青少年的不健康时间营养行为具有聚集性及其对心血管代谢风险的联合影响

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

青少年的时间营养行为与心血管代谢风险：一项生态瞬时评估研究

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：探讨不健康时间营养行为（进餐时间、频率和规律性）及其对青少年心血管代谢风险的联合影响之间的潜在关联。

方法：采用7天生态瞬时评估（ecological momentary assessment，EMA）探究时间营养行为。根据较晚的进餐时间、较低的进餐频率和进餐不规律性来确定不健康的时间营养评分（分数为0－8）。心血管代谢风险评分为腰围（waist circumference，WC）、平均动脉压（mean arterial pressure，MAP）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、甘油三酯（triglycerides，TG）及胰岛素抵抗指数（homeostatic model assessment of insulin resistance，HOMA-IR）这5个指标基于性别特异性的标准化z分之和。采用限制性立方样条来估计不健康时间营养评分与结局之间的剂量反应关联。

结果：在458名参与者中 [平均年龄17.9±0.7岁；74.2%为女性 ]，不健康的时间营养评分≥6的个体占比14.3%，表现出较高的MAP（β= 3.86; 95% CI: 1.24, 6.47），较高的心血管代谢风险评分（β= 1.80；95% CI: 0.70, 2.90）和较低的HDL-C（β= 0.18; 95% CI: -0.30, - 0.06）。此外，早餐时间较晚（早上9点后与早上8点前相比）、低进餐频率（每天三次正餐与每天≤2次正餐相比）和进餐不规律（较差分数3－5与良好得分6－9相比）与心血管代谢风险结局的增加相关。

结论： 研究结果表明，不健康时间营养行为具有聚集性及其对心血管代谢健康的联合影响。需要进一步的前瞻性和干预性调查来验证这些发现并探索其潜在机制。

关键词：心血管代谢风险；时间营养行为；生态瞬时评估；不健康的时间营养评分