Adjustment for total energy intake in epidemiologic studies
Adjustment for total energy intake in epidemiologic studies
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DOI：
10.1093/ajcn/65.4.1220s
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发表时间：
1997-04-01
影响因子：
7.1
通讯作者：
Kushi, LH
中科院分区：
文献类型：
--
作者：
Willett, WC;Howe, GR;Kushi, LH
在流行病学研究中，总能量摄入量通常与疾病风险有关，因为身体活动或身体大小与疾病概率之间存在关联。理论上，疾病发生率的差异也可能与代谢效率有关，因此与总能量摄入有关。由于大多数特定营养素的摄入量，特别是大量营养素，与总能量摄入量相关，它们可能与疾病无因果关系，因为总能量摄入量的混淆。此外，由与疾病风险无关的总能量摄入变化引起的营养摄入的外来变化可能会削弱相关性。此外，除非体力活动或体重发生重大变化，否则个人或群体必须主要通过改变饮食组成而不是通过改变总能量摄入量来改变其特定营养素的摄入量。因此，在流行病学研究中，调整总能量摄入通常是适当的，以控制混杂因素，减少外来变异，并预测饮食干预的效果。不考虑总能量摄入可能会掩盖营养摄入与疾病风险之间的关联，甚至逆转关联的方向。几种疾病风险模型和这些模型的公式可用于在流行病学分析中考虑能量摄入，包括通过回归分析调整营养素摄入量以获得总能量摄入量，以及将总能量添加到营养素密度模型（营养素除以能量）中。
In epidemiologic studies, total energy intake is often related to disease risk because of associations between physical activity or body size and the probability of disease. Ln theory, differences in disease incidence may also be related to metabolic efficiency and therefore to total energy intake. Because intakes of most specific nutrients, particularly macronutrients, are correlated with total energy intake, they may be noncausally associated with disease as a result of confounding by total energy intake. In addition, extraneous variation in nutrient intake resulting from variation in total energy intake that is unrelated to disease risk may weaken associations. Furthermore, individuals or populations must alter their intake of specific nutrients primarily by altering the composition of their diets rather than by changing their total energy intake, unless physical activity or body weight are changed substantially. Thus, adjustment for total energy intake is usually appropriate in epidemiologic studies to control for confounding, reduce extraneous variation, and predict the effect of dietary interventions. Failure to account for total energy intake can obscure associations between nutrient intakes and disease risk or even reverse the direction of association. Several disease-risk models and formulations of these models are available to account for energy intake in epidemiologic analyses, including adjustment of nutrient intakes for total energy intake by regression analysis and addition of total energy to a model with the nutrient density (nutrient divided by energy).