Sebai Ines, Fusco Milena Nardocci, Ing Amy, Fediuk Karen, Chan Hing Man, Batal Malek
Canada Research Chair in Nutrition and Health Inequalities (CIENS), Département de nutrition, Faculté de médecine, Pavillon Liliane de Stewart, Université de Montréal, CP 6128 succ. Centre-Ville, Montréal, QC H3T 1A8, Canada.
TRANSNUT, Centre de recherche en santé publique de l'Université de Montréal et du CIUSS du Centre-sud-de-l'Île-de-Montréal (CReSP), 7101 avenue du Parc, Montréal, QC H3N 1X7, Canada.
Appl Physiol Nutr Metab. 2025 Jan 1;50:1-12. doi: 10.1139/apnm-2024-0422.
Assessing diet quality is crucial in public health research, as it reveals relationships between dietary patterns and health. The Healthy Eating Food Index-2019 (HEFI-2019) and the Canadian Healthy Eating Index 2007 (C-HEI 2007) are robust tools used to evaluate adherence to dietary guidelines. While the C-HEI 2007 has been widely applied in nutritional epidemiology, research exploring associations between the HEFI-2019, which reflects the updated 2019 Canadian dietary guidelines, and health remains limited. Given the distinct dietary habits and health profiles of First Nations, evaluating these indices in this population is essential. This study investigates associations between HEFI-2019 and C-HEI 2007 scores and health variables, including obesity, type 2 diabetes (T2D), and self-perceived health among First Nations adults. Data were drawn from the First Nations Food, Nutrition and Environment Study, which included interviews and 24 h dietary recalls from 5455 adults across 92 communities. Higher HEFI-2019 scores were significantly associated with increased odds of T2D but not with obesity or self-perceived health. C-HEI 2007 scores were also associated with T2D, with stronger associations in the highest tertile. However, C-HEI 2007 scores were not significantly associated with obesity or self-perceived health. The study highlights the significant relationships between HEFI-2019 and C-HEI 2007 scores and T2D among First Nations adults, underscoring the role of diet quality in chronic disease management. The positive associations with T2D may reflect dietary improvements following diagnosis, wherein individuals adopt healthier eating habits. The absence of associations between these indices and obesity or self-perceived health may also be explained by reverse causation, potentially obscuring expected associations. Furthermore, factors such as socioeconomic status and access to healthcare likely contribute to these outcomes. However, given the cross-sectional design, causal relationships cannot be established, and the observed associations should be interpreted with caution. These findings underscore the need for culturally relevant dietary interventions to improve health in Indigenous populations.
评估饮食质量在公共卫生研究中至关重要，因为它揭示了饮食模式与健康之间的关系。《2019年健康饮食食品指数》（HEFI - 2019）和《2007年加拿大健康饮食指数》（C - HEI 2007）是用于评估对饮食指南遵守情况的有力工具。虽然C - HEI 2007已在营养流行病学中广泛应用，但探索反映2019年加拿大更新饮食指南的HEFI - 2019与健康之间关联的研究仍然有限。鉴于原住民独特的饮食习惯和健康状况，在该人群中评估这些指数至关重要。本研究调查了HEFI - 2019和C - HEI 2007得分与健康变量之间的关联，这些变量包括肥胖、2型糖尿病（T2D）以及原住民成年人的自我感知健康状况。数据取自《原住民食品、营养与环境研究》，该研究包括对92个社区的5455名成年人进行的访谈和24小时饮食回忆。较高的HEFI - 2019得分与T2D患病几率增加显著相关，但与肥胖或自我感知健康无关。C - HEI 2007得分也与T2D相关，在最高三分位数中关联更强。然而，C - HEI 2007得分与肥胖或自我感知健康无显著关联。该研究强调了HEFI - 2019和C - HEI 2007得分与原住民成年人T2D之间的显著关系，突出了饮食质量在慢性病管理中的作用。与T2D的正相关可能反映了诊断后饮食的改善，即个体养成了更健康的饮食习惯。这些指数与肥胖或自我感知健康之间缺乏关联也可能由反向因果关系来解释，这可能掩盖了预期的关联。此外，社会经济地位和获得医疗保健等因素可能导致了这些结果。然而，鉴于横断面设计，无法建立因果关系，对观察到的关联应谨慎解释。这些发现强调了需要开展与文化相关的饮食干预措施以改善原住民的健康状况。
