Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria 3220, Australia.
University of Oxford, Nuffield Department of Population Health, Medical Sciences Division, Old Road Campus, Headington, Oxford OX3 7LF, United Kingdom.
Nutr Metab Cardiovasc Dis. 2023 Apr;33(4):797-808. doi: 10.1016/j.numecd.2023.02.002. Epub 2023 Feb 14.
Individual dietary fats can differentially impact on cardiometabolic health. However, their impact within a dietary pattern is not well understood, and warrants comparison with diet quality scores with a dietary fat focus. The aim of this study was to investigate cross-sectional associations between a posteriori dietary patterns characterized by fat type and cardiometabolic health markers, and compare these with two diet quality scores.
UK Biobank adults with ≥two 24-h dietary assessments and data on cardiometabolic health were included (n = 24 553; mean age: 55.9 y). A posteriori dietary patterns (DP1; DP2) were generated through reduced rank regression (response variables: SFA, MUFA, PUFA). Mediterranean Diet Score (MDS) and Dietary Approaches to Stop Hypertension (DASH) dietary patterns were created. Multiple linear regression analyses were used to investigate associations between standardized dietary patterns and cardiometabolic health (total cholesterol, HDL-C, LDL-C and VLDL-C cholesterol, triglycerides, C-reactive protein [CRP], glycated hemoglobin [HbA1c]). DP1, positively correlated with SFAs, MUFAs and PUFAs, characterized by higher nuts, seeds and vegetables intake and lower fruits and low-fat yoghurt intake, was associated with lower HDL-C (β: -0.07; 95% CI: -0.10, -0.03) and triglycerides (-0.17; -0.23, -0.10) and higher LDL-C (0.07; 0.01,0.12), CRP (0.01; 0.01, 0.03) and HbA1c (0.16; 0.11,0.21). DP2, positively correlated with SFAs, negatively correlated with PUFAs, characterized by higher butter and high-fat cheese intake and lower nuts, seeds and vegetable intake, was associated with higher total cholesterol (0.10; 0.01, 0.21), VLDL-C (0.05; 0.02, 0.07), triglycerides (0.07; 0.01, 0.13), CRP (0.03; 0.02, 0,04) and HbA1c (0.06; 0.01, 0.11). Higher adherence to MDS and DASH was associated with favorable cardiometabolic health markers concentration.
Irrespective of the method used, dietary patterns that encourage healthy fat consumption were associated with favorable cardiometabolic health biomarkers. This study strengthens the evidence for incorporation of dietary fat type into policy and practice guidelines for CVD prevention.
个体膳食脂肪会对心血管代谢健康产生不同影响。然而，它们在膳食模式中的影响尚不清楚，因此有必要对其进行研究，并与以膳食脂肪为重点的饮食质量评分进行比较。本研究旨在调查基于脂肪类型的后天膳食模式与心血管代谢健康标志物的横断面相关性，并与两种饮食质量评分进行比较。
本研究纳入了 UK Biobank 中至少有两次 24 小时膳食评估和心血管代谢健康数据的成年人（n=24553；平均年龄：55.9 岁）。通过降秩回归（反应变量：SFA、MUFA、PUFA）生成后天膳食模式（DP1；DP2）。创建了地中海饮食评分（MDS）和停止高血压的饮食方法（DASH）饮食模式。使用多元线性回归分析来研究标准化膳食模式与心血管代谢健康（总胆固醇、HDL-C、LDL-C 和 VLDL-C 胆固醇、甘油三酯、C 反应蛋白[CRP]、糖化血红蛋白[HbA1c]）之间的相关性。DP1 与 SFA、MUFA 和 PUFA 呈正相关，其特点是坚果、种子和蔬菜摄入量较高，而水果和低脂酸奶摄入量较低，与较低的 HDL-C（β：-0.07；95%CI：-0.10，-0.03）和甘油三酯（-0.17；-0.23，-0.10）以及较高的 LDL-C（0.07；0.01，0.12）、CRP（0.01；0.01，0.03）和 HbA1c（0.16；0.11，0.21）有关。DP2 与 SFA 呈正相关，与 PUFA 呈负相关，其特点是黄油和高脂肪奶酪摄入量较高，而坚果、种子和蔬菜摄入量较低，与较高的总胆固醇（0.10；0.01，0.21）、VLDL-C（0.05；0.02，0.07）、甘油三酯（0.07；0.01，0.13）、CRP（0.03；0.02，0.04）和 HbA1c（0.06；0.01，0.11）有关。较高的 MDS 和 DASH 依从性与有利的心血管代谢健康标志物浓度相关。
无论使用何种方法，鼓励健康脂肪摄入的膳食模式与有利的心血管代谢健康生物标志物有关。本研究为将膳食脂肪类型纳入 CVD 预防政策和实践指南提供了更有力的证据。
