Wang Yankun, Armijos Rodrigo X, Weigel Mary-Margaret
Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA.
Global Environmental Health Research Lab, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA.
J Am Nutr Assoc. 2023 Aug;42(6):618-627. doi: 10.1080/27697061.2022.2113177. Epub 2022 Aug 18.
Cardiometabolic diseases and metabolic syndrome (MetS) are becoming increasingly prevalent in low- and middle-income countries (LMICs). Cardiometabolic diseases and MetS are closely associated with low-grade systemic inflammation, which may be modified by diet. Previous studies have focused on the association of dietary inflammation with MetS and cardiometabolic risk in adult populations, but few studies have examined this issue in children, especially in LMICs.
We conducted a cross-sectional study to explore the association of dietary inflammation with cardiometabolic risk components and MetS in urban Ecuadorian children aged 6-12 years old (n = 276). A semi-quantitative food frequency questionnaire (FFQ) was used to collect data on child dietary intake. Dietary inflammation was evaluated using an energy-adjusted Dietary Inflammatory Index (DII), divided into quartiles. Data were also collected on cardiometabolic risk indicators including blood lipids, blood pressure (BP), blood glucose, body mass index, and waist circumference. Data were analyzed using multivariable linear and logistic regression.
Child DII scores ranged from -4.87 (most anti-inflammatory) to 4.75 (most pro-inflammatory). We transformed the continuous scores into quartiles (Q): Q1 was the most anti-inflammatory (-4.87 to -3.35), Q2 was anti-inflammatory (-3.34 to -1.45), Q3 was pro-inflammatory (-1.44 to 1.08), and Q4 was the most pro-inflammatory (1.09 to 4.75). In the covariate-adjusted model, DII scores were positively associated with total blood cholesterol (p = 0.027), triglycerides (p = 0.034), and diastolic BP (p = 0.013). In addition, for every one-unit increase in DII score, MetS increased by 1.20 in the covariate-adjusted model (95% CI = 1.01,1.43).
The findings suggest that more pro-inflammatory diets may contribute to poorer cardiometabolic health in school-age children. This is important because even small increases in child blood pressure, blood cholesterol, and glucose levels over time can damage health and lead to earlier progression to conditions such as hypertension and atherosclerosis.
心血管代谢疾病和代谢综合征（MetS）在低收入和中等收入国家（LMICs）中日益普遍。心血管代谢疾病和MetS与低度全身性炎症密切相关，而饮食可能会改变这种炎症。以往的研究主要关注成人人群中饮食炎症与MetS及心血管代谢风险的关联，但很少有研究在儿童中，尤其是在低收入和中等收入国家的儿童中探讨这一问题。
我们开展了一项横断面研究，以探究厄瓜多尔城市中6至12岁儿童（n = 276）的饮食炎症与心血管代谢风险成分及MetS之间的关联。使用半定量食物频率问卷（FFQ）收集儿童饮食摄入数据。采用能量调整后的饮食炎症指数（DII）评估饮食炎症，并将其分为四分位数。还收集了包括血脂、血压（BP）、血糖、体重指数和腰围在内的心血管代谢风险指标数据。使用多变量线性和逻辑回归分析数据。
儿童DII评分范围为-4.87（最具抗炎性）至4.75（最具促炎性）。我们将连续评分转换为四分位数（Q）：Q1为最具抗炎性（-4.87至-3.35），Q2为抗炎性（-3.34至-1.45），Q3为促炎性（-1.44至1.08），Q4为最具促炎性（1.09至4.75）。在协变量调整模型中，DII评分与总胆固醇（p = 0.027）、甘油三酯（p = 0.034）和舒张压（p = 0.013）呈正相关。此外，在协变量调整模型中，DII评分每增加一个单位，MetS增加1.20（95%可信区间 = 1.01,1.43）。
研究结果表明，更具促炎性的饮食可能会导致学龄儿童的心血管代谢健康状况较差。这一点很重要，因为即使儿童的血压、胆固醇和血糖水平随着时间的推移出现小幅升高，也会损害健康，并导致更早发展为高血压和动脉粥样硬化等疾病。
