膳食和体力活动因素对BMI影响的多水平分析研究

目的用多水平线性分析方法分析膳食和体力活动因素对BMI的影响。方法以"中国居民健康与营养调查"追踪调查项目中参加1997、2000和2004年三轮调查中至少一次调查的18～60岁成年人(男5565;女5833)为研究对象,拟合包括社区、个体和调查时间三个水平的多水平线性模型,分析平均每日总能量摄入量、脂肪供能比、中重度体力活动时间和其它社会经济因素对BMI的影响。结果调整了其它因素后,男性总能量摄入量与BMI呈正相关(β=0.000115,S-X=0.000188,P<0.01);女性中重度体力活动时间与BMI呈负相关(β=-0.00718,S-X=0.001839,P<0.001)。男性BMI在个体和社区水平的变异分别占51.8%和12.3%,女性分别为55.9%和7.9%。结论考虑了数据在社区、个体、调查时间的层次结构后,膳食和体力活动因素对BMI有影响,并且BMI的影响因素在不同性别间存在差异。     

慢性病与平衡膳食、体力活动的关系研究

目的:讨论慢性病与平衡膳食、体力活动的关系研究。方法:选取本学院附近小区中老年人群营养与健康调查的情况,在其中选取1000例中老年人群,调查并分析他们的膳食结构、体力活动以及超重、糖尿病、高血压、高血脂等慢性病的情况。结果:其中大多数老年人群膳食结构中水果以及蔬菜的摄入量较少,盐以及油的摄入量较多。脂肪摄入数量与慢性病的发展成正相关关系,蔬菜和水果的摄入与慢性病发展成负相关关系。根据调查,每天运动30分钟以上可以有效较少发生慢性病的风险。结论:根据调查发现,中老年人群膳食情况以及体力活动情况与慢性病发生具有重要的关系。中老年人群能够通过平衡膳食,增加体力活动,达到有效减轻慢性病,具有较好的实用性。     

高钾饮食防治高血压病

高血压病是心脑血管疾患发生的最重要的危险因素。防治高血压病则成为减少心脑血管疾病和人类死亡的有效措施之一。有关专家一致认为,对于所有的轻、中度老年高血压病,一开始就应进行非药物疗法,包括对肥胖者减轻体重、限盐,适当增加运动量,戒烟、限酒,增加钙、钾摄入等。 关于钾摄入量对血压的影响,流行病调查、动物实验、临床观察都一致证明钾摄入量与血压呈负相关,而与尿中的钠/钾比呈正相关,并且这个关系存在于各个年龄段。如Khaw等观察685名美国人的血压与膳食中各种营养素的关系,发现膳食总钾及蔬菜、水果中的钾对收缩压及舒张压呈显著的负相关。日本报道本国北部的两个乡村,盐摄入     

居民膳食营养状况与糖尿病、冠心病和脑卒中的相关性

目的探讨居民膳食营养状况与糖尿病、冠心病和脑卒中的相关性。方法通过洛阳市疾病控制中心慢性病检测系统获取2017年度老城区、西工区、涧西区、洛龙区、瀍河区居民糖尿病、冠心病、脑卒中的发病率,在上述5个区的慢性病监测范围内各随机抽取1个社区,采用24 h回顾调查法调查5个社区1 476人的膳食营养数据。结果各调查点居民谷类、畜禽肉类、蛋类、豆制品类摄入量均在推荐范围之内;老城区、涧西区、瀍河区居民蔬菜、水果的摄入量存在不同程度的不足;各调查点居民奶制品摄入量分别为(52.6±8.3)、(48.2±10.0)、(58.1±6.4)、(45.0±9.6)、(50.3±11.8)g/d,均明显低于推荐量;植物油、食盐摄入量明显高于推荐量。各调查点居民人均能量、蛋白质、碳水化合物摄入量均在推荐范围之内;脂肪摄入量均明显高于推荐量,膳食纤维摄入量均明显低于推荐量;各调查点居民人均核黄素、Fe、Ca的摄入量均低于推荐量。瀍河区糖尿病标准化发病率最高(172.5/10万),洛龙区最低(60.3/10万);老城区脑卒中标准化发病率最高(185.3/10万),洛龙区最低(82.5/10万);冠心病的标准化发病率各调查点之间比较差异无统计学意义(P0.05)。各监测区居民糖尿病标准化发生率与奶制品、食盐的摄入量呈正相关(P0.05),与水果摄入量呈负相关(P0.05)。脑卒中标准化发生率与植物油、食盐的摄入量呈正相关(P0.05),与水果摄入量呈负相关(P0.05)。冠心病标准化发生率与各膳食因素之间无明显关联(P0.05)。多变量线性回归分析显示,水果摄入是糖尿病和脑卒中的保护因素,过量植物油是脑卒中的危险因素。结论本市居民奶制品摄入量低于推荐范围,植物油、食盐摄入量高于推荐范围,部分区域存在蔬菜、水果摄入量不足;应进一步加强居民膳食平衡,降低糖尿病和脑卒中的发生率。     

学龄儿童膳食模式及其影响因素的研究（英文）

目的分析中国7城市学龄儿童的膳食模式及其影响因素。方法采取立意抽样和整群随机抽样选取7城市学龄儿童620名,通过问卷调查获得其一般情况,采用膳食频率调查收集膳食资料。结果共确定了3种膳食模式:模式1与谷类、薯类、蔬菜、水果、大豆/豆制品的高摄入量相关;模式2与水果、水产品类、蛋类、奶类/奶制品、大豆/大豆制品、盐的高摄入量相关;模式3食物与谷类、禽畜肉类、蛋类、油脂类、盐、饮料的高摄入量相关。膳食模式受地域、父母文化程度、家庭收入、是否挑食、外出就餐次数、体力活动、是否超重等因素影响。结论中国7城市学龄儿童有3种主要膳食模式,分别为"传统型"膳食模式、"高蛋白型"膳食模式和"油脂/饮料类"膳食模式。膳食模式与人口社会学因素、生活方式等有关。     

2010年北京市丰台区城乡居民膳食摄入的总体情况

目的了解北京市丰台区居民食物消费的总体情况。方法采用多阶段分层整群随机抽样的方法,2010年8-10月在丰台区抽取6个居委会180户居民共计595人进行膳食调查,计算每标准人日食物消费量。膳食调查采用24h膳食回顾法与调味品称重法相结合的方法。结果丰台区居民每标准人日谷类、薯类、豆及豆制品、蔬菜、水果、坚果、畜禽肉类、奶及奶制品、蛋及蛋制品、水产类、食用油、糖及淀粉、糕点小吃类、盐、酱油的摄入量分别为337.1、27.2、11.0、258.6、119.8、3.9、77.0、71.4、41.8、20.2、36.7、7.1、13.1、9.3和13.5g。城镇居民蔬菜、水果、禽畜肉、蛋及蛋制品、水产品的摄入量与人均收入水平成正相关,相关系数分别为0.151、0.234、0.123、0.142和0.142;薯类、盐的摄入量与人均收入水平成负相关,相关系数分别为-0.134和-0.108。结论与2002年北京市居民膳食结构相比,丰台区居民膳食结构有所优化,但仍存在不利于健康的因素。     

妊娠中期孕妇水果、蔬菜摄入量与妊娠糖尿病风险的研究

目的探讨妊中期孕妇水果、蔬菜和果汁摄入量与妊娠期糖尿病(gestational diabetes mellitus,GDM)发病风险的关系。方法对象为2013年6月至2014年6月在武警总医院门诊产前检查的孕妇2987例,采用24h膳食回顾法和食物频次调查法,水果、蔬菜和果汁摄入量与GDM发病风险的关联采用COX比例风险回归模型分析,不同种类蔬菜、水果的摄入量的GDM发病率用单因素方差分析。结果全部2987例孕妇中,405例孕妇(405/2987,13.6%)被首次诊断为妊娠期糖尿病。COX比例风险回归分析:全部种类的水果和蔬菜摄入量与GDM发病风险并无相关性,但茎块类蔬菜和果汁摄入量与GDM发病风险呈正相关,苹果和橙子的摄入量与GDM发病风险呈负相关,除茎块类以外的蔬菜摄入量与GDM发病风险呈负相关,而葡萄和西瓜摄入量与GDM发病之间的相关关系为非线性:在前三个区间,GDM发病率随着摄入量的增加而降低,但葡萄和西瓜摄入量P75区间的孕妇GDM发病率明显高于前三个区间。结论孕期适量增加叶类蔬菜和某些水果的摄入量能降低GDM发病风险,但进食过多茎块类蔬果以及经常饮用果汁会增加孕妇患GDM的风险。     

2007-2012年上海市杨浦区居民膳食结构变化分析

目的了解2007-2012年上海市杨浦区居民食物摄入状况并探讨居民膳食结构及其变化情况。方法收集整理杨浦区于2007、2011、2012年开展的三次"上海市居民营养与健康状况调查"资料数据,计算居民平均每标准人日各类食物摄入量及膳食结构并与《中国居民膳食指南》中各类食物推荐量进行比较分析。结果 2007-2012年杨浦区居民粮谷类、蔬菜、水果、畜禽肉类、蛋类、奶类的平均摄入量成增加趋势(P值均0.05),分别增加20.3%、56.7%、78.9%、30.4%、55.9%、32.1%;居民能量、蛋白质、脂肪、碳水化合物的平均摄入量成增加趋势(P值均0.05),分别增加24.5%、12.4%、16.7%,35.7%;但脂肪供能比成下降趋势(P值0.05),碳水化合物供能比成升高趋势(P值0.05)。结论杨浦区居民膳食状况逐步改善,但仍存在膳食结构不平衡现象,居民奶类、水果、大豆及坚果类消费仍处于较低水平,油、盐摄入量过多及脂肪供能过高。应鼓励居民多吃蔬菜、水果、奶类、大豆及其制品,减少油、盐及动物性食物摄入量,同时广泛开展健康教育,指导人群合理膳食,提高健康水平。     

广州市40～65岁居民膳食因素与血浆高敏C反应蛋白水平的相关关系分析

目的探讨膳食因素与血浆高敏C反应蛋白(hs CRP)水平的关系。方法以志愿者的形式招募广州市40~65岁居民,采用膳食频数问卷法(FFQ)调查研究对象的膳食摄入情况,并用免疫比浊散射法检测其血浆hs CRP的水平。结果共招募553名志愿者,血浆hs CRP值为(1.56±2.19)mg/L。校正了年龄、教育程度、吸烟、饮酒、BMI、能量摄入等混杂因素的偏相关分析显示,女性的蔬菜、水果摄入量与hs CRP水平负相关(P0.05),总体研究对象碳水化合物、膳食纤维的摄入量与hs CRP负相关(P0.05),在男性中膳食纤维的相关关系显著(P0.05)。根据血浆hs CRP水平1 mg/L、1~3 mg/L、≥3 mg/L预测可能发生心血管疾病(CVD)的低、中、高风险,在校正了年龄、性别、BMI等混杂因素后,Logistic回归分析显示:随着水果摄入量、膳食纤维摄入量的减少、研究对象将来发生高hs CRP的风险增加(P0.05);以最高摄入量Q4组为对照,水果摄入量Q3组、膳食纤维摄入量Q2组、脂肪供能比Q1组、饱和脂肪酸供能比Q2组是Q4组将来发生高hs CRP的风险的1.69、1.71、0.42、0.41倍(OR值)(P0.05)。结论增加膳食中蔬菜、水果、碳水化合物、膳食纤维的摄入可降低血浆hs CRP水平,增加水果和膳食纤维摄入量、控制膳食总脂肪供能比、降低饱和脂肪供能比可能会降低心血管疾病发生的风险。     

生活方式干预在控制高血压病中的作用

本文综述了包括减轻体重、限制钠盐摄入量、限制酒精摄入量、增加身体活动或参加适宜的体育锻炼、降低饱和脂肪和胆固醇的摄入量,增加水果、蔬菜和低脂奶和膳食纤维、全谷类食物的消费量,生活规律、心理平衡以及不吸烟等生活方式干预措施在控制高血压病中的作用。综合干预措施除了能降低个体的血压,还可轻度降低整个人群的平均血压,对预防和降低人群高血压及心血管疾病发病率具有重要意义。     

Commuting physical activity is favourably associated with biological risk factors for cardiovascular disease

Background Little is known about the effects of commuting physical activity on biological cardiovascular risk factors although such knowledge may form an important basis for interventions aimed at reducing cardiovascular disease (CVD) by increasing physical activity. We examined the associations between commuting, leisure time and total physical activity and biological risk factors for CVD. Design A cross-sectional study of men and women, who participated in a health screening programme. Methods The study population comprised persons aged 30–60 years from a population-based random sample, response rate 53% (n = 6,906). Weight, height, waist circumference and blood pressure were measured and blood samples were collected. Physical activity was assessed by a self-administered questionnaire. Results Time spent on commuting, leisure time and total physical activity was positively associated with high-density lipoprotein cholesterol and negatively associated with low-density lipoprotein cholesterol, triglycerides, waist circumference and body mass index. Time spent on total physical activity was negatively associated with total cholesterol and diastolic blood pressure. Among men there was no relationship between time spent on physical activity and systolic blood pressure. Time spent on commuting physical activity and total physical activity was negatively associated with systolic blood pressure among women. Conclusion Commuting physical activity, independent of leisure time physical activity, was associated with a healthier level of most of the cardiovascular risk factors. An increase in commuting physical activity in the population may therefore reduce the incidence of CVD.     

Association of lifestyle and personality characteristics with blood pressure and hypertension: a cross-sectional study in the elderly.

The association between certain lifestyle and personality characteristics and blood pressure in the elderly was assessed in a cross-sectional study of 843 independent living 60-87 year old volunteers. They comprised 338 women and 505 men of whom 35 and 30% respectively were being treated with antihypertensive drugs. Among untreated volunteers, 28% of women and 28% of men had systolic blood pressure greater than 160 or diastolic blood pressure greater than 95. Isolated systolic hypertension was found in 20% of untreated women and 14% of untreated men. Lifestyle factors and personality characteristics associated with blood pressure were similar to those described in younger adult populations, although there were some differences related to gender and whether subjects were being treated for hypertension. Stepwise multiple regression showed that higher blood pressure was associated with greater body mass index (BMI), alcohol intake and coffee drinking and measures of irritability. Increased physical activity, and high values for measures of suspicion and extraversion were negatively related to blood pressure. Age was positively related to systolic, but not to diastolic blood pressure. The presence of hypertension was significantly associated with self-reports of raised cholesterol, diabetes or angina, as well as past history of heart failure, heart attack or stroke. Thus, in this elderly free-living population blood pressures are still significantly associated with behavioural characteristics which could be further investigated as an alternative or adjunct to antihypertensive therapy.     

Characteristics influencing daily consumption of fruits and vegetables and low-fat dairy products in older adults with hypertension

The objective of this study ws to examine the characteristics that may influence fruit, vegetable, and dairy intake in older adults with hypertension. A cross-sectional survey was conducted in a random sample of older adults who participate in a Pennsylvania pharmaceutical assistance program. Among those who reported having hypertension (N = 592), daily fruit/vegetable intake was more prevalent among women, those who were older, and those who spent more time with others. Daily intake of dairy foods was more prevalent among women and whites as well as those who exhibited certain health-conscious behaviors and those who spent more time with others.     

Associations of body mass index and obesity with physical activity, food choices, alcohol intake, and smoking in the 1982-1997 FINRISK Studies

BACKGROUND: Recent increases in the prevalence of obesity worldwide are suggested to be caused largely by an environment that promotes sedentariness and excessive food intake. OBJECTIVE: We investigated associations of body mass index (BMI) and obesity with physical activity, food choices, alcohol consumption, and smoking history. In addition, we examined the consistency of these associations over time, with the aim of assessing whether the significance of lifestyle variables as correlates of obesity increased over a 15-y period. DESIGN: Independent cross-sectional surveys were carried out in 1982, 1987, 1992, and 1997. Altogether, 24604 randomly selected men and women (aged 25-64 y) participated in these surveys. The subjects' weights and heights were measured, and data on lifestyle were collected with self-administered questionnaires. RESULTS: In men and women, perceived general health, leisure-time physical activity, and daily vegetable consumption were inversely associated with obesity, as were bread consumption in women and activity at work in men. Consumption of sausages, milk, and sour milk and heavy work (in women only) were positively associated with obesity. Obesity was also associated with alcohol consumption and smoking history. Most associations were constant over the 15-y period. However, the inverse associations of BMI with physical activity in women and with perceived health in men seemed to strengthen over time. CONCLUSIONS: A physically active lifestyle with abstention from smoking, moderate alcohol consumption, and consumption of healthy foods maximizes the chances of having a normal weight. The significance of avoiding sedentariness increases over time as a factor associated with normal weight.     

Alcohol consumption and blood pressure

The relationship between alcohol consumption and systolic and diastolic blood pressure was examined in a representative population sample of 1,429 men and women aged 35-64 years in Auckland, New Zealand during 1982. Univariate plots demonstrated a U-shaped relationship between alcohol consumption and systolic and diastolic blood pressures in men and in women aged 50 years and older, with light and moderate drinkers (less than 0-34 g alcohol/day) having lower blood pressure levels than either nondrinkers or heavy drinkers. No clear relationship was seen in younger women. The U-shaped relationship in men, particularly for systolic blood pressure, remained after controlling for potential confounders, whereas in women aged 50 years and older, there appeared to be a threshold level of approximately four drinks per day, below which drinkers had similar blood pressure levels to nondrinkers. In the multivariate analyses, it was calculated that among men, light and moderate drinkers had systolic levels 4.8 mmHg lower and diastolic levels 1.7 mmHg lower than nondrinkers and heavy drinkers, while among women aged 50-64 years, nondrinkers, light drinkers, or moderate drinkers had systolic levels 10.2 mmHg lower and diastolic levels 4.5 mmHg lower than heavy drinkers. These findings suggest that in men and in women aged 50 years and older, there is a nonlinear relationship between blood pressure and alcohol consumption, and that there is a level of alcohol consumption, of approximately four drinks per day, below which drinkers have either similar or lower blood pressure levels compared to nondrinkers.     

Dairy products, calcium, and blood pressure

The previously reported inverse association of dietary calcium intake and blood pressure levels was examined in a Southern California community, in order to determine whether this association was independent of age, obesity, and alcohol consumption. In the total population significantly less calcium intake from milk was reported in hypertensive versus normotensive men (but not women) and the association was independent of age and obesity. In a 23% subsample of men from this cohort the effect of total dietary calcium intake from all dairy products was estimated from a 24-h dietary recall. Again hypertensive men consumed significantly less calcium than normotensives. In men, both systolic and diastolic blood pressure levels were inversely associated with calcium intake from dairy products. After controlling for age, obesity, and alcohol, diastolic blood pressure was negatively and significantly associated with total calcium intake from dairy products, while systolic blood pressure was similarly associated with whole milk calcium alone. Although these data are cross-sectional, they suggest that some component of dairy products, probably calcium, exerts a protective effect against hypertension, and are compatible with the protective effect of calcium reported in hypertension-prone rats.     

Multivariate correlates of adult blood pressures in nine North American populations: The lipid research clinics prevalence study

The associations of seven variables—age, education, body mass index, alcohol consumption, cigarette smoking, regular exercise, and gonadal hormone use in women—with systolic and diastolic blood pressure were studied in 4,780 white adult men and women in nine North American populations. We chose these variables because, with the exception of age and to some extent education, they are all potentially amenable to preventive intervention. We employed multiple linear regression to determine which variables were independently associated with blood pressure. Age was positively associated with systolic and diastolic pressure in men and younger women, and with systolic but not diastolic pressure in older women. Education was not consistently associated with blood pressure. Body mass index and alcohol consumption were positively associated with systolic and diastolic pressure, while cigarette smoking was negatively associated with systolic and diastolic pressure. Regular exercise was negatively associated with systolic pressure in women and diastolic pressure in men. Gonadal hormone use in younger women, mostly oral contraceptives, was positively associated with systolic pressure. Gonadal hormone use, mostly postmenopausal estrogens, in older women showed a weak positive association with systolic pressure but this association was not statistically significant. We conclude that several potentially modifiable variables have independent relationships to systolic and diastolic blood pressure.     

Alcohol consumption and insulin resistance syndrome parameters: associations and evolutions in a longitudinal analysis of the French DESIR cohort

PURPOSE: To determine the effects of average alcohol consumption and changes in alcohol intake on the insulin resistance syndrome parameters in a 3-year follow-up study. METHODS: Longitudinal study of 1856 and 1529 alcohol drinking men and women in the French DESIR study (Data from an Epidemiological Study on the Insulin Resistance syndrome), aged 30 to 64 years. RESULTS: In men, fasting glucose, body mass index, waist circumference, systolic blood pressure, and HDL-cholesterol were positively associated with average alcohol consumption while there was no association with insulin or triglycerides concentrations. A change in alcohol intake was positively associated with HDL-cholesterol concentration and systolic blood pressure at follow-up. These effects of alcohol could not be attributed specifically to the intake of wine. In women, while the alcohol HDL-cholesterol relation was similar to that found in the men, the only significant effect of average alcohol intake was an increase in systolic blood pressure, with a spurious decrease in blood pressure related to a 3-year increase in alcohol intake. CONCLUSIONS: Alcohol only provided a beneficial effect on HDL-cholesterol. The beneficial effect seen by other authors of moderate alcohol drinking on diabetes and cardiovascular risk may be due to effects on parameters other than those included in the current definitions of the insulin resistance syndrome.     

The relationship between education and risk factors for coronary heart disease

In nine samples of adult populations (2707 males and 2871 females, aged 20–59 years) we studied the relationship between educational level and several lifestyle factors at risk for coronary heart disease (CHD), (i.e., smoking, alcohol consumption, dietary fat intake, sedentary behaviour at work and leisure) and the association between education and certain CHD risk factors (i.e., total cholesterol, HDL-cholesterol, triglycerides, systolic and diastolic blood pressure, body mass index). The data were analyzed separately in samples from North, Central and Southern Italy. The results show that educational level is often associated to the lifestyle factors considered here. This association was positive for both men and women for physical activity at leisure and work stress and only for women with respect to smoking. It was negative for both men and women for alcohol consumption and physical activity at work and for men only for cigarette smoking. The age-adjusted mean levels of the CHD risk factors show some significant differences among subjects with different educational levels, which were not always the same for the three geographical areas. This was with the exception of BMI in females, which appears negatively associated to education in all areas. These differences decreased after adjustments were made for daily cigarette smoking, wine consumption and dietary fat intake. Education seems to play a determining role in lifestyle, however its direct and indirect effects on some major CHD risk factors are somewhat different in areas at different socio-economic conditions.