Relationship Between Dietary Behavior And Hypertension In Middle-aged And Elderly Residents In Hainan Province

ObjectiveTo understand the occurrence level and epidemic characteristics of hypertension among the middle-aged and elderly residents in tropical areas of Hainan,explore the influencing factors of hypertension in the middle-aged and elderly in Hainan and its correlation with relevant dietary behavior and dietary pattern,and explore its formation causes,the change trend of dietary structure,based on the current situation of characteristic dietary culture,food consumption behavior and nutritional health-related dietary behavior in tropical areas represented by Hainan influencing factors and their correlation with the nutritional health status of local HBP residents.MethodsThis study consists of two parts.In the first part,the epidemiological survey was conducted on the middle-aged and elderly aged 35-74 years old by using the current epidemiological research method and the health examination project of residents in cities and counties in cooperation with the Affiliated Hospital of Hainan Medical College and the workers’sanatorium.The field survey was conducted by using the National Key R&D Program（2017YFC0907104）.The database is established by Excel 2016 software,and the quantitative data are statistically analyzed by SPSS 20.0statistical analysis software.In case of skew distribution,the median and lower and upper quartiles M(P₂₅～P₇₅)are used respectively.Principal component analysis was used to reduce the dimension of the data.The result of descriptive test shows that the KMO statistic is 0.838,and the result of Bartlett spherical test（P<0.001）,which shows that the analysis result is effective.The first three principal components are selected according to the principle that the characteristic root is greater than 1,combined with the gravel map and component interpretability.According to the division of dietary patterns,the score of each component are calculated,which are named y1,y2 and y3respectively.According to the interquartile spacing method,they are divided into Q1,Q2,Q3 and Q4 respectively.Univariate analysis was performed by test.The variables with statistical significance were analyzed by multivariate logistic regression.The second part applies a variety of qualitative research methods,including:（1）Using literature research method to study the characteristics and causes of traditional dietary behavior and dietary culture in Hainan;（2）Using the methods of expert consultation and group interview,this paper studies the common food consumption behavior,some specific eating habits and their impact on health in various parts of Hainan,analyzes and compares the similarities and differences in various parts,and provides expert suggestions on improvement measures;（3）The characteristics of daily food consumption behavior of residents in Hainan were studied by non participatory observation.Nvivo 11 qualitative data analysis software was used for analysis.Results1.A total of 1479 subjects were enrolled in this study,and the prevalence of hypertension was 28.7%.There were 714 males（48.28%）and 765 females（51.72%）,of which the prevalence rate of males was 31.7%and that of females was 25.9%.The distribution results of middle-aged and elderly people in various factors showed that there were significant differences between gender,age,education level,marital status,occupation,total income of a family last year,family history of chronic diseases,central obesity,BMI,drinking and hypertension（P<0.05）.2.The factor analysis of this study uses the principal component method to extract the initial components for analysis,and extracts three dietary patterns:traditional food diversity pattern,modern food diversity pattern and modern simplified pattern.Chi square analysis showed that there were significant differences between traditional food diversity model score,modern food diversity model score,modern simplified model score,dash comprehensive score and hypertension（P<0.05）.3.The results of single factor analysis are statistically significant.Then the stepwise backward logistic regression analysis was used to construct the multi factor model of dietary behavior.According to the regression analysis results,age,education,central obesity,occupation,BMI,total family income last year,modern food diversity model score y2,comprehensive score y and hypertension were statistically significant（P<0.05）.Among them,66-74 years old group（OR:5.948,95%CI:3.577-9.891）,56-65 years old group（OR:3.090,95%CI:2.047-4.665）,46-55 years old group（OR:1.770,95%CI:1.266-2.476）,centralobesity（OR:1.548,95%CI:1.104-2.171）.BMI overweight（OR:3.458,95%CI:1.848-6.469）;workers（OR:0.497,95%CI:0.282-0.876）,administrative and management personnel（OR:0.452,95%CI:0.251-0.814）,professional and technical personnel（doctors,teachers,etc.）（OR:0.289,95%CI:0.147-0.570）,sales and service personnel(OR:0.295,95%CI:0.145-0.599,private owners（OR:0.224,95%CI:0.081-0.622）and retirees（OR:0.546,95%CI:0.302-0.989）were associated with high risk of HBP（p<0.05）.When the modern food diversity mode y2 score takes Q1 as the reference level,the risk of hypertension is 1.7 times（OR:0.606,95%CI:0.419-0.877）,2.0 times（OR:0.493,95%CI:0.334-0.730）and 1.7 times（OR:0.588,95%CI:0.400-0.864）of Q2,Q3 and Q4 levels,respectively,which is associated with the low risk of hypertension;the higher the score,the lower the risk of hypertension.While advanced age,central obesity and overweight were associated with a high risk of hypertension.Old age,central obesity and overweight are associated with high risk of hypertension.4.Through the extension of quantitative research results,it is not difficult to find that the middle-aged and elderly residents in Hainan are closely related to the local food culture.Hainan residents have light food taste,simple cooking methods,fresh and green ingredients,and Hainan’s characteristic agriculture is dominated by rice,poultry and aquatic products.Therefore,local Hainan people also have a source of high-quality protein.The local characteristic dad tea shop is directly related to the obesity problem of Hainan residents.In addition,Hainan people like to use soy sauce,which may lead to excessive salt intake.5.There is a correlation between the dietary pattern of middle-aged and elderly residents in Hainan and the local dietary cultural background.Conclusions1.BMI,income level,education level,lifestyle and other factors are closely related to HBP.The modern food diversity model of Hainan local residents can reduce the risk of disease.Old age,central obesity and overweight are the risk factors of hypertension.2.On the whole,the diet mode of local residents in Hainan is close to DASH diet mode.The diet tastes light,the cooking method is simple,and pays attention to the combination of meat and vegetables,which is worth advocating.3.The dietary pattern of middle-aged and elderly residents in Hainan is related to the local dietary cultural background,and the modern traditional food diversity pattern is a protective factor for the prevalence of hypertension.