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Seafood intake in childhood/adolescence and the risk of obesity: results from a Nationwide Cohort Study. 儿童/青少年时期的海鲜摄入量与肥胖风险:全国队列研究的结果。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-16 DOI: 10.1186/s12937-024-00986-6
Tianyue Zhang, Hao Ye, Xiaoqin Pang, Xiaohui Liu, Yepeng Hu, Yuanyou Wang, Chao Zheng, Jingjing Jiao, Xiaohong Xu

Background & aims: Obesity has been linked to various detrimental health consequences. While there is established evidence of a negative correlation between seafood consumption and obesity in adults, the current research on the association between seafood intake in childhood/adolescence and the risk of obesity is lacking. Our aim was to evaluate the association between seafood intake in childhood/adolescence and the risk of obesity in a Chinese nationwide cohort.

Methods: We utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1997 to 2015. Seafood consumption was evaluated through 3-day 24-hour recalls. In our study, overweight/obesity status was determined based on the Chinese Criteria of Overweight and Obesity in School-age Children and Adolescents (WS/T 586-2018), while abdominal obesity status was determined according to the Chinese Criteria of Waist Circumference Screening Threshold among Children and Adolescents (WS/T 611-2018).

Results: During an average follow-up of 7.9 years, 404 cases developed overweight/obesity among 2206 participants in the seafood-overweight/obesity analysis, while 381 cases developed abdominal obesity among 2256 participants in the seafood-abdominal-obesity analysis. The high-consumer group was associated with 35% lower risk of overweight/obesity risk and 26% lower risk of abdominal obesity after fully adjusting for sociodemographic and lifestyle factors, compared with the non-consumer group. Considering different cooking methods, boiled seafood consumption was associated with 43% lower risk of overweight/obesity and 23% lower risk of abdominal obesity in the fully adjusted model, while stir-fried seafood did not demonstrate a statistical significance.

Conclusion: Higher intake of seafood in childhood/adolescents, particularly in a boiled way, was associated with lower obesity risk.

背景与目的:肥胖与各种有害健康的后果有关。虽然已有证据表明海鲜摄入量与成人肥胖之间存在负相关,但目前还缺乏对儿童/青少年海鲜摄入量与肥胖风险之间关系的研究。我们的目的是评估中国全国队列中儿童/青少年海鲜摄入量与肥胖风险之间的关系:我们利用了中国健康与营养调查(CHNS)1997 年至 2015 年的数据。海鲜摄入量通过 3 天 24 小时回忆进行评估。在我们的研究中,超重/肥胖状态根据《中国学龄儿童和青少年超重和肥胖标准》(WS/T 586-2018)确定,而腹型肥胖状态则根据《中国儿童青少年腰围筛查阈值标准》(WS/T 611-2018)确定:在平均7.9年的随访期间,2206名海产品超重/肥胖分析参与者中有404例出现超重/肥胖,而2256名海产品腹部肥胖分析参与者中有381例出现腹部肥胖。在对社会人口学和生活方式因素进行充分调整后,与非消费群体相比,高消费群体的超重/肥胖风险降低了35%,腹部肥胖风险降低了26%。考虑到不同的烹饪方法,在完全调整模型中,水煮海鲜与超重/肥胖风险降低43%和腹部肥胖风险降低23%相关,而炒海鲜则没有统计学意义:结论:儿童/青少年海鲜摄入量越高,尤其是水煮海鲜摄入量越高,肥胖风险越低。
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引用次数: 0
Is the frequency of breakfast consumption associated with life satisfaction in children and adolescents? A cross-sectional study with 154,151 participants from 42 countries. 吃早餐的频率与儿童和青少年的生活满意度有关吗?一项针对 42 个国家 154 151 名参与者的横断面研究。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-16 DOI: 10.1186/s12937-024-00979-5
José Francisco López-Gil, Mark A Tully, Carlos Cristi-Montero, Javier Brazo-Sayavera, Anelise Reis Gaya, Joaquín Calatayud, Rubén López-Bueno, Lee Smith

Background: The promotion of daily breakfast consumption and the importance of making appropriate breakfast choices have been underscored as significant public health messages. The aim of this study was to examine the relationship between breakfast frequency and life satisfaction in large and representative samples of school-going children and adolescents aged 10-17 years from 42 different countries.

Methods: This study used information from the 2017/2018 Health Behavior in School-aged Children study, comprising nationally representative samples of children and adolescents aged 10-17 years who were attending school. The total number of participants from the 42 countries included in the study was 155,451 (51.3% girls). The evaluation of breakfast consumption in this study involved a specific question: "How often do you typically have breakfast (more than a glass of milk or fruit juice)?". To measure life satisfaction, a subjective assessment scale was used in the form of a ladder, visually spanning from 0 to 10. On this scale, the topmost point (10) denotes the highest conceivable quality of life, whereas the bottom point (0) represents the worst imaginable quality of life.

Results: After adjusting for several covariates, the lowest estimated marginal mean of life satisfaction was identified in those participants who skipped breakfast (mean [M] = 5.6, 95% confidence interval [CI] 5.5 to 5.8). Conversely, the highest estimated marginal mean of life satisfaction was observed in those who had breakfast every day (M = 6.5, 95% CI 6.3 to 6.6). Overall, a nearly linear relationship between higher frequency of breakfast and greater life satisfaction in children and adolescents was identified (p-for-trend < 0.001). In addition, the highest estimated marginal mean of life satisfaction score was identified in those participants from Portugal who had breakfast every day (M = 7.7; 95% CI 6.9 to 8.5 points). Conversely, the lowest estimated marginal mean of life satisfaction was observed in those participants from Romania who no breakfast (M = 3.5; 95% CI 2.6 to 4.4 points).

Conclusions: There is a nearly linear relationship between higher frequency of breakfast and greater life satisfaction in children and adolescents. Considering the potential health advantages associated with breakfast during this critical age phase, these findings imply the necessity for additional global efforts to promote increased breakfast consumption among children and adolescents.

背景:提倡每天食用早餐和选择适当早餐的重要性已被强调为重要的公共健康信息。本研究的目的是在来自 42 个不同国家的 10-17 岁在校儿童和青少年的大型代表性样本中,研究早餐频率与生活满意度之间的关系:本研究使用了 2017/2018 年学龄儿童健康行为研究的信息,其中包括具有全国代表性的 10-17 岁在校儿童和青少年样本。来自 42 个国家的参与者共计 155 451 人(51.3% 为女孩)。在这项研究中,对早餐消费的评估涉及一个具体问题:"您通常多长时间吃一次早餐(一杯牛奶或果汁以上)?为了测量生活满意度,采用了一种主观评估量表,其形式为阶梯式,视觉跨度从 0 到 10。在这个阶梯上,最高点(10)代表可以想象的最高生活质量,而最低点(0)则代表可以想象的最差生活质量:在对几个协变量进行调整后,不吃早餐的参与者的生活满意度估计边际平均值最低(平均值 [M] = 5.6,95% 置信区间 [CI] 5.5 至 5.8)。相反,每天都吃早餐的参与者的生活满意度估计边际平均值最高(平均值[M] = 6.5,95% 置信区间[CI] 为 6.3 至 6.6)。总体而言,儿童和青少年吃早餐的频率越高,生活满意度越高,两者之间几乎呈线性关系(P-趋势结论):儿童和青少年吃早餐的频率越高,生活满意度越高,两者之间几乎呈线性关系。考虑到在这一关键年龄阶段吃早餐对健康的潜在益处,这些发现意味着有必要在全球范围内加大力度,促进儿童和青少年更多地食用早餐。
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引用次数: 0
Experiences participating in federal nutrition assistance programs during the early months of the COVID-19 pandemic: an investigation in Vermont. 在 COVID-19 大流行的最初几个月参与联邦营养援助计划的经历:佛蒙特州的一项调查。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-15 DOI: 10.1186/s12937-024-00963-z
Emma H Spence, Meredith T Niles, Farryl Bertmann, Emily H Belarmino

Background: Federal nutrition assistance programs serve as safety nets for many American households, and participation has been linked to increased food security and, in some instances, improved diet quality and mental health outcomes. The COVID-19 pandemic brought new and increased economic, social, and psychological challenges, necessitating inquiry into how nutrition assistance programs are functioning and associated with public health outcomes.

Methods: Using data from a representative statewide survey administered in Vermont (n = 600) between July and September 2020, we examined participant experiences with major federal nutrition assistance programs: the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and school meal programs. We explored quantitative and qualitative responses regarding perceptions of program utility, and used nearest neighbors matching analyses in combination with bivariate statistical tests to assess associations between program participation and food insecurity, perceived stress, and fruit and vegetable intake as indicators of dietary quality.

Results: One in four respondents (27.3%) used at least one federal nutrition assistance program. As compared to non-participants, we found higher rates of food insecurity among program participants (57.5% vs. 18.1%; p < 0.001), an association that persisted even when we compared similar households using matching techniques (p ≤ 0.001). From matched analyses, we found that, compared to low-income non-participants, low-income program participants were less likely to meet fruit intake recommendations (p = 0.048) and that low-income SNAP and WIC participants were less likely to meet vegetable intake recommendations (p = 0.035). We also found lower rates of perceived stress among low-income school meal participant households compared to low-income non-participants (p = 0.039). Despite these mixed outcomes, participants broadly valued federal nutrition assistance programs, characterizing them as helpful or easy to use.

Conclusions: We found that federal nutrition assistance programs as a group were not sufficient to address food insecurity and stress or increase fruit and vegetable intake in the state of Vermont during the early months of the COVID-19 pandemic. Nonetheless, participants perceived benefits from participation in these programs. Optimizing the utility of nutrition assistance programs depends on critical examination of their functioning under conditions of great stress.

背景:联邦营养援助计划是许多美国家庭的安全网,参与该计划可提高粮食安全,在某些情况下还可改善饮食质量和心理健康。COVID-19 大流行带来了新的和更多的经济、社会和心理挑战,因此有必要调查营养援助计划是如何运作的以及与公共卫生结果的关联:利用 2020 年 7 月至 9 月期间在佛蒙特州进行的一项具有代表性的全州调查(n = 600)中的数据,我们研究了参与者在主要联邦营养援助计划方面的经验:补充营养援助计划 (SNAP)、妇女、婴儿和儿童特别补充营养计划 (WIC) 以及学校膳食计划。我们探讨了有关对计划效用看法的定量和定性回答,并结合使用近邻匹配分析和双变量统计检验来评估计划参与与食物不安全、感知压力以及作为饮食质量指标的水果和蔬菜摄入量之间的关联:四分之一的受访者(27.3%)至少参加过一项联邦营养援助计划。与未参与计划的受访者相比,我们发现参与计划的受访者中粮食不安全的比例更高(57.5% 对 18.1%;P 结论:我们发现,联邦营养援助计划作为一种膳食质量指标,能够帮助受访者提高膳食质量:我们发现,在 COVID-19 大流行的最初几个月中,联邦营养援助计划作为一个群体并不足以解决佛蒙特州的食物不安全和压力问题,也不足以增加水果和蔬菜的摄入量。尽管如此,参与者还是认为参与这些计划是有益的。要优化营养援助计划的效用,就必须对其在巨大压力条件下的功能进行严格审查。
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引用次数: 0
Lower energy intake associated with higher risk of cardiovascular mortality in chronic kidney disease patients on a low-protein diets. 低蛋白饮食的慢性肾病患者能量摄入较低与心血管死亡风险较高有关。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-15 DOI: 10.1186/s12937-024-00980-y
Yao Liu, Fei Deng, Ping Zhou, Cong Peng, ChunPeng Xie, Wuyu Gao, Qianyu Yang, Tingyu Wu, Xiang Xiao

Objective: An increasing number of studies shown that inadequate energy intake causes an increase in adverse incidents in chronic kidney disease (CKD) patients on low-protein diets (LPD). The study aimed to investigate the relationship between energy intake and cardiovascular mortality in CKD patients on a LPD.

Methods: This was a cross-sectional study, a total of 4264 CKD patients were enrolled from the NHANES database between 2009 and 2018. Restricted cubic spline plots and Cox regression analysis were used to analyze the association between energy intake and cardiovascular mortality in CKD patients on a LPD. Additionally, a nomogram was constructed to estimate cardiovascular survival in CKD patients on a LPD.

Results: Among CKD patients on a LPD in the United States, 90.05% had an energy intake of less than 25 kcal/kg/day, compared to 36.94% in CKD patients on a non-LPD. Energy intake and cardiovascular mortality showed a linear relationship in CKD patients on a LPD, while a 'U-shaped' relationship was observed in CKD patients on a non-LPD. Multifactorial Cox regression models revealed that for Per-standard deviation (Per-SD) decrement in energy intake, the risk of cardiovascular mortality increased by 41% (HR: 1.41, 95% CI: 1.12, 1.77; P = 0.004) in CKD patients on a LPD. The concordance index of the nomogram was 0.79 (95% CI, 0.75, 0.83).

Conclusion: CKD patients, especially those on a LPD, have significantly inadequate energy intake. Lower energy intake is associated with higher cardiovascular mortality in CKD patients on a LPD.

目的:越来越多的研究表明,能量摄入不足会导致低蛋白饮食(LPD)的慢性肾脏病(CKD)患者不良事件的增加。本研究旨在调查低蛋白饮食的慢性肾脏病患者的能量摄入与心血管死亡率之间的关系:这是一项横断面研究,2009年至2018年期间,共有4264名CKD患者从NHANES数据库中注册。研究采用限制立方样条图和 Cox 回归分析方法,分析接受 LPD 的 CKD 患者能量摄入与心血管疾病死亡率之间的关系。此外,还构建了一个提名图来估算接受低密度脂蛋白血症治疗的 CKD 患者的心血管存活率:结果:在美国接受低密度脂蛋白胆固醇治疗的 CKD 患者中,90.05% 的能量摄入量低于 25 千卡/千克/天,而在非低密度脂蛋白胆固醇治疗的 CKD 患者中,这一比例为 36.94%。接受低密度脂蛋白胆固醇治疗的慢性肾脏病患者的能量摄入量与心血管死亡率呈线性关系,而接受非低密度脂蛋白胆固醇治疗的慢性肾脏病患者的能量摄入量与心血管死亡率呈 "U "型关系。多因素 Cox 回归模型显示,能量摄入量每标准差(Per-SD)下降,低密度脂蛋白血症患者的心血管死亡风险增加 41%(HR:1.41,95% CI:1.12,1.77;P = 0.004)。提名图的一致性指数为 0.79 (95% CI, 0.75, 0.83):结论:慢性肾脏病患者,尤其是接受低密度脂蛋白血症治疗的患者,能量摄入明显不足。结论:接受低密度脂蛋白血症治疗的慢性肾脏病患者,尤其是低密度脂蛋白血症患者,能量摄入不足与心血管死亡率升高有关。
{"title":"Lower energy intake associated with higher risk of cardiovascular mortality in chronic kidney disease patients on a low-protein diets.","authors":"Yao Liu, Fei Deng, Ping Zhou, Cong Peng, ChunPeng Xie, Wuyu Gao, Qianyu Yang, Tingyu Wu, Xiang Xiao","doi":"10.1186/s12937-024-00980-y","DOIUrl":"10.1186/s12937-024-00980-y","url":null,"abstract":"<p><strong>Objective: </strong>An increasing number of studies shown that inadequate energy intake causes an increase in adverse incidents in chronic kidney disease (CKD) patients on low-protein diets (LPD). The study aimed to investigate the relationship between energy intake and cardiovascular mortality in CKD patients on a LPD.</p><p><strong>Methods: </strong>This was a cross-sectional study, a total of 4264 CKD patients were enrolled from the NHANES database between 2009 and 2018. Restricted cubic spline plots and Cox regression analysis were used to analyze the association between energy intake and cardiovascular mortality in CKD patients on a LPD. Additionally, a nomogram was constructed to estimate cardiovascular survival in CKD patients on a LPD.</p><p><strong>Results: </strong>Among CKD patients on a LPD in the United States, 90.05% had an energy intake of less than 25 kcal/kg/day, compared to 36.94% in CKD patients on a non-LPD. Energy intake and cardiovascular mortality showed a linear relationship in CKD patients on a LPD, while a 'U-shaped' relationship was observed in CKD patients on a non-LPD. Multifactorial Cox regression models revealed that for Per-standard deviation (Per-SD) decrement in energy intake, the risk of cardiovascular mortality increased by 41% (HR: 1.41, 95% CI: 1.12, 1.77; P = 0.004) in CKD patients on a LPD. The concordance index of the nomogram was 0.79 (95% CI, 0.75, 0.83).</p><p><strong>Conclusion: </strong>CKD patients, especially those on a LPD, have significantly inadequate energy intake. Lower energy intake is associated with higher cardiovascular mortality in CKD patients on a LPD.</p>","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Brief instruments for measuring nutrition literacy - the Nutrition Health Literacy Scale and the Self-Perceived Food Literacy Scale Short Form. 测量营养知识的简易工具--营养健康知识量表和自我感觉食物知识量表简表。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-11 DOI: 10.1186/s12937-024-00971-z
Robert Griebler, Denise Schütze, Thomas Link, Karin Schindler

Background: A healthy diet is a critical factor in maintaining long-term health. In addition to a health-promoting food environment, the nutrition health literacy (NHL) and food literacy (FL) of the population are important in this context. This paper describes the development and validation of two short instruments to measure the nutrition literacy of the population, used in the Austrian Nutrition Literacy Survey 2021.

Methods: An instrument to measure NHL (Nutrition Health Literacy Scale; NHLS) has been adapted and further developed. To measure FL, the Self-perceived Food Literacy Scale by Poelman et al. has been modified and shortened (SPFL-SF). Validation of the instruments was based on data from a web survey conducted in Austria in 2021 with almost 3,000 participants aged 18 years and older. Exploratory and confirmatory factor analyses were performed to assess the factorial validity/dimensionality of the instruments. Additionally, internal consistency was assessed using Cronbach's alpha, ordinal alpha, and McDonald's omega.

Results: Both instruments demonstrate excellent data-model fit. The NHLS also shows excellent internal consistency (α = 0.91), while the SPFL-SF displays a sufficient internal consistency for all (α between 0.70 and 0.89) but one sub-dimension (resisting temptation α = 0.61). Furthermore, the distribution of the items indicates that the measures are understandable and suitable, as evidenced by the absence of missing values in the sample. In addition, the items of both instruments differ in their level of difficulty or agreement.

Conclusions: The NHLS and SPFL-SF are reliable and valid instruments for measuring NHL and FL in the general adult population. The brief instruments measuring the different aspects of nutrition literacy can be easily used in nutritional or evaluation studies. Further work is required to investigate other aspects of validity.

背景:健康饮食是保持长期健康的关键因素。在此背景下,除了促进健康的食品环境外,居民的营养健康素养(NHL)和食品素养(FL)也很重要。本文介绍了 2021 年奥地利营养素养调查(Austrian Nutrition Literacy Survey 2021)中使用的两种测量居民营养素养的简易工具的开发和验证情况:方法:对营养健康素养测量工具(营养健康素养量表;NHLS)进行了改编和进一步开发。为了测量FL,对Poelman等人的 "自我感觉食物素养量表"(SPFL-SF)进行了修改和缩短。2021 年在奥地利对近 3000 名 18 岁及以上的参与者进行了网络调查,根据调查数据对这些工具进行了验证。为了评估问卷的因子有效性/维度性,我们对问卷进行了探索性和确认性因子分析。此外,还使用 Cronbach's alpha、ordinal alpha 和 McDonald's omega 评估了内部一致性:结果:两种工具都显示出极佳的数据模型拟合度。NHLS 也显示出极佳的内部一致性(α = 0.91),而 SPFL-SF 除一个子维度(抵制诱惑 α = 0.61)外,其他维度都显示出足够的内部一致性(α 在 0.70 和 0.89 之间)。此外,从项目的分布来看,测量结果是可以理解的,也是合适的,这一点可以从样本中没有缺失值得到证明。此外,两种工具的项目在难度或一致性方面也存在差异:NHLS和SPFL-SF是测量普通成年人NHL和FL的可靠有效的工具。测量营养素养不同方面的简明工具可轻松用于营养或评估研究。还需要进一步研究其他方面的有效性。
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引用次数: 0
Adverse events profile associated with intermittent fasting in adults with overweight or obesity: a systematic review and meta-analysis of randomized controlled trials. 与超重或肥胖成人间歇性禁食有关的不良事件概况:随机对照试验的系统回顾和荟萃分析。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-10 DOI: 10.1186/s12937-024-00975-9
Fan Zhong, Ting Zhu, Xingyi Jin, Xiangjun Chen, Ruipeng Wu, Li Shao, Shaokang Wang

Background: There is little evidence to comprehensively summarize the adverse events (AEs) profile of intermittent fasting (IF) despite its widespread use in patients with overweight or obesity.

Methods: We searched the main electronic databases and registry websites to identify eligible randomized controlled trials (RCTs) comparing IF versus control groups. A direct meta-analysis using a fixed-effect model was conducted to pool the risk differences regarding common AEs and dropouts. Study quality was assessed by using the Jadad scale. Pre-specified subgroup and sensitivity analyses were conducted to explore potential heterogeneity.

Results: A total of 15 RCTs involving 1,365 adult individuals were included. Findings did not show a significant difference between IF and Control in risk rate of fatigue [0%, 95% confidence interval (CI), -1% to 2%; P = 0.61], headache [0%, 95%CI: -1% to 2%; P = 0.86] and dropout [1%, 95%CI: -2% to 4%; P = 0.51]. However, a numerically higher risk of dizziness was noted among the IF alone subgroup with non-early time restricted eating [3%, 95%CI: -0% to 6%; P = 0.08].

Conclusions: This meta-analysis suggested that IF was not associated with a greater risk of AEs in adult patients affected by overweight or obesity. Additional large-scale RCTs stratified by key confounders and designed to evaluate the long-term effects of various IF regimens are needed to ascertain these AEs profile.

背景:尽管间歇性禁食广泛用于超重或肥胖症患者,但全面总结间歇性禁食不良事件(AEs)概况的证据却很少:我们搜索了主要的电子数据库和注册网站,以确定符合条件的随机对照试验(RCT),这些试验比较了间歇性禁食组和对照组。采用固定效应模型进行直接荟萃分析,以汇集常见AEs和辍学的风险差异。研究质量采用 Jadad 量表进行评估。进行了预先指定的亚组和敏感性分析,以探讨潜在的异质性:共纳入了 15 项 RCT,涉及 1,365 名成人。研究结果显示,在疲劳风险率[0%,95% 置信区间(CI):-1% 至 2%;P = 0.61]、头痛风险率[0%,95%CI:-1% 至 2%;P = 0.86]和辍学风险率[1%,95%CI:-2% 至 4%;P = 0.51]方面,IF 和对照组之间没有显著差异。然而,在不限制进食时间的单用 IF 亚组中,出现头晕的风险较高[3%,95%CI:-0% 至 6%;P = 0.08]:这项荟萃分析表明,在受超重或肥胖影响的成年患者中,中性食物与发生 AEs 的更大风险无关。要确定这些 AEs 的情况,还需要进行更多大规模的 RCT 研究,根据主要的混杂因素进行分层,并评估各种 IF 方案的长期效果。
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引用次数: 0
Differences in the cost and environmental impact between the current diet in Brazil and healthy and sustainable diets: a modeling study. 巴西当前饮食与健康和可持续饮食在成本和环境影响方面的差异:一项模型研究。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-09 DOI: 10.1186/s12937-024-00973-x
Thaís Cristina Marquezine Caldeira, Stefanie Vandevijvere, Boyd Swinburn, Sally Mackay, Rafael Moreira Claro

Background: While healthy and sustainable diets benefit human and planetary health, their monetary cost has a direct impact on consumer food choices. This study aimed to identify the cost and environmental impact of the current Brazilian diet (CBD) and compare it with healthy and sustainable diets.

Methods: Data from the Brazilian Household Budget Survey 2017/18 and the Footprints of Foods and Culinary Preparations Consumed in Brazil database were used for a modeling study comparing the cost of healthy and sustainable diets (based on the Brazilian Dietary Guidelines (BDG) diet and the EAT-Lancet diet) versus the CBD. The DIETCOST program generated multiple food baskets for each scenario (Montecarlo simulations). Nutritional quality, cost, and environmental impact measures (carbon footprint (CF) and water footprint (WF)) were estimated for all diets and compared by ANOVA. Simple linear regressions used standardized environmental impacts measures to estimate differentials in costs and environmental impacts among diets scenarios.

Results: We observed significant differences in costs/1000 kcal. The BDG diet was cheaper (BRL$4.9 (95%IC:4.8;4.9) ≈ USD$1.5) than the CBD (BRL$5.6 (95%IC:5.6;5.7) ≈ USD$1.8) and the EAT-Lancet diet (BRL$6.1 (95%IC:6.0;6.1) ≈ USD$1.9). Ultra-processed foods (UPF) and red meat contributed the most to the CBD cost/1000 kcal, while fruits and vegetables made the lowest contribution to CBD. Red meat, sugary drinks, and UPF were the main contributors to the environmental impacts of the CBD. The environmental impact/1000 kcal of the CBD was nearly double (CF:3.1 kg(95%IC: 3.0;3.1); WF:2,705 L 95%IC:2,671;2,739)) the cost of the BDG diet (CF:1.4 kg (95%IC:1.4;1.4); WF:1,542 L (95%IC:1,524;1,561)) and EAT-Lancet diet (CF:1.1 kg (95%IC:1.0;1.1); WF:1,448 L (95%IC:1,428;1,469)). A one standard deviation increase in standardized CF corresponded to an increase of BRL$0.48 in the cost of the CBD, similar to standardized WF (BRL$0.56). A similar relationship between the environmental impact and the cost of the BDG (CF: BRL$0.20; WF: BRL$0.33) and EAT-Lancet (CF: BRL$0.04; WF: BRL$0.18) was found, but with a less pronounced effect.

Conclusions: The BDG diet was cost-effective, while the EAT-Lancet diet was slightly pricier than the CBD. The CBD presented almost double the CF and WF compared to the BDG and EAT-Lancet diets. The lower cost in each diet was associated with lower environmental impact, particularly for the BDG and EAT-Lancet diets. Multisectoral public policies must be applied to guide individuals and societies towards healthier and more sustainable eating patterns.

背景:健康和可持续饮食有利于人类和地球健康,但其货币成本对消费者的食品选择有直接影响。本研究旨在确定当前巴西饮食(CBD)的成本和环境影响,并将其与健康和可持续饮食进行比较:这项建模研究使用了 2017/18 年巴西家庭预算调查的数据以及巴西食品和烹饪制剂消费足迹数据库的数据,比较了健康和可持续饮食(基于巴西膳食指南(BDG)饮食和 EAT-Lancet 饮食)与 CBD 的成本。DIETCOST 程序为每种方案生成了多个食物篮子(蒙特卡罗模拟)。对所有膳食的营养质量、成本和环境影响指标(碳足迹(CF)和水足迹(WF))进行估算,并通过方差分析进行比较。简单线性回归使用标准化的环境影响指标来估算不同饮食方案的成本和环境影响差异:结果:我们观察到成本/1000 千卡有明显差异。BDG饮食(4.9 BRL$4.9 (95%IC:4.8;4.9) ≈ USD$1.5)比CBD饮食(5.6 BRL$5.6 (95%IC:5.6;5.7) ≈ USD$1.8)和EAT-Lancet饮食(6.1 BRL$6.1 (95%IC:6.0;6.1) ≈ USD$1.9)便宜。超加工食品(UPF)和红肉对 CBD 成本/1000 千卡的贡献最大,而水果和蔬菜对 CBD 的贡献最小。红肉、含糖饮料和超加工食品是造成 CBD 环境影响的主要因素。CBD 的环境影响/1000 千卡几乎是 BDG 饮食成本的两倍(CF:3.1 千克(95%IC:3.0;3.1);WF:2,705 千卡(95%IC:2,671;2,739))(CF:1.4 kg (95%IC:1.4;1.4); WF:1,542 L (95%IC:1,524;1,561)) 和 EAT-Lancet 日粮 (CF:1.1 kg (95%IC:1.0;1.1); WF:1,448 L (95%IC:1,428;1,469)) 的成本。标准化 CF 值每增加一个标准差,CBD 的成本就会增加 0.48 BRL,与标准化 WF 值(0.56 BRL)相似。环境影响与 BDG(CF:0.20 BRL$;WF:0.33 BRL$)和 EAT-Lancet(CF:0.04 BRL$;WF:0.18 BRL$)的成本之间存在类似的关系,但影响不那么明显:结论:BDG 日粮具有成本效益,而 EAT-Lancet 日粮的价格略高于 CBD 日粮。与 BDG 和 EAT-Lancet 日粮相比,CBD 日粮的 CF 和 WF 几乎是后者的两倍。每种日粮的成本较低,对环境的影响也较小,尤其是 BDG 和 EAT-Lancet 日粮。必须采用多部门公共政策,引导个人和社会采用更健康、更可持续的饮食模式。
{"title":"Differences in the cost and environmental impact between the current diet in Brazil and healthy and sustainable diets: a modeling study.","authors":"Thaís Cristina Marquezine Caldeira, Stefanie Vandevijvere, Boyd Swinburn, Sally Mackay, Rafael Moreira Claro","doi":"10.1186/s12937-024-00973-x","DOIUrl":"10.1186/s12937-024-00973-x","url":null,"abstract":"<p><strong>Background: </strong>While healthy and sustainable diets benefit human and planetary health, their monetary cost has a direct impact on consumer food choices. This study aimed to identify the cost and environmental impact of the current Brazilian diet (CBD) and compare it with healthy and sustainable diets.</p><p><strong>Methods: </strong>Data from the Brazilian Household Budget Survey 2017/18 and the Footprints of Foods and Culinary Preparations Consumed in Brazil database were used for a modeling study comparing the cost of healthy and sustainable diets (based on the Brazilian Dietary Guidelines (BDG) diet and the EAT-Lancet diet) versus the CBD. The DIETCOST program generated multiple food baskets for each scenario (Montecarlo simulations). Nutritional quality, cost, and environmental impact measures (carbon footprint (CF) and water footprint (WF)) were estimated for all diets and compared by ANOVA. Simple linear regressions used standardized environmental impacts measures to estimate differentials in costs and environmental impacts among diets scenarios.</p><p><strong>Results: </strong>We observed significant differences in costs/1000 kcal. The BDG diet was cheaper (BRL$4.9 (95%IC:4.8;4.9) ≈ USD$1.5) than the CBD (BRL$5.6 (95%IC:5.6;5.7) ≈ USD$1.8) and the EAT-Lancet diet (BRL$6.1 (95%IC:6.0;6.1) ≈ USD$1.9). Ultra-processed foods (UPF) and red meat contributed the most to the CBD cost/1000 kcal, while fruits and vegetables made the lowest contribution to CBD. Red meat, sugary drinks, and UPF were the main contributors to the environmental impacts of the CBD. The environmental impact/1000 kcal of the CBD was nearly double (CF:3.1 kg(95%IC: 3.0;3.1); WF:2,705 L 95%IC:2,671;2,739)) the cost of the BDG diet (CF:1.4 kg (95%IC:1.4;1.4); WF:1,542 L (95%IC:1,524;1,561)) and EAT-Lancet diet (CF:1.1 kg (95%IC:1.0;1.1); WF:1,448 L (95%IC:1,428;1,469)). A one standard deviation increase in standardized CF corresponded to an increase of BRL$0.48 in the cost of the CBD, similar to standardized WF (BRL$0.56). A similar relationship between the environmental impact and the cost of the BDG (CF: BRL$0.20; WF: BRL$0.33) and EAT-Lancet (CF: BRL$0.04; WF: BRL$0.18) was found, but with a less pronounced effect.</p><p><strong>Conclusions: </strong>The BDG diet was cost-effective, while the EAT-Lancet diet was slightly pricier than the CBD. The CBD presented almost double the CF and WF compared to the BDG and EAT-Lancet diets. The lower cost in each diet was associated with lower environmental impact, particularly for the BDG and EAT-Lancet diets. Multisectoral public policies must be applied to guide individuals and societies towards healthier and more sustainable eating patterns.</p>","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correlation between serum trimethylamine-N-oxide and body fat distribution in middle-aged and older adults: a prospective cohort study. 中老年人血清三甲胺-N-氧化物与体内脂肪分布的相关性:一项前瞻性队列研究。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-09 DOI: 10.1186/s12937-024-00974-w
Si Chen, Xiao-Yan Chen, Zi-Hui Huang, Ai-Ping Fang, Shu-Yi Li, Rong-Zhu Huang, Yu-Ming Chen, Bi-Xia Huang, Hui-Lian Zhu

Background: Trimethylamine-N-oxide (TMAO) is linked with obesity, while limited evidence on its relationship with body fat distribution. Herein, we investigated the associations between serum TMAO and longitudinal change of fat distribution in this prospective cohort study.

Methods: Data of 1964 participants (40-75y old) from Guangzhou Nutrition and Health Study (GNHS) during 2008-2014 was analyzed. Serum TMAO concentration was quantified by HPLC-MS/MS at baseline. The body composition was assessed by dual-energy X-ray absorptiometry at each 3-y follow-up. Fat distribution parameters were fat-to-lean mass ratio (FLR) and trunk-to-leg fat ratio (TLR). Fat distribution changes were derived from the coefficient of linear regression between their parameters and follow-up duration.

Results: After an average of 6.2-y follow-up, analysis of covariance (ANCOVA) and linear regression displayed women with higher serum TMAO level had greater increments in trunk FLR (mean ± SD: 1.47 ± 4.39, P-trend = 0.006) and TLR (mean ± SD: 0.06 ± 0.24, P-trend = 0.011). Meanwhile, for women in the highest TMAO tertile, linear mixed-effects model (LMEM) analysis demonstrated the annual estimated increments (95% CI) were 0.03 (95% CI: 0.003 - 0.06, P = 0.032) in trunk FLR and 1.28 (95% CI: -0.17 - 2.73, P = 0.083) in TLR, respectively. In men, there were no similar significant observations. Sensitivity analysis yielded consistent results.

Conclusion: Serum TMAO displayed a more profound correlation with increment of FLR and TLR in middle-aged and older community-dwelling women in current study. More and further studies are still warranted in the future.

Trial registration: NCT03179657.

背景:三甲胺-N-氧化物(TMAO)与肥胖有关,但其与体内脂肪分布关系的证据有限。在这项前瞻性队列研究中,我们探讨了血清 TMAO 与脂肪分布纵向变化之间的关系:方法:分析 2008-2014 年期间广州营养与健康研究(GNHS)中 1964 名参与者(40-75 岁)的数据。采用 HPLC-MS/MS 对基线血清 TMAO 浓度进行定量。每3年随访一次,采用双能X射线吸收测定法评估身体成分。脂肪分布参数为脂肪与瘦体重比(FLR)和躯干与腿部脂肪比(TLR)。脂肪分布变化是根据其参数与随访时间之间的线性回归系数得出的:经过平均 6.2 年的随访,协方差分析(ANCOVA)和线性回归显示,血清 TMAO 水平越高的女性,其躯干 FLR(平均值±标准差:1.47±4.39,P-趋势 = 0.006)和 TLR(平均值±标准差:0.06±0.24,P-趋势 = 0.011)的增量越大。同时,线性混合效应模型(LMEM)分析表明,TMAO最高三分位数的女性躯干FLR和TLR的年估计增量(95% CI)分别为0.03(95% CI:0.003 - 0.06,P = 0.032)和1.28(95% CI:-0.17 - 2.73,P = 0.083)。在男性中,没有类似的显著观察结果。敏感性分析结果一致:结论:在目前的研究中,血清 TMAO 与中老年社区女性的 FLR 和 TLR 增量有更密切的相关性。结论:在本次研究中,血清 TMAO 与中老年社区居住妇女的 FLR 和 TLR 增量有更密切的相关性:NCT03179657.
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引用次数: 0
Identifying the barriers and facilitators to fruit and vegetable consumption in rural Australian adults: a mixed methods analysis. 确定澳大利亚农村成年人食用水果和蔬菜的障碍和促进因素:混合方法分析。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-06-28 DOI: 10.1186/s12937-024-00972-y
Brooke T Carroll, Sarah A McNaughton, Kate E Parker, Laura E Marchese, Katherine M Livingstone

Background: Low fruit and vegetable consumption is a leading contributor to non-communicable disease risk. However, understanding of barriers and facilitators to fruit and vegetable intake in rural settings is limited. This study used a mixed methods approach to determine the barriers and facilitators to increasing fruit and vegetable intake in rural Australian adults and to identify if these varied by gender.

Methods: Quantitative and qualitative data were used from the 2019 Active Living Census, completed by adults living in north-west Victoria, Australia. Data were collected on fruit and vegetable intakes and barriers and facilitators to meeting fruit and vegetable recommendations. Multivariate logistic regression analyses were used to investigate the association between facilitators, classified using the socio-ecological framework, and meeting recommendations. Machine learning was used to automate content analysis of open ended information on barriers.

Results: A total of 13,464 adults were included in the quantitative analysis (51% female; mean age 48 [SE 0.17] years) with 48% and 19% of participants consuming the recommended two serves of fruit and five serves of vegetables daily, respectively. Strongest facilitators to fruit consumption were at the individual level: never smoked (OR: 2.12 95% CI: 1.83-2.45) and not drinking alcohol (OR: 1.47 95% CI: 1.31-1.64). Strongest facilitators for vegetable consumption were found at all levels; i.e., individual level: used to smoke (OR: 1.48 95% CI: 1.21-1.80), social-environmental level: living with three or more people (OR: 1.41 95% CI: 1.22-1.63), and physical-environmental level: use community gardens (OR: 1.20 95% CI: 1.07-1.34). Qualitative analyses (fruit n = 5,919; vegetable n = 9,601) showed that barriers to fruit consumption included a preference for other snacks and desire to limit sugar content, whilst lack of time and unachievable guidelines were barriers for vegetables. Barriers and facilitators differed by gender; females experienced barriers due to having a more varied diet while males reported a dislike of the taste.

Conclusions: Barriers and facilitators to fruit and vegetable consumption among rural Australian adults were identified across all levels of the socio-ecological framework and varied between fruit and vegetables and by gender. Strategies that address individual, social, and physical-level barriers are required to improve consumption.

背景:水果和蔬菜摄入量低是导致非传染性疾病风险的一个主要因素。然而,人们对农村地区水果和蔬菜摄入量的障碍和促进因素了解有限。本研究采用混合方法确定澳大利亚农村成年人增加水果和蔬菜摄入量的障碍和促进因素,并确定这些因素是否因性别而异:研究使用了澳大利亚维多利亚州西北部成年人填写的 "2019 年积极生活普查 "中的定量和定性数据。收集的数据涉及水果和蔬菜摄入量以及达到水果和蔬菜建议摄入量的障碍和促进因素。多变量逻辑回归分析用于研究使用社会生态框架分类的促进因素与满足建议之间的关联。使用机器学习对有关障碍的开放式信息进行自动内容分析:共有 13,464 名成年人参与了定量分析(51% 为女性;平均年龄 48 [SE 0.17] 岁),其中 48% 和 19% 的参与者每天分别食用两份水果和五份蔬菜。在个人层面上,促进水果摄入量最大的因素是:从不吸烟(OR:2.12 95% CI:1.83-2.45)和不饮酒(OR:1.47 95% CI:1.31-1.64)。在所有层面都发现了蔬菜消费的最强促进因素,即个人层面:习惯吸烟(OR:1.48 95% CI:1.21-1.80),社会环境层面:与三人或三人以上共同生活(OR:1.41 95% CI:1.22-1.63),以及物理环境层面:使用社区菜园(OR:1.20 95% CI:1.07-1.34)。定性分析(水果 n = 5919;蔬菜 n = 9601)显示,水果消费的障碍包括偏爱其他零食和希望限制含糖量,而蔬菜消费的障碍则是缺乏时间和无法实现指南。阻碍因素和促进因素因性别而异;女性因饮食更多样化而遇到障碍,而男性则表示不喜欢水果的味道:结论:在澳大利亚农村成年人中,水果和蔬菜消费的障碍和促进因素在社会生态框架的各个层面上都有体现,并且因水果和蔬菜以及性别而异。需要采取针对个人、社会和物理层面障碍的策略来提高消费。
{"title":"Identifying the barriers and facilitators to fruit and vegetable consumption in rural Australian adults: a mixed methods analysis.","authors":"Brooke T Carroll, Sarah A McNaughton, Kate E Parker, Laura E Marchese, Katherine M Livingstone","doi":"10.1186/s12937-024-00972-y","DOIUrl":"https://doi.org/10.1186/s12937-024-00972-y","url":null,"abstract":"<p><strong>Background: </strong>Low fruit and vegetable consumption is a leading contributor to non-communicable disease risk. However, understanding of barriers and facilitators to fruit and vegetable intake in rural settings is limited. This study used a mixed methods approach to determine the barriers and facilitators to increasing fruit and vegetable intake in rural Australian adults and to identify if these varied by gender.</p><p><strong>Methods: </strong>Quantitative and qualitative data were used from the 2019 Active Living Census, completed by adults living in north-west Victoria, Australia. Data were collected on fruit and vegetable intakes and barriers and facilitators to meeting fruit and vegetable recommendations. Multivariate logistic regression analyses were used to investigate the association between facilitators, classified using the socio-ecological framework, and meeting recommendations. Machine learning was used to automate content analysis of open ended information on barriers.</p><p><strong>Results: </strong>A total of 13,464 adults were included in the quantitative analysis (51% female; mean age 48 [SE 0.17] years) with 48% and 19% of participants consuming the recommended two serves of fruit and five serves of vegetables daily, respectively. Strongest facilitators to fruit consumption were at the individual level: never smoked (OR: 2.12 95% CI: 1.83-2.45) and not drinking alcohol (OR: 1.47 95% CI: 1.31-1.64). Strongest facilitators for vegetable consumption were found at all levels; i.e., individual level: used to smoke (OR: 1.48 95% CI: 1.21-1.80), social-environmental level: living with three or more people (OR: 1.41 95% CI: 1.22-1.63), and physical-environmental level: use community gardens (OR: 1.20 95% CI: 1.07-1.34). Qualitative analyses (fruit n = 5,919; vegetable n = 9,601) showed that barriers to fruit consumption included a preference for other snacks and desire to limit sugar content, whilst lack of time and unachievable guidelines were barriers for vegetables. Barriers and facilitators differed by gender; females experienced barriers due to having a more varied diet while males reported a dislike of the taste.</p><p><strong>Conclusions: </strong>Barriers and facilitators to fruit and vegetable consumption among rural Australian adults were identified across all levels of the socio-ecological framework and varied between fruit and vegetables and by gender. Strategies that address individual, social, and physical-level barriers are required to improve consumption.</p>","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11214237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dietary choline intake in European and non-european populations: current status and future trends-a narrative review. 欧洲和非欧洲人群的膳食胆碱摄入量:现状和未来趋势--综述。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-06-28 DOI: 10.1186/s12937-024-00970-0
Ewelina Zuk, Grzegorz Nikrandt, Agata Chmurzynska

Background: Choline is a nutrient necessary for the proper functioning of the body with a multidimensional impact on human health. However, comprehensive studies evaluating the dietary intake of choline are limited. The aim of this narrative review is to analyze current trends in choline intake in European and non-European populations. The secondary aim was to discuss possible future choline trends.

Methods: The search strategy involved a systematic approach to identifying relevant literature that met specific inclusion criteria. Observational studies and randomized clinical trials were searched for in PubMed and Scopus databases from January 2016 to April 2024. This review includes the characteristics of study groups, sample sizes, methods used to assess choline intake and time period, databases used to determine intake, choline intakes, and the main sources of choline in the diet. The review considered all population groups for which information on choline intake was collected.

Results: In most studies performed in Europe after 2015 choline intake did not exceed 80% of the AI standard value. The mean choline intake for adults in different European countries were 310 mg/day, while the highest value was reported for Polish men at 519 mg/day. In non-European countries, mean choline intakes were 293 mg/day and above. The main reported sources of choline in the diet are products of animal origin, mainly eggs and meat. The available data describing the potential intake of these products in the EU in the future predict an increase in egg intake by another 8% compared to 2008-2019 and a decrease in meat intake by about 2 kg per capita from 2018 to 2030.

Conclusions: In the last decade, choline intake among adults has been insufficient, both in Europe and outside it. In each population group, including pregnant women, choline intake has been lower than recommended. Future choline intake may depend on trends in meat and egg consumption, but also on the rapidly growing market of plant-based products. However, the possible changes in the intake of the main sources of choline may lead to either no change or a slight increase in overall choline intake.

背景:胆碱是人体正常运作所必需的营养物质,对人体健康有多方面的影响。然而,对胆碱膳食摄入量进行评估的全面研究十分有限。本综述旨在分析欧洲和非欧洲人群胆碱摄入量的当前趋势。其次是讨论胆碱未来可能的发展趋势:检索策略包括采用系统方法来确定符合特定纳入标准的相关文献。在 PubMed 和 Scopus 数据库中搜索了 2016 年 1 月至 2024 年 4 月期间的观察性研究和随机临床试验。本综述包括研究群体的特征、样本大小、评估胆碱摄入量的方法和时间段、用于确定摄入量的数据库、胆碱摄入量以及膳食中胆碱的主要来源。综述考虑了所有收集到胆碱摄入量信息的人群:2015 年后在欧洲进行的大多数研究中,胆碱摄入量均未超过 AI 标准值的 80%。欧洲各国成年人的平均胆碱摄入量为 310 毫克/天,波兰男性的最高值为 519 毫克/天。非欧洲国家的平均胆碱摄入量为 293 毫克/天及以上。据报道,膳食中胆碱的主要来源是动物源性产品,主要是蛋类和肉类。现有数据描述了欧盟未来这些产品的潜在摄入量,预测鸡蛋摄入量将比 2008-2019 年再增加 8%,肉类摄入量从 2018 年到 2030 年人均减少约 2 千克:在过去十年中,无论是在欧洲还是在欧洲以外地区,成年人的胆碱摄入量都不足。包括孕妇在内的每个人群的胆碱摄入量都低于建议摄入量。未来的胆碱摄入量可能取决于肉类和蛋类的消费趋势,也取决于快速增长的植物性产品市场。不过,胆碱主要来源摄入量的可能变化可能会导致胆碱总摄入量不变或略有增加。
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Nutrition Journal
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