| Objective:1.To analyze the relationship between different the proportion of energy from dietary fat and diseases relevant to obesity.2.To evaluate the relationship between the proportion of energy from dietary fat and the anthropometric,blood indices related to obesity in natural and energy balance status.Methods:1.SubjectsThe research data was part of the project "The association study on dietary fat intake with obesity related chronic disease on energy balance status "supported by National Natural Science Foundation of China.The data used in this study are four rounds of follow-up data collected from three monitoring sites in Zhejiang Province in December 2014,November 2015,December 2016 and October 2017.According to the purpose of the study,subjects were divided into the following two groups:1)The subjects of the association study on the proportion of energy from dietary fat with anthropometric indicators were 418 adults aged 30-65 who had at least twice complete dietary records and anthropometric data in four rounds of follow-up survey.The subjects whose weight change was less than 2 kg between each survey were regarded as the energy balance group.When the time interval was 3 years(2014-2017),there were 209 people in energy balance group.When the time interval was 2 years(including 2014-2016 and 2015-2017),there were 477 person-times in energy balance group.When the time interval was 1 year(including 2014-2015,2015-2016 and 2016-2017),there were 832 person-times in energy balance group.2)The subjects of the association study on the proportion of energy from dietary fat with blood indicators were 380 adults aged 30-65 who had complete dietary records,anthropometric data and blood sample test data in the first and last two rounds of follow-up investigation.There were 197 subjects in the energy balance group(2014-2017).2.Research methodsFor each time of investigation,3-day household condiments weighing method and 3-day 24-hour dietary recall method were used to collect dietary information while questionnaire survey was conducted to collect physical activity status and basic information.Height,weight,waist and blood pressure of each participant were measured by physical examination during each investigation.Serum samples were collected in the first and last investigation for detection,i.e.Blood lipid,NEFA,Glucose,Insulin,Leptin,Adiponectin,Ghrelin,Obestatin and LBP.The subjects were grouped into three-digit groups according to the proportion of energy from dietary fat,and the differences of indexes between different proportion of energy from dietary fat groups were compared.Correlation analysis and multilevel models were used to analyze the association between dietary fat and parameters mentioned above.If the subjects maintained a stable weight(weight changes within ±2kg)during any two investigations,they were considered to be in energy balance group.Different energy balance groups were screened according to the time interval of the investigation,and the relationship between the proportion of energy from dietary fat and the anthropometric,blood indices related to obesity in energy balance status was evaluated.Results:1.During four investigations,men’s energy and macronutrient intake,weight,waist,SBP and DBP were higher than those of women’s,women’s WHtR was higher than that of men’s.There was no significant difference in BMI and average physical activity between men and women.In the first and last investigations,women’s Leptin,Adiponectin and Obestatin were higher than men’s.Women’s serum Insulin and HOMA-IR were higher than men’s in the baseline investigation.At the end of follow-up,serum HDL-C and Ghrelin were higher in women than in men,and serum TG was lower than in men.2.The relationship between the proportion of energy from dietary macronutrient and anthropometric indicators:After adjusting dietary total energy intake and physical activity level,the spearmen correlation analysis showed that there was no significant correlation between the proportion of energy from dietary fat/protein and anthropometric indicators in both men and women.The proportion of energy from dietary carbohydrate of women was negatively correlated with BMI,but there was no significant difference in the anthropometric indicators in different dietary carbohydrate groups.3.The results of multi-level stochastic slope model show that:1)A rise of 1 year in average age increased 0.20 kg in men’s weight.Compared with the low dietary fat group,the middle dietary fat group was observed to have 0.69 kg higher weight in men.Compared with the low level of physical activity group,women in the high and middle level of physical activity group lost 0.50 kg and 0.76 kg of weight respectively.2)Compared with the low dietary fat group,the middle dietary fat group was observed to have 0.22 kg/m2 higher BMI in men.Compared with the low level of physical activity group,women in the high and middle level of physical activity group decreased 0.21 kg/m2 and 0.31 kg/m2 in BMI respectively.3)Compared with the low level of physical activity group,men and women in the middle level of physical activity group decreased 0.95 cm and 0.97 cm in waist respectively.A rise of one year in average age increased 0.18 cm in women’s waist.Occupation was one of the influence factors of waist.Compared with jobwaiting/retired/houseworking women,laborers on farming,forestry,husbandry or fishing were observed to have 2.09cm lower waist in women.The effect of the proportion of energy from dietary fat on waist was not statistically significant.4)SBP was positively correlated with age.A rise of 1 year in average age increased 0.54 mmHg in men’s SBP and 0.62 mmHg in women’s SBP.Women’s SBP was positively correlated with the total energy intake of diet.A rise of 1 kcal in the total dietary energy intake increased 0.002 mmHg in women’s SBP.The effect of the proportion of energy from dietary fat on SBP was not statistically significant.5)Women’s DBP was positively correlated with age and the total energy intake of diet.A rise of 1 year in average age increased 0.19 mmHg in women’s DBP.A rise of 1 kcal in the total energy intake of diet increased 0.001 mmHg in women’s DBP.For male drinkers,DBP increased by 1.48 mmHg compared with non-drinkers.The effect of the proportion of energy from dietary fat on DBP was not statistically significant.4.The relationship between the proportion of energy from dietary fat and anthropometric indicators is affected by the time interval of energy balance.In the energy balance group with one-year interval,the waist of women in high dietary fat group was higher than those women in low dietary fat group,while DBP of women in high dietary fat group was lower than those women in low and middle dietary fat group;In the energy balance group with two-year interval,the waist and WHtR of women in high dietary fat group was higher than those women in middle dietary fat group.In the energy balance group with three-year interval,there was no significant difference in the anthropometric indicators between different dietary fat groups.5.The age of men in overweight/obesity group was younger than those in normal group.For men,Serum TC,TG,LDL-C,Insulin,HOMA-IR,Leptin and Ghrelin in overweight/obesity group were higher than those in normal group,while serum HDL-C and Adiponectin were lower than those in normal group.For women,serum TC,TG,LDL-C,Glucose,Insulin,HOMA-IR,Leptin,Ghrelin,Obestatin and LBP in overweight/obesity group were higher than those in normal group.For men,serum TG,NEFA,Insulin,HOMA-IR,Leptin and Ghrelin in central obesity group(according to waist)were higher than those in normal group;while serum HDL-C and Adiponectin were lower than those in normal group;For women,the levels of physical activity in central obesity group(according to waist)were lower than those in normal group.Serum TG,LDL-C,Insulin,HOMA-IR,Leptin,Ghrelin,Obestatin and LBP in central obesity group were higher than those in normal group,while serum HDL-C was lower than those in normal group.For men,serum TC,TG,LDL-C,Glucose,Insulin,HOMA-IR,Leptin and Ghrelin in central obesity group(according to WHtR)were higher than those in normal group,while serum HDL-C and Adiponectin were lower than those in normal group;The age of women in central obesity group(according to WHtR)was higher than those in normal group,and their serum TC,TG,LDL-C,Glucose,Insulin,HOMA-IR,Leptin,Ghrelin and Obestatin were higher than those in normal group.For men,serum TC,TG,NEFA,Insulin and HOMA-IR in hypertension group were higher than those in normal group.For women,the average age in hypertension group was higher than those in normal group,the level of physical activity in hypertension group was lower than those in normal group,and the levels of serum TG,NEFA and Ghrelinwere higher than those in normal group.For men,serum TC,TG,HDL-C,LDL-C,Glucose,Insulin,HOMA-IR and Obestatin in diabetic group were higher than those in normal group.For women,serum TC,TG,HDL-C,LDL-C,Glucose,Insulin,HOMA-IR,Leptin,Ghrelin and Obestatin in diabetic group were higher than those in normal group.6.The Spearman correlation analysis results of the first and last two surveys on the average indicators showed that the proportion of energy from dietary fat of men was negatively correlated with serum HDL-C,while that of women was negatively correlated with serum Ghrelin.However,in baseline and follow-up investigations,there was no significant difference in blood parameters between men and women in different dietary fat groups.In energy balance status,The spearman correlation analysis showed no statistically relationship between dietary fat and blood indicators and there was no significant difference in blood parameters between different dietary fat groups.Conclusion:1.There was no significant correlation between the proportion of energy from dietary fat/protein and anthropometric indicators in both men and women.The proportion of energy from dietary carbohydrate of women was negatively correlated with BMI.2.Men’s weight and BMI was influenced by the proportion of energy from dietary fat.The higher the proportion of energy from dietary fat,the higher the body weight and BMI of men.The effect of the proportion of energy from dietary fat on waist and blood pressure had no statistically significant.3.In energy balance status,the relationship between dietary fat and anthropometric indicators was affected by the time interval.Reducing dietary fat may reduce women’s waist in a short time,but it had no effect on anthropometric indicators for a long time.4.Blood lipid,Glucose,Insulin,Leptin,Adiponectin,Ghrelin,Obestatin and LBP were closely related to anthropometric indicators and chronic diseases.However,no correlation had been found between dietary fat and blood indicators in both natural and energy balanced status. |
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