Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden.
Centre for Clinical Research Sörmland, Uppsala University, 631 88 Eskilstuna, Sweden.
Eur J Cardiovasc Nurs. 2023 Jul 19;22(5):537-543. doi: 10.1093/eurjcn/zvac093.
Eating a varied diet promotes adequate micronutrient intake. Poor appetite could decrease the desire to eat a varied diet leading to dietary micronutrient insufficiencies. The interrelationships among appetite, diet variety, and dietary micronutrient intake have not been investigated in patients with heart failure (HF). The purpose of the study was to determine whether the relationship between appetite and micronutrient insufficiency was mediated through diet variety.
A total of 238 patients with HF, mean age 61 ± 12.1; 68% male, and 45% NYHA class III/IV were included in this secondary analysis. Data collection consisted of a 4-day food diary and self-reported appetite on a 10-point visual analogue scale. Micronutrient insufficiency was defined as the total number of 17 minerals and vitamins that were insufficient in the diet. Diet variety was calculated as the number of 23 food types consumed over the 4 days. Mediation analysis, controlling for covariates age, gender, NYHA class, and body mass index showed that diet variety mediated the relationship between appetite and micronutrient insufficiencies [indirect effect = -0.0828, 95% confidence interval (CI): -0.1585 to -0.0150]. There was no direct effect of appetite on micronutrient insufficiency (c´ = -0.1802; 95% CI = -0.3715 to.0111).
Diet variety played a previously unrecognized role in the relationship between appetite and dietary micronutrient intake in patients with HF. More research is needed to validate these associations in patients with HF.
多样化的饮食可促进充足的微量营养素摄入。食欲不佳可能会降低人们对多样化饮食的渴望，从而导致饮食中微量营养素摄入不足。在心力衰竭（HF）患者中，尚未研究食欲、饮食多样性和饮食微量营养素摄入之间的相互关系。本研究旨在确定食欲和微量营养素不足之间的关系是否通过饮食多样性来介导。
共有 238 名 HF 患者（平均年龄 61 ± 12.1；68%为男性，45%为 NYHA Ⅲ/Ⅳ级）纳入本二次分析。数据收集包括 4 天的饮食日记和 10 分制视觉模拟量表上的自我报告食欲。微量营养素不足定义为饮食中缺乏的 17 种矿物质和维生素的总数。饮食多样性通过 4 天内食用的 23 种食物类型的数量来计算。在控制协变量（年龄、性别、NYHA 分级和体重指数）后进行中介分析表明，饮食多样性介导了食欲与微量营养素不足之间的关系[间接效应=-0.0828，95%置信区间（CI）：-0.1585 至-0.0150]。食欲对微量营养素不足没有直接影响（c'=-0.1802；95%CI=-0.3715 至 0.0111）。
饮食多样性在 HF 患者的食欲和饮食微量营养素摄入之间的关系中起着以前未被认识到的作用。需要进一步研究来验证 HF 患者中的这些关联。
