Varela Jeanette J, Mattei Josiemer, Sotres-Alvarez Daniela, Mossavar-Rahmani Yasmin, McClain Amanda C, Maldonado Luis E, Daviglus Martha L, Stephenson Briana J K
Department of Biostatistics, Harvard T.H. Chan School of Public Health.
Department of Nutrition, Harvard T.H. Chan School of Public Health.
medRxiv. 2023 May 5:2023.05.04.23289531. doi: 10.1101/2023.05.04.23289531.
Ethnicity, cultural background, and geographic location differ significantly amongst the US Hispanic/Latino population. These characteristic differences can greatly define measured diet and its relationship with cardiometabolic disease, thus influencing generalizability of results.
We aimed to examine dietary patterns of Hispanic/Latino adults and their association with cardiometabolic risk factors (high cholesterol, hypertension, obesity, diabetes) across two representative studies with differing sampling strategies.
Data were collected from Mexican or Other Hispanic adult participants from 2007-2012 National Health and Nutrition Examination Survey (NHANES, n=3,209) and 2007-2011 Hispanic Community Health Survey/Study of Latinos (HCHS/SOL, n=13,059). Nutrient-based food patterns (NBFPs) were derived using factor analysis on nutrient intake data estimated from 24-hour dietary recalls and interpreted using common foods prominent in these nutrients. Cross-sectional association between NBFPs (quintiles) and cardiometabolic risk factors, defined by clinical measures and self-report, were estimated using survey-weighted logistic regression.
Five NBFPs were identified in both studies: (1) meats, (2) grains/legumes, (3) fruits/vegetables, (4) dairy, and (5) fats/oils. Association to cardiometabolic risk factors differed by NBFP and study. In HCHS/SOL, persons in the highest quintile of meats NBFP had higher odds of diabetes (OR=1.43, 95%CI: 1.10, 1.86) and obesity (OR=1.36, 95%CI: 1.14, 1.63). Those in the lowest quintile of grains/legumes NBFP (OR=1.22, 95%CI: 1.02, 1.47) and the highest quintile of fats/oils (OR=1.26, 95%CI: 1.03, 1.53) also had higher odds of obesity. In NHANES, NBFPs associated with higher odds of diabetes included those in the lowest quintile of dairy (OR=1.66, 95%CI: 1.01, 2.72) and highest quintile of grains/legumes (OR=2.10, 95%CI: 1.26, 3.50). Persons in the fourth quintile of meats (OR=0.68, 95%CI: 0.47, 0.99) had lower odds of cholesterol.
Diet-disease relationships among Hispanic/Latino adults vary according to two representative studies. These differences have research and practical implications when generalizing inferences on heterogeneous underrepresented populations.
美国西班牙裔/拉丁裔人群在种族、文化背景和地理位置上存在显著差异。这些特征差异能够极大地界定所测量的饮食及其与心脏代谢疾病的关系，从而影响研究结果的普遍性。
我们旨在通过两项采用不同抽样策略的代表性研究，探究西班牙裔/拉丁裔成年人的饮食模式及其与心脏代谢风险因素（高胆固醇、高血压、肥胖、糖尿病）之间的关联。
数据收集自2007 - 2012年国家健康与营养检查调查（NHANES，n = 3209）以及2007 - 2011年西班牙裔社区健康调查/拉丁裔研究（HCHS/SOL，n = 13059）中的墨西哥或其他西班牙裔成年参与者。基于营养素的食物模式（NBFPs）通过对根据24小时饮食回忆估算的营养素摄入数据进行因子分析得出，并使用这些营养素中突出的常见食物进行解释。使用调查加权逻辑回归估计NBFPs（五分位数）与通过临床测量和自我报告定义的心脏代谢风险因素之间的横断面关联。
两项研究均确定了五种NBFPs：（1）肉类，（2）谷物/豆类，（3）水果/蔬菜，（4）乳制品，以及（5）脂肪/油类。NBFPs与心脏代谢风险因素的关联因研究和NBFPs而异。在HCHS/SOL中，肉类NBFPs最高五分位数的人群患糖尿病（OR = 1.43，95%CI：1.10，1.86）和肥胖（OR = 1.36，95%CI：1.14，1.63）的几率更高。谷物/豆类NBFPs最低五分位数的人群（OR = 1.22，95%CI：1.02，1.47）以及脂肪/油类最高五分位数的人群（OR = 1.26，95%CI：1.03，1.53）患肥胖的几率也更高。在NHANES中，与糖尿病几率较高相关的NBFPs包括乳制品最低五分位数的人群（OR = 1.66，95%CI：1.01，2.72）以及谷物/豆类最高五分位数的人群（OR = 2.10，95%CI：1.26，3.50）。肉类第四五分位数的人群（OR = 0.68，95%CI：0.47，0.99）患胆固醇的几率较低。
根据两项代表性研究，西班牙裔/拉丁裔成年人的饮食与疾病关系各不相同。在对异质且代表性不足的人群进行推断时，这些差异具有研究和实际意义。
