Vegetarianism and cardiometabolic disease risk factors: Differences between South Asian and US adults.
Vegetarianism and cardiometabolic disease risk factors: Differences between South Asian and US adults.
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DOI：
10.1016/j.nut.2016.02.011
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发表时间：
2016-09
期刊：
影响因子：
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通讯作者：
Prabhakaran D
中科院分区：
文献类型：
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作者：
Jaacks LM;Kapoor D;Singh K;Narayan KM;Ali MK;Kadir MM;Mohan V;Tandon N;Prabhakaran D
与世界其他地区相比，南亚的心脏代谢疾病正在不成比例地增加，尽管素食主义水平很高。这种意想不到的不一致可能是由于南亚与美国的素食和非素食饮食的健康差异。(1)比较南亚和美国素食者与非素食者的食物组摄入量;（2）评价素食主义与心脏代谢疾病风险因素（超重/肥胖、向心性肥胖、糖尿病、高血压、高甘油三酯、高LDL、低HDL和高Fragrance心脏评分）之间的相关性。使用南亚（CARRS 2010-2011; n= 15，665）和美国（NHANES 2003-2006; n=2159）成人（20-69岁）的横断面数据，使用食物倾向问卷评估素食饮食的依从性。多变量逻辑回归用于估计比值比和预测界值（例如，调整后的结局患病率）。南亚样本中三分之一（33.0%; n=4968）的成年人是素食者，而美国样本中只有2.4%（n=59）。在南亚人中，与非素食者相比，素食者更经常吃乳制品，豆类，蔬菜，水果，甜点和油炸食品（所有p<0.05）。在美国人中，与非素食者相比，素食者更经常吃豆类、水果和全谷物，而不经常吃精制谷物、甜点、油炸食品、果汁和软饮料（所有p<0.05）。调整混杂因素后（年龄，性别，教育，烟草，酒精，以及CARRS中的城市），南亚素食者与非素食者相比，超重/肥胖的频率略低- 49%（95% CI：45%，53%）vs 53%（51%，56%），而美国素食者超重/肥胖的频率远低于非素食者：48%（32%，63%）与68%（65%，70%）。此外，与非素食者相比，美国素食者不太可能表现出中心性肥胖：分别为62%（43%，78%）和78%（76%，80%）。与南亚相比，美国素食者和非素食者之间的差异更大，与南亚素食者相比，美国素食者的食物摄入量更稳定。与非素食者相比，这两个人群中的素食者超重/肥胖的概率较低。对于美国素食来说，这种关联的强度可能更强，因为素食也可以预防中心性肥胖。
Cardiometabolic diseases are increasing disproportionately in South Asia compared to other regions of the world despite high levels of vegetarianism. This unexpected discordance may be explained by differences in the healthfulness of vegetarian and non-vegetarian diets in South Asia versus the US. (1) To compare the food group intake of vegetarians versus non-vegetarians in South Asia and the US and (2) to evaluate associations between vegetarianism and cardiometabolic disease risk factors (overweight/obesity, central obesity, diabetes, hypertension, high triglycerides, high LDL, low HDL, and high Framingham Heart Score). Using cross-sectional data from adults (20–69 years) in South Asia (CARRS 2010–2011; n=15,665) and the US (NHANES 2003–2006; n=2159), adherence to a vegetarian diet was assessed using food propensity questionnaires. Multivariable logistic regression was used to estimate odds ratios and predicted margins (e.g. adjusted prevalence of the outcomes). One-third (33.0%; n=4968) of adults in the South Asian sample were vegetarian in contrast to only 2.4% (n=59) in the US sample. Among South Asians, compared with non-vegetarians, vegetarians more frequently ate dairy, legumes, vegetables, fruit, desserts, and fried foods (all p<0.05). Among Americans, compared with non-vegetarians, vegetarians more frequently ate legumes, fruit, and whole grains, and less frequently ate refined cereals, desserts, fried foods, fruit juice, and soft drinks (all p<0.05). After adjustment for confounders (age, sex, education, tobacco, alcohol, and also city in CARRS), South Asian vegetarians were slightly less frequently overweight/obese compared to non-vegetarians – 49% (95% CI: 45%, 53%) versus 53% (51%, 56%), respectively – while US vegetarians were considerably less frequently overweight/obese compared to non-vegetarians: 48% (32%, 63%) versus 68% (65%, 70%), respectively. Furthermore, US vegetarians were less likely to exhibit central obesity compared to non-vegetarians: 62% (43%, 78%) versus 78% (76%, 80%), respectively. There is greater divergence between vegetarian and non-vegetarian diets in the US compared to South Asia, and US vegetarians have more consistently healthier food group intakes compared to South Asian vegetarians. Vegetarians in both populations have a lower probability of overweight/obesity compared to non-vegetarians. The strength of this association may be stronger for US vegetarian diets, which were also protective against central obesity.