BMJ Nutrition, Prevention and Health最新文献_第2页

Plant-based diets and the incidence of cardiovascular disease: the Million Veteran Program 植物性饮食和心血管疾病的发病率:百万退伍军人计划

BMJ Nutrition, Prevention and Health

Pub Date : 2023-10-25 DOI: 10.1136/bmjnph-2021-000401

Yanping Li, Dong D Wang, Xuan-Mai T Nguyen, Rebecca J Song, Yuk-Lam Ho, Frank B Hu, Walter C Willett, Peter W F Wilson, Kelly Cho, John Michael Gaziano, Luc Djousse

Background A healthful plant-based diet was associated with lower risks of coronary heart disease and type 2 diabetes, and a favourable profile of adiposity-associated biomarkers, while an unhealthful plant-based diet was associated with elevated risk of cardiometabolic disease in health professional populations. However, little is known about the associations between plant-based dietary patterns and risk of cardiovascular disease (CVD) in US veterans. Methods The study population consisted of 148 506 participants who were free of diabetes, CVD and cancer at baseline in the Veterans Affairs (VA) Million Veteran Program. Diet was assessed using a Food Frequency Questionnaire at baseline. We calculated an overall Plant-Based Diet Index (PDI), a healthful PDI (hPDI) and an unhealthful PDI (uPDI). The CVD endpoints included non-fatal myocardial infarction (MI) and acute ischaemic stroke (AIS) identified through high-throughput phenotyping algorithms approach and fatal CVD events identified by searching the National Death Index. Results With up to 8 years of follow-up, we documented 5025 CVD cases. After adjustment for confounding factors, a higher PDI was significantly associated with a lower risk of CVD (HR comparing extreme quintiles=0.75, 95% CI 0.68 to 0.82, P trend <0.0001). We observed an inverse association between hPDI and the risk of CVD (HR comparing extreme quintiles=0.71, 95% CI 0.64 to 0.78, P trend <0.001), whereas uPDI was positively associated with the risk of CVD (HR comparing extreme quintiles=1.12, 95% CI 1.02 to 1.24, P trend <0.001). We found similar associations of hPDI with subtypes of CVD; a 10-unit increment in hPDI was associated with HRs (95% CI) of 0.81 (0.75 to 0.87) for fatal CVD, 0.86 (0.79 to 0.94) for non-fatal MI and 0.86 (0.78 to 0.95) for non-fatal AIS. Conclusions Plant-based dietary pattern enriched with healthier plant foods was associated with a substantially lower CVD risk in US veterans.

健康的植物性饮食与较低的冠心病和2型糖尿病风险以及有利的脂肪相关生物标志物相关，而在卫生专业人群中，不健康的植物性饮食与心脏代谢疾病风险升高相关。然而，在美国退伍军人中，人们对植物性饮食模式与心血管疾病(CVD)风险之间的关系知之甚少。方法研究人群包括1448506名在退伍军人事务(VA)百万退伍军人计划基线时无糖尿病、心血管疾病和癌症的参与者。基线时使用食物频率问卷对饮食进行评估。我们计算了总体植物性饮食指数(PDI)、健康PDI (hPDI)和不健康PDI (uPDI)。CVD终点包括通过高通量表型算法确定的非致死性心肌梗死(MI)和急性缺血性卒中(AIS)，以及通过搜索国家死亡指数确定的致死性CVD事件。结果在长达8年的随访中，我们记录了5025例CVD病例。校正混杂因素后，较高的PDI与较低的CVD风险显著相关(HR比较极端五分位数=0.75,95% CI 0.68至0.82,P趋势<0.0001)。我们观察到hPDI与CVD风险呈负相关(HR比较极端五分位数=0.71,95% CI 0.64至0.78,P趋势<0.001)，而uPDI与CVD风险呈正相关(HR比较极端五分位数=1.12,95% CI 1.02至1.24,P趋势<0.001)。我们发现hPDI与CVD亚型有类似的关联;10个单位的hPDI增加与致死性心血管疾病的hr (95% CI)相关，非致死性心肌梗死为0.86(0.79至0.94)，非致死性AIS为0.86(0.78至0.95)。结论:富含健康植物性食物的植物性饮食模式与美国退伍军人心血管疾病风险显著降低相关。

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引用次数: 1

Time to treat the climate and nature crisis as one indivisible global health emergency 是时候将气候和自然危机视为一个不可分割的全球卫生紧急事件

BMJ Nutrition, Prevention and Health

Pub Date : 2023-10-25 DOI: 10.1136/bmjnph-2023-000804

Chris Zielinski

引用次数: 0

Embracing systems biology: a paradigm shift in modern medicine for identifying and treating nutritional deficiencies 拥抱系统生物学:现代医学识别和治疗营养缺乏症的范式转变

BMJ Nutrition, Prevention and Health

Pub Date : 2023-10-19 DOI: 10.1136/bmjnph-2023-000787

Ramona M Wallace

引用次数: 0

Effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism: a national inpatient database study 营养不良对急性肺栓塞住院治疗结果的影响:一项全国住院患者数据库研究

BMJ Nutrition, Prevention and Health

Pub Date : 2023-10-17 DOI: 10.1136/bmjnph-2023-000705

Si Li, Ka U Lio, Truong-An Ho, Yichen Wang, Parth Rali

Background To evaluate the occurrence of malnutrition in pulmonary embolism (PE)-related hospitalisations and assess the impact of malnutrition on the outcomes of patients with PE. Methods A retrospective observational study using data extracted from the Nationwide Inpatient Sample from 2016 to 2018. Hospitalisations with a principal diagnosis of PE were obtained using International Classification of Diseases, Tenth Revision codes and divided into groups based on a secondary diagnosis of malnutrition. Results Of 563 135 PE hospitalisations, 30 495 (5.4%) had malnutrition. PE patients with malnutrition were older (mean age±SD, 69.1±14.5 vs 62.3±16.6, p<0.001) and with higher Charlson Comorbidity Index score (3 to 5, 24.8% vs 12.9%, p<0.001). Concurrent malnutrition was associated with higher adjusted OR (aOR) of in-hospital mortality (aOR 2.43, 95% CI 2.18 to 2.70, p<0.001), acute kidney injury (aOR 1.56, 95% CI 1.45 to 1.67, p<0.001), sepsis (aOR 4.37, 95% CI 3.79 to 5.03, p<0.001), shock (aOR 2.52, 95% CI 2.25 to 2.81, p<0.001), acidosis (aOR 2.55, 95% CI 2.34 to 2.77, p<0.001) and mechanical ventilation (aOR 2.95, 95% CI 2.61 to 3.33, p<0.001). Patients with PE and malnutrition had an increased mean length of stay (adjusted difference 3.39 days, 95% CI 3.14 to 3.65, p<0.001), hospital charges (adjusted difference US$34 802.11, 95% CI US$31 005.01 to US$38 599.22, p<0.001) and costs (adjusted difference US$8 332.01, 95% CI US$7489.09 to US$9174.94, p<0.001). Conclusion Concurrent PE and malnutrition were associated with worse outcomes. The study highlights the importance of identifying malnutrition in patients with PE to improve outcomes and reduce healthcare utilisation.

研究背景:评估肺栓塞(PE)相关住院患者营养不良的发生率，并评估营养不良对PE患者预后的影响。方法采用2016 - 2018年全国住院患者样本数据进行回顾性观察研究。主要诊断为肺水肿的住院情况是根据《国际疾病分类》第十次修订代码获得的，并根据营养不良的次要诊断进行分组。结果563135例PE住院患者中，30495例(5.4%)存在营养不良。营养不良的PE患者年龄较大(平均年龄±SD, 69.1±14.5 vs 62.3±16.6,p < 0.001)， Charlson合并症指数评分较高(3 ~ 5,24.8% vs 12.9%， p < 0.001)。并发营养不良与住院死亡率较高的调整OR (aOR)相关(aOR 2.43, 95% CI 2.18 ~ 2.70, p<0.001)、急性肾损伤(aOR 1.56, 95% CI 1.45 ~ 1.67, p<0.001)、败血症(aOR 4.37, 95% CI 3.79 ~ 5.03, p<0.001)、休克(aOR 2.52, 95% CI 2.25 ~ 2.81, p<0.001)、酸中毒(aOR 2.55, 95% CI 2.34 ~ 2.77, p<0.001)和机械通气(aOR 2.95, 95% CI 2.61 ~ 3.33, p<0.001)。PE和营养不良患者的平均住院时间(调整差值3.39天，95% CI 3.14至3.65,p<0.001)、住院费用(调整差值34 802.11美元，95% CI 31 005.01至38 599.22美元，p<0.001)和费用(调整差值8 332.01美元，95% CI 7489.09至9174.94美元，p<0.001)增加。结论并发PE和营养不良与较差的预后相关。该研究强调了确定PE患者营养不良对改善预后和减少医疗保健利用的重要性。

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引用次数: 0

Postpartum lifestyle behaviour among women with prior gestational diabetes mellitus: evidence from the HUNT study 有妊娠期糖尿病的妇女产后生活方式行为:来自HUNT研究的证据

BMJ Nutrition, Prevention and Health

Pub Date : 2023-10-11 DOI: 10.1136/bmjnph-2022-000612

Hanne Ringvoll, Marit Kolberg, Vegar Rangul, Ingrid Hafskjold, Eirin Beate Haug, Rune Blomhoff, Hege Berg Henriksen, Julie Horn

Introduction Women with a history of gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Recommendations for postpartum follow-up include targeted lifestyle advice to lower the risk. The aim of this study was to compare postpartum lifestyle behaviours and perceptions among women with and without a history of GDM. In addition, we examined whether lifestyle behaviours of women with a history of GDM participating in a lifestyle intervention study differed from lifestyle behaviours of women with a history of GDM in the general population. Research design and methods We linked data from the fourth survey of the population-based Trøndelag Health Study (HUNT4) to information from the Medical Birth Registry of Norway for women with registered births between 2000 and 2019. Using logistic regression, we compared lifestyle behaviours in women with and without GDM. In secondary analyses, lifestyle behaviours in women with GDM participating in a postpartum lifestyle intervention study were compared with HUNT participants with GDM using Fisher’s exact tests/t-tests. Results A high proportion of the women in our population, regardless of GDM history, reported several unhealthy lifestyle behaviours. We found no significant association between history of GDM and lifestyle behaviours. The lifestyle intervention study for women with a history of GDM appeared to recruit women with more favourable lifestyle behaviours. Conclusions Women, regardless of GDM history, could potentially benefit from further support for lifestyle improvement, but it may be especially important in women with a history of GDM given their increased risk of T2DM and CVD. Interventions targeting women with GDM might not reach the women with the unhealthiest lifestyle behaviours, and measures to reach out to all women should be further investigated.

有妊娠期糖尿病(GDM)病史的女性患2型糖尿病(T2DM)和心血管疾病(CVD)的风险增加。产后随访的建议包括有针对性的生活方式建议，以降低风险。本研究的目的是比较有和没有GDM病史的妇女的产后生活方式行为和观念。此外，我们研究了参与生活方式干预研究的GDM病史女性的生活方式行为是否与一般人群中GDM病史女性的生活方式行为不同。研究设计和方法我们将基于人群的Trøndelag健康研究(HUNT4)第四次调查的数据与挪威医学出生登记处2000年至2019年登记出生妇女的信息联系起来。使用逻辑回归，我们比较了患有和不患有GDM的女性的生活方式行为。在二次分析中，使用Fisher精确检验/t检验比较参加产后生活方式干预研究的GDM妇女的生活方式行为与HUNT的GDM参与者的生活方式行为。结果在我们的人群中，无论是否有GDM病史，都有很高比例的女性报告了一些不健康的生活方式行为。我们发现GDM病史和生活方式行为之间没有显著的关联。对有GDM病史的女性进行的生活方式干预研究似乎招募了更有利的生活方式行为的女性。结论:无论女性是否有GDM病史，都可能从生活方式改善的进一步支持中获益，但对于有GDM病史的女性来说，这可能尤其重要，因为她们患T2DM和CVD的风险增加。针对患有GDM的妇女的干预措施可能无法覆盖生活方式最不健康的妇女，应该进一步调查针对所有妇女的措施。

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引用次数: 0

Plant-based diet and COVID-19 severity: results from a cross-sectional study 植物性饮食与COVID-19严重程度:一项横断面研究的结果

BMJ Nutrition, Prevention and Health

Pub Date : 2023-10-04 DOI: 10.1136/bmjnph-2023-000688

Samira Soltanieh, Marieh Salavatizadeh, Tooba Ghazanfari, Soodeh Razeghi Jahromi, Zahra Yari, Mohammad Ali Mansournia, Maryam Nazemipour, Jalil Arab Kheradmand, Sussan K Ardestani, Sara Karimi, Azita Hekmatdoost

Although previous findings have shown the beneficial role of healthy eating pattern on the human immune system, the association between plant-based diet and COVID-19 severity has not yet been elucidated. This study aimed to determine the possible role of plant-based diet index (PDI) in COVID-19 severity. This cross-sectional, multicentral study was conducted on 141 patients with confirmed COVID-19. Dietary intakes of the patients were evaluated using a validated food frequency questionnaire. Then, PDI was compared between patients who needed to be hospitalised (considered severe cases), and those who got treatment at home (considered non-severe cases). After adjustment for confounders including age, sex, energy intake and body mass index, lower odds of hospitalisation were found for participants having a greater score of overall PDI (OR per 10 units increase: 0.42; 95% CI 0.22 to 0.80) and healthy PDI (OR per 10 unit increase: 0.45; 95% CI 0.26 to 0.78). In conclusion, our data presented that there is a relation between PDI and lower risk of hospitalisation in COVID-19 patients, possibly through boosting the immune function.

尽管之前的研究结果表明健康饮食模式对人体免疫系统有益，但植物性饮食与COVID-19严重程度之间的关系尚未得到阐明。本研究旨在确定植物性饮食指数(PDI)在COVID-19严重程度中的可能作用。这项横断面、多中心研究对141例确诊的COVID-19患者进行了研究。使用有效的食物频率问卷对患者的饮食摄入量进行评估。然后，比较需要住院治疗的患者(被认为是严重病例)和在家接受治疗的患者(被认为是非严重病例)之间的PDI。在对混杂因素(包括年龄、性别、能量摄入和体重指数)进行调整后，发现总体PDI得分较高的参与者住院的几率较低(每10个单位增加的OR: 0.42;95% CI 0.22 - 0.80)和健康PDI (OR / 10单位增加:0.45;95% CI 0.26 ~ 0.78)。总之，我们的数据显示，PDI与COVID-19患者住院风险降低之间存在关联，可能是通过增强免疫功能。

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引用次数: 0

Influence of care group participation on infant and young child feeding, dietary diversity, WASH behaviours and nutrition outcomes in rural Zimbabwe 护理小组参与对津巴布韦农村婴幼儿喂养、饮食多样性、讲卫生行为和营养结果的影响

BMJ Nutrition, Prevention and Health

Pub Date : 2023-09-14 DOI: 10.1136/bmjnph-2023-000627

Tonderayi Mathew Matsungo, Faith Kamazizwa, Tafadzwa Mavhudzi, Starlet Makota, Blessing Kamunda, Calvin Matsinde, Dexter Chagwena, Kudzai Mukudoka, Prosper Chopera

Background The care group approach (CGA) is a community-based nutrition behaviour change strategy centred on ‘peer-to-peer learning’ through women support groups. Objective To assess the impact of the CGA on the adoption of appropriate infant and young child feeding (IYCF), dietary diversity and water, sanitation and hygiene (WASH) practices, and associated nutrition-related outcomes. Methods A retrospective cohort study used a mixed-method approach in selected rural districts in Zimbabwe in June 2022. A structured questionnaire was used to collect data on IYCF, diet quality, WASH and child morbidity. Binary logistic regression was used to evaluate the association between exposure and outcome. Significance was at p<0.05. Results A total of 127 exposed and 234 controls were enrolled. There was no significant difference between exposed and controls on the prevalence of; diarrhoea (p = 0.659), cough (p=0.191) and fever (p=0.916). No significant difference was observed in the proportion ever breastfed (p=0.609), Children with Adequate Dietary Diversity Score (p=0.606) across the two groups. However, the proportion of families with adequate Household Dietary Diversity Score (HDDS) (p=0.005) and Minimum Dietary Diversity for Women (MDD-W) (p=0.009) were significantly higher in exposed than controls. Knowledge on all promoted behaviours was significantly higher in the exposed than in controls with the exception of exclusive breast feeding. While the practices were significantly higher in exposed compared with controls for: ‘Appropriate complementary feeding for children aged 6–24 months’ (p=0.001), ‘good nutrition for women of reproductive age’ (p=0.001), ‘production and consumption of diverse nutritious food’ (p=0.001) and ‘production and consumption of biofortified crops’ (p=0.001). Conclusions The results showed that CGA potential to increase knowledge and achieve nutrition and health-related behaviour change in low-income settings if integrated into existing community programmes. Interestingly, HDDS and MDD-W were significantly higher in exposed than controls. However, more research is required to obtain conclusive results.

护理小组方法(CGA)是一种以社区为基础的营养行为改变战略，其核心是通过妇女支持小组进行“同伴对同伴学习”。目的评估CGA对采用适当婴幼儿喂养(IYCF)、饮食多样性和水、环境卫生和个人卫生(WASH)做法以及相关营养相关结果的影响。方法于2022年6月在津巴布韦选定的农村地区采用混合方法进行回顾性队列研究。采用结构化问卷收集有关IYCF、饮食质量、WASH和儿童发病率的数据。使用二元逻辑回归来评估暴露与结果之间的关系。p < 0.05。结果共纳入暴露者127例，对照组234例。暴露组与对照组之间的患病率无显著差异;腹泻(p= 0.659)、咳嗽(p=0.191)、发热(p=0.916)。两组的母乳喂养比例(p=0.609)和饮食多样性充足儿童评分(p=0.606)无显著差异。然而，家庭膳食多样性评分(HDDS) (p=0.005)和女性最低膳食多样性评分(MDD-W) (p=0.009)充足的家庭比例在暴露组中显著高于对照组。除纯母乳喂养外，接触者对所有促进行为的了解明显高于对照组。与对照组相比，“为6-24个月的儿童提供适当的补充喂养”(p=0.001)、“为育龄妇女提供良好的营养”(p=0.001)、“生产和消费多种营养食品”(p=0.001)和“生产和消费生物强化作物”(p=0.001)的做法明显更高。结论:研究结果表明，如果将CGA纳入现有的社区方案，它有可能增加低收入环境的知识，并实现营养和健康相关行为的改变。有趣的是，暴露组的hdd和MDD-W明显高于对照组。然而，要获得结论性的结果，还需要更多的研究。

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引用次数: 0

Measurable and immeasurable spread of knowledge for research impact: a reflection on the validated NutComp tool 可测量和不可测量的知识传播对研究的影响:对经过验证的NutComp工具的反思

BMJ Nutrition, Prevention and Health

Pub Date : 2023-09-13 DOI: 10.1136/bmjnph-2023-000723

Lauren Ball, Breanna Lepre, Clare Van Dorssen

Background Contemporary research now includes effort to generate impact beyond the creation of new knowledge. Methods This report provides an illustrative case study of tactful research planning and dissemination for impact and provides an emerging pathway for others to holistically track reach, spread and uptake, to create a nuanced impact narrative. Results Nutrition Competence Tool (NutComp) is a validated tool that assesses the self-perceived competence of health professionals in providing nutrition care. Since open-access publication in 2015, it has been used by researchers and health professionals in 28 countries across 6 continents. The reach, spread, uptake and impact of NutComp are summarised, including indicators to support impact tracking for knowledge. Conclusion Given the complex phenomenon of research impact, careful planning is required to capture and attribute research impact.

当代研究现在包括努力产生超越创造新知识的影响。本报告提供了一个关于影响的巧妙研究规划和传播的说明性案例研究，并为其他人提供了一个整体跟踪影响、传播和吸收的新途径，以创建一个细致入微的影响叙事。结果营养能力评估工具(NutComp)是一种评估卫生专业人员提供营养护理自我感知能力的有效工具。自2015年开放获取出版以来，它已被六大洲28个国家的研究人员和卫生专业人员使用。总结了nutcompp的范围、传播、吸收和影响，包括支持跟踪知识影响的指标。鉴于研究影响的复杂现象，需要仔细规划以捕获和属性研究影响。

引用次数: 0

Do markers of adiposity and glycaemia mediate the association between low carbohydrate diet and cardiovascular risk factors: findings from the UK National Diet and Nutrition Survey (NDNS) 2008-2016. 肥胖和血糖标志物是否介导低碳水化合物饮食与心血管风险因素之间的关系：英国国家饮食和营养调查（NDNS）2008-2016的结果

BMJ Nutrition, Prevention and Health

Pub Date : 2023-08-30 eCollection Date: 2023-01-01 DOI: 10.1136/bmjnph-2022-000551

Cláudia Raulino Tramontt, Saad Mouti, Marjorie Lima Do Vale, Xunhan Li, Rajna Golubic, Sumantra Ray

Objectives: To examine the associations between low carbohydrate diet (LCD) and conventional cardiovascular risk factors and investigate whether these associations are mediated by body mass index (BMI), waist circumference (WC) and haemoglobin A1c (HbA1c) applying causal mediation analyses.

Methods: We included 3640 adults aged 45-80 years from the UK National Diet and Nutrition Survey programme (2008-2016) with data on dietary intake, anthropometric and biochemical parameters. Four hypothetical interventions were examined: (1) LCD, (2) Low carbohydrate (LC) and high fibre diet (LCHF), (3) LC and high saturated fat diet (LCHS) and (4) LC and high unsaturated fat diet (LCHU). BMI and WC were used as markers of obesity. Biochemical markers included HbA1c, total cholesterol, high-density lipoprotein and low-density lipoprotein (LDL) cholesterol, triglycerides, systolic and diastolic blood pressure and C reactive protein (CRP). BMI, WC and HbA1c were used as a mediator of the effects. The analysis was adjusted for sociodemographic characteristic, smoking, estimated total energy intake, alcohol consumption and antihypertensive medication. To identify a potential causal effect of LCD on cardiovascular disease (CVD) risk, we estimated the average treatment effect, and corresponding p values and CI for the total, indirect and direct effect of the treatment on the outcome.

Results: BMI, WC and HbA1c fully mediated the association between LCD and triglycerides and fully mediated the effects of LCHF on LDL, although BMI and WC were not sufficient to fully mediate the effects of LCHF on triglycerides and CRP. BMI alone fully mediated the effects of LCHS on HbA1c, triglycerides, LDL and CRP. None of these mediators explained the effect of LCHU on CVD risk markers.

Conclusion: The causal hypotheses tested in this study demonstrate that individuals on LCD with high fibre intakes improved their CVD markers as expected, but those on LCD who increase fat intake had no effects on CVD markers mediated by obesity and diabetes.

目的探讨低碳水化合物饮食（LCD）与传统心血管危险因素之间的相关性，并应用因果中介分析探讨这些相关性是否由体重指数（BMI）、腰围（WC）和血红蛋白A1c（HbA1c）介导。方法我们纳入了3640名年龄在45-80岁之间的英国国家饮食和营养调查项目（2008-2016）的成年人，包括饮食摄入量、人体测量和生化参数的数据。研究了四种假设的干预措施：（1）LCD，（2）低碳水化合物（LC）和高纤维饮食（LCHF），（3）LC和高饱和脂肪饮食（LCHS），（4）LC和低不饱和脂肪饮食。BMI和WC被用作肥胖的标志物。生化指标包括HbA1c、总胆固醇、高密度脂蛋白和低密度脂蛋白胆固醇、甘油三酯、收缩压和舒张压以及C反应蛋白。BMI、WC和HbA1c被用作效应的中介。该分析根据社会人口统计学特征、吸烟、估计的总能量摄入、饮酒量和抗高血压药物进行了调整。为了确定LCD对心血管疾病（CVD）风险的潜在因果影响，我们估计了平均治疗效果，以及治疗对结果的总、间接和直接影响的相应p值和CI。结果BMI、WC和HbA1c完全介导LCD与甘油三酯的关系，并完全介导LCHF对LDL的影响，尽管BMI和WC不足以完全介导LCOHF对甘油三酯和CRP的影响。单独的BMI完全介导了LCHS对HbA1c、甘油三酯、LDL和CRP的影响。这些介质都不能解释LCHU对CVD风险标志物的影响。结论本研究中检验的因果假设表明，摄入高纤维的LCD患者的CVD标志物如预期的那样得到了改善，但摄入高脂肪的LCD患者对肥胖和糖尿病介导的CVD标记物没有影响。

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引用次数: 0

Effectiveness of individual nutrition counselling for the prevention of undernutrition among elderly people living in depopulated areas: secondary analysis of a model project in Tsu city. 个人营养咨询对预防人口稀少地区老年人营养不良的有效性:对苏州市示范项目的二次分析

BMJ Nutrition, Prevention and Health

Pub Date : 2023-07-20 eCollection Date: 2023-01-01 DOI: 10.1136/bmjnph-2022-000576

Keiko Okumura, Shuhei Ichikawa, Hideki Wakabayashi, Young Jae Hong, Yuko Tokudome, Yousuke Takemura

Objectives: To examine the effectiveness of nutrition counselling (NC) in preventing undernutrition in elderly people living in depopulated areas.

Design: Participants were elderly people aged at least 65 years living in a depopulated area. Participants completed self-administered questionnaires evaluating nutritional status, frailty and body composition at the start of the study, after a non-NC period (3-month control) and after an NC period (3-month intervention). During the NC period, participants attended monthly 1-hour NC sessions over 3 months. Sessions were conducted in three areas (A, B and C), and the schedule was staggered so that the NC period in one area was conducted simultaneously with the non-NC period of the next. All sessions within an area were attended by the same registered dietitian. Outcomes were assessed three times: before the non-NC period, after the non-NC period and after the NC period. The effects of NC were assessed by comparing the results between the non-NC and NC periods of all participants, using the Cochran-Mantel-Haenszel stratified test.

Outcome measures: The primary outcome was undernutrition, as determined by the Mini Nutritional Assessment-Short Form. Secondary outcomes were Dietary Diversity Score (DVS), body weight and frailty. Body composition was also assessed.

Results: Of 106 individuals who joined the project, 61 completed the project and were analysed. The NC in this study had no effect on the primary outcome. DVS in area A was significantly higher after the NC period than after the non-NC period (p=0.012). Frailty in area C was significantly lower after the NC period than after the non-NC period (p=0.025). NC had no significant effects on the other outcomes.

Conclusions: NC improved food variety but did not improve nutritional status, frailty or body composition.

目的探讨营养咨询（NC）在预防人口减少地区老年人营养不良方面的有效性。设计参与者是居住在人口稀少地区的至少65岁的老年人。参与者在研究开始时、非NC期（3个月对照）后和NC期（三个月干预）后完成了评估营养状况、虚弱和身体成分的自填问卷。在NC期间，参与者参加了为期3个月的每月1小时的NC会议。会议在三个区域（A、B和C）进行，时间表交错，以便一个区域的NC时段与下一个区域非NC时段同时进行。一个区域内的所有课程都由同一注册营养师参加。对结果进行了三次评估：非NC期前、非NC期后和NC期后。通过比较所有参与者的非NC期和NC期的结果，使用Cochran-Mantel-Haenszel分层检验来评估NC的效果。结果测量主要结果是营养不良，由迷你营养评估（简称）确定。次要结果是饮食多样性评分（DVS）、体重和虚弱。还对身体成分进行了评估。结果在参与该项目的106人中，61人完成了该项目并进行了分析。本研究中的NC对主要结果没有影响。NC期后A区DVS明显高于非NC期（p=0.012）。NC期后C区虚弱明显低于非NC期后（p=0.025）。NC对其他结果无显著影响。结论NC改善了食物种类，但没有改善营养状况、虚弱或身体成分。

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引用次数: 0