在美国生活的南亚人（MASALA）研究中，遵守EAT-Lancet行星健康饮食和动脉粥样硬化介质中的心脏代谢风险标志物

IF 3.2 Q2 NUTRITION & DIETETICS

Current Developments in Nutrition Pub Date : 2025-06-01 DOI:10.1016/j.cdnut.2025.107468

Nilendra K Nair , Linh P Bui , Caleigh M Sawicki , Namratha R Kandula , Alka M Kanaya , Kyu Ha Lee , Meir J Stampfer , Walter C Willett , Shilpa N Bhupathiraju

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引用次数: 0

摘要

全球粮食系统对环境和人类健康产生重大影响，造成大量温室气体排放。目的：在南亚人群中，我们研究了反映EAT-Lancet推荐的新型行星健康饮食指数（PHDI）与心脏代谢风险之间的关系。方法我们分析来自MASALA研究参与者的基线数据（n = 891）和5年随访数据（n = 735）。PHDI包括15种食品成分，范围从0到最高140，得分越高表明对PHDI的遵守程度越高。我们使用多变量线性和逻辑回归模型来检验基线PHDI与心脏代谢危险因素之间的横断面和前瞻性（5-y）关联，调整了人口统计学、健康和生活方式因素以及结果的基线值（仅限前瞻性分析）。结果在MASALA研究参与者中（47%为女性，平均年龄55岁），平均PHDI评分为88.8 （SD 9.47）。前瞻性地，较高的PHDI与较低的空腹血糖（- 0.29±0.15%）、糖化血红蛋白（- 0.08±0.04%）、较高的高密度脂蛋白（0.40±0.17 mmol/L）、较低的体重（- 0.37±0.12 kg）、体重指数（BMI）（- 0.08±0.03 kg/m2）、腰围（- 0.49±0.17 cm）和收缩压（- 0.65±0.30 mmHg） (P <；0.05)。PHDI每升高10个单位，发生2型糖尿病的可能性降低20% （OR [95% CI]: 0.80[0.54, 0.86]）。横断面上，基线时，高10个单位的PHDI与（β±SE）空腹血糖（- 0.45±0.22%）和HbA1c（- 0.49±0.22%）、低密度脂蛋白（- 0.015±0.007 mmol/L）、CRP（- 5.40±2.42 ug/L）、高脂联素（4.67±2.02 mg/dL）、低体重（- 0.59±0.26 kg）、BMI（- 0.27±0.11 kg/m2）、腰围（- 025±0.29 cm）、内脏脂肪（- 1.37±1.32 cm2）和心包脂肪（- 0.58±0.43 cm3） (P <；0.05)。PHDI评分越高，肥胖（OR [95% CI]: 0.80[0.71, 0.92]）和超重（0.77[0.74,0.85]）的几率越低。结论：更坚持行星健康饮食与较低的心脏代谢危险因素和发生2型糖尿病的风险相关。

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Adherence to the EAT-Lancet Planetary Health Diet and Cardiometabolic Risk Markers in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study

Background

The global food system significantly impacts environmental and human health, contributing to substantial greenhouse gas emissions.

Objective

We examined associations between a novel Planetary Health Diet Index (PHDI) that reflects adherence to the EAT-Lancet recommendations and cardiometabolic risk in a cohort of South Asians.

Methods

We analyzed data from MASALA study participants with baseline (n = 891) and 5-y follow-up (n = 735) data. The PHDI comprised 15 food components and ranged from 0 to a maximum of 140, with higher scores indicating greater adherence to the PHDI. We used multivariable linear and logistic regression models to examine cross-sectional and prospective (5-y) associations between baseline PHDI and cardiometabolic risk factors, adjusting for demographic, health, and lifestyle factors and baseline values of the outcome (prospective analyses only).

Results

Among MASALA study participants (47% female, mean age 55 y), the mean PHDI score was 88.8 (SD 9.47). Prospectively, higher PHDI was associated with lower percentage difference in fasting glucose (−0.29 ± 0.15 %), glycated hemoglobin (HbA1c) (−0.08 ± 0.04%), higher high-density lipoprotein (0.40 ± 0.17 mmol/L), lower body weight (−0.37 ± 0.12 kg), body mass index (BMI) (−0.08 ± 0.03 kg/m²), waist circumference (−0.49 ± 0.17 cm), and systolic blood pressure (−0.65 ± 0.30 mmHg) (P < 0.05 for all). Each 10-unit higher PHDI was associated with a 20% lower likelihood of incident type 2 diabetes (OR [95% CI]: 0.80 [0.54, 0.86]). Cross-sectionally, at baseline, 10 unit higher PHDI was associated with (β ± SE) lower percentage difference in fasting glucose (−0.45 ± 0.22 %) and HbA1c (−0.49 ± 0.22%), lower LDL (−0.015 ± 0.007 mmol/L), CRP (−5.40 ± 2.42 ug/L), higher adiponectin (4.67 ± 2.02 mg/dL), lower body weight (−0.59 ± 0.26 kg), BMI (−0.27 ± 0.11 kg/m²), waist circumference (−025 ± 0.29 cm), visceral fat (−1.37 ± 1.32 cm²), and pericardial fat (−0.58 ± 0.43 cm³) (P < 0.05 for all). Higher PHDI scores were associated with lower odds of obesity (OR [95% CI]: 0.80 [0.71, 0.92]) and overweight (0.77 [0.74, 0.85]).