中国成年人基于植物性饮食指数的轨迹及其高血压患病风险：一项基于2004 - 2015年中国健康与营养调查的队列研究

Trajectories of plant-based diet indices and the associated risk of hypertension among Chinese adults: a cohort study based on the China Health and Nutrition Survey 2004-2015.

作者信息

Zhao Yajie, Gao Qian, Zhang Junyan, Wang Juping, Araki Tetsuya, Zhao Junkang

机构信息

Laboratory of International Agro-Informatics, Department of Global Agricultural Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan.

Department of Health Statistics, School of Public Health, Shanxi Medical University, No. 56 Xinjian South Road, Taiyuan, China.

出版信息

Nutr J. 2024 Dec 3;23(1):155. doi: 10.1186/s12937-024-01053-w.

DOI:10.1186/s12937-024-01053-w

PMID:39627809

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11613601/

Abstract

BACKGROUND

Plant-based diets have been found to be associated with hypertension. Dietary intake is a dynamic and changing process that can be better characterized by trajectories of dietary indices. However, the associations between plant-based diet trajectories and hypertension over time remained unknown.

METHODS

We used data from the China Health and Nutrition Survey 2004-2015 to analyze a cohort of Chinese adults ≥ 18 years of age who had no hypertension at baseline. Plant-based diets were measured by an overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI) based on three 24-hour recalls. Trajectories of PDI, hPDI, and uPDI (2004 to 2011) were identified using group-based trajectory modeling. The associations between trajectories of PDIs and the risk of new-onset hypertension were estimated using Cox proportional hazard models.

RESULTS

We identified three trajectories for PDI, two for hPDI, and four for uPDI among the 2853 participants with a mean follow-up of 9.6 years. Compared with the PDI "low and stable" class, the PDI "high and decreasing" class had a 23% decreased risk (HR: 0.77; 95% CI: 0.62-0.95) of hypertension. There was no significant association with PDI "low and increasing" class. Compared with the hPDI "low and stable" class, the hPDI "high and stable" class had a 24% decreased risk (HR: 0.76; 95%CI: 0.64-0.91). For uPDI trajectories, compared with the "low and decreasing" class, the "high and increasing," "high and stable," and "low and increasing" classes had increased risks of 43% (HR: 1.43; 95% CI: 1.06-1.94), 77% (HR: 1.77; 95% CI: 1.26-2.49), and 72% (HR: 1.72; 95% CI: 1.26-2.33), respectively.

CONCLUSIONS

This study underscores the importance of maintaining high intakes of healthful plant-based diets and low intakes of unhealthful plant-based diets overtime for hypertension prevention.

摘要

背景

已发现以植物为基础的饮食与高血压有关。饮食摄入是一个动态变化的过程，通过饮食指数轨迹能更好地描述这一过程。然而，以植物为基础的饮食轨迹与高血压随时间的关联仍不清楚。

方法

我们使用了2004 - 2015年中国健康与营养调查的数据，分析了一组基线时无高血压的18岁及以上中国成年人。基于三次24小时饮食回忆，通过总体植物性饮食指数（PDI）、健康植物性饮食指数（hPDI）和不健康植物性饮食指数（uPDI）来衡量植物性饮食。使用基于群体的轨迹模型确定2004年至2011年PDI、hPDI和uPDI的轨迹。使用Cox比例风险模型估计PDI轨迹与新发高血压风险之间的关联。

结果

在2853名参与者中，我们确定了PDI的三种轨迹、hPDI的两种轨迹和uPDI的四种轨迹，平均随访时间为9.6年。与PDI“低且稳定”类别相比，PDI“高且下降”类别患高血压的风险降低了23%（风险比：0.77；95%置信区间：0.62 - 0.95）。与PDI“低且上升”类别无显著关联。与hPDI“低且稳定”类别相比，hPDI“高且稳定”类别患高血压的风险降低了24%（风险比：0.76；95%置信区间：0.64 - 0.91）。对于uPDI轨迹，与“低且下降”类别相比，“高且上升”、“高且稳定”和“低且上升”类别患高血压的风险分别增加了43%（风险比：1.43；95%置信区间：1.06 - 1.94）、77%（风险比：1.77；95%置信区间：1.26 - 2.49）和72%（风险比：1.72；95%置信区间：1.26 - 2.33）。