卫生研究

目的 分析和提取中国成年居民残余胆固醇保护性膳食模式，并分析膳食模式不同依从组成人的能量与营养素摄入情况。方法 数据来自中国居民营养与健康状况监测(2015—2017),采用分层多阶段随机抽样方法抽取样本，全国298个监测点61 317名18岁及以上的居民被纳入本研究。使用国际通用的估计方法，估计残余胆固醇水平。采用降秩回归法提取中国成年居民残余胆固醇保护性膳食模式。结果 中国成年居民残余胆固醇保护性膳食模式主要以新鲜蔬菜、新鲜水果、菌藻类、大豆及其制品摄入较多，而精制谷物与酒类摄入较低为特征。该膳食模式解释了食物组8.24%的变异，解释了反应变量53.69%的变异。相关性分析中膳食评分与因子载荷为负值的解释变量呈负相关，与因子载荷为正值的解释变量呈正相关，且具有统计学意义(P<0.01)。反应变量间均呈正相关(P<0.01),其中膳食纤维与维生素E摄入量的相关程度最高(r=0.73,P<0.01),与钙摄入量相关程度也呈现较强的正相关(r=0.71,P<0.01)。此外反应变量与膳食评分之间也均呈正相关，相关系数具有统计学意义(P<0.01)。膳食评分和膳食纤维(r=0.78,P<0.01)与维生素E(r=0.75,P<0.01)的相关性最高。营养素分析中发现该模式较高依从性组可能摄入更高的蛋白质、脂肪、碳水化合物、膳食纤维、胆固醇、总维生素A、胡萝卜素、视黄醇、核黄素、维生素C、维生素E、钙、磷、钾、钠、镁、铁、锌、硒、铜、锰，以及更低的能量、硫胺素、烟酸。其中Q5组相较于Q1组能量摄入量中位数下降596.08 kcal/d,蛋白质摄入量中位数升高2.01 g/d,脂肪摄入量下降0.60 g/d,碳水化合物增加29.99 g/d。结论 2015—2017年中国成年居民残余胆固醇保护性膳食模式各依从性组中能量及各营养素摄入存在显著差异。

OBJECTIVE To analyze and identify protective dietary patterns for reducing remnant cholesterol levels in Chinese adult residents, and to analyze the energy and nutrient intake of different compliance groups.METHODS The data for this study was obtained from the China Residents Nutrition and Health Survey(2015-2017). The sampling method used was stratified, multi-stage, and random sampling. A total of 61 317 residents aged 18 and over from 298 monitoring sites across the country were included in the study. The remnant cholesterol levels were estimated using internationally recognized method. The protective dietary patterns were identified using the principal component regression method.RESULTS The protective dietary patterns for remnant cholesterol in Chinese adult residents are characterized by a higher intake of fresh vegetables, fresh fruits, fungi and algae, and soybean products, and a lower intake of refined grains and alcoholic beverages. This dietary pattern explains 8.24% of the variability in food groups and 53.69% of the variability in the response variable. In the correlation analysis, the dietary score was found to have a negative correlation with explanatory variables that had negative factor loadings, and a positive correlation with explanatory variables that had positive factor loadings. These correlations were statistically significant(P<0.01). The response variables also showed a positive correlation(P<0.01), with dietary fiber having the strongest correlation with vitamin E intake(r=0.73, P<0.01) and a strong positive correlation with calcium intake(r=0.71, P<0.01). Additionally, there was a significant positive correlation between the response variable and dietary score(P<0.01). The highest correlations were found between dietary score and dietary fiber(r=0.78, P<0.01) and vitamin E(r=0.75, P<0.01). In the nutrient analysis, the high compliance group showed higher intakes of protein, fat, carbohydrates, dietary fiber, cholesterol, total vitamin A, beta-carotene, retinol, thiamine, vitamin C, vitamin E, calcium, phosphorus, potassium, sodium, magnesium, iron, zinc, selenium, copper, and manganese, and lower intakes of energy, thiamine, and niacin. The median energy intake of the Q5 group decreased by 596.08 kcal/d compared to the Q1 group. Additionally, the median protein intake increased by 2.01 g/d, while the fat intake decreased by 0.60 g/d. However, the carbohydrate intake increased by 29.99 g/d.CONCLUSION There are significant differences in energy and nutrient intake among the compliance groups of the protective dietary patterns for remnant cholesterol in Chinese adult residents. This highlights the importance of a balanced and nutrient-rich diet in reducing remnant cholesterol levels.