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1999 - 2018年美国国家健康与营养检查调查中膳食纤维摄入量与美国成年人肥胖之间的关联

Association between dietary fiber intake and obesity in US adults: from NHANES 1999-2018.

作者信息

Lai Siran, Zeng Yuning, Lin Geer, Li Yue, Lin Zixian, Ouyang Xueren

机构信息

Department of Pediatrics, Shunde Women and Children's Hospital of Guangdong Medical University, Foshan, China.

Institute of Traditional Chinese Medicine,Shunde Women and Children's Hospital of Guangdong Medical University, Foshan, China.

出版信息

Front Nutr. 2025 Jul 7;12:1602600. doi: 10.3389/fnut.2025.1602600. eCollection 2025.

Abstract

BACKGROUND

Previous studies have demonstrated that dietary fiber reduces the incidence of diabetes or hyperlipidemia, but it remains unclear how dietary fiber intake relates to obesity incidence.

METHODS

A total of 39,184 adults were obtained from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Multifactorial logistic regression analysis and Cox regression analysis were used to investigate the correlation between dietary fiber intake and obesity. Restricted cubic spline (RCS) analyses were used to describe the dose-response correlation between dietary fiber intake and the incidence of obesity. The robustness of the results was enhanced by Kaplan-Meier survival analyses and subgroup analyses.

RESULTS

After adjusting for confounders, dietary fiber intake in the quartile 4 (≥ 20.8 g/day) was linked with a 26% lower incidence of obesity than those in the quartile 1 [≤9.1 g/day; odds ratios (OR) = 0.74, 95% confidence interval (95% CI): 0.67-0.83,  < 0.0001]. Further study indicated that a heightened dietary fiber intake was linked with a 21% decrease in all-cause mortality in quartile 4 compared to quartile 1 [hazard ratio (HR) = 0.79, 95% CI: 0.65-0.96,  = 0.02]. The RCS analysis conspicuously showed a non-linear U-shaped association between dietary fiber intake and all-cause mortality ( < 0.05), with 26.3 g/day being the turning point. The HR curve for all-cause mortality initially decreased and then increased.

CONCLUSION

Adequate dietary fiber intake has a favorable effect on reducing the incidence of obesity events, and obese patients with high dietary fiber intake exhibit lower all-cause mortality.

摘要

背景

先前的研究表明膳食纤维可降低糖尿病或高脂血症的发病率,但膳食纤维摄入量与肥胖症发病率之间的关系仍不清楚。

方法

从1999年至2018年的美国国家健康与营养检查调查(NHANES)中选取了总共39184名成年人。采用多因素逻辑回归分析和Cox回归分析来研究膳食纤维摄入量与肥胖症之间的相关性。使用受限立方样条(RCS)分析来描述膳食纤维摄入量与肥胖症发病率之间的剂量反应相关性。通过Kaplan-Meier生存分析和亚组分析增强了结果的稳健性。

结果

在调整混杂因素后,四分位数4(≥20.8克/天)的膳食纤维摄入量与肥胖症发病率比四分位数1(≤9.1克/天)的人群低26%相关[优势比(OR)=0.74,95%置信区间(95%CI):0.67-0.83,P<0.0001]。进一步研究表明,与四分位数1相比,四分位数4中膳食纤维摄入量增加与全因死亡率降低21%相关[风险比(HR)=0.79,95%CI:0.65-0.96,P=0.02]。RCS分析明显显示膳食纤维摄入量与全因死亡率之间呈非线性U形关联(P<0.05),转折点为26.3克/天。全因死亡率的HR曲线最初下降然后上升。

结论

充足的膳食纤维摄入量对降低肥胖症事件的发生率有积极作用,膳食纤维摄入量高的肥胖患者全因死亡率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8f5/12277132/5df9be2cf163/fnut-12-1602600-g001.jpg

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