中国九省居民膳食、体力活动与血压水平关系的纵向分析研究

目的 通过构建多水平模型,对中国九省居民饮食、体力活动与血压水平之间的关系进行纵向分析.方法 以"中国健康与营养调查"追踪调查项目中参加1997、2000、2004和2006年四轮调查中至少一次调查的18岁及以上成年人(男性6706名,女性7140名)为研究对象,分性别拟合包括个体和调查时间两个水平的发展模型,分析膳食中盐、蔬菜、水果、脂肪和蛋白质摄入量以及中重度体力活动时间对SBP和DBP的影响.结果 在调整年龄、教育程度、BMI、饮酒和能量摄入量等因素之后,四轮调查女性个体平均盐摄入量与SBP呈正相关(β=0.0481,s-x=0.0178,P＜0.01);男女性个体平均蔬菜摄入量与SBP呈负相关(P＜0.01),其回归系数估计值分别为-0.0063、-0.0068,即个体四次调查日均蔬菜摄入量每增加100 g,其SBP会降低0.6mm Hg(1 mm Hg=0.133kPa)以上,另外,男女性个体平均蔬菜摄入量同DBP亦呈负相关(P＜0.01).对同一调查时间的不同个体或不同调查时间的同一个体来说,男女性水果摄入量和SBP呈负相关,其回归系数估计值分别为-0.0029、-0.0031.中重度体力活动时间与男女性SBP和女性DBP均呈负相关(P＜0.05).不过,膳食总脂肪和蛋白质摄入量与血压水平之间并无关联.结论 膳食中盐、蔬菜和水果摄入量以及中重度体力活动时间与血压水平有关.限盐、增加蔬菜和水果摄入量、提高各项体力活动水平、积极控制体重等生活方式的转变是控制血压水平的重要方法.

Effects of diet and physical activity factors on blood pressure in nine provinces of China:a longitudinal analysis

Objective To study the effects of diet and physical activity factors on blood pressure in nine provinces, using the multilevel model. Methods Data was collected in the China Health and Nutrition Survey (CHNS). A total of 6706 men and 7140 women aged above 18 who attended at least one of the surveys in the year of 1997,2000,2004 and 2006 were selected, and a two-level male and female random intercept-slope growth models were applied to estimate the relationship between the intake of daily salt, vegetable, fruit, fat, protein as well as the time spent on the moderate or heavy physical activity and blood pressure. Results After controlling for age,education, BMI, drinks and total energy intake, mean of the daily salt intake per person was positively associated with systolic blood pressure in women ( β= 0.0481, s-x= 0.0178, P＜0.01 ). Mean of the daily vegetable intake per person was negatively associated with systolic blood pressure in men and women, with the regression coefficients as -0.0063,-0.0068 respectively, indicating that if mean of the daily vegetable intake per person increased by 100 g, the systolic blood pressure would decrease by 0.6 mm Hg (1 mm Hg=0.133 kPa) or more. In addition, the daily vegetable intake was also negatively associated with diastolic blood pressure (P＜0.01). Daily fruit intake was negatively associated with systolic blood pressure both in men and women, with regression coefficients as -0.0029 and -0.0031 respectively. Time spent on the moderate or heavy physical activity was also negatively associated with systolic blood pressure in both men and women, and diastolic blood pressure in women (P＜0.05). No relationship was found between daily fat, protein intake and blood pressure. Conclusion Daily salt, vegetable, fruit intake, time spent on the moderate or heavy physical activity were associated with blood pressure in both men and women. Programs on integrated lifestyle modifications including dietary salt reduction, eating more vegetable and fruits, increasing physical activity level, plus weight control were critical for the control of high blood pressure.