中国慢性病控制中膳食关键因素的研究

目的分析膳食结构对健康的影响，探讨预防人群慢性病和促进健康的膳食关键因素。方法以“2002年中国居民营养与健康状况调查”数据为基础，首先根据粮谷类食物供能比、碳水化合物供能比、脂肪供能比等膳食结构指标的人群分布及已有的推荐标准，将人群分为若干水平组，然后采用协方差分析方法分析不同组别在调整年龄、性别、地区等因素后常见慢性病指标的差异，并用logistic回归模型计算控制混杂因素（年龄、性别、地区、能量摄入、非睡眠静态牛活时间等）后，人群慢性病患病率随膳食结构变化的趋势及不同膳食结构下人群患各种慢性病的相对危险度（OR），进行趋势检验。结果随着粮谷类食物供能比的增加，人群体重指数（BMI）、血浆总胆固醇（TC）、低密度脂蛋白月日固醇（LDL—C）水平均显著下降，患超重、肥胖、高血压、高胆固醇血症、高甘油三酯血症、高低密度脂蛋白胆固醇血症的风险显著降低，人群低体重患病率则上升；随着碳水化合物供能比的增加，人群BMI、TC、LDL—C水平下降，相应人群超重及肥胖、高胆固醇血症、高低密度脂蛋白胆固醇血症的患病风险越低，但在粮谷类食物供能比〉75％时，人群低体重患病率则明显卜升；而脂肪供能比越高，人群BMI、TC、LDL—C水平均显著上升，相应人群超重及肥胖、高胆固醇血症、高低密度脂蛋白胆固醇血症的患病风险也增加，人群低体重率则降低。结论保持粮谷类食物占适宜比例的膳食结构，坚持按照中国居民膳食指南的建议，对于维护健康和预防慢性病具有重要意义；现有中国居民的膳食结构如能加以适当调整，是一种较好的膳食结构。

The role of dietary factors in chronic disease control in China

Objective To examine the association of dietary patterns with chronic diseases and their indicators. Methods Using the data from 2002 National Nutrition and Health Survey, we divided the subjects into clusters according to their dietary patterns classified by different percentage of energy intake from cereal foods, carbohydrate and fat, respectively. The analysis of variance was used to identify the difference in chronic disease prevalence across clusters of subjects while controlling for age, gender and geographic regions. Logistic regression analysis was applied to calculate the odd ratios (OR) for association of chronic disease and each dietary pattern, after adjusted for age, gender, region, energy intake, leisure time. Results The higher percentage of energy intake from cereals was significantly associated with lower body mass index (BMI), lower total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C). While it was significantly associated with lower risk for overweight/obesity, hypertension, high total cholesterol, high triglyceride (TG) and high LDL-C, but the prevalence of underweight was significantly higher in the cluster of subjects with cereal energy share more than 75% . The higher percentage of energy intake from fat was significantly associated with higher BMI, higher total cholesterol and higher LDL-C, which accordingly, was significantly associated with higher risk for overweight/obesity, hypertension, high total cholesterol, triglyceride and high LDL-C. Conclusion Our study confirmed the important role of dietary pattern in chronic disease control; in particular, appropriate percentage of energy intake from fat and cereals/carbohydrates are beneficial to control and prevention of chronic diseases.