营养咨询频率和基线食物模式可预测高蛋白和高多不饱和脂肪酸饮食模式的实施：随机 NutriAct 试验的 1 年结果。

Nutritional counseling frequency and baseline food pattern predict implementation of a high-protein and high-polyunsaturated fatty acid dietary pattern: 1-year results of the randomized NutriAct trial.

机构信息

Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany.

Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Germany.

出版信息

Clin Nutr. 2021 Nov;40(11):5457-5466. doi: 10.1016/j.clnu.2021.09.022. Epub 2021 Sep 25.

DOI:10.1016/j.clnu.2021.09.022

PMID:34656026

Abstract

BACKGROUND & AIMS: NutriAct is a 36-month randomized controlled multi-center trial designed to analyze the effects of a food pattern focusing on a high-protein and high-unsaturated fatty acids (UFA) intake on healthy aging. We aimed to determine factors associated with a successful modulation of dietary pattern after 12 months in elderly participants.

METHODS

502 participants were randomized into either usual care control group including dietary recommendations of the German Nutrition Society (DGE) or an intervention group, which used supplementation of rapeseed oil and specifically designed foods as well as repetitive advices to implement a food pattern based on high intake of predominantly plant proteins, UFA and fiber (NutriAct pattern). Food intake was repeatedly assessed by 3-day food records at months 0, 3, 6 and 12. Linear regression models were used to investigate determinants of basal food intake and modulation of dietary pattern during the intervention.

RESULTS

Food records of 242 intervention and 246 control participants (median age 66 y, 37% males) were available at baseline and were included. At baseline, high BMI was related to higher protein and saturated fatty acids and lower fiber intake. The intervention resulted in higher intake of protein, mono- and polyunsaturated fatty acids (MUFA and PUFA) and fiber, and lower carbohydrate and saturated fatty acid consumption (all p < 0.001). While individuals who were already at baseline closer to the NutriAct pattern also achieved a diet closer to the proposed pattern at month 12, the strongest absolute changes (%E) of dietary behavior were seen in those with dietary patterns further away from the proposed pattern at baseline. Attendance to nutritional sessions was crucial to change MUFA, PUFA, fiber and carbohydrate intake.

CONCLUSIONS

A successful modification of dietary pattern was achieved by the performed intervention within 12 months. Baseline dietary habits and attendance to nutritional sessions were substantial determinants predicting changes in dietary pattern.

CLINICAL TRIAL REGISTRATION

The trial was registered at German Clinical Trials Register (drks.de) as DRKS00010049.

摘要

背景与目的

NutriAct 是一项为期 36 个月的随机对照多中心试验，旨在分析以高蛋白和高不饱和脂肪酸（UFA）摄入为重点的饮食模式对健康老龄化的影响。我们旨在确定 12 个月后老年参与者成功调节饮食模式的相关因素。

方法

502 名参与者被随机分为常规护理对照组（包括德国营养学会（DGE）的饮食建议）或干预组，干预组使用菜籽油和专门设计的食品补充剂以及反复建议来实施以高摄入为主的饮食模式植物蛋白、UFA 和纤维（NutriAct 模式）。通过 0、3、6 和 12 个月的 3 天食物记录反复评估食物摄入量。线性回归模型用于研究基线时基本食物摄入量和干预期间饮食模式调节的决定因素。

结果

干预组和对照组分别有 242 名和 246 名参与者（中位年龄 66 岁，37%为男性）的食物记录可用于基线并被纳入。基线时，高 BMI 与较高的蛋白质和饱和脂肪酸以及较低的纤维摄入量有关。干预导致蛋白质、单不饱和脂肪酸和多不饱和脂肪酸（MUFA 和 PUFA）和纤维摄入量增加，碳水化合物和饱和脂肪酸摄入量减少（均 p < 0.001）。虽然基线时已经更接近 NutriAct 模式的个体在 12 个月时也能达到更接近建议模式的饮食，但基线时饮食模式与建议模式相差较大的个体的饮食行为绝对变化（%E）最大。参加营养课程对于改变 MUFA、PUFA、纤维和碳水化合物的摄入量至关重要。