Chrononutrition behaviors and cardiometabolic risk in adolescence: an ecological momentary assessment study 

青少年的時(shí)間營(yíng)養(yǎng)行為與心血管代謝風(fēng)險(xiǎn)：一項(xiàng)生態(tài)瞬時(shí)評(píng)估研究

Authors: Yu-Ting Shen , Qi Li , Yu-Xiang Xu , Yan Huang , Yu-Hui Wan , Pu-Yu Su , Fang-Biao Tao , Ying Sun.

Source: Eur J Nutr.

Doi: 10.1007/s00394-024-03557-x.?

Abstract

Purpose: To investigate the potential associations between unhealthy chrononutrition behaviors (meal timing, frequency, and regularity) and their combined impact on cardiometabolic risk in adolescence.

Methods: Chrononutrition behaviors were assessed using a 7-day ecological momentary assessment (EMA). The unhealthy chrononutrition score (ranging from 0 to 8) was determined based on late meal timing, low meal frequency, and meal irregularity. The cardiometabolic (CM)-risk z score was calculated utilizing age- and sex-specific reference values for waist circumference (WC), mean arterial pressure (MAP), homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). Restricted cubic splines were employed to estimate the dose-response relationships between the unhealthy chrononutrition score and outcomes.

Results: Among 458 participants [mean (SD) age, 17.9 (0.7) years; 340 (74.2%) Female], 14.3% had an unhealthy chrononutrition score ≥ 6, who exhibited higher MAP (β = 3.86; 95% CI 1.24, 6.47), higher CM-risk scores (β = 1.80; 95% CI 0.70, 2.90), and lower HDL-C (β = 0.18; 95% CI - 0.30, - 0.06), as opposed to those with a healthy score ≤ 2 (n = 136, 31.4%). Moreover, late breakfast (later than 9AM compared to earlier than 8AM), low meal frequency (eating two or fewer meals versus three meals a day), and meal irregularity (score of 3-5 compared to a good score of 6-9) were associated with an increased risk of CM-risk outcomes.

Conclusion: The findings suggest a clustering of unhealthy chrononutrition behaviors that collectively impact cardiometabolic health in adolescence. Further prospective and interventional investigations is necessary to validate these findings and explore the underlying mechanisms.

Keywords: Cardiometabolic risk; Chrononutrition behaviors; Ecological momentary assessment; Unhealthy chrononutrition score.

摘要

目的：探討不健康時(shí)間營(yíng)養(yǎng)行為（進(jìn)餐時(shí)間、頻率和規(guī)律性）及其對(duì)青少年心血管代謝風(fēng)險(xiǎn)的聯(lián)合影響之間的潛在關(guān)聯(lián)。

方法：采用7天生態(tài)瞬時(shí)評(píng)估（ecological momentary assessment，EMA）探究時(shí)間營(yíng)養(yǎng)行為。根據(jù)較晚的進(jìn)餐時(shí)間、較低的進(jìn)餐頻率和進(jìn)餐不規(guī)律性來確定不健康的時(shí)間營(yíng)養(yǎng)評(píng)分（分?jǐn)?shù)為0－8）。心血管代謝風(fēng)險(xiǎn)評(píng)分為腰圍（waist circumference，WC）、平均動(dòng)脈壓（mean arterial pressure，MAP）、高密度脂蛋白膽固醇（high-density lipoprotein cholesterol，HDL-C）、甘油三酯（triglycerides，TG）及胰島素抵抗指數(shù)（homeostatic model assessment of insulin resistance，HOMA-IR）這5個(gè)指標(biāo)基于性別特異性的標(biāo)準(zhǔn)化z分之和。采用限制性立方樣條來估計(jì)不健康時(shí)間營(yíng)養(yǎng)評(píng)分與結(jié)局之間的劑量反應(yīng)關(guān)聯(lián)。

結(jié)果：在458名參與者中 [平均年齡17.9±0.7歲；74.2%為女性 ]，不健康的時(shí)間營(yíng)養(yǎng)評(píng)分≥6的個(gè)體占比14.3%，表現(xiàn)出較高的MAP（β= 3.86; 95% CI: 1.24, 6.47），較高的心血管代謝風(fēng)險(xiǎn)評(píng)分（β= 1.80；95% CI: 0.70, 2.90）和較低的HDL-C（β= 0.18; 95% CI: -0.30, - 0.06）。此外，早餐時(shí)間較晚（早上9點(diǎn)后與早上8點(diǎn)前相比）、低進(jìn)餐頻率（每天三次正餐與每天≤2次正餐相比）和進(jìn)餐不規(guī)律（較差分?jǐn)?shù)3－5與良好得分6－9相比）與心血管代謝風(fēng)險(xiǎn)結(jié)局的增加相關(guān)。

結(jié)論： 研究結(jié)果表明，不健康時(shí)間營(yíng)養(yǎng)行為具有聚集性及其對(duì)心血管代謝健康的聯(lián)合影響。需要進(jìn)一步的前瞻性和干預(yù)性調(diào)查來驗(yàn)證這些發(fā)現(xiàn)并探索其潛在機(jī)制。

關(guān)鍵詞：心血管代謝風(fēng)險(xiǎn)；時(shí)間營(yíng)養(yǎng)行為；生態(tài)瞬時(shí)評(píng)估；不健康的時(shí)間營(yíng)養(yǎng)評(píng)分

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