上海社区成年人群超重肥胖与膳食模式的关系探讨

Overweight and obesity in Shanghai adults and their associations with dietary patterns

目的探讨上海社区成年人群超重肥胖与不同膳食模式的关系。方法采用多阶段整群随机抽样的方法,选取上海市1535名18岁以上成年人进行膳食频率问卷调查。采用中国肥胖问题工作组标准诊断超重和肥胖。利用因子分析确定主要的膳食模式,继而讨论对超重肥胖有潜在影响的膳食模式。结果因子分析得到4种主要的膳食模式,分别是西方食物型膳食模式、高蛋白高钙型膳食模式、水果零食型膳食模式和主食蔬菜型膳食模式。logistic回归分析显示无论是否控制年龄、性别、文化程度等混杂因素,主食蔬菜型膳食模式高4分位数组(Q4)相对于低4分位数组(Q1)都显示较高的肥胖患病风险(调整前OR=2.76,P<0.01;调整后,OR=2.67,P<0.01)。碳水化合物在三大营养素供能比中的贡献率结果显示,主食蔬菜型Q4组远高于Q1组(43.9%vs.34.3%,P<0.01),主食蔬菜型Q4组能量的平均摄入水平是Q1组的1.96倍。结论主食蔬菜型膳食模式是肥胖的危险因素,其原因可能与主食蔬菜型膳食模式摄入过多的碳水化合物有关。

Objective To investigate the prevalence of overweight and obesity in Shanghai adults, and explore their associations with dietary patterns. Methods Food frequency questionnaire information of 1535 adults aged ≥ 18 years old were collected by multi-stage cluster random sampling method, and used for the identification of overweight and obesity based on the criteria from Working Group On Obesity In China. Factor analysis was applied to determine major dietary patterns that may potentially associated with overweight and obesity. Results Four dietary patterns were identified, namely ＂western food＂ pattern, ＂high protein and calcium＂ pattern, ＂fruits and snacks＂ pattern, ＂stapple food and vegetables＂ pattern. Whether or not controlling the confounding factors of age, gender and degree of education, a positively association was found between ＂stapple food and vegetables＂ pattern and obesity by logistic analysis （before adjustment,OR = 2.76 between the upper （Q4） and lower （Q1） quartile, P 〈 0.01, after adjustment, OR =2.67 between Q4 and Q1, P 〈0.01）. The Q4 group of ＂stapple food and vegetables＂ pattern had higher proportion of carbohydrates that contributed to total energy than the Q1 group （43.9% vs. 34. 3% , P 〈0.01）. The Q4 group of ＂stapple food and vegetables＂ pattern had higher energy intake of 1.96 - fold than the Q1 group. Conclusion ＂Stapple food and vegetables＂ pattern may be a risk factor for obesity.