Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.
Centro de Investigaciones Epidemiológicas, Facultad de Salud, Universidad Industrial de Santander, Bucaramanga, Colombia.
Am J Trop Med Hyg. 2023 Jun 20;109(2):397-403. doi: 10.4269/ajtmh.22-0619. Print 2023 Aug 2.
The burden of flaviviral infections, especially dengue and Zika, is high in the Americas. Malnutrition affects the risk and response to infections, but the role of diet on flaviviral infection risk is uncertain. The objective of this study was to investigate the relations between dietary patterns adherence and anti-flavivirus IgG seroconversion in children during a Zika epidemic in a dengue-endemic area of Colombia. In 2015-2016, we followed 424 anti-flavivirus IgG seronegative children aged 2 to 12 years for 1 year. Baseline data included children's sociodemographic, anthropometric, and dietary information collected through a 38-item food frequency questionnaire (FFQ). IgG testing was repeated at the end of follow-up. The primary exposure was adherence to each of four dietary patterns (animal foods, traditional, ultraprocessed foods, and prudent) that were identified from the FFQ through principal component analysis. Secondary exposures were intake frequencies of foods contributing to relevant patterns. We estimated risk of seroconversion by quartiles of adherence scores and compared them using relative risks (RR) and 95% CI from Poisson regression adjusted for sex, age, and socioeconomic status indicators. Seroconversion risk was 32.1%. Adherence to the traditional pattern was positively related to seroconversion. RR comparing fourth versus first quartiles of adherence was 1.52 (95% CI: 1.04-2.21; P trend = 0.02). Of the most representative foods in this pattern, potato and sugarcane water intake frequencies were related to increased seroconversion risk. In conclusion, adherence to a traditional foods pattern, including potatoes and sugarcane water, was positively associated with anti-flavivirus IgG seroconversion.
拉丁美洲的黄病毒感染负担，尤其是登革热和寨卡病毒，很高。营养不良会影响感染的风险和反应，但饮食对黄病毒感染风险的作用尚不确定。本研究的目的是调查在哥伦比亚登革热流行地区的寨卡疫情期间，饮食模式的遵守情况与抗黄病毒 IgG 血清转化率之间的关系。2015-2016 年，我们对 424 名抗黄病毒 IgG 血清阴性的 2-12 岁儿童进行了为期 1 年的随访。基线数据包括儿童的社会人口统计学、人体测量学和饮食信息，通过 38 项食物频率问卷（FFQ）收集。在随访结束时重复进行 IgG 检测。主要暴露是通过主成分分析从 FFQ 中确定的四种饮食模式（动物食品、传统、超加工食品和谨慎）的遵守情况。次要暴露是对相关模式有贡献的食物的摄入频率。我们通过四分位组的依从性评分估计血清转化率，并使用泊松回归调整性别、年龄和社会经济地位指标后比较相对风险（RR）和 95%置信区间（CI）。血清转化率为 32.1%。对传统模式的依从性与血清转化率呈正相关。RR 比较第四与第一四分位的依从性为 1.52（95%CI：1.04-2.21；P 趋势=0.02）。在该模式中最具代表性的食物中，土豆和甘蔗水的摄入频率与血清转化率增加相关。总之，传统食物模式（包括土豆和甘蔗水）的遵守与抗黄病毒 IgG 血清转化率呈正相关。
