Abstract：
This study investigates sex differences in the effects of macronutrient quantity, quality, and timing on mortality in metabolically unhealthy overweight/obesity (MUO) populations. The study included 18,345 participants, including 9204 men and 9141 women. The Cox proportional risk model and isocaloric substitution effects were used to examine the association of macronutrient intake and subtype with all-cause mortality in the MUO populations. After adjusting for the potential covariates, The risk of all-cause mortality was elevated in men in the highest 25% percentile of poor-quality carbohydrates compared with men in the lowest quartile (odds ratio [OR]: 2.04; 95% confidence interval [CI], 1.40-2.98). Compared with women in the lowest quartile, the risk of all-cause mortality for women in the highest 25% percentile for high-quality carbohydrates (OR: 0.74; 95% CI, 0.55-0.99) and unsaturated fatty acids (OR: 0.54; 95% CI, 0.32-0.93) were decreased. In women, replacing low-quality carbohydrates with high-quality carbohydrates on an isocaloric basis reduces the risk of all-cause mortality by approximately 9%. We find that different macronutrient consumption subtypes are associated with all-cause mortality in MUO populations, with differential effects between men and women, and that the risk of all-cause mortality is influenced by macronutrient quality and meal timing.
摘要：
这项研究调查了性别差异对大量营养素数量的影响，质量,以及代谢不健康的超重/肥胖（MUO）人群的死亡率时间。这项研究包括18,345名参与者，包括9204名男性和9141名女性。Cox比例风险模型和等热量替代效应用于检查MUO人群中大量营养素摄入量和亚型与全因死亡率的关系。在调整潜在协变量后，与最低四分位数的男性相比，不良碳水化合物含量最高的25％百分位的男性全因死亡风险升高（比值比[OR]：2.04；95％置信区间[CI]，1.40-2.98)。与最低四分位数的女性相比，优质碳水化合物(OR:0.74;95%CI,0.55~0.99)和不饱和脂肪酸(OR:0.54;95%CI,0.32~0.93)占25%百分位数最高的女性全因死亡率风险降低.在女性中，在等热量基础上用高质量碳水化合物代替低质量碳水化合物可将全因死亡风险降低约9%.我们发现不同的常量营养素消费亚型与MUO人群的全因死亡率相关。男女之间有不同的影响，全因死亡的风险受大量营养素质量和进餐时间的影响。
