膳食蛋白质摄入量与便秘之间关联的性别差异:来自美国国家健康与营养检查调查(NHANES)的结果

Gender differences in the association between dietary protein intake and constipation: findings from NHANES.

作者信息

Hong Yongping, Shen Hongchen, Chen Xingxing, Li Guofeng

机构信息

Department of Anorectal Surgery, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, China.

The Second Department of Medicine, Renji College of Wenzhou Medical University, Wenzhou, China.

出版信息

Front Nutr. 2024 Jun 19;11:1393596. doi: 10.3389/fnut.2024.1393596. eCollection 2024.

Abstract

PURPOSE

Dietary factors play a crucial role in the development and management of chronic constipation, yet the relationship between dietary protein intake and constipation remains underexplored. This study aims to investigate the association between dietary protein intake and the prevalence of constipation among American adults, with a focus on potential gender differences, using large-scale national data.

MATERIALS AND METHODS

Data from 14,048 participants aged 20 and above (7,072 men and 6,976 women) from the National Health and Nutrition Examination Survey (NHANES) 2005-2010 were analyzed. The Bristol Stool Form Scale's types 1 (separate hard lumps, resembling nuts) and 2 (sausage-shaped, but lumpy) were used to define constipation. A 24-h dietary recall technique was used to measure dietary protein intake. After controlling for covariates, the association between protein consumption and constipation risk was examined using multivariable logistic regression, smooth curve fitting, and testing for gender interaction effects. We then further determined the threshold effect between dietary protein intake and constipation risk.

RESULTS

Constipation was present in 7.49% of people overall, with a higher proportion among women (10.19%) than among males (4.82%). In men, higher protein intake was significantly associated with a lower rate of constipation. However, in women, higher protein intake correlated with an increased risk of constipation, and the interaction between gender was significant ( for interaction = 0.0298). These results were corroborated by smooth curve fits, which also demonstrated a dose-response effect. Further threshold effect analysis showed that the turning points of dietary protein intake differed between male and female participants (119.42 gm/day for men; 40.79 gm/day for women).

CONCLUSION

The association between dietary protein intake and constipation was different in different genders with threshold effect. For men, moderately increasing protein intake could be beneficial, while for women, exceeding a certain level may increase the risk of constipation. These insights are crucial for guiding dietary protein recommendations for different genders and have significant clinical implications.

摘要

目的

饮食因素在慢性便秘的发生和管理中起着关键作用,但饮食蛋白质摄入量与便秘之间的关系仍未得到充分研究。本研究旨在利用大规模的全国性数据,调查美国成年人饮食蛋白质摄入量与便秘患病率之间的关联,并重点关注潜在的性别差异。

材料与方法

分析了2005 - 2010年美国国家健康与营养检查调查(NHANES)中14048名20岁及以上参与者(7072名男性和6976名女性)的数据。使用布里斯托大便分类法的1型(分开的硬块状,类似坚果)和2型(香肠状,但有块状)来定义便秘。采用24小时饮食回忆法来测量饮食蛋白质摄入量。在控制协变量后,使用多变量逻辑回归、平滑曲线拟合和性别交互效应检验来研究蛋白质摄入量与便秘风险之间的关联。然后,我们进一步确定饮食蛋白质摄入量与便秘风险之间的阈值效应。

结果

总体上7.49%的人存在便秘,女性比例(10.19%)高于男性(4.82%)。在男性中,较高的蛋白质摄入量与较低的便秘发生率显著相关。然而,在女性中,较高的蛋白质摄入量与便秘风险增加相关,且性别之间的交互作用显著(交互作用P = 0.0298)。平滑曲线拟合证实了这些结果,也显示出剂量反应效应。进一步的阈值效应分析表明,男性和女性参与者饮食蛋白质摄入量的转折点不同(男性为119.42克/天;女性为40.79克/天)。

结论

饮食蛋白质摄入量与便秘之间的关联在不同性别中存在差异且有阈值效应。对于男性,适度增加蛋白质摄入量可能有益,而对于女性,超过一定水平可能会增加便秘风险。这些见解对于指导不同性别的饮食蛋白质建议至关重要,具有重要的临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cba1/11220262/80afa385a299/fnut-11-1393596-g001.jpg

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