中国成年人红肉摄入量对体重指数、体重及超重危险性影响的多水平纵向研究

摘要

Objective To examine the longitudinal association between red meat consumption and changes in body mass index (BMI),body weight and overweight risk in Chinese adults.Methods Data from the open,prospective cohort study ‘ China Health and Nutrition Survey '(CHNS),18 006 adults (47.5％ males) were chosen as the study subjects who participated in at least one wave of survey between 1991 and 2009.Three-level (community-individual-measure occasion) mixed effect modeling was performed to investigate the effect of red meat consumption on BMI,body weight changes and risk of overweight.The average daily red meat intake was assessed using consecutive 3 d 24 h recalls.Results In general,participants with higher red meat intake appeared to be those with younger age,higher personal income and higher education level,lower physical activities,higher total energy intake,smokers and alcohol drinkers.3-level mixed-effects linear regression models showed that red meat intake was positively associated with changes in BMI and body weight.Compared to those who consumed no red meat,men and women in the highest quartile of red meat intake showed an increase of 0.17(95％CI:0.08-0.26,P＜0.0001)and 0.12 kg/m2(95％CI:0.02-0.22,P＜0.05) on BMI and increase of 596 g(95％CI:329-864,P＜0.0001) and 400 g (95％CI:164-636,P＜ 0.0001) on body weight,respectively,after adjustment for potential confounders (age,income,education,smoking,alcohol,physical activity level,community urbanization index and total energy intake).After adjustment for above confounders and baseline BMI,results from the 3-level mixed effect logistic model indicated that the odds ratios of being overweight in males and females who had the highest quartile of red meat intake were 1.21 (95％CI:1.01-1.46,P＜0.05) and 1.18 (95％ CI:1.01-1.37,P＜0.05) in comparison with non-consumers of red meat,respectively.Conclusion Higher red meat intake was associated with increased BMI and body weight,as well as increased overweight risk.%目的 分析中国成年人红肉摄入量对BMI、体重及超重危险的影响.方法 利用开放式队列研究“中国健康与营养调查”在1991-2009年间至少参加过一轮调查的18 006名成年人(其中男性占47.5％),应用三水平(社区-个人-调查时间)混合效应模型分析红肉摄入量对BMI、体重变化和超重(BMI≥24 kg/m2)危险的影响.采用连续3天24小时膳食回顾方法评价成年人平均每日红肉摄入量.结果 中国成年人高红肉摄入量一般是年轻、收入水平和受教育程度高、体力活动水平低、总能量摄入高及有吸烟和饮酒习惯者.三水平混合效应线性模型显示成年人红肉摄入量与BMI、体重的变化呈正相关.在调整其他因素(年龄、收入水平、受教育程度、吸烟、饮酒、体力活动水平、城市化程度和总能量摄入水平)后,与不进食红肉男女性相比,红肉摄入水平最高组的男女性BMI值分别增加了0.17 kg/m2(95％CI:0.08～ 0.26,P＜0.0001)和0.12 kg/m2(95％CI:0.02～ 0.22,P＜0.05),体重分别增加了596 g(95％CI:329～ 864,P＜0.0001)和400 g(95％CI:164～636,P＜0.0001).进一步调整基线BMI值后,三水平logistic模型显示,与不进食红肉的成年人相比,最高红肉摄入水平的男女性发生超重的相对危险分别是1.21(95％CI:1.01 ～ 1.46,P＜0.05)和1.18(95％CI:1.01～ 1.37,P＜0.05).结论 较高的红肉摄入量可增加BMI和体重,并增加发生超重的危险.