Dietary share of ultra-processed foods and metabolic syndrome in the US adult population
Dietary share of ultra-processed foods and metabolic syndrome in the US adult population
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DOI：
10.1016/j.ypmed.2019.05.004
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发表时间：
2019-08-01
影响因子：
5.1
通讯作者：
Monteiro, Carlos A.
中科院分区：
文献类型：
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作者：
Steele, Euridice Martinez;Juul, Filippa;Monteiro, Carlos A.
这项研究旨在探讨美国成年人饮食中超加工食品的比例与代谢综合征之间的关系。我们对 2009 年至 2014 年全国健康和营养横断面调查中的 6, 385 名参与者进行了研究，这些参与者的年龄都在 20 岁以上，他们在空腹条件下进行了血液检查，并至少回忆了一次 24 小时饮食情况。食品根据工业食品加工的范围和目的进行分类。超加工食品 (UPF) 是由多种成分组成的配方，大部分为专用工业用途，是一系列工业过程的结果（因此是超加工食品）。根据 2009 年联合科学声明，代谢综合征 (MetS) 被定义为满足以下三个或更多标准：(1) 腰围升高 (2) 空腹血糖升高 (3) 血压升高 (4) 甘油三酯升高 (5) 高密度脂蛋白 (HDL-C) 降低。针对年龄、性别、种族/族裔、家庭收入、教育、体力活动和吸烟进行调整后的稳健方差泊松回归模型显示，UPF 的饮食贡献与 MetS 患病率之间存在显着的线性相关性（贡献增加 10% 与患病率增加 4% 相关）（患病率 -PR- = 1.04；95% CI 1.02, 1.07）。膳食UPF贡献>71%（第五人口五分位数）与MetS患病率升高28%相关，而贡献低于40%（第一人口五分位数）则与此相关（PR = 1.28；95% CI 1.09，1.50）。这种关联在年轻人中更强（上五分位数和下五分位数之间的 PR = 1.94；95% CI 1.39, 2.72），并且随着年龄的增长而减弱。这些发现进一步证明 UPF 的摄入与饮食相关的非传染性疾病有关。
This study sought to examine the relationship between dietary share of ultra-processed foods and metabolic syndrome among US adults. We studied 6, 385 participants from the cross-sectional National Health and Nutrition Examination Survey 2009-2014, aged 20+ years, with blood tests under fasting conditions and at least one 24-hour dietary recall. Food items were classified according to the extent and purpose of industrial food processing. Ultra-processed foods (UPF) are formulations of many ingredients, mostly of exclusive industrial use, that result from a sequence of industrial processes (hence ultra-processed). Metabolic Syndrome (MetS) was defined according to the 2009 Joint Scientific Statement as meeting three or more of the following criteria: (1) elevated waist circumference (2) elevated fasting plasma glucose (3) elevated blood pressure (4) elevated triglycerides (5) reduced high-density lipoprotein (HDL-C). Poisson regression models with robust variance adjusted for age, sex, race/ethnicity, family income, education, physical activity and smoking showed significant linear association between the dietary contribution of UPF and the prevalence of MetS (a 10% increase in contribution was associated with a 4% prevalence increase) (prevalence ratio -PR- = 1.04; 95% CI 1.02, 1.07). A dietary UPF contribution of >71% (5th population quintile) was associated with 28% higher prevalence of MetS compared to a contribution below 40% (1st population quintile) (PR = 1.28; 95% CI 1.09, 1.50). The association was stronger in young adults (PR between upper and lower quintiles = 1.94; 95% CI 1.39, 2.72) and decreased with age. These findings add to the growing evidence that UPF consumption is associated with diet-related non-communicable diseases.