Food-Insecure Dietary Patterns Are Associated With Poor Longitudinal Glycemic Control in Diabetes: Results From the Boston Puerto Rican Health Study
Food-Insecure Dietary Patterns Are Associated With Poor Longitudinal Glycemic Control in Diabetes: Results From the Boston Puerto Rican Health Study
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DOI：
10.2337/dc14-0753
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发表时间：
2014-09-01
期刊：
影响因子：
16.2
通讯作者：
Tucker, Katherine L.
中科院分区：
文献类型：
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作者：
Berkowitz, Seth A.;Gao, Xiang;Tucker, Katherine L.
目的 确定与食品不安全相关的饮食模式是否与纵向血糖控制不良有关。 研究设计和方法 在一项基于人群的前瞻性纵向队列研究中，我们确定了波多黎各老年人的食品安全（食品安全调查模块）、饮食模式（健康饮食指数-2005 [HEI 2005]）和血红蛋白 A(1c) (HbA(1c))。基线时（2004-2009 年）患有糖尿病的年龄为 45-75 岁，随访 2 年（2006-2012 年）时患有 HbA(1c)。我们使用多变量调整重复受试者混合效应模型确定了食品不安全与饮食模式之间的关联，并评估了这些饮食模式是否与随着时间的推移较差的 HbA(1c) 浓度相关。 结果 基线时有 584 名参与者患有糖尿病，随访时有 516 名参与者患有糖尿病。粮食不安全的参与者报告总体饮食质量较低，水果和蔬菜的摄入量较低。粮食不安全*HEI 2005 交互作用（P < 0.001）表明，与粮食安全参与者相比，粮食不安全参与者更好的饮食质量与较低的 HbA(1c) 之间的相关性更强。在调整后的模型中，较低的后续 HbA(1c) 与较高的 HEI 2005 分数相关（β = -0.01 HbA(1c)% 每 HEI 2005 分数，每年，P = 0.003），并且与全部蔬菜的子分数（β = -0.09，P = 0.04）以及深绿色和橙色蔬菜和豆类（β = -0.06，P = 0.003）相关。 0.048）。与最低总蔬菜得分相比，得分最高的参与者的 HbA(1c) 每年相对改善 0.5%。 结论 食物不安全与总体膳食质量较低和植物性食品消费量较低有关，而这又与纵向血糖控制不佳有关。
OBJECTIVETo determine whether dietary patterns associated with food insecurity are associated with poor longitudinal glycemic control.RESEARCH DESIGN AND METHODSIn a prospective, population-based, longitudinal cohort study, we ascertained food security (Food Security Survey Module), dietary pattern (Healthy Eating Index-2005 [HEI 2005]), and hemoglobin A(1c) (HbA(1c)) in Puerto Rican adults aged 45-75 years with diabetes at baseline (2004-2009) and HbA(1c) at similar to 2 years follow-up (2006-2012). We determined associations between food insecurity and dietary pattern and assessed whether those dietary patterns were associated with poorer HbA(1c) concentration over time, using multivariable-adjusted repeated subjects mixed-effects models.RESULTSThere were 584 participants with diabetes at baseline and 516 at follow-up. Food-insecure participants reported lower overall dietary quality and lower intake of fruit and vegetables. A food insecurity*HEI 2005 interaction (P < 0.001) suggested that better diet quality was more strongly associated with lower HbA(1c) in food-insecure than food-secure participants. In adjusted models, lower follow-up HbA(1c) was associated with greater HEI 2005 score (beta = -0.01 HbA(1c)% per HEI 2005 point, per year, P = 0.003) and with subscores of total vegetables (beta = -0.09, P = 0.04) and dark green and orange vegetables and legumes (beta = -0.06, P = 0.048). Compared with the minimum total vegetable score, a participant with the maximum score showed relative improvements of HbA(1c) of 0.5% per year.CONCLUSIONSFood insecurity was associated with lower overall dietary quality and lower consumption of plant-based foods, which was associated with poor longitudinal glycemic control.