Improving adherence to healthy dietary patterns, genetic risk, and long term weight gain: gene-diet interaction analysis in two prospective cohort studies.
Improving adherence to healthy dietary patterns, genetic risk, and long term weight gain: gene-diet interaction analysis in two prospective cohort studies.
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提高对健康饮食模式、遗传风险和长期体重增加的依从性：两项前瞻性队列研究中的基因-饮食相互作用分析。
DOI：
10.1136/bmj.k693
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发表时间：
2018-02-12
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目的调查改善对健康饮食模式的依从性是否与体重指数和体重长期变化相关的肥胖遗传易感性相互作用。设计前瞻性队列研究。设置美国的健康专业人员。参与者来自护士健康研究的 8828 名女性和来自健康专业人员随访研究的 5218 名男性。暴露遗传易感性评分是根据与体重指数相关的 77 个变异计算的。通过替代健康饮食指数 2010 (AHEI-2010)、预防高血压的饮食方法 (DASH) 和替代地中海饮食 (AMED) 来评估饮食模式。 主要结果指标 随访期间（1986 年至 2006 年）对体重指数和体重的四年变化进行五次重复测量。 结果在 20 年的随访期间，体重指数变化与遗传相关性显着在护士健康研究（交互作用 P=0.001）和卫生专业人员随访研究（交互作用 P=0.005）中，随着对 AHEI-2010 的遵守程度的增加而减弱。在合并队列中，每 10 个风险等位基因增量的体重指数四年变化在 AHEI-2010 评分降低的参与者中为 0.07 (SE 0.02)，在 AHEI-2010 评分升高的参与者中为 -0.01 (0.02)，相当于每四年 0.16 (0.05) kg 体重变化与 -0.02 (0.05) kg 体重变化（P<0.001）互动）。从不同角度来看，低、中、高遗传风险参与者中，AHEI-2010 评分每增加 1 个 SD，体重指数变化分别为 -0.12 (0.01)、-0.14 (0.01) 和 -0.18 (0.01)（体重变化：-0.35 (0.03)、-0.36 (0.04) 和 -0.50 (0.04) kg。 DASH 也发现了类似的相互作用，但 AMED 却没有。结论这些数据表明，提高对健康饮食模式的坚持可以减弱与体重增加的遗传关联。此外，改善饮食质量对体重管理的有益作用对于肥胖遗传风险高的人群尤其明显。
ObjectiveTo investigate whether improving adherence to healthy dietary patterns interacts with the genetic predisposition to obesity in relation to long term changes in body mass index and body weight.DesignProspective cohort study.SettingHealth professionals in the United States.Participants8828 women from the Nurses’ Health Study and 5218 men from the Health Professionals Follow-up Study.ExposureGenetic predisposition score was calculated on the basis of 77 variants associated with body mass index. Dietary patterns were assessed by the Alternate Healthy Eating Index 2010 (AHEI-2010), Dietary Approach to Stop Hypertension (DASH), and Alternate Mediterranean Diet (AMED).Main outcome measuresFive repeated measurements of four year changes in body mass index and body weight over follow-up (1986 to 2006).ResultsDuring a 20 year follow-up, genetic association with change in body mass index was significantly attenuated with increasing adherence to the AHEI-2010 in the Nurses’ Health Study (P=0.001 for interaction) and Health Professionals Follow-up Study (P=0.005 for interaction). In the combined cohorts, four year changes in body mass index per 10 risk allele increment were 0.07 (SE 0.02) among participants with decreased AHEI-2010 score and −0.01 (0.02) among those with increased AHEI-2010 score, corresponding to 0.16 (0.05) kg versus −0.02 (0.05) kg weight change every four years (P<0.001 for interaction). Viewed differently, changes in body mass index per 1 SD increment of AHEI-2010 score were −0.12 (0.01), −0.14 (0.01), and −0.18 (0.01) (weight change: −0.35 (0.03), −0.36 (0.04), and −0.50 (0.04) kg) among participants with low, intermediate, and high genetic risk, respectively. Similar interaction was also found for DASH but not for AMED.ConclusionsThese data indicate that improving adherence to healthy dietary patterns could attenuate the genetic association with weight gain. Moreover, the beneficial effect of improved diet quality on weight management was particularly pronounced in people at high genetic risk for obesity.