Nutrition and Health Research Group, Department of Precision Health, Luxembourg Institute of Health, rue 1 A-B Thomas Edison, 1445, Strassen, Luxembourg.
Department of Public Health, University of Liège, Liège, Belgium.
Eur J Nutr. 2023 Aug;62(5):2063-2085. doi: 10.1007/s00394-023-03095-y. Epub 2023 Mar 14.
Diet quality is a critical modifiable factor related to health, including the risk of cardiometabolic complications. Rather than assessing the intake of individual food items, it is more meaningful to examine overall dietary patterns. This study investigated the adherence to common dietary indices and their association with serum/metabolic parameters of disease risk.
Dietary intakes of the general adult population (n = 1404, 25-79 years) were assessed by a validated food-frequency questionnaire (174 items). The French ANSES-Ciqual food composition database was used to compute nutrient intakes. Seven indicators were calculated to investigate participants' diet quality: the Alternative Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension Score (DASH-S), Mediterranean Diet Score (MDS), Diet Quality Index-International (DQI-I), Dietary Inflammatory Index (DII), Dietary Antioxidant Index (DAI), and Naturally Nutrient-Rich Score (NNRS). Various serum/metabolic parameters were used in the validity and association analyses, including markers of inflammation, blood glucose, and blood lipid status.
Following linear regression models adjusted for confounders, the DASH-S was significantly associated with most metabolic parameters (14, e.g., inversely with blood pressure, triglycerides, urinary sodium, uric acid, and positively with serum vitamin D), followed by the DQI-I (13, e.g., total cholesterol, apo-A/B, uric acid, and blood pressure) and the AHEI (11, e.g., apo-A, uric acid, serum vitamin D, diastolic blood pressure and vascular age).
Food-group-based indices, including DASH-S, DQI-I, and AHEI, were good predictors for serum/metabolic parameters, while nutrient-based indices, such as the DAI or NNRS, were less related to biological markers and, thus, less suitable to reflect diet quality in a general population.
饮食质量是与健康相关的一个关键可改变因素，包括患心血管代谢并发症的风险。与其评估个别食物的摄入量，不如检查整体饮食模式更有意义。本研究调查了常见饮食指数的依从性及其与血清/代谢疾病风险参数的关系。
通过验证后的食物频率问卷（174 项）评估一般成年人群（n=1404，25-79 岁）的饮食摄入。使用法国 ANSES-Ciqual 食物成分数据库计算营养素摄入量。计算了七个指标来研究参与者的饮食质量：替代健康饮食指数（AHEI）、停止高血压的饮食方法评分（DASH-S）、地中海饮食评分（MDS）、饮食质量指数-国际（DQI-I）、饮食炎症指数（DII）、饮食抗氧化指数（DAI）和天然营养素丰富评分（NNRS）。在有效性和相关性分析中使用了各种血清/代谢参数，包括炎症标志物、血糖和血液脂质状况。
在调整混杂因素后的线性回归模型中，DASH-S 与大多数代谢参数显著相关（14 个，例如与血压、甘油三酯、尿钠、尿酸呈负相关，与血清维生素 D 呈正相关），其次是 DQI-I（13 个，例如总胆固醇、载脂蛋白 A/B、尿酸和血压）和 AHEI（11 个，例如载脂蛋白 A、尿酸、血清维生素 D、舒张压和血管年龄）。
基于食物组的指数，包括 DASH-S、DQI-I 和 AHEI，是血清/代谢参数的良好预测指标，而基于营养素的指数，如 DAI 或 NNRS，与生物标志物的相关性较低，因此不太适合反映一般人群的饮食质量。
