Chen Chunmei, Zhao Fayun, Du Maozong, Wang Xin
Department of Cardiology, Henan Provincial Chest Hospital, Zhengzhou University, Zhengzhou, China.
Front Nutr. 2025 May 22;12:1539920. doi: 10.3389/fnut.2025.1539920. eCollection 2025.
Dietary habits, particularly staple food consumption, play a significant role in influencing cardiovascular disease (CVD) risk. However, limited research has examined the relationship between staple food types and CVD incidence in aging populations, especially in China. This study aims to identify which types of staple foods are most beneficial for cardiovascular health among older Chinese adults.
Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were analyzed to explore the associations between staple food types (rice, wheat, and coarse cereals) and CVD risk among 16,498 adults aged 65 and older. Cox proportional hazards models were employed to evaluate the relationship between staple food types and CVD incidence, while restricted cubic splines assessed potential non-linear relationships between staple food intake and CVD risk. Stratified analyses were performed based on age, sex, and hypertension history.
During a median follow-up of 7.38 years, 1757 participants experienced new-onset CVD. Wheat as a staple food was related to a 40.8% higher risk of CVD compared to rice (HR: 1.408; 95% CI: 1.195-1.658; < 0.001), while no significant association was observed for coarse cereals. Stratified analyses revealed that the association with wheat was stronger among participants aged 65-79 years, males, and those without hypertension. No linear relationship was found between intake levels of rice, wheat, or coarse cereals and CVD risk, but non-linear associations emerged for rice and wheat intake (P for non-linear association<0.001 and = 0.010, respectively). A U-shaped relationship was observed for wheat, with the lowest CVD risk at a cooked intake of 375 g/day, consistent with dietary guidelines.
This study highlights the differential impact of staple food types on CVD risk, with wheat consumption linked to a higher incidence of CVD compared to rice, particularly in specific subgroups. These findings provide evidence to inform dietary guidelines for older Chinese adults and underscore the need for further research into the underlying mechanisms.
饮食习惯，尤其是主食消费，在影响心血管疾病（CVD）风险方面起着重要作用。然而，针对老年人群，特别是中国老年人群，主食类型与CVD发病率之间关系的研究有限。本研究旨在确定在中国老年成年人中，哪种主食类型对心血管健康最为有益。
分析中国老年健康长寿纵向调查（CLHLS）的数据，以探讨16498名65岁及以上成年人主食类型（大米、小麦和粗粮）与CVD风险之间的关联。采用Cox比例风险模型评估主食类型与CVD发病率之间的关系，同时使用受限立方样条评估主食摄入量与CVD风险之间潜在的非线性关系。根据年龄、性别和高血压病史进行分层分析。
在中位随访7.38年期间，1757名参与者出现新发CVD。与大米相比，以小麦为主食与CVD风险高40.8%相关（HR：1.408；95%CI：1.195 - 1.658；P < 0.001），而粗粮未观察到显著关联。分层分析显示，65 - 79岁参与者中、男性以及无高血压者与小麦的关联更强。未发现大米、小麦或粗粮的摄入量与CVD风险之间存在线性关系，但大米和小麦摄入量出现了非线性关联（非线性关联P值分别<0.001和 = 0.01）。观察到小麦呈U形关系，熟摄入量为375克/天时CVD风险最低，这与饮食指南一致。
本研究强调了主食类型对CVD风险的不同影响，与大米相比，食用小麦与CVD发病率较高相关，尤其是在特定亚组中。这些发现为制定中国老年成年人饮食指南提供了依据，并强调需要进一步研究其潜在机制。
