上海市50岁及以上人群膳食模式与衰弱关联的研究

Association between dietary pattern and frailty among people aged 50 years and over in Shanghai

目的探索上海市≥50岁人群膳食模式并分析其与衰弱的关联。方法利用全球老龄化与成人健康队列研究上海项目第三轮调查资料(2018-2019年),采用食物频率问卷法收集食物的摄入频率和平均摄入量,利用因子分析法提取居民的膳食模式,采用健康缺陷累计总评分与所考虑35个健康相关变量的比值构建衰弱指数并进行分组,采用有序多分类logistic回归模型分析膳食模式与衰弱的关联性。结果共纳入研究对象3274人,男性1971人(60.2%),女性1303人(39.8%),年龄(67.9±9.2)岁。共提取4种膳食模式:高蛋白坚果模式、薯豆蔬果模式、禽畜肉模式、高油盐模式。调整混杂因素后,logistic回归分析结果显示,与高油盐模式相比,高蛋白坚果模式人群与更高程度衰弱的发生风险呈负相关(OR=0.743,95%CI:0.580~0.951)。在不同性别人群中,未发现以上膳食模式与衰弱有关;在50~64岁人群中,高蛋白坚果模式和薯豆蔬果模式相较于高油盐模式与更高程度衰弱的发生风险呈负相关;在低水平体力活动人群中,高蛋白坚果模式相较于高油盐模式与更高程度衰弱的发生风险呈负相关(OR=0.509,95%CI:0.361~0.720),但在中高水平体力活动人群中,未发现其他膳食模式对更高程度衰弱的发生风险有显著影响。结论相较于高油盐模式,多摄入高蛋白坚果类和薯豆蔬果类的饮食模式可能与50~64岁居民发生更高程度的衰弱风险更低有关,同时可能对较低水平体力活动的人群保护效果更显著。提示多摄入高蛋白类食物、坚果、薯豆类和蔬果类膳食可能有助于减轻和延缓衰弱的发生风险。

Objective To investigate dietary patterns of individuals aged≥50 in Shanghai and analyze their association with frailty.Methods Using data from the third wave of the Study on Global Ageing and Adult Health in Shanghai conducted between 2018 and 2019.We collected the frequency and average intake of food by the food frequency questionnaire.Factor analysis was used to extract dietary patterns,and a frailty index was constructed using the ratio of the cumulative total score of health deficits to 35 health-related variables considered.We used an ordinal multinomial logistic regression model to analyze the association between dietary patterns and frailty.Results A total of 3274 participants aged(67.9±9.2)years were included in the study,including 1971(60.2%)men and 1303(39.8%)women.We extracted four dietary patterns:high-protein-nuts pattern,potato-bean-vegetable-fruit pattern,poultry-meat pattern,and high-oil-salt pattern.After adjusting for confounding factors,the logistic regression analysis showed that compared with the high-oil-salt pattern,the high-protein-nuts pattern was negatively associated with the risk of higher frailty(OR=0.743,95%CI:0.580-0.951).We did not find an association between dietary patterns and frailty between the different gender groups.In the age group 50-64,the high-protein-nuts and potato-bean-vegetable-fruit patterns were negatively correlated with a higher degree of frailty than the high-oil-salt pattern.In the low-level physical activity group,the high-protein-nuts pattern was negatively correlated with a higher degree of frailty than the high-oil-salt pattern(OR=0.509,95%CI:0.361-0.720).However,we found no significant effect of the high-protein nuts pattern,potato-bean-vegetable-fruit pattern,and poultry-meat pattern on the risk of higher frailty compared to the high-oil-salt pattern in the moderate to high level of physical activity group.Conclusions Compared to the high-oil-salt pattern,dietary patterns with a higher intake of high-protein nuts,potatoes,legumes,and fruits and vegetables might be associated with a lower risk of higher frailty in residents aged 50-64 years of age than with a high oil and salt pattern.At the same time,it may have a more significant protective effect in people with lower physical activity levels.It is suggested that a diet rich in high-protein foods,nuts,potatoes,beans,vegetables,and fruits may help reduce and delay the risk of frailty.