四川地区中老年人不同肥胖代谢表型的膳食模式现状分析

Current situation analysis of dietary patterns among middle-aged and elderly with different obesity metabolic phenotypes in Sichuan area

目的 了解四川地区中老年人群不同肥胖代谢表型人群的膳食模式现状。方法 从2019-2021年四川大学华西医院自然人群健康队列研究的基线调查中筛选出符合条件的中老年人15 160例,根据肥胖代谢表型判定标准将其分成4个亚组:代谢健康型非肥胖组(MHNO)、代谢不健康型非肥胖组(MUNO)、代谢健康型肥胖组(MHO)、代谢不健康型肥胖组(MUO)。以食物频率法进行膳食调查;主成分分析法(PCA)提取膳食模式;方差分析比较不同膳食模式间能量及产能营养素摄入量的差异;卡方检验比较不同肥胖代谢表型人群的膳食模式分布,并按性别、年龄段进行分层分析。结果 四川地区15 160例中老年人不同肥胖代谢表型的人数(构成比)为MHNO组8 340人(55.0%)、MUNO组4 789人(31.6%)、MHO组763人(5.0%)、MUO组1 268人(8.4%)。四川地区中老年人膳食模式主要有4种:豆类蔬果膳食模式(22.5%),米面腌制品膳食模式(25.5%),内脏饮料膳食模式(21.1%),蛋奶类膳食模式(30.9%)。不同肥胖代谢表型人群的膳食模式分布如下:MHNO组、MUNO组和MHO组以蛋奶类膳食模式为主,MUO组以米面腌制品膳食模式为主。不同肥胖代谢表型人群的膳食模式分布差异有统计学意义(P<0.05),米面腌制品膳食模式在不同肥胖代谢表型人群中占比MUO组>MUNO组>MHNO组;蛋奶类膳食模式在MUO组占比较MHNO组和MUNO组低。不同年龄段女性肥胖代谢表型的膳食模式分布差异均有统计学意义(P<0.05):对于45~<60岁女性,其肥胖代谢表型的膳食模式分布与总人群的研究结果相似;对于≥60岁女性,内脏饮料膳食模式在MUO组占比较MHNO组和MUNO组高。结论 四川地区中老年人不同肥胖代谢表型人群的膳食模式分布存在差异,建议MUO组人群在日常饮食中应适当减少米面和腌制品的摄入量,增加蛋类和奶类的摄入。对于≥60岁女性MUO组人群,应适当减少内脏和饮料的摄入量。

Objective To explore the current dietary patterns of different obesity metabolic phenotypes in the middle-aged and elderly population in Sichuan area.Methods From the baseline survey of the Natural Population Health Cohort Study at West China Hospital,Sichuan University from 2019-2021,15 160 eligible middle-aged and older adults were screened out,and then based on their obesity metabolic phenotypes,they were divided into metabolic healthy non-obesity(MHNO),metabolic unhealthy non-obesity(MUNO),metabolic healthy obesity(MHO) and metabolic unhealthy obesity(MUO) groups.Dietary survey was conducted by food frequency questionnaire.The dietary pattern was extracted by principal component analysis.ANOVA was performed to compare the differences in energy and nutrients among the participants with different dietary patterns.Chi-square test was used to compare the distribution of dietary patterns among people with different obese metabolic phenotypes,and stratified analysis was performed by gender and age groups.Results Among the 15 160 middle-aged and elderly participants in Sichuan area,there were 8 340(55.0%) in the MHNO group,4 789(31.6%) in the MUNO group,763(5.0%) in the MHO group,and 1 268(8.4%) in the MUO group.The dietary patterns of these participants mainly consisted of following 4 types:legumes and fruits(22.5%),rice,flour and pickled products(25.5%),offal and drinks(21.1%) and egg and milk(30.9%).The dietary patterns of the different obesity metabolic phenotypes were distributed as follows:the MHNO,MUNO and MHO groups had a predominantly egg and milk diet,while the MUO group had a predominantly rice,flour and pickled products diet.There were statistical differences in the distributions of dietary patterns among different obesity metabolic phenotypes(P<0.05):the dietary patterns of rice,flour and pickled products accounted for the following percentages among different obesity metabolic phenotypes:MUOMUNOMHNO;the dietary patterns of egg and milk were lower in the MUO group than in the MHNO and MUNO groups.The distribution of dietary patterns for the metabolic phenotypes of obesity was statistically different in all age groups of women(P<0.05).For the women aged 45-60 years,the distribution of dietary patterns of obesity metabolic phenotypes was similar to that found in the total population.For the women aged ≥60 years,the offal and drinks dietary pattern was more common in the MUO group than the MHNO and MUNO groups.Conclusion There are differences in the distribution of dietary patterns among middle-aged and elderly people with different obesity metabolic phenotypes in Sichuan area.It is recommended that the MUO people should reduce the intake of rice,flour and pickled products and increase the intake of eggs and milk in their daily diet.In addition,for the female MUO people ≥60 years of age,the intake of offal and beverages should be reduced appropriately.