Everything in Moderation--Dietary Diversity and Quality, Central Obesity and Risk of Diabetes.
Everything in Moderation--Dietary Diversity and Quality, Central Obesity and Risk of Diabetes.
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DOI：
10.1371/journal.pone.0141341
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Mozaffarian D
中科院分区：
文献类型：
--
作者：
Otto MC;Padhye NS;Bertoni AG;Jacobs DR Jr;Mozaffarian D
饮食指南建议增加饮食多样性。然而，饮食多样性的指标既没有明确定义，也没有评估对代谢健康的影响。此外，多样性是否具有独立于饮食质量的影响尚不清楚。在动脉粥样硬化的多民族研究中，我们描述并评估了饮食多样性和质量与腹部肥胖和II型糖尿病（T2D）的关系。在基线（2000 - 2002年），5160名年龄在45-84岁、无T2D的白人、西班牙裔、黑人和中国人使用有效问卷进行饮食评估。饮食多样性有三个不同方面的特征，包括计数（每周吃一次以上的不同食物的数量，多样性的广泛衡量标准），均匀性（浆果指数，多样性传播的衡量标准）和不相似性（贾卡德距离，所消耗食物属性多样性的衡量标准）。采用aHEI、DASH和先验模式对饮食质量进行表征。计数和均匀度与饲粮质量呈弱正相关（r与AHEI分别为0.20和0.04），不相似度与饲粮质量呈中度负相关（r = -0.34）。在多变量模型中，计数和均匀度都与腰围（WC）或T2D的变化无关。食物差异越大，体重增加越高（p趋势<0.01），差异得分最高五分位数的参与者体重增加120%。饮食多样性与T2D的发生无关。此外，当仅限于健康或不太健康的食物时，没有任何多样性指标与WC或T2D事件的变化相关。较高的饮食质量与较低的T2D风险相关。我们的发现几乎没有证据表明饮食多样性对腹部肥胖或糖尿病有好处。食物之间的较大差异实际上与体重增加有关。这些结果并不支持“吃任何东西都要适度”会带来更好的饮食质量或更好的代谢健康的观点。
Diet guidelines recommend increasing dietary diversity. Yet, metrics for dietary diversity have neither been well-defined nor evaluated for impact on metabolic health. Also, whether diversity has effects independent of diet quality is unknown. We characterized and evaluated associations of diet diversity and quality with abdominal obesity and type II diabetes (T2D) in the Multi-Ethnic Study of Atherosclerosis. At baseline (2000–02), diet was assessed among 5,160 Whites, Hispanic, Blacks, and Chinese age 45–84 y and free of T2D, using a validated questionnaire. Three different aspects of diet diversity were characterized including count (number of different food items eaten more than once/week, a broad measure of diversity), evenness (Berry index, a measure of the spread of the diversity), and dissimilarity (Jaccard distance, a measure of the diversity of the attributes of the foods consumed). Diet quality was characterized using aHEI, DASH, and a priori pattern. Count and evenness were weakly positively correlated with diet quality (r with AHEI: 0.20, 0.04), while dissimilarity was moderately inversely correlated (r = -0.34). In multivariate models, neither count nor evenness was associated with change in waist circumference (WC) or incident T2D. Greater food dissimilarity was associated with higher gain in WC (p-trend<0.01), with 120% higher gain in participants in the highest quintile of dissimilarity scores. Diet diversity was not associated with incident T2D. Also, none of the diversity metrics were associated with change in WC or incident T2D when restricted to only healthier or less healthy foods. Higher diet quality was associated with lower risk of T2D. Our findings provide little evidence for benefits of diet diversity for either abdominal obesity or diabetes. Greater dissimilarity among foods was actually associated with gain in WC. These results do not support the notion that “eating everything in moderation” leads to greater diet quality or better metabolic health.