Pérez-Vega Karla-Alejandra, Lassale Camille, Zomeño María-Dolores, Castañer Olga, Salas-Salvadó Jordi, Basterra-Gortari F Javier, Corella Dolores, Estruch Ramón, Ros Emilio, Tinahones Francisco J, Blanchart Gemma, Malcampo Mireia, Muñoz-Aguayo Daniel, Schröder Helmut, Fitó Montserrat, Hernáez Álvaro
Hospital del Mar Research Institute (IMIM), Carrer Doctor Aiguader 88, 08003 Barcelona, Spain; Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; PhD Program in Food Science and Nutrition, Universitat de Barcelona, Campus Diagonal, Avinguda Joan XXIII 27-31, 08028 Barcelona, Spain.
Hospital del Mar Research Institute (IMIM), Carrer Doctor Aiguader 88, 08003 Barcelona, Spain; Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Barcelona Institute for Global Health (ISGlobal), Carrer Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Carrer Ramon Trias Fargas 25-27, 08005 Barcelona, Spain.
J Nutr Health Aging. 2024 Dec;28(12):100406. doi: 10.1016/j.jnha.2024.100406. Epub 2024 Nov 5.
Not skipping breakfast is associated with a better overall diet quality and lower cardiometabolic risk. However, the impact of calorie intake and dietary quality of breakfast on cardiovascular health remains unexplored. We aimed to study the associations between breakfast energy intake and quality and time trajectories of cardiometabolic traits in high cardiovascular risk participants.
Prospective observational exploratory study with repeated measurements.
Spanish older adults.
383 participants aged 55-75 with metabolic syndrome from PREDIMED-Plus, a clinical trial involving a weight-loss lifestyle intervention based on the Mediterranean diet.
Participants were followed for 36 months. Longitudinal averages of breakfast energy intake and quality were calculated. Three categories were defined for energy intake: 20-30% (reference), <20% (low), and >30% (high). Quality was estimated using the Meal Balance Index; categories were above (reference) or below the median score (low). Natural cubic spline mixed effects regressions described trajectories of cardiometabolic indicators (anthropometry, blood pressure, lipids, glucose, glycated hemoglobin, and kidney function) in breakfast groups. Inter-group differences in predicted values were estimated by linear regressions. Analyses were adjusted for age, sex, PREDIMED-Plus intervention group, education, smoking, physical activity, and total daily kilocalorie intake. Lipid profile analyses were further adjusted for baseline hypercholesterolemia, blood pressure analyses for baseline hypertension, and glucose/glycated hemoglobin analyses for baseline diabetes. Breakfast energy intake analyses were adjusted for breakfast quality, and vice versa.
At 36 months, compared to the reference, low- or high-energy breakfasts were associated with differences in body mass index (low: 0.61 kg/m² [95% confidence interval: 0.19; 1.02]; high: 1.18 kg/m² [0.71; 1.65]), waist circumference (low: 2.22 cm [0.96; 3.48]; high: 4.57 cm [3.13; 6.01]), triglycerides (low: 13.8 mg/dL [10.8; 16.8]; high: 28.1 cm [24.7; 31.6]), and HDL cholesterol (low: -2.13 mg/dL [-3.41; -0.85]; high: -4.56 mg/dL [-6.04; -3.09]). At 36 months, low-quality breakfast was associated with higher waist circumference (1.50 cm [0.53; 2.46]), and triglycerides (5.81 mg/dL [3.50; 8.12]) and less HDL cholesterol (-1.66 mg/dL [-2.63; -0.69]) and estimated glomerular filtration rate (-1.22 mL/min/1.73m [-2.02; -0.41]).
Low- or high-energy and low-quality breakfasts were associated with higher adiposity and triglycerides, and lower HDL cholesterol in high-risk older adults. Low-quality breakfasts were also linked to poorer kidney function.
不吃早餐与更好的整体饮食质量及较低的心血管代谢风险相关。然而，早餐的热量摄入和饮食质量对心血管健康的影响仍未得到充分研究。我们旨在研究高心血管疾病风险参与者的早餐能量摄入和质量与心血管代谢特征的时间轨迹之间的关联。
重复测量的前瞻性观察性探索性研究。
西班牙老年人。
383名年龄在55至75岁之间、患有代谢综合征的参与者，来自PREDIMED-Plus，这是一项基于地中海饮食的减肥生活方式干预临床试验。
对参与者进行36个月的随访。计算早餐能量摄入和质量的纵向平均值。能量摄入分为三类：20%-30%（参考值）、<20%（低）和>30%（高）。使用膳食平衡指数评估质量；分类为高于（参考值）或低于中位数得分（低）。自然立方样条混合效应回归描述了早餐组中心血管代谢指标（人体测量学、血压、血脂、血糖、糖化血红蛋白和肾功能）的轨迹。通过线性回归估计预测值的组间差异。分析对年龄、性别、PREDIMED-Plus干预组、教育程度、吸烟、身体活动和每日总千卡摄入量进行了调整。血脂分析进一步对基线高胆固醇血症进行了调整，血压分析对基线高血压进行了调整，血糖/糖化血红蛋白分析对基线糖尿病进行了调整。早餐能量摄入分析对早餐质量进行了调整，反之亦然。
在36个月时，与参考值相比，低能量或高能量早餐与体重指数差异相关（低：0.61kg/m²[95%置信区间：0.19；1.02]；高：1.18kg/m²[0.71；1.65]）、腰围差异相关（低：2.22cm[0.96；3.48]；高：4.57cm[3.13；6.01]）、甘油三酯差异相关（低：13.8mg/dL[10.8；16.8]；高：28.1cm[24.7；31.6]）以及高密度脂蛋白胆固醇差异相关（低：-2.13mg/dL[-3.41；-0.85]；高：-4.56mg/dL[-6.04；-3.09]）。在36个月时，低质量早餐与较高的腰围（1.50cm[0.53；2.46]）、甘油三酯（5.81mg/dL[3.50；8.12]）、较少的高密度脂蛋白胆固醇（-1.66mg/dL[-2.63；-0.69]）和估计肾小球滤过率（-1.22mL/min/1.73m[-2.02；-0.41]）相关。
低能量或高能量以及低质量早餐与高危老年人较高的肥胖程度和甘油三酯水平以及较低的高密度脂蛋白胆固醇水平相关。低质量早餐还与较差的肾功能相关。
