Zhangjiagang Center for Disease Control and Prevention, 18 Zhizhong Road, Zhangjiagang 215600, China.
Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, 199 Ren'ai Road, Suzhou 215127, China.
Nutrients. 2023 Aug 11;15(16):3546. doi: 10.3390/nu15163546.
Prediabetes presents a high-risk state for the development of various diseases and is reversible by adhering to a healthy lifestyle. We conducted this analysis to explore the associations of the Healthy Eating Index-2015 (HEI-2015) and the Alternate Mediterranean Diet Index (aMed index) with the risk of prediabetes. The data were derived from the National Health and Nutrition Examination Survey, including 20,844 participants. Multivariable-adjusted odds ratios (OR) of prediabetes and 95% confidence intervals (CI) by tertile of diet quality scores were estimated using a weighted logistic regression. Compared to those in the lowest tertile, the multivariable-adjusted OR of prediabetes for the highest tertile was 0.82 (95% CI: 0.72, 0.94; for trend = 0.005) for HEI-2015 and 0.87 (95% CI: 0.76, 0.98; for trend = 0.02) for the aMed index. After mutual adjustment, the association for HEI-2015 ( for trend = 0.03) but not for the aMed index ( for trend = 0.59) remained significant. Among the component food groups and nutrients, higher intakes of red and processed meat, sodium, and total saturated fatty acids were associated with a higher risk of prediabetes, while moderate alcohol consumption was associated with a lower risk. In conclusion, adherence to the 2015-2020 Dietary Guidelines for Americans, as compared with the Mediterranean Diet, appeared to be more strongly associated with a lower risk of prediabetes among adults in the United States.
糖尿病前期是多种疾病发生的高危状态，通过坚持健康的生活方式可以逆转。我们进行此项分析旨在探讨健康饮食指数-2015（HEI-2015）和交替地中海饮食指数（aMed 指数）与糖尿病前期风险的关联。数据来自全国健康和营养检查调查，共纳入 20844 名参与者。采用加权 logistic 回归估计饮食质量评分三分位数与糖尿病前期风险的多变量校正比值比（OR）和 95%置信区间（CI）。与最低三分位数相比，最高三分位数的糖尿病前期多变量校正 OR 为 HEI-2015 为 0.82（95%CI：0.72，0.94；趋势检验=0.005），aMed 指数为 0.87（95%CI：0.76，0.98；趋势检验=0.02）。相互调整后，HEI-2015 仍具有显著相关性（趋势检验=0.03），而 aMed 指数无相关性（趋势检验=0.59）。在各组成食物组和营养素中，较高的红肉类和加工肉类、钠和总饱和脂肪酸摄入量与糖尿病前期风险升高相关，而适量饮酒与糖尿病前期风险降低相关。总之，与地中海饮食相比，美国 2015-2020 年膳食指南的遵循与美国成年人糖尿病前期风险降低的相关性似乎更强。
