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中国≥80岁高龄老人蔬菜及水果摄入量与睡眠时长关系:基于2015—2017年中国居民营养与健康状况监测

Associations between vegetable and fruit intake and sleep duration among Chinese adults aged over 80 years: an analysis based on the China Nutrition and Health Surveillance, 2015–2017

  • 摘要:
    目的  探索中国80岁及以上高龄老人蔬菜及水果摄入量与睡眠时长的关系,为改善该人群睡眠质量提供科学依据。
    方法  基于中国居民营养与健康状况监测(2015—2017年)数据,采用多阶段分层整群随机抽样,自中国31个省(自治区、直辖市)抽取2 319名高龄老人,并完成问卷调查、体格测量和实验室检测。调查其日均蔬菜、水果及蔬果总摄入量,并分别按升序将人群按五分位法分组,将每日睡眠时长为7~9 h者定义为健康睡眠时长组,<7或>9 h者定义为非健康睡眠时长组,使用多因素非条件logistic回归探索二者关系,并结合限制性立方样条分析探讨蔬果摄入与非健康睡眠时长的剂量—反应关系。
    结果  中国2 319名高龄老人中,非健康睡眠时长者占52.13%,且不同睡眠时长组在性别(χ2=6.672)、居住地(χ2=8.422)、文化程度(χ2=15.573)、家庭人均年收入(χ2=23.021)、婚姻状况(χ2=8.894)、身体活动水平(χ2=9.873)、静态行为(χ2=6.631)分布差异均有统计学意义(均P<0.05),且年龄(t=2.220)、蔬菜(t=3.420)、水果(t=3.470)及蔬果总摄入量(t=4.190)组间差异亦有统计学意义(均P<0.05)。多因素非条件logistic回归结果显示,在调整年龄、性别、BMI、居住地、文化程度、家庭人均年收入、婚姻状况、家中有人共同居住、目前吸烟、目前饮酒、身体活动水平、静态行为、一年内参加健康体检以及高血压、糖尿病和血脂异常的患病情况后,蔬菜、水果及其总摄入量均与非健康睡眠时间的风险存在负向关联,最高组与最低组相比,蔬菜摄入量(OR=0.74,95%CI=0.56~0.97),水果摄入量(OR=0.72,95%CI=0.55~0.95),蔬果总摄入量(OR=0.71,95%CI=0.54~0.94)(均P趋势<0.05)。RCS分析提示,水果摄入量、蔬果总摄入量与非健康睡眠时长呈显著负向线性关联(均P非线性≥0.05)。
    结论  蔬菜、水果及蔬果总摄入量与中国80岁以上高龄老人非健康睡眠时长风险呈负向关联,本研究结果可为促进该人群保持健康睡眠时长提供潜在的干预策略。

     

    Abstract:
    Objective To explore the relationship between vegetable and fruit intake and sleep duration among Chinese adults aged over 80 years, thereby providing a scientific basis for improving sleep quality in this population.
    Methods Multistage stratified cluster random sampling was conducted for data from the China Nutrition and Health Surveillance (2015–2017). A total of 2319 elderly participants from 31 provinces (autonomous regions, municipalities directly under the Central Government) in China were selected to complete a questionnaire survey, physical measurements, and laboratory tests. The average daily intake of vegetables, fruits, and total vegetable and fruit intake was investigated, and the population was divided into quintiles in ascending order. Those with the daily sleep duration of 7–9 h were defined as the healthy sleep duration group, and those with the daily sleep duration of < 7 h or > 9 h were defined as the unhealthy sleep duration group. Multivariate unconditional logistic regression was adopted to explore the association between the two. Restricted cubic spline (RCS) analysis was performed to explore the dose-response relationship between fruit and vegetable intake and unhealthy sleep duration.
    Results Among the 2319 elderly participants in China, 52.13% had unhealthy sleep duration. Different sleep duration groups varied in sex (χ2 = 6.672), place of residence (χ2 = 8.422), educational background (χ2 = 15.573), per capita annual household income (χ2 = 23.021), marital status (χ2 = 8.894), physical activity level (χ2 = 9.873), and sedentary behavior distribution (χ2 = 6.631) (all P < 0.05). In addition, there were also differences in age (t = 2.220), vegetable intake (t = 3.420), fruit intake (t = 3.470), and total vegetable and fruit intake (t = 4.190) among different groups (all P < 0.05). Multivariate unconditional logistic regression showed that after adjusting for age, sex, BMI, place of residence, educational background, per capita annual household income, marital status, number of cohabitants, current smoking, current alcohol consumption, physical activity level, sedentary behavior, participation in health checkups within the past year, and the prevalence of hypertension, diabetes, and dyslipidemia, vegetable intake, fruit intake, and total vegetable and fruit intake were negatively associated with the risk of unhealthy sleep duration. Compared with the lowest group, the highest group showed reductions of 26% (vegetable intake: OR = 0.74, 95%CI: 0.56–0.97), 28% (fruit intake: OR = 0.72, 95%CI: 0.55–0.95), and 29% (total fruit and vegetable intake: OR = 0.71, 95%CI: 0.54–0.94) in the risk of unhealthy sleep duration (all Ptrend < 0.05). RCS analysis revealed that both fruit intake and total vegetable and fruit intake had significantly negatively linearly associations with unhealthy sleep duration (both Pnon-linearity ≥ 0.05).
    Conclusions The vegetable intake, fruit intake, and total vegetable and fruit intake are negatively correlated with the risk of unhealthy sleep duration in Chinese adults aged 80 and above. The findings provide a potential intervention target to promote healthy sleep duration in this population.

     

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