Article(id=1240730053567369541, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202411303, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1731600000000, receivedDateStr=2024-11-15, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773742696420, onlineDateStr=2026-03-17, pubDate=1745510400000, pubDateStr=2025-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773742696420, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773742696420, creator=13701087609, updateTime=1773742696420, updator=13701087609, issue=Issue{id=1240730050669113883, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='8', pageStart='1345', pageEnd='1536', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773742695728, creator=13701087609, updateTime=1773742807836, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240730520988995837, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240730520988995838, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1386, endPage=1391, ext={EN=ArticleExt(id=1240730053798056267, articleId=1240730053567369541, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Relationship between dietary fiber intake and cognitive function in people aged 50 and above, Chengdu, columnId=1228016572783063333, journalTitle=Modern Preventive Medicine, columnName=Nutrition and Food Hygiene, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the relationship between dietary fiber intake and cognitive function, providing insights for nutritional interventions to prevent cognitive impairment.

Methods

Adults over 50 years old from the 2022 Southwest Population Cohort were selected as study subjects. Multiple linear regression and multivariable logistic regression models were used to analyze the relationship between dietary fiber intake and cognitive impairment. Subgroup analysis was performed to explore the association between dietary fiber intake and cognitive impairment across different age and gender groups.

Results

A total of 1 267 participants were included,the median dietary fiber intake of the participants was 13.3 g/d. The dietary fiber intake of individuals with cognitive dysfunction, specifically those with mild cognitive impairment (11.6 g/d), was significantly lower than that of the normal group (13.7 g/d), and the difference was statistically significant (Z=3.93, P<0.001). After adjusting for age, gender, body mass index, education, smoking, per capita monthly household income, hypertension, diabetes, and daily energy intake, dietary fiber intake was positively correlated with cognitive function scores. The logistic regression analysis showed that, compared to the lowest dietary fiber intake group (Q1), the highest dietary fiber intake group (Q4) had a reduced risk of cognitive dysfunction, with statistically significant OR values of 0.29 (95% CI: 0.16–0.53), 0.27 (95% CI: 0.14–0.49), and 0.39 (95% CI: 0.18–0.84). The impact of dietary fiber intake was more pronounced in males and in individuals aged 63 and above.

Conclusion

There is a negative association between dietary fiber intake and cognitive dysfunction, suggesting that dietary fiber may be a protective factor against cognitive dysfunction, with this association being particularly significant in males and individuals aged 63 years and older.

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目的

探究膳食纤维摄入量和认知功能之间的关系,为认知障碍的防治提供线索。

方法

选择2022年西南人群队列中50岁以上成年人作为研究对象,利用多重线性回归和多因素logistic回归模型分析膳食纤维摄入量和认知障碍之间的关系。然后进行亚组分析,探索不同性别年龄人群中膳食纤维摄入量和认知障碍之间的关联。

结果

共纳入1 267名研究对象,128(10.1%)人认知功能异常。研究对象膳食纤维摄入量中位数为13.3 g/d,认知功能异常者的膳食纤维摄入量(11.6 g/d)明显低于正常人群(13.7 g/d)且差异具有统计学意义(Z=3.93,P<0.001)。调整年龄、性别、身体质量指数、教育、吸烟、家庭人均月收入、高血压、糖尿病、日均能量摄入后,膳食纤维摄入量与认知功能得分呈正相关。逻辑回归显示与膳食纤维摄入量最低组(Q1)相比,膳食纤维摄入量最高组(Q4)认知功能异常的风险降低,且有统计学差异,Q2至Q4的OR值分别为0.29(95% CI: 0.16~0.53)、0.27(95% CI: 0.14~0.49)、0.39(95% CI: 0.18~0.84)。膳食纤维摄入量在男性和大于等于63岁的人群中影响更显著。

结论

膳食纤维摄入量与认知功能异常存在负相关关联,膳食纤维可能是认知功能异常的保护因素,并且在男性和大于等于63岁的人群中这种相关性可能更加明显。

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成果,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=fIXRG+nT9QODgRdtrC/NsQ==, magXml=TQsJWzugTUSyVBPv2VEBfg==, pdfUrl=null, pdf=5uHIQ5/3EwF7Tuc5nIDvAA==, pdfFileSize=602672, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=cc8Yig5cLQnIcnDVMJ2dYw==, mapNumber=null, authorCompany=null, fund=null, authors=

程志宝(2000—),男,硕士在读,研究方向:流行病学

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Journal of Functional Foods, 2022, 90: 104986., articleTitle=Dietary fiber intake is positively related with cognitive function in US older adults, refAbstract=null), Reference(id=1241070736530526633, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, doi=null, pmid=null, pmcid=null, year=2023, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[24], rfOrder=28, authorNames=中国营养学会, journalName=中国居民膳食营养素参考摄入量:2023版, refType=null, unstructuredReference=中国营养学会.中国居民膳食营养素参考摄入量:2023版[M].北京:人民卫生出版社,2023., articleTitle=null, refAbstract=null), Reference(id=1241070736639578544, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, doi=null, pmid=null, pmcid=null, year=2023, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[24], rfOrder=29, authorNames=Chinese Soclety of Nutrition, journalName=Dietary intake of nutrients for Chinese residents: 2023 edition, refType=null, unstructuredReference=Chinese Soclety of Nutrition. Dietary intake of nutrients for Chinese residents: 2023 edition[M]. Beijing: The People’s Health Publishing House, 2023. (In Chinese), articleTitle=null, refAbstract=null)], funds=[Fund(id=1241070730314567869, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, awardId=82173512, language=CN, fundingSource=国家自然科学基金(82173512), fundOrder=null, country=null), Fund(id=1241070730448785604, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, awardId=82304135, language=CN, fundingSource=国家自然科学基金青年项目(82304135), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241070724589343597, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, xref=1., ext=[AuthorCompanyExt(id=1241070724597732208, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, companyId=1241070724589343597, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1241070724606120817, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, companyId=1241070724589343597, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川大学华西公共卫生学院/华西第四医院,四川 成都 610041)]), AuthorCompany(id=1241070724698395512, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, xref=2., ext=[AuthorCompanyExt(id=1241070724710978426, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, companyId=1241070724698395512, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.四川大学华西第二医院妇儿营养中心)]), AuthorCompany(id=1241070724786475905, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, xref=3., ext=[AuthorCompanyExt(id=1241070724807447430, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, companyId=1241070724786475905, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.四川大学华西护理学院)])], figs=[ArticleFig(id=1241070729282769028, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, language=EN, label=Table 1, caption=

Characteristics of the study population

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特征总计(n=1 267)认知功能异常χ2/ZP
正常组(n=1 139)异常组(n=128)
性别[n(%)]2.7710.096
598(47.2)547(48.0)51(39.8)
669(52.8)592(52.0)77(60.2)
年龄[岁, M(P25, P75)]63(60,66)63(60,66)64(61,70)-2.7050.006
BMI[kg/m2, M(P25, P75)]23.68(21.94,25.7)23.67(21.93,25.64)24.24(22.22,26.31)-1.3590.174
受教育水平[n(%)]20.093<0.001
文盲23(1.8)17(1.5)6(4.7)
小学111(8.8)98(8.6)13(10.2)
中学828(65.4)730(64.1)98(76.5)
大学及以上305(24.1)294(25.8)11(8.6)
家庭人均月收入[元,n(%)]22.673<0.001
<1 800115(9.1)92(8.1)23(18.0)
1 800~3 200390(30.8)340(29.9)50(39.1)
>3 200~5 000410(32.4)379(33.3)31(24.2)
>5 000352(27.8)328(28.8)24(18.8)
婚姻状况[n(%)]3.1540.076
非在婚152(12.0)143(12.5)9(7.0)
在婚1 115(88.0)996(87.5)119(93.0)
吸烟状况[n(%)]4.6220.099
不吸烟1 003(79.2)893(78.4)110(85.9)
吸烟117(9.2)111(9.7)6(4.7)
已戒烟147(11.6)135(11.9)12(9.4)
高血压[n(%)]8.9560.003
378(29.8)355(31.2)23(18.0)
889(70.2)784(68.8)104(82.0)
糖尿病[n(%)]0.1680.682
102(8.1)91(8.0)11(8.6)
1 165(91.9)1 048(92.0)117(91.4)
MMSE得分[分, M(P25, P75)]28(26,29)28(27,29)23(21,24)17.456<0.001
日均能量摄入[kcal/d, M(P25, P75)]1 670.1(1 422.7,2 061.33)1 688.8(1 437.0,2079.8)1 546.0(1 221.7,2 001.9)3.499<0.001
膳食纤维摄入[g/d, M(P25, P75)]13.3(9.6,18.0)13.7(10.0,18.3)11.6(8.7,14.2)3.928<0.001
), ArticleFig(id=1241070729383432331, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, language=CN, label=表1, caption=

研究人群特征

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特征总计(n=1 267)认知功能异常χ2/ZP
正常组(n=1 139)异常组(n=128)
性别[n(%)]2.7710.096
598(47.2)547(48.0)51(39.8)
669(52.8)592(52.0)77(60.2)
年龄[岁, M(P25, P75)]63(60,66)63(60,66)64(61,70)-2.7050.006
BMI[kg/m2, M(P25, P75)]23.68(21.94,25.7)23.67(21.93,25.64)24.24(22.22,26.31)-1.3590.174
受教育水平[n(%)]20.093<0.001
文盲23(1.8)17(1.5)6(4.7)
小学111(8.8)98(8.6)13(10.2)
中学828(65.4)730(64.1)98(76.5)
大学及以上305(24.1)294(25.8)11(8.6)
家庭人均月收入[元,n(%)]22.673<0.001
<1 800115(9.1)92(8.1)23(18.0)
1 800~3 200390(30.8)340(29.9)50(39.1)
>3 200~5 000410(32.4)379(33.3)31(24.2)
>5 000352(27.8)328(28.8)24(18.8)
婚姻状况[n(%)]3.1540.076
非在婚152(12.0)143(12.5)9(7.0)
在婚1 115(88.0)996(87.5)119(93.0)
吸烟状况[n(%)]4.6220.099
不吸烟1 003(79.2)893(78.4)110(85.9)
吸烟117(9.2)111(9.7)6(4.7)
已戒烟147(11.6)135(11.9)12(9.4)
高血压[n(%)]8.9560.003
378(29.8)355(31.2)23(18.0)
889(70.2)784(68.8)104(82.0)
糖尿病[n(%)]0.1680.682
102(8.1)91(8.0)11(8.6)
1 165(91.9)1 048(92.0)117(91.4)
MMSE得分[分, M(P25, P75)]28(26,29)28(27,29)23(21,24)17.456<0.001
日均能量摄入[kcal/d, M(P25, P75)]1 670.1(1 422.7,2 061.33)1 688.8(1 437.0,2079.8)1 546.0(1 221.7,2 001.9)3.499<0.001
膳食纤维摄入[g/d, M(P25, P75)]13.3(9.6,18.0)13.7(10.0,18.3)11.6(8.7,14.2)3.928<0.001
), ArticleFig(id=1241070729488289942, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, language=EN, label=Table 2, caption=

Multivariate linear regression analysis of dietary fiber intake and cognitive function

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线性回归模型β(95% CIS.E.P
模型10.04(0.02~0.06)0.01<0.001
模型20.04(0.02~0.06)0.01<0.001
模型30.03(0.01~ 0.05)0.010.007
), ArticleFig(id=1241070729622507672, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, language=CN, label=表2, caption=

膳食纤维摄入量与认知功能的多重线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
线性回归模型β(95% CIS.E.P
模型10.04(0.02~0.06)0.01<0.001
模型20.04(0.02~0.06)0.01<0.001
模型30.03(0.01~ 0.05)0.010.007
), ArticleFig(id=1241070729723170976, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, language=EN, label=Table 3, caption=

Logisticregressionanalysisofdietary fiber intake and cognitive function

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变量模型1模型2模型3
OR(95% CIPOR(95% CIPOR(95% CIP
Q1refrefref
Q20.68(0.42~1.09)0.1080.66(0.41~1.07)0.0940.72(0.42~1.22)0.219
Q30.67(0.42~1.08)0.9870.65(0.40~1.06)0.0840.81(0.45~1.49)0.503
Q40.29(0.16~0.53)<0.0010.27(0.14~0.49)<0.0010.39(0.18~0.84)0.016
P趋势<0.001<0.0010.041
), ArticleFig(id=1241070729844805798, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, language=CN, label=表3, caption=

膳食纤维摄入量与认知功能的logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
OR(95% CIPOR(95% CIPOR(95% CIP
Q1refrefref
Q20.68(0.42~1.09)0.1080.66(0.41~1.07)0.0940.72(0.42~1.22)0.219
Q30.67(0.42~1.08)0.9870.65(0.40~1.06)0.0840.81(0.45~1.49)0.503
Q40.29(0.16~0.53)<0.0010.27(0.14~0.49)<0.0010.39(0.18~0.84)0.016
P趋势<0.001<0.0010.041
), ArticleFig(id=1241070729945469102, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, language=EN, label=Table 4, caption=

Correlation analysis of dietary fiber intake and cognitive function by gender and age

, figureFileSmall=null, figureFileBig=null, tableContent=
分组OR值(95% CI)POR值(95% CI)P
性别
Q1refref
Q20.52(0.21~1.27)0.1540.75(0.38~1.49)0.410
Q30.41(0.14~1.18)0.0990.98(0.46~2.13)0.975
Q40.19(0.05~0.68)0.0110.45(0.16~1.23)0.119
年龄(岁)<63≥63
Q1refref
Q20.64(0.25~1.60)0.3480.76(0.38~1.50)0.429
Q31.93(0.70~5.33)0.2060.53(0.24~1.18)0.121
Q40.52(0.11~2.36)0.2880.33(0.12~0.88)0.027
), ArticleFig(id=1241070730083881141, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730053567369541, language=CN, label=表4, caption=

不同性别、年龄膳食纤维摄入与认知功能的相关性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
分组OR值(95% CI)POR值(95% CI)P
性别
Q1refref
Q20.52(0.21~1.27)0.1540.75(0.38~1.49)0.410
Q30.41(0.14~1.18)0.0990.98(0.46~2.13)0.975
Q40.19(0.05~0.68)0.0110.45(0.16~1.23)0.119
年龄(岁)<63≥63
Q1refref
Q20.64(0.25~1.60)0.3480.76(0.38~1.50)0.429
Q31.93(0.70~5.33)0.2060.53(0.24~1.18)0.121
Q40.52(0.11~2.36)0.2880.33(0.12~0.88)0.027
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成都市50岁以上人群膳食纤维摄入量与认知功能的关系
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程志宝 1 , 汪晓语 2 , 陈梦雪 2 , 徐裕杰 2 , 熊静远 1 , 成果 2, 3
现代预防医学 | 营养与食品卫生 2025,52(8): 1386-1391
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现代预防医学 | 营养与食品卫生 2025, 52(8): 1386-1391
成都市50岁以上人群膳食纤维摄入量与认知功能的关系
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程志宝1, 汪晓语2, 陈梦雪2, 徐裕杰2, 熊静远1, 成果2, 3
作者信息
  • 1.四川大学华西公共卫生学院/华西第四医院,四川 成都 610041
  • 2.四川大学华西第二医院妇儿营养中心
  • 3.四川大学华西护理学院
  • 程志宝(2000—),男,硕士在读,研究方向:流行病学

通讯作者:

成果,E-mail:
Relationship between dietary fiber intake and cognitive function in people aged 50 and above, Chengdu
Zhi-bao CHENG1, Xiao-yu WANG2, Meng-xue CHEN2, Yu-jie XU2, Jing-yuan XIONG1, Guo CHENG2, 3
Affiliations
  • West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2025-04-25 doi: 10.20043/j.cnki.MPM.202411303
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目的

探究膳食纤维摄入量和认知功能之间的关系,为认知障碍的防治提供线索。

方法

选择2022年西南人群队列中50岁以上成年人作为研究对象,利用多重线性回归和多因素logistic回归模型分析膳食纤维摄入量和认知障碍之间的关系。然后进行亚组分析,探索不同性别年龄人群中膳食纤维摄入量和认知障碍之间的关联。

结果

共纳入1 267名研究对象,128(10.1%)人认知功能异常。研究对象膳食纤维摄入量中位数为13.3 g/d,认知功能异常者的膳食纤维摄入量(11.6 g/d)明显低于正常人群(13.7 g/d)且差异具有统计学意义(Z=3.93,P<0.001)。调整年龄、性别、身体质量指数、教育、吸烟、家庭人均月收入、高血压、糖尿病、日均能量摄入后,膳食纤维摄入量与认知功能得分呈正相关。逻辑回归显示与膳食纤维摄入量最低组(Q1)相比,膳食纤维摄入量最高组(Q4)认知功能异常的风险降低,且有统计学差异,Q2至Q4的OR值分别为0.29(95% CI: 0.16~0.53)、0.27(95% CI: 0.14~0.49)、0.39(95% CI: 0.18~0.84)。膳食纤维摄入量在男性和大于等于63岁的人群中影响更显著。

结论

膳食纤维摄入量与认知功能异常存在负相关关联,膳食纤维可能是认知功能异常的保护因素,并且在男性和大于等于63岁的人群中这种相关性可能更加明显。

膳食纤维  /  认知功能异常  /  线性回归模型  /  逻辑回归模型
Objective

To explore the relationship between dietary fiber intake and cognitive function, providing insights for nutritional interventions to prevent cognitive impairment.

Methods

Adults over 50 years old from the 2022 Southwest Population Cohort were selected as study subjects. Multiple linear regression and multivariable logistic regression models were used to analyze the relationship between dietary fiber intake and cognitive impairment. Subgroup analysis was performed to explore the association between dietary fiber intake and cognitive impairment across different age and gender groups.

Results

A total of 1 267 participants were included,the median dietary fiber intake of the participants was 13.3 g/d. The dietary fiber intake of individuals with cognitive dysfunction, specifically those with mild cognitive impairment (11.6 g/d), was significantly lower than that of the normal group (13.7 g/d), and the difference was statistically significant (Z=3.93, P<0.001). After adjusting for age, gender, body mass index, education, smoking, per capita monthly household income, hypertension, diabetes, and daily energy intake, dietary fiber intake was positively correlated with cognitive function scores. The logistic regression analysis showed that, compared to the lowest dietary fiber intake group (Q1), the highest dietary fiber intake group (Q4) had a reduced risk of cognitive dysfunction, with statistically significant OR values of 0.29 (95% CI: 0.16–0.53), 0.27 (95% CI: 0.14–0.49), and 0.39 (95% CI: 0.18–0.84). The impact of dietary fiber intake was more pronounced in males and in individuals aged 63 and above.

Conclusion

There is a negative association between dietary fiber intake and cognitive dysfunction, suggesting that dietary fiber may be a protective factor against cognitive dysfunction, with this association being particularly significant in males and individuals aged 63 years and older.

Dietary fiber  /  Cognitive dysfunction  /  Linear regression model  /  Logistic regression model
程志宝, 汪晓语, 陈梦雪, 徐裕杰, 熊静远, 成果. 成都市50岁以上人群膳食纤维摄入量与认知功能的关系. 现代预防医学, 2025 , 52 (8) : 1386 -1391 . DOI: 10.20043/j.cnki.MPM.202411303
Zhi-bao CHENG, Xiao-yu WANG, Meng-xue CHEN, Yu-jie XU, Jing-yuan XIONG, Guo CHENG. Relationship between dietary fiber intake and cognitive function in people aged 50 and above, Chengdu[J]. Modern Preventive Medicine, 2025 , 52 (8) : 1386 -1391 . DOI: 10.20043/j.cnki.MPM.202411303
随着全球老龄化的加速发展,阿尔兹海默症和痴呆等神经退行性疾病已成为全球重要的公共卫生问题。2019年全球痴呆症患者人数估计为5 700万,预计到2050年将增加到1.53亿[1]。轻度认知障碍(Mild Cognitive Impairment, MCI)是认知功能下降到痴呆之间的中间状态,患有MCI的个体表现为记忆、思维或语言等认知能力下降,但生活行动能力几乎不变[2]。痴呆暂无有效治疗方法且不可逆,而MCI具有可逆性[3],早期预防和控制MCI具有重要意义。影响认知功能的因素众多,有研究表明超过三分之一痴呆病例可以通过解决可改变的风险因素来预防,饮食是其中可改变的重要影响因素[4]。有流行病学证据表明,合理的饮食能够降低认知功能障碍的风险,多种食物及成分可以保护认知功能,改善记忆和学习能力[5]。有研究显示膳食纤维含量低的饮食与认知障碍有关,以高消费富含纤维的食物组为特征的健康饮食模式对认知有积极影响[6],也有实验研究表明膳食纤维能通过影响肠道菌群对大脑和认知功能产生保护作用[7]。50岁以上的中老年人是患认知障碍的高危人群[8],现有研究证明膳食纤维摄入可以对认知功能产生积极影响。但目前,人群中针对膳食纤维摄入量与认知功能之间关系的研究较少,尤其是针对中老年人群,其摄入量对人群认知功能的影响并不明确。本研究通过横断面研究调查膳食纤维摄入量与人群认知功能的关系,旨在为认知功能下降的干预提供科学依据。
本研究采取整群随机抽样方法,于2022年6月至12月选取成都市的6个社区作为调查点,参与者为50岁以上,能正常交流,无严重肢体残疾且自愿参加的常住居民。通过问卷收集了研究对象的社会人口学资料和膳食摄入信息,通过体格测量获得了身高体重信息。本研究获得了四川大学华西第二医院医学伦理委员会的伦理批准(医学科研2022伦审批第(042)号),所有参与者已签署书面知情同意书。
本研究共纳入1 354名研究对象。在排除基础信息、膳食数据缺失者(n=62)及能量摄入异常(男性>4 200或<800 kcal/d,女性>3 500或<500 kcal/d)(n=25)的调查对象共计87例后[9],最终1 267名研究对象被纳入分析。
本研究由经统一培训的调查人员使用半定量食物频率问卷(Food Frequency Questionnaire, FFQ)进行膳食调查,收集研究对象过去一年内各种食物的摄入频率和份量。该问卷是基于全国营养与健康调查的FFQ问卷[10],根据西南地区饮食习惯进行了地域化调整,包括67类食物及饮料等信息,并且经过了信效度检验。参与者需要回忆每种食物的消费频率:每天、每周、每月、每年或从不;以及食用的次数和份量。为了提高估计份量的准确性,提供了包括碗、盘子和玻璃杯等标准餐具,供受试者参考。总能量摄入量和营养素摄入量根据《中国食物成分表》进行评估计算[11]
本研究使用简易智能精神状态检查量表(Mini Mental State Examination, MMSE)评估参与者的认知功能。MMSE包括五个维度:定向力、记忆力、注意力和计算力、回忆能力以及语言能力。总分范围为0~30分。根据研究对象的文化程度,采用不同的MMSE分数标准来判断认知功能是否异常:①文盲≤17分认为认知功能异常;②小学文化≤20分认为认知功能异常;③中学及以上文化程度≤24分则认为认知功能异常,其余为正常人群[12]
本研究纳入性别、年龄、身体质量指数(Body Mass Index, BMI)、受教育水平、婚姻、高血压、糖尿病、吸烟、家庭人均月收入、能量摄入为协变量。年龄、受教育水平、婚姻、高血压、糖尿病、吸烟、家庭人均月收入根据自我报告的问卷获得;婚姻状况将已婚且同居定义为在婚,将未婚、离异、丧偶和分居定义为非在婚[13]。BMI按体重(kg)除以身高的平方(m2)计算。
数据采用EpiData 3.1软件录入,使用R 4.4.1进行数据分析。经正态性检验,本调查涉及的定量资料均不符合正态分布,故采用M(P25, P75)描述,分类变量采用频数和百分比描述。使用卡方检验比较分类资料,Wilcoxon检验比较定量资料。采用多重线性回归模型和多因素logistic回归模型分析50岁以上成年人膳食纤维摄入量与认知功能的关联,模型1未调整混杂因素,模型2调整了性别、年龄、BMI,模型3在模型2的基础上进一步调整了受教育水平、婚姻、高血压、糖尿病、吸烟、家庭人均月收入和能量摄入。进一步对性别和年龄进行了亚组分析。统计学检验均为双侧检验,检验水准α=0.05。
本研究共纳入1 267名研究对象。中位年龄为63岁,女性669人(52.8%),男性598人(47.2%)。1 267名对象中有128人被判定为认知功能异常,占总人数的10.1%,其MMSE得分中位数为23分;研究对象膳食纤维摄入量中位数为13.3 g/d,能量摄入量中位数为1 670.1 kcal/d。
认知功能异常的中位年龄大于认知功能正常组,膳食纤维摄入量(11.6 g/d)明显低于正常人群(13.7 g/d),能量摄入量(1 546.0 kcal/d)明显低于正常人群(1 688.8 kcal/d),差异均具有统计学意义。见表1
在模型1、模型2和模型3中均发现膳食纤维与认知功能得分相关,且均为正相关。在未调整协变量的模型1中,线性回归结果显示膳食纤维摄入量每增加1g,认知功能得分增加0.04分(95% CI:0.02~0.06),模型2在调整了性别、年龄和BMI后得出相同结果。模型3在模型2的基础上进一步调整了受教育水平、婚姻、高血压、糖尿病、吸烟、家庭人均月收入和能量摄入等因素,结果显示膳食纤维摄入量每增加1g,认知功能得分增加0.03分(95% CI:0.01~0.05)。线性回归结果表明膳食纤维摄入量的增加可能改善中老年人认知功能。见表2
为了进一步探索膳食纤维与认知功能的潜在关联,使用了三个模型对膳食纤维和认知功能进行了logistic回归分析。将膳食纤维摄入量按照四分位数分组进行logistic回归分析,计算结果详见表3。三个模型都显示出,与膳食纤维摄入量最低组(Q1)相比,Q2、Q3、Q4的OR值分别为0.29(95% CI: 0.16~0.53)、0.27(95% CI: 0.14~0.49)、0.39(95% CI: 0.18~0.84),且P均小于0.05。趋势性检验结果均具有统计学意义,与线性回归分析结果一致,认知功能异常的风险随着膳食纤维摄入量的增加而逐步降低。
本研究还根据性别、年龄进行了亚组分析,根据研究对象的中位年龄63岁进行分组,结果显示,在男性和年龄大于等于63岁的人群中,与膳食纤维摄入量最低组(Q1)相比,膳食纤维摄入量最低组(Q4)的认知功能异常风险最低,且具有统计学意义,其OR值分别为0.19(0.05~0.68),0.33(0.12~0.88)。见表4
本研究基于西南人群队列的数据探讨了膳食纤维摄入量与认知功能异常风险的关联。目前针对膳食纤维与认知功能异常的关系的流行病学研究较少,尤其是国内相关研究更少。本研究结果表明,认知功能异常的患者的膳食纤维摄入量明显低于正常人群,摄入更多的膳食纤维对认知功能有积极影响。
在澳大利亚的一项对50岁及以上、且无癌症、冠状动脉疾病等重大合并症的成年人的研究中,发现长期食用高膳食纤维饮食显著改善了认知功能[14]。一项针对老年法国妇女的随访研究发现,低膳食纤维摄入量与认知能力下降有关[15]。在儿童中也发现膳食纤维摄入量与整体托伦斯创造性思维测试(Torrance Tests of Creative Thinking, TTCT)表现呈正相关,能够促进儿童创造力的发展[16]。以上研究展示的膳食纤维与认知功能的关系与本研究的结果一致。但是一项人群来自英国生物样本库的研究提出摄入过多或过低膳食纤维成年人整体认知功能呈负相关,极高的膳食纤维摄入量可能会削弱认知功能,但该研究并未具体说明每日膳食纤维的摄入量[17]。膳食纤维的摄入量对人群认知功能的影响还需进一步研究,确定与认知功能的剂量反应关系。
研究表明,膳食纤维摄入量可以影响肠道微生物群,肠道菌群失调被认为是影响神经炎症和神经元功能障碍发生的重要因素[18]。膳食纤维保护认知功能的潜在机制可能在于改善肠道功能,尤其是通过维持肠道屏障和血脑屏障的完整性[19]。膳食纤维在肠道中发酵产生的主要是乙酸盐、丙酸盐和丁酸盐,丁酸盐被证明可以增加脑源性神经营养因子(Brain-Derived Neurotrophic Factor , BDNF)的表达,对大脑和认知功能产生益处[20]。另有研究表明,膳食纤维能够通过改变pH值和肠道通透性来降低炎症的作用[21],炎症可能是膳食纤维与认知功能关系的潜在中介,适量的膳食纤维可能有助于减少或预防炎症从而改善认知功能。但目前有关膳食纤维对认知功能影响机制的研究还较少,其作用机制并不明确。
本研究性别亚组分析中发现膳食纤维在男性中对认知功能的影响更显著,在一项有关儿童的研究中也发现较高的膳食果糖和纤维摄入量与认知能力相关,这一关系在男孩中更明显,与女孩无关[22]。然而,在美国的一项针对60岁以上人群的研究中,调整潜在的混杂因素后,膳食纤维与认知功能在男性中的关联没有统计学意义,与女性的关联具有边际显著性[23],这些研究的差异可能源于人群的差异,拥有不同的膳食纤维饮食来源,造成了不同的影响。本研究还发现膳食纤维在大于等于63岁的人群中对认知功能的影响效果更显著,可能是高年龄组食物摄入和营养状况的不同导致的,具体影响机制还需要进一步研究分析。
综上所述,本研究发现膳食纤维与50岁以上人群的认知功能存在正相关,对认知功能有积极影响,尤其在男性和大于等于63岁的人群中效果更显著,但是其影响机制并不明确,还需要进一步研究。此外本研究人群膳食纤维摄入量中位数为13.3 g/d,远低于《中国居民膳食营养素参考摄入量》的25~30 g/d[24],还需要增加膳食纤维的摄入量,可能会对认知功能产生更积极的影响。
本研究的优势在于首次在西南地区针对膳食纤维摄入量和认知功能做了调查。在问卷调查和录入时采取了严格的质量控制。但本研究是横断面研究,无法提供证据证明膳食纤维摄入量与认知之间存在因果关系,需要进一步进行前瞻性研究确定因果关系。此外,本研究仅使用MMSE问卷作为认知评估的工具,对认知功能的评估可能不够准确,后续研究可以结合多种认知测试综合判定认知状况,以更好的分析膳食因素与认知不同方面的关联。
  • 国家自然科学基金(82173512)
  • 国家自然科学基金青年项目(82304135)
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2025年第52卷第8期
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doi: 10.20043/j.cnki.MPM.202411303
  • 接收时间:2024-11-15
  • 首发时间:2026-03-17
  • 出版时间:2025-04-25
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  • 收稿日期:2024-11-15
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国家自然科学基金(82173512)
国家自然科学基金青年项目(82304135)
作者信息
    1.四川大学华西公共卫生学院/华西第四医院,四川 成都 610041
    2.四川大学华西第二医院妇儿营养中心
    3.四川大学华西护理学院

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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