Hosseinpour-Niazi Somayeh, Malmir Hanieh, Mirmiran Parvin, Shabani Maryam, Hasheminia Mitra, Azizi Fereidoun
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nutr Metab (Lond). 2024 Aug 1;21(1):58. doi: 10.1186/s12986-024-00831-x.
This prospective cohort study aimed to investigate the association between ultra-processed food (UPF) and the risk of metabolic syndrome (MetS), as well as to assess whether fruit and vegetable intake and weight change modify this association.
We included 1915 healthy participants who participated in the Tehran Lipid and Glucose Study (TLGS), all of whom had complete demographic, anthropometric, and dietary measurements. A validated food frequency questionnaire was used to assess UPF consumption based on the NOVA classification system. MetS was defined according to the Joint Interim Statement. Multivariable adjusted Cox regression was used to estimate hazard ratios (HRs) for MetS events across tertiles of UPF. The effect of fruit and vegetable consumption and weight change on this association was assessed using joint classification by Cox regression.
UFP consumption showed no association with MetS risk after adjusting for confounders. However, after adjustment for dietary fiber, fruits, and vegetables, the highest tertile of UPF consumption was positively linked to MetS risk, compared to the lowest tertile. There was a significant interaction between fruit, vegetable, and dietary fiber intake and UPF consumption concerning the risk of MetS (All P values < 0.05). Among individuals consuming less than 248 g/day of fruit, the risk of MetS increased by 54% (confidence interval: 1.13-2.10) in the highest UPF tertile. Consuming vegetables and dietary fiber below the median (258 g/day and 42.2 g/day, respectively) increased the risk of MetS in the third tertile of UPF. However, consuming vegetables and fiber ≥ median intake, reduced the risk of MetS among those with the lowest UPF consumption. Furthermore, the risk of MetS was observed in the third tertile of UPF consumption among individuals with fruit and vegetable consumption < 537 g/day. UPF consumption was not associated with the risk of MetS in different weight change statuses.
Consuming more fruits and vegetables mitigated the adverse effect of UPF on the risk of developing MetS.
这项前瞻性队列研究旨在调查超加工食品（UPF）与代谢综合征（MetS）风险之间的关联，并评估水果和蔬菜摄入量以及体重变化是否会改变这种关联。
我们纳入了1915名参与德黑兰脂质与葡萄糖研究（TLGS）的健康参与者，他们均有完整的人口统计学、人体测量学和饮食测量数据。基于NOVA分类系统，使用经过验证的食物频率问卷来评估UPF的摄入量。根据联合临时声明对MetS进行定义。多变量调整后的Cox回归用于估计UPF三分位数中MetS事件的风险比（HRs）。通过Cox回归联合分类评估水果和蔬菜消费以及体重变化对这种关联的影响。
在调整混杂因素后，UPF消费与MetS风险无关联。然而，在调整膳食纤维、水果和蔬菜后，与最低三分位数相比，最高三分位数的UPF消费与MetS风险呈正相关。水果、蔬菜和膳食纤维摄入量与UPF消费之间在MetS风险方面存在显著交互作用（所有P值<0.05）。在每天水果摄入量低于248克的个体中，最高UPF三分位数的MetS风险增加了54%（置信区间：1.13 - 2.10）。在UPF的第三个三分位数中，蔬菜和膳食纤维摄入量低于中位数（分别为258克/天和42.2克/天）会增加MetS风险。然而，蔬菜和纤维摄入量≥中位数时，在UPF消费最低的人群中可降低MetS风险。此外，在水果和蔬菜消费量<537克/天的个体中，在UPF消费的第三个三分位数中观察到MetS风险。在不同体重变化状态下UPF消费与MetS风险无关。
摄入更多水果和蔬菜可减轻UPF对发生MetS风险的不利影响。
