量营养素摄入阈值，以预测或预防消化不良，并减轻消化不良患者的症状。（2）方法：共有 4763 名伊朗人参加了这项基于人群的横断面研究。未调查消化不良（UD）及其症状，包括餐后饱胀、早饱和上腹痛，使用罗马 III 标准的经过修改的波斯语版本进行评估。使用经过验证的食物频率问卷评估参与者的饮食摄入量。使用接收器操作特征（ROC）曲线分析计算预防普通人群 UD 的膳食宏量营养素摄入阈值。然后在 UD 患者中重复该分析，以计算减轻 UD 症状的摄入量阈值。（3）结果：早饱发生率为 6.3%（n=302），餐后饱胀发生率为 8.0%（n=384），上腹痛发生率为 7.8%（n=371）。UD 的患病率为 15.2%。与无 UD 者相比，UD 者碳水化合物摄入量较低（48.2%比 49.1%），脂肪摄入量较高（38.3%比 37.4%），而蛋白质和能量摄入量无差异。较高的膳食脂肪和蛋白质摄入量分别与较高的餐后饱胀和上腹痛患病率相关。预测普通人群 UD 的宏量营养素摄入量分别为：碳水化合物供能<49%，蛋白质>14.7%，脂肪>37.7%。计算出预防 UD 患者症状的碳水化合物、蛋白质和脂肪摄入量分别为>48.2%、<14.6%和<38.6%。（4）结论：较高的碳水化合物摄入量和较低的脂肪或蛋白质摄入量与 UD 的可能性降低相关。需要进行前瞻性研究，仔细操纵膳食宏量营养素组成，以调查饮食改变对改善 UD 患者症状的价值。
