Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA.
David Geffen School of Medicine, University of California, Los Angeles, CA.
Diabetes Care. 2024 Dec 1;47(12):2172-2179. doi: 10.2337/dc24-1345.
To examine the associations of energy intake and glycemic load (GL) in different time periods during the day with cardiovascular disease (CVD) mortality risk in adults with type 2 diabetes.
This cohort study included 2,911 adults with diabetes from who were part of the U.S. National Health and Nutrition Examination Survey 2003-2014 (baseline), and CVD mortality data obtained by linkage to the National Death Index through 2019. Energy intake and GL in early morning (6:00-7:59 a.m.), late morning (8:00-10:59 a.m.), afternoon (11:00 a.m.-5:59 p.m.), evening (6:00-11:59 p.m.), and night (0:00-5:59 a.m.) were derived from two 24-h dietary recalls at baseline. Cox models were used to estimate hazard ratios (HRs) for CVD mortality, adjusted for total energy intake, diet quality, sociodemographic and lifestyle characteristics, and medical conditions.
At baseline, the study population (51.8% female, 62.3% non-Hispanic White) had a mean age of 57.4 (SE, 0.4) years. Over a median follow-up of 9.3 (interquartile range = 6.8, 12.1) years, 190 CVD deaths were documented. Energy intake and GL in late morning were inversely associated with CVD mortality risk (per 100-kcal energy intake increment, HR 0.90 [95% CI 0.83-0.98]; per 10-unit GL increment, HR 0.86 [95% CI 0.77-0.95]). In contrast, energy intake and GL at night were positively associated with CVD mortality risk (per 100-kcal energy intake increment, HR 1.22 [95% CI 1.07-1.40]; per 10-unit GL increment, HR 1.44 [95% CI 1.17-1.77]).
For adults with type 2 diabetes, late morning may be a protective eating time against CVD mortality, whereas night may be a detrimental eating time.
研究成年人 2 型糖尿病患者一天中不同时间段的能量摄入和血糖负荷（GL）与心血管疾病（CVD）死亡率风险的相关性。
本队列研究纳入了美国国家健康与营养调查 2003-2014 年（基线）期间的 2911 名糖尿病患者，通过与国家死亡指数的链接获取 CVD 死亡数据，随访至 2019 年。通过两次基线 24 小时膳食回顾，得出了清晨（6:00-7:59 点）、上午（8:00-10:59 点）、下午（11:00 点-5:59 点）、傍晚（6:00-11:59 点）和夜间（0:00-5:59 点）的能量摄入和 GL。采用 Cox 模型估计 CVD 死亡率的危险比（HRs），调整了总能量摄入、饮食质量、社会人口学和生活方式特征以及医疗状况。
在基线时，研究人群（51.8%女性，62.3%非西班牙裔白人）的平均年龄为 57.4（SE，0.4）岁。在中位随访 9.3 年（四分位距=6.8，12.1）期间，记录了 190 例 CVD 死亡。与傍晚相比，清晨的能量摄入和 GL 与 CVD 死亡率风险呈负相关（每 100 千卡能量摄入增加，HR 0.90[95%CI 0.83-0.98]；每 10 个 GL 单位增加，HR 0.86[95%CI 0.77-0.95]）。相反，夜间的能量摄入和 GL 与 CVD 死亡率风险呈正相关（每 100 千卡能量摄入增加，HR 1.22[95%CI 1.07-1.40]；每 10 个 GL 单位增加，HR 1.44[95%CI 1.17-1.77]）。
对于 2 型糖尿病患者，傍晚可能是预防 CVD 死亡率的有益进食时间，而夜间可能是有害的进食时间。
