汕头市社区中老年素食女性膳食模式与骨健康的相关性研究
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摘要
目的调查汕头市社区中老年素食女性的膳食模式及与骨健康的关系,为制定其健康促进计划提供依据。方法于2017年7月-9月整群随机抽取汕头市龙湖区和潮阳区各1个佛堂的≥40岁的素食女性共127例为素食组,并按年龄1∶1匹配普食女性127例为普食组。采用回顾性问卷调查食物摄入频次及生活饮食习惯,运用超声骨密度仪测定右足跟骨骨密度。结果素食组骨密度BMD均值低于普食组(0. 38±0. 11 vs 0. 41±0. 11,P <0. 05)。素食组包括绝对素食者28例(22. 1%),乳-蛋素食者70例(55. 1%),半素食者29例(22. 8%),与普食组相比,其膳食中每周摄入频次的秩均值豆腐干较高(P <0. 05),而酸奶、鸡蛋、肉类、水产品较低(均P <0. 05)。多因素分析表明,年龄(OR=4. 752,95%CI:2. 515～8. 979)为被调查女性OP患病的危险因素,而较高的体质指数(OR=0. 861,95%CI:0. 785～0. 944)、摄入豆及豆制品(OR=0. 300,95%CI:0. 093～0. 973)为保护因素。结论汕头市社区中老年素食女性膳食中含钙高的食物摄入频次较低,骨密度偏低,须重视膳食结构的调整,预防骨质疏松症的发生。
Objective To investigate the correlation between dietary pattern and bone health of the middle aged and elderly female vegetarians in community of Shantou,and to provide scientific basis for preventive intervention of osteoporosis( OP).Methods A total of 127 female vegetarians who were over 40 years old,having adhered to a vegetarian diet and 127 age-matched female omnivores were recruited from a temple of Buddhism in Longhu and Chaoyang district by random cluster sampling from July to September 2017. Frequency of food intake and lifestyle were surveyed by retrospective questionnaire.Bone mineral density of right calcaneus was measured by ultrasound bone sonometers. Results Compared with female omnivores,bone mineral density of female vegetarians was statistically lower( 0. 38 ± 0. 11 vs 0. 41 ± 0. 11,P < 0. 05).Vegetarian samples could be classified into 28 vegans( 22. 1%),70 lacto-ovo vegetarians( 55. 1%) and 29 semi-vegetarians( 22. 8%). According to food frequency questionnaire,the mean ranks of frequency of eggs,yogurt,meat and sea food weekly intake in vegetarian diet were lower than omnivorous diet,while the mean rank of frequency of dried toufu weekly intake was higher( all P < 0. 05). Multivariable regression analysis indicated that age( OR = 4. 752,95% CI: 2. 515 ～ 8. 979)was risk factor of OP,while higher body mass index( OR = 0. 861,95% CI: 0. 785 ～ 0. 944) and eating soy and soy food( OR= 0. 300,95% CI: 0. 093 ～ 0. 973) were beneficial factors. Conclusion The middle aged and elderly female vegetarians in community of Shantou have lower intake frequency of foods high in calcium and have lower bone mineral density than female omnivores. To prevent the occurrence of OP,we should attach importance to the improvement of diet pattern of vegetarians in proper ways.
Objective To investigate the correlation between dietary pattern and bone health of the middle aged and elderly female vegetarians in community of Shantou,and to provide scientific basis for preventive intervention of osteoporosis( OP).Methods A total of 127 female vegetarians who were over 40 years old,having adhered to a vegetarian diet and 127 age-matched female omnivores were recruited from a temple of Buddhism in Longhu and Chaoyang district by random cluster sampling from July to September 2017. Frequency of food intake and lifestyle were surveyed by retrospective questionnaire.Bone mineral density of right calcaneus was measured by ultrasound bone sonometers. Results Compared with female omnivores,bone mineral density of female vegetarians was statistically lower( 0. 38 ± 0. 11 vs 0. 41 ± 0. 11,P < 0. 05).Vegetarian samples could be classified into 28 vegans( 22. 1%),70 lacto-ovo vegetarians( 55. 1%) and 29 semi-vegetarians( 22. 8%). According to food frequency questionnaire,the mean ranks of frequency of eggs,yogurt,meat and sea food weekly intake in vegetarian diet were lower than omnivorous diet,while the mean rank of frequency of dried toufu weekly intake was higher( all P < 0. 05). Multivariable regression analysis indicated that age( OR = 4. 752,95% CI: 2. 515 ～ 8. 979)was risk factor of OP,while higher body mass index( OR = 0. 861,95% CI: 0. 785 ～ 0. 944) and eating soy and soy food( OR= 0. 300,95% CI: 0. 093 ～ 0. 973) were beneficial factors. Conclusion The middle aged and elderly female vegetarians in community of Shantou have lower intake frequency of foods high in calcium and have lower bone mineral density than female omnivores. To prevent the occurrence of OP,we should attach importance to the improvement of diet pattern of vegetarians in proper ways.
引文
[1]张宏伟,朱旭峥.素食与健康[J].首都医药,2013,20(19):43.
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[3] Ho-Pham LT,Nguyen ND,Nguyen TV. Effect of vegetarian diets on bone mineral density:a Bayesian meta-analysis[J]. The American Journal of Clinical Nutrition,2009,90(4):943-950.
[4] Ho-Pham LT,Vu BQ,Lai TQ,et al. Vegetarianism,bone loss,fracture and vitamin D:a longitudinal study in Asian vegans and non-vegans[J]. European Journal of Clinical Nutrition,2012,66(1):75-82.
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[7]中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊治指南(2011年)[J].中华骨质疏松和骨矿盐疾病杂志,2011,4(1):2-17.
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[9]范文强,耿秀琴,边彩月,等.新乡市部分社区人群骨质疏松症流行病学调查及相关影响因素logistic回归分析[J].中国骨质疏松杂志,2016,22(2):179-182.
[10] Danielson L,Zamulko A. Osteoporosis:a review[J]. South Dakota medicine:the Journal of the South Dakota State Medical Association,2015,68(11):503-505,507-509.
[11]张智海,刘忠厚,石少辉,等.中国大陆地区以-2. 5 SD为诊断的骨质疏松症发病率文献回顾性研究[J].中国骨质疏松杂志,2015,21(1):1-7,24.
[12] Wacker M,Holick MF. Vitamin D-effects on skeletal and extraskeletal health and the need for supplementation[J].Nutrients,2013,5(1):111-148.
[13] Tucker KL. Vegetarian diets and bone status[J]. The American journal of clinical nutrition,2014,100(Suppl 1):329S-335S.
[14] Feng J,Liu S,Ma S,et al. Protective effects of resveratrol on postmenopausal osteoporosis:regulation of SIRT1-NF-κB signaling pathway[J]. Acta Biochimica et Biophysica Sinica,2014,46(12):1024-1033.
[15] Reinehr T,Roth CL. A new Link between skeleton,obesity and insulin resistance:relationships between osteocalcin,leptin and insulin resistance in obese children before and after weight loss[J].International Journal of Obesity,2010,34(5):852-858.
[16] Deroo BJ,Korach KS. Estrogen receptors and human disease[J].The Journal of Clinical Investigation,2006,116(3):561-570.
[17] Rizzo G,Baroni L. Soy,Soy foods and their role in vegetarian diets[J]. Nutrients,2018,10(1):43.
[18]张建东,张天东,陶若奇,等.大豆异黄酮对绝经后妇女骨的影响[J].中国骨质疏松杂志,2013(6):616-618.
[2]卢晓靖,连福治.膳食模式与骨质疏松[J].中国骨质疏松杂志,2015,21(11):1389-1392.
[3] Ho-Pham LT,Nguyen ND,Nguyen TV. Effect of vegetarian diets on bone mineral density:a Bayesian meta-analysis[J]. The American Journal of Clinical Nutrition,2009,90(4):943-950.
[4] Ho-Pham LT,Vu BQ,Lai TQ,et al. Vegetarianism,bone loss,fracture and vitamin D:a longitudinal study in Asian vegans and non-vegans[J]. European Journal of Clinical Nutrition,2012,66(1):75-82.
[5] Song FY,Takezaki T,Li K, et al. Development of semiquantitative food frequency questionnaire for inhabitants in Chaoshan region,China[J]. South China J Pre Med,2005,31(5):7-10.
[6] Song FY,Takezaki T,Li K,et al. Test for relative validity of a semi-quantitative food frequency questionnaire in Chaoshan area[J]. Modern Preventive Medicine,2007,34(11):2024-2027,2030.
[7]中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊治指南(2011年)[J].中华骨质疏松和骨矿盐疾病杂志,2011,4(1):2-17.
[8] Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk[J]. Lancet,2002,359(9321):1929-1936.
[9]范文强,耿秀琴,边彩月,等.新乡市部分社区人群骨质疏松症流行病学调查及相关影响因素logistic回归分析[J].中国骨质疏松杂志,2016,22(2):179-182.
[10] Danielson L,Zamulko A. Osteoporosis:a review[J]. South Dakota medicine:the Journal of the South Dakota State Medical Association,2015,68(11):503-505,507-509.
[11]张智海,刘忠厚,石少辉,等.中国大陆地区以-2. 5 SD为诊断的骨质疏松症发病率文献回顾性研究[J].中国骨质疏松杂志,2015,21(1):1-7,24.
[12] Wacker M,Holick MF. Vitamin D-effects on skeletal and extraskeletal health and the need for supplementation[J].Nutrients,2013,5(1):111-148.
[13] Tucker KL. Vegetarian diets and bone status[J]. The American journal of clinical nutrition,2014,100(Suppl 1):329S-335S.
[14] Feng J,Liu S,Ma S,et al. Protective effects of resveratrol on postmenopausal osteoporosis:regulation of SIRT1-NF-κB signaling pathway[J]. Acta Biochimica et Biophysica Sinica,2014,46(12):1024-1033.
[15] Reinehr T,Roth CL. A new Link between skeleton,obesity and insulin resistance:relationships between osteocalcin,leptin and insulin resistance in obese children before and after weight loss[J].International Journal of Obesity,2010,34(5):852-858.
[16] Deroo BJ,Korach KS. Estrogen receptors and human disease[J].The Journal of Clinical Investigation,2006,116(3):561-570.
[17] Rizzo G,Baroni L. Soy,Soy foods and their role in vegetarian diets[J]. Nutrients,2018,10(1):43.
[18]张建东,张天东,陶若奇,等.大豆异黄酮对绝经后妇女骨的影响[J].中国骨质疏松杂志,2013(6):616-618.