Petersen Kristina S, Smith Sydney, Lichtenstein Alice H, Matthan Nirupa R, Li Zhaoping, Sabate Joan, Rajaram Sujatha, Segovia-Siapco Gina, Reboussin David M, Kris-Etherton Penny M
Department of Nutritional Sciences, Pennsylvania State University, State College, PA, United States.
Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, Unite States.
Curr Dev Nutr. 2024 Jan 11;8(2):102079. doi: 10.1016/j.cdnut.2024.102079. eCollection 2024 Feb.
Few clinical trials have evaluated diet quality change as a predictor of intervention effectiveness.
The aim of this study was to examine changes in the Healthy Eating Index (HEI)-2015 after a food-based intervention, and assess the associations between HEI-2015 change and intervention effects on cardiometabolic risk-related outcomes.
The Habitual Diet and Avocado Trial was a 26-wk, multicenter, randomized, controlled parallel-arm study. Participants were 1008 individuals aged ≥25 y with abdominal obesity (females ≥ 35 inches; males ≥ 40 inches). The avocado-supplemented diet group was provided 1 avocado per day, and the habitual diet group maintained their usual diet. Change in diet quality was assessed using the HEI-2015 from a single 24-h recall conducted at 4 time points. Mixed models were used for analysis.
The avocado-supplemented diet group had a greater increase in the HEI-2015 (4.74 points; 95% CI: 2.93, 6.55) at 26 wk than the habitual diet group. Compared with the habitual diet group, the avocado-supplemented diet group had greater increases in the following HEI-2015 components from baseline: total vegetables (0.99 points; 95% CI: 0.77, 1.21), fatty acid ratio (2.25 points; 95% CI: 1.74, 2.77), sodium (1.03 points; 95% CI: 0.52, 1.55), refined grains (0.82 points; 95% CI: 0.32, 1.31), and added sugars (0.84 points; 95% CI: 0.49, 1.19). No differences in HEI-2015 improvements were observed by race, ethnicity, study site, body mass index, or age category. In the avocado-supplemented diet compared with the habitual diet group, the HEI-2015 increased in females (6.50 points; 95% CI: 4.39, 8.62) but not in males (0.02 points; 95% CI: -3.44, 3.48). Median HEI-2015 change was not associated with intervention-related changes in cardiometabolic disease risk factors.
Intake of 1 avocado per day for 26 wk in adults with abdominal obesity increased adherence to the Dietary Guidelines for Americans. Changes in diet quality did not predict changes in risk factors for cardiometabolic disease.This trial was registered at clinicaltrials.gov as NCT03528031 (https://clinicaltrials.gov/study/NCT03528031).
很少有临床试验将饮食质量变化作为干预效果的预测指标进行评估。
本研究旨在探究基于食物的干预后健康饮食指数（HEI）-2015的变化，并评估HEI-2015变化与干预对心血管代谢风险相关结局的影响之间的关联。
习惯性饮食与牛油果试验是一项为期26周的多中心随机对照平行组研究。参与者为1008名年龄≥25岁的腹部肥胖个体（女性腰围≥35英寸；男性腰围≥40英寸）。牛油果补充饮食组每天提供1个牛油果，习惯性饮食组维持其日常饮食。在4个时间点通过单次24小时饮食回顾，使用HEI-2015评估饮食质量变化。采用混合模型进行分析。
在26周时，牛油果补充饮食组的HEI-2015增加幅度（4.74分；95%CI：2.93，6.55）大于习惯性饮食组。与习惯性饮食组相比，牛油果补充饮食组从基线开始，在以下HEI-2015成分上增加幅度更大：蔬菜总量（0.99分；95%CI：0.77，1.21）、脂肪酸比例（2.25分；95%CI：1.74，2.77）、钠（1.03分；95%CI：0.52，1.55）、精制谷物（0.82分；95%CI：0.32，1.31）和添加糖（0.84分；95%CI：0.49，1.19）。未观察到种族、民族、研究地点、体重指数或年龄类别在HEI-2015改善方面存在差异。与习惯性饮食组相比，牛油果补充饮食组中女性的HEI-2015有所增加（6.50分；95%CI：4.39，8.62），而男性则没有增加（0.02分；95%CI：-3.44，3.48）。HEI-2015的中位数变化与心血管代谢疾病风险因素的干预相关变化无关。
腹部肥胖的成年人每天摄入1个牛油果，持续26周，可提高对《美国膳食指南》的依从性。饮食质量变化并未预测心血管代谢疾病风险因素的变化。本试验已在clinicaltrials.gov上注册，注册号为NCT03528031（https://clinicaltrials.gov/study/NCT03528031）。
