BMJ:脂肪和碳水化合物摄入与心血管疾病和死亡率的关系

2020-03-19 MedSci原创 MedSci原创

宏量营养素摄入与健康之间存在非线性关系。因此,饮食建议可以根据当前的摄入量进行调整。关于宏量营养素(如碳水化合物)的膳食指南还应考虑到其成分的不同相关性。

近日,顶级杂志BMJ上发表了一篇研究文章,该研究旨在探讨宏量营养素摄入与全因死亡率和心血管疾病(CVD)之间的关系,并探究饮食建议的意义。

该研究为基于英国生物库502536名参与者的前瞻性研究,195658人完成了至少一份饮食问卷,并被纳入分析。研究人员使用基于24小时回访问卷Oxford WebQ进行评估饮食情况,营养摄入使用标准方法进行评估。Cox 比例模型和三次样条用于探究非线性关联。该研究的主要结局指标为全因死亡率和心血管疾病的发病率。

4780人(2.4%)在平均10.6年(范围9.4-13.9年)的随访期内死亡,948人(0.5%)和9776人(5.0%)在平均9.7年(范围8.5-13.0年)的随访期内分别经历了致命性和非致命性CVD事件。研究人员发现许多宏量营养素与死亡率之间存在非线性关联。碳水化合物摄入与死亡率呈非线性关系;在总能量摄入20-50%之间没有相关性,但在能量摄入50-70%之间存在正相关性(每1000人每年3.14 vs. 2.75,平均风险比为1.14,95%置信区间为1.03~1.28 (60-70% vs. 50%的能量))。较高的不饱和脂肪摄入量(每1000人每年2.94 vs. 3.50,平均风险比为0.58,0.51-0.66 (20-25% vs. 5%能量)以及较低的多不饱和脂肪(每1000人每年2.66 vs 3.04, 0.78, 0.75-0.81 (5-7% vs. 12%的能量)和饱和脂肪(每1000人每年2.66 vs 3.59, 0.67, 0.62-0.73 (5-10% vs. 20%的能源)与死亡风险降低相关。

由此可见,宏量营养素摄入与健康之间存在非线性关系。因此,饮食建议可以根据当前的摄入量进行调整。关于宏量营养素(如碳水化合物)的膳食指南还应考虑到其成分的不同相关性。

原始出处:

Frederick K Ho,et al.Associations of fat and carbohydrate intake with cardiovascular disease and mortality: prospective cohort study of UK Biobank participants.BMJ 2020;https://doi.org/10.1136/bmj.m688

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    2020-09-06 gaoxiaoe
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    2020-03-21 yuanming9
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