心血管疾病(CVD)是中低收入国家(LMIC)男性和女性死亡的主要原因。营养过渡到高盐饮食,脂肪和糖,水果和蔬菜含量低,与LMICs中饮食相关CVD危险因素的患病率增加同时,确定需要采取紧急行动扭转这一趋势。为了帮助确定最有效的干预措施,至关重要的是要了解与CVD风险相关的饮食行为是否存在性别差异。
从46项全国代表性调查的数据集中,我们纳入了来自七个国家的数据,这些国家记录了成年人的相同饮食行为测量;不丹,埃斯瓦蒂尼,格鲁吉亚,圭亚那,肯尼亚,尼泊尔和圣文森特和格林纳丁斯(2013-2017)。调查了三种饮食行为:积极的盐使用行为(SUB),满足水果和蔬菜(F&V)的建议,并在烹饪中使用植物油而不是动物脂肪。使用广义线性模型来研究饮食行为和腰围(WC)与未诊断和诊断的高血压和糖尿病之间的关系。添加了性别和饮食行为之间的相互作用术语以测试性别差异。
两万四千三百三十二名参与者被包括在内。报告SUB阳性的女性多于男性(31.3vs.27.2%p值<0.001),但未达到F&V建议(13.2与14.8%,p值<0.05)。以积极方式报告所有三种饮食行为的患病率为2.7%,因国家而异,但不是性。SUB较差与女性未诊断高血压的患病率较高相关(13.1%vs.9.9%,p值=0.04),男性未诊断糖尿病的患病率较高(2.4%vs.1.5%,p值=0.02)。符合F&V建议与较高的高WC患病率相关(24.4%vs22.6%,p值=0.01),但与未确诊或确诊的高血压或糖尿病无关.
在所包括的国家,迫切需要采取干预措施来增加F&V摄入量和积极的SUB。性别之间的饮食行为没有明显差异。然而,我们的研究结果受到报告积极饮食行为的一小部分人群的限制,需要进一步的研究来了解与CVD危险因素的关联和性别之间的相互作用是否会随着积极行为患病率的增加而改变.
Cardiovascular diseases (CVD) are the leading causes of death for men and women in low-and-middle income countries (LMIC). The nutrition transition to diets high in salt, fat and sugar and low in fruit and vegetables, in parallel with increasing prevalence of diet-related CVD risk factors in LMICs, identifies the need for urgent action to reverse this trend. To aid identification of the most effective interventions it is crucial to understand whether there are sex differences in dietary behaviours related to CVD risk.
From a dataset of 46 nationally representative surveys, we included data from seven countries that had recorded the same dietary behaviour measurements in adults; Bhutan, Eswatini, Georgia,
Guyana, Kenya, Nepal and St Vincent and the Grenadines (2013-2017). Three dietary behaviours were investigated: positive salt use behaviour (SUB), meeting fruit and vegetable (F&V) recommendations and use of vegetable oil rather than animal fats in cooking. Generalized linear models were used to investigate the association between dietary behaviours and waist circumference (WC) and undiagnosed and diagnosed hypertension and diabetes. Interaction terms between sex and dietary behaviour were added to test for sex differences.
Twenty-four thousand three hundred thirty-two participants were included. More females than males reported positive SUB (31.3 vs. 27.2% p-value < 0.001), yet less met F&V recommendations (13.2 vs. 14.8%, p-value< 0.05). The prevalence of reporting all three dietary behaviours in a positive manner was 2.7%, varying by country, but not sex. Poor SUB was associated with a higher prevalence of undiagnosed hypertension for females (13.1% vs. 9.9%, p-value = 0.04), and a higher prevalence of undiagnosed diabetes for males (2.4% vs. 1.5%, p-value = 0.02). Meeting F&V recommendations was associated with a higher prevalence of high WC (24.4% vs 22.6%, p-value = 0.01), but was not associated with undiagnosed or diagnosed hypertension or diabetes.
Interventions to increase F&V intake and positive SUBs in the included countries are urgently needed. Dietary behaviours were not notably different between sexes. However, our findings were limited by the small proportion of the population reporting positive dietary behaviours, and further research is required to understand whether associations with CVD risk factors and interactions by sex would change as the prevalence of positive behaviours increases.