蛋白质与碳水化合物比值能反映饮食质量，并与全因死亡率相关：来自国家健康和营养检测调查（2007-2014 年）的结果。

Protein-to-carbohydrate ratio is informative of diet quality and associates with all-cause mortality: Findings from the National Health and Nutrition Examination Survey (2007-2014).

机构信息

Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China.

Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, China.

出版信息

Front Public Health. 2022 Dec 22;10:1043035. doi: 10.3389/fpubh.2022.1043035. eCollection 2022.

DOI:10.3389/fpubh.2022.1043035

PMID:36620249

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9814161/

Abstract

BACKGROUND

Dietary protein and carbohydrate intake and health outcomes have received extensive attention in recent years. However, the nutritional context in which these associations occur is less studied.

OBJECTIVES

We aimed to examine the dietary context associating protein-to-carbohydrate ratio and all-cause mortality in US adults.

METHODS

Data from 17,814 adults enrolled in the 2007-2014 NHANES was analyzed. Information on mortality was obtained from the US mortality registry updated in December 2015. Diet quality was assessed using the Healthy Eating Index (HEI) and Total Nutrients Index (TNI). ANCOVA was used to test the mean differences in HEI and TNI scores across %E P:C quintiles. Linear regression examined the association of HEI and TNI with %E P:C. Cox proportional hazards regression evaluated the association between %E P:C and all-cause mortality. A restricted cubic spline examined the non-linear relationship between %E P:C and death.

RESULTS

Low %E P:C was associated with lower HEI and TNI scores while higher %E P:C was associated with healthier HEI and TNI scores. HEI and TNI were positively associated with %E P:C ( = 0.22, 95% CI: 0.19-0.25, and = 0.16, 95% CI: 0.14-0.18), respectively. Low %E P:C was associated with an increased risk of death from all-cause. The higher HRs (95% CIs) of all-cause mortality were 1.97(1.46-2.65), and 7.35 (2.57-21.03) in the second quintile for the age-sex-ethnicity model, and the fully adjusted model, respectively. There was a significant reverse -shape relationship between %E P:C and all-cause mortality with , non-linearity < 0.001.

CONCLUSION

This study indicates that a low %E P:C that gives emphasis to unhealthy foods increases the risk of death. Hence, it would be useful to consider the complete diet associated with protein intake when making dietary recommendations for populations.

摘要

背景

近年来，人们对膳食蛋白质和碳水化合物的摄入量与健康结果之间的关系进行了广泛的研究。然而，与这些关联相关的营养背景研究较少。

目的

本研究旨在检验美国成年人中蛋白质与碳水化合物比例与全因死亡率之间的饮食关系。

方法

对 2007-2014 年 NHANES 中纳入的 17814 名成年人的数据进行分析。通过美国死亡登记处（截至 2015 年 12 月更新）获得死亡率信息。采用健康饮食指数（HEI）和总营养素指数（TNI）评估饮食质量。采用协方差分析（ANCOVA）检验 HEI 和 TNI 评分在蛋白质与碳水化合物比例（%E P:C）五分位数间的均值差异。线性回归分析 HEI 和 TNI 与 %E P:C 的关系。Cox 比例风险回归评估 %E P:C 与全因死亡率的关系。限制性三次样条检验 %E P:C 与死亡之间的非线性关系。

结果

低 %E P:C 与较低的 HEI 和 TNI 评分相关，而高 %E P:C 与更健康的 HEI 和 TNI 评分相关。HEI 和 TNI 与 %E P:C 呈正相关（ = 0.22，95%CI：0.19-0.25 和 = 0.16，95%CI：0.14-0.18）。低 %E P:C 与全因死亡风险增加相关。在年龄性别种族模型和完全调整模型中，第二五分位数的全因死亡率的较高 HR（95%CI）分别为 1.97（1.46-2.65）和 7.35（2.57-21.03）。%E P:C 与全因死亡率之间存在显著的反向形状关系，非线性<0.001。