Article(id=1324044644543242310, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044540067328424, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202512191, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1765382400000, receivedDateStr=2025-12-11, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793606442818, onlineDateStr=2026-11-02, pubDate=1777046400000, pubDateStr=2026-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793606442818, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793606442818, creator=13701087609, updateTime=1793606442818, updator=13701087609, issue=Issue{id=1324044540067328424, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='8', pageStart='1345', pageEnd='1536', issueExtLink='null', onlineDate='null', pubDate='1777046400000', pubDateStr='2026-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793606417910, creator='13701087609', updateTime=1793606417910, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1459, endPage=1465, ext={EN=ArticleExt(id=1324044644849426503, articleId=1324044644543242310, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between the healthy eating index and falls and injuries from falls in Chinese older adults, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the relationship between the healthy eating index (HEI) and falls and injuries from falls in older adults.

Methods

Data from the 2018 Chinese Longitudinal Healthy Longevity survey and happy family study (CLHLS-HF, wave 2018) were used. HEI scores were calculated based on the consumption frequency of 13 food categories collected through face-to-face interviews. Fall events and fall injuries were based on self-reports. Multivariate logistic regression and restricted cubic spline (RCS) analysis were used to analyze the association between HEI and falls and fall injuries. Confounding factors were adjusted and subgroup analyses were performed.

Results

A total of 8 701 older adults aged 65 years and above were included in this study. After adjusting for potential confounding variables, HEI was significantly negatively correlated with falls (OR=0.98, 95%CI: 0.97-0.99) and fall injuries (OR=0.97, 95%CI: 0.96-0.98). RCS analysis showed a linear dose-response relationship between HEI and falls (P overall<0.001, P for non-linearity=0.208) and fall injuries (P overall<0.001, P for non-linearity=0.059). Subgroup analysis showed that this association remained significant in men (P trend=0.032), women (P trend=0.002), individuals aged 80 years and older (P trend<0.001), and non-living-alone elderly (P trend<0.001).

Conclusion

Higher HEI levels among the elderly in China are associated with a reduced risk of falls and fall injuries. Paying attention to HEI levels may help the early identification of high-risk groups for falls, providing new ideas for the early prevention and intervention of falls in the elderly.

, authors=Kong-yu LIU1, Shao-hua HU2, Xiao-mei WANG1, Yan DONG3, Tao-tao RAN1, Han-bang WANG4, authorsList=Kong-yu LIU, Shao-hua HU, Xiao-mei WANG, Yan DONG, Tao-tao RAN, Han-bang WANG, authorCompany=null, correspAuthors=Han-bang WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324044647894491216, articleId=1324044644543242310, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=中国老年人健康饮食指数与跌倒及跌倒损伤的相关性研究, columnId=1228016572640461823, journalTitle=现代预防医学, columnName=健康与社会行为, runingTitle=null, highlight=null, articleAbstract=
目的

探讨健康饮食指数(HEI)和老年人跌倒及跌倒损伤的关系。

方法

基于中国老年健康与家庭幸福调查(CLHLS-HF)2018的数据。HEI评分基于面对面访谈收集的13类食物的消费频率计算,跌倒及跌倒损伤基于自我报告,采用多因素logistic回归、限制性立方样条(RCS)分析HEI与跌倒及跌倒损伤之间的关联,并进行混杂因素调整及亚组分析。

结果

本研究共纳入8 701名65岁及以上老年人,调整潜在混杂变量后,HEI与跌倒(OR=0.98,95%CI:0.97~0.99)及跌倒损伤(OR=0.97,95%CI:0.96~0.98)均呈负相关。RCS分析显示HEI与跌倒(P overall<0.001,P for non-linearity=0.208)、跌倒损伤(P overall<0.001,P for non-linearity=0.059)之间均存在线性剂量-反应关系。亚组分析显示,这种关联在男性(P趋势=0.032)、女性(P趋势=0.002)、80岁及以上个体(P趋势<0.001)、非独居老人(P趋势<0.001)中仍显著。

结论

中国老年人群高HEI与跌倒及跌倒损伤发生风险降低有关,关注HEI水平可能有助于早期识别跌倒高风险人群,为老年人跌倒的早期预防和干预提供新思路。

, authors=刘孔玉1, 胡少华2, 王晓梅1, 董艳3, 冉陶陶1, 王汉邦4, authorsList=刘孔玉, 胡少华, 王晓梅, 董艳, 冉陶陶, 王汉邦, authorCompany=null, correspAuthors=王汉邦, authorNote=

刘孔玉(1990—),女,硕士,主管护师,研究方向:老年护理

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王汉邦,E-mail:
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Journal of Nutrition Health & Aging, 2025, 29(12): 100718., articleTitle=Comparative effectiveness of exercise and Protein-Based interventions on muscle strength, mass, and function in sarcopenia: a systematic review and network Meta-Analysis, refAbstract=null)], funds=[Fund(id=1324044654190141580, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, awardId=2023AH050681, language=CN, fundingSource=安徽省高校科研重点项目(2023AH050681), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324044648309727313, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, xref=1., ext=[AuthorCompanyExt(id=1324044648322310226, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, companyId=1324044648309727313, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of operation room, the Fuyang Affiliated Hospital of Anhui Medical University, Fuyang, Anhui 236000, China), AuthorCompanyExt(id=1324044648330698835, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, companyId=1324044648309727313, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.安徽医科大学附属阜阳医院手术室,安徽 阜阳 236000)]), AuthorCompany(id=1324044648414584916, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, xref=2., ext=[AuthorCompanyExt(id=1324044648427167829, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, companyId=1324044648414584916, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.安徽医科大学第一附属医院护理部)]), AuthorCompany(id=1324044648502665302, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, xref=3., ext=[AuthorCompanyExt(id=1324044648515248215, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, companyId=1324044648502665302, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.安徽医科大学附属阜阳医院护理部)]), AuthorCompany(id=1324044648586551384, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, xref=4., ext=[AuthorCompanyExt(id=1324044648599134297, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, companyId=1324044648586551384, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.安徽医科大学附属阜阳医院骨科)])], figs=[ArticleFig(id=1324044652868935808, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=EN, label=Fig. 1, caption=Flowchart of subject selection, figureFileSmall=ScydEm5Lr27IXbmF/VkHXA==, figureFileBig=M7csnX6UzfS4VEuoa+P9pg==, tableContent=null), ArticleFig(id=1324044652961210497, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=CN, label=图1, caption=研究对象筛选流程图, figureFileSmall=ScydEm5Lr27IXbmF/VkHXA==, figureFileBig=M7csnX6UzfS4VEuoa+P9pg==, tableContent=null), ArticleFig(id=1324044653141565570, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=EN, label=Fig. 2, caption=Dose-response relationship between HEI and falls and serious fall injuries, figureFileSmall=82z5/o96zX0qvnztI8BcaQ==, figureFileBig=HqxexJcqENToBw5+jatw1A==, tableContent=null), ArticleFig(id=1324044653250617475, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=CN, label=图2, caption=HEI与跌倒及严重跌倒受伤的剂量-反应关系

注:A,跌倒;B,严重跌倒受伤。

, figureFileSmall=82z5/o96zX0qvnztI8BcaQ==, figureFileBig=HqxexJcqENToBw5+jatw1A==, tableContent=null), ArticleFig(id=1324044653422583940, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=EN, label=Fig. 3, caption=Association between HEI components and falls, figureFileSmall=VO7xjbRlgqvounG7hS5o+Q==, figureFileBig=/7AgAM4wIJw0Zyi/iSET9Q==, tableContent=null), ArticleFig(id=1324044653519052933, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=CN, label=图3, caption=HEI组成成分与跌倒的关联, figureFileSmall=VO7xjbRlgqvounG7hS5o+Q==, figureFileBig=/7AgAM4wIJw0Zyi/iSET9Q==, tableContent=null), ArticleFig(id=1324044653619716230, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=EN, label=Table 1, caption=

Characteristics of study population based on HEI quartile [n (%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总体(n=8 701)Q1(n=2 266)Q2(n=1 857)Q3(n=2 515)Q4(n=2 063)χ2值P值
跌倒1 915(22.0)585(25.8)410(22.1)532(21.2)388(18.8)32.534<0.001
严重跌倒受伤625(7.2)209(9.2)125(6.7)167(6.6)124(6.0)20.081<0.001
年龄(岁)180.750<0.001
65~793 286(37.8)639(28.2)664(35.8)1 001(39.8)982(47.6)
≥805 415(62.2)1 627(71.8)1 193(64.2)1 514(60.2)1 081(52.4)
性别185.130<0.001
男3 963(45.5)815(36.0)799(43.0)1 191(47.4)1 158(56.1)
女4 738(54.5)1 451(64.0)1 058(57.0)1 324(52.6)905(43.9)
民族68.479<0.001
汉族8 205(94.3)2 090(92.2)1 719(92.6)2 385(94.8)2 011(97.5)
其他民族496(5.7)176(7.8)138(7.4)130(5.2)52(2.5)
居住地432.610<0.001
城市/城镇5 063(58.2)1 053(46.5)937(50.5)1 515(60.2)1 558(75.5)
农村3 638(41.8)1 213(53.5)920(49.5)1 000(39.8)505(24.5)
居住安排117.390<0.001
非独居7 340(84.4)1 769(78.1)1 544(83.1)2 194(87.2)1 833(88.9)
独居1 361(15.6)497(21.9)313(16.9)321(12.8)230(11.1)
教育水平1 290.200<0.001
文盲4 036(46.4)1 483(65.4)992(53.4)1 104(43.9)457(22.2)
小学2 053(23.6)482(21.3)504(27.1)647(25.7)420(20.4)
初中及以上2 612(30.0)301(13.3)361(19.4)764(30.4)1 186(57.5)
职业1 421.400<0.001
农民5 389(61.9)1 870(82.5)1 409(75.9)1 475(58.6)635(30.8)
非农民3 312(38.1)396(17.5)448(24.1)1 040(41.4)1 428(69.2)
婚姻状况218.620<0.001
已婚3 831(44.0)776(34.2)749(40.3)1 154(45.9)1 152(55.8)
丧偶/离异/未婚4 870(56.0)1 490(65.8)1 108(59.7)1 361(54.1)911(44.2)
经济水平558.210<0.001
富裕1 716(19.7)213(9.4)300(16.2)548(21.8)655(31.7)
一般6 142(70.6)1 648(72.7)1 370(73.8)1 794(71.3)1 330(64.5)
困难843(9.7)405(17.9)187(10.1)173(6.9)78(3.8)
吸烟状态81.546<0.001
从未6 021(69.2)1 684(74.3)1 317(70.9)1 690(67.2)1 330(64.5)
以前1 341(15.4)262(11.6)255(13.7)404(16.1)420(20.4)
现在1 339(15.4)320(14.1)285(15.3)421(16.7)313(15.2)
饮酒状态58.531<0.001
从未6 332(72.8)1 756(77.5)1 370(73.8)1 785(71.0)1 421(68.9)
以前1 037(11.9)233(10.3)238(12.8)315(12.5)251(12.2)
现在1 332(15.3)277(12.2)249(13.4)415(16.5)391(19.0)
身体锻炼647.200<0.001
从未5 193(59.7)1 712(75.6)1 234(66.5)1 441(57.3)806(39.1)
以前651(7.5)109(4.8)111(6.0)215(8.5)216(10.5)
现在2 857(32.8)445(19.6)512(27.6)859(34.2)1 041(50.5)
高血压96.090<0.001
有3 604(41.4)834(36.8)694(37.4)1 043(41.5)1 033(50.1)
无5 097(58.6)1 432(63.2)1 163(62.6)1 472(58.5)1 030(49.9)
糖尿病210.820<0.001
有883(10.1)113(5.0)126(6.8)286(11.4)358(17.4)
无7 818(89.9)2 153(95.0)1 731(93.2)2 229(88.6)1 705(82.6)
心脏病117.610<0.001
有1 493(17.2)113(5.0)246(13.2)460(18.3)494(23.9)
无7 208(82.8)1 973(87.1)1 611(86.8)2 055(81.7)1 569(76.1)
中风及脑血管疾病42.166<0.001
有927(10.7)212(9.4)145(7.8)286(11.4)284(13.8)
无7 774(89.3)2 054(90.6)1 712(92.2)2 229(88.6)1 779(86.2)
癌症31.487<0.001
有138(1.6)22(1.0)18(1.0)39(1.6)59(2.9)
无8 563(98.4)2 244(99.0)1 839(99.0)2 476(98.4)2 004(97.1)
BMI(kg/m2)220.210<0.001
<18.51 435(16.5)492(21.7)353(19.0)379(15.1)211(10.2)
18.5~23.94 460(51.3)1 207(53.3)982(52.9)1 291(51.3)980(47.5)
24.0~27.92 085(24.0)417(18.4)376(20.2)643(25.6)649(31.5)
≥28.0721(8.3)150(6.6)146(7.9)202(8.0)223(10.8)
), ArticleFig(id=1324044653720379527, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=CN, label=表1, caption=

基于HEI四分位数的研究人群特征[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总体(n=8 701)Q1(n=2 266)Q2(n=1 857)Q3(n=2 515)Q4(n=2 063)χ2值P值
跌倒1 915(22.0)585(25.8)410(22.1)532(21.2)388(18.8)32.534<0.001
严重跌倒受伤625(7.2)209(9.2)125(6.7)167(6.6)124(6.0)20.081<0.001
年龄(岁)180.750<0.001
65~793 286(37.8)639(28.2)664(35.8)1 001(39.8)982(47.6)
≥805 415(62.2)1 627(71.8)1 193(64.2)1 514(60.2)1 081(52.4)
性别185.130<0.001
男3 963(45.5)815(36.0)799(43.0)1 191(47.4)1 158(56.1)
女4 738(54.5)1 451(64.0)1 058(57.0)1 324(52.6)905(43.9)
民族68.479<0.001
汉族8 205(94.3)2 090(92.2)1 719(92.6)2 385(94.8)2 011(97.5)
其他民族496(5.7)176(7.8)138(7.4)130(5.2)52(2.5)
居住地432.610<0.001
城市/城镇5 063(58.2)1 053(46.5)937(50.5)1 515(60.2)1 558(75.5)
农村3 638(41.8)1 213(53.5)920(49.5)1 000(39.8)505(24.5)
居住安排117.390<0.001
非独居7 340(84.4)1 769(78.1)1 544(83.1)2 194(87.2)1 833(88.9)
独居1 361(15.6)497(21.9)313(16.9)321(12.8)230(11.1)
教育水平1 290.200<0.001
文盲4 036(46.4)1 483(65.4)992(53.4)1 104(43.9)457(22.2)
小学2 053(23.6)482(21.3)504(27.1)647(25.7)420(20.4)
初中及以上2 612(30.0)301(13.3)361(19.4)764(30.4)1 186(57.5)
职业1 421.400<0.001
农民5 389(61.9)1 870(82.5)1 409(75.9)1 475(58.6)635(30.8)
非农民3 312(38.1)396(17.5)448(24.1)1 040(41.4)1 428(69.2)
婚姻状况218.620<0.001
已婚3 831(44.0)776(34.2)749(40.3)1 154(45.9)1 152(55.8)
丧偶/离异/未婚4 870(56.0)1 490(65.8)1 108(59.7)1 361(54.1)911(44.2)
经济水平558.210<0.001
富裕1 716(19.7)213(9.4)300(16.2)548(21.8)655(31.7)
一般6 142(70.6)1 648(72.7)1 370(73.8)1 794(71.3)1 330(64.5)
困难843(9.7)405(17.9)187(10.1)173(6.9)78(3.8)
吸烟状态81.546<0.001
从未6 021(69.2)1 684(74.3)1 317(70.9)1 690(67.2)1 330(64.5)
以前1 341(15.4)262(11.6)255(13.7)404(16.1)420(20.4)
现在1 339(15.4)320(14.1)285(15.3)421(16.7)313(15.2)
饮酒状态58.531<0.001
从未6 332(72.8)1 756(77.5)1 370(73.8)1 785(71.0)1 421(68.9)
以前1 037(11.9)233(10.3)238(12.8)315(12.5)251(12.2)
现在1 332(15.3)277(12.2)249(13.4)415(16.5)391(19.0)
身体锻炼647.200<0.001
从未5 193(59.7)1 712(75.6)1 234(66.5)1 441(57.3)806(39.1)
以前651(7.5)109(4.8)111(6.0)215(8.5)216(10.5)
现在2 857(32.8)445(19.6)512(27.6)859(34.2)1 041(50.5)
高血压96.090<0.001
有3 604(41.4)834(36.8)694(37.4)1 043(41.5)1 033(50.1)
无5 097(58.6)1 432(63.2)1 163(62.6)1 472(58.5)1 030(49.9)
糖尿病210.820<0.001
有883(10.1)113(5.0)126(6.8)286(11.4)358(17.4)
无7 818(89.9)2 153(95.0)1 731(93.2)2 229(88.6)1 705(82.6)
心脏病117.610<0.001
有1 493(17.2)113(5.0)246(13.2)460(18.3)494(23.9)
无7 208(82.8)1 973(87.1)1 611(86.8)2 055(81.7)1 569(76.1)
中风及脑血管疾病42.166<0.001
有927(10.7)212(9.4)145(7.8)286(11.4)284(13.8)
无7 774(89.3)2 054(90.6)1 712(92.2)2 229(88.6)1 779(86.2)
癌症31.487<0.001
有138(1.6)22(1.0)18(1.0)39(1.6)59(2.9)
无8 563(98.4)2 244(99.0)1 839(99.0)2 476(98.4)2 004(97.1)
BMI(kg/m2)220.210<0.001
<18.51 435(16.5)492(21.7)353(19.0)379(15.1)211(10.2)
18.5~23.94 460(51.3)1 207(53.3)982(52.9)1 291(51.3)980(47.5)
24.0~27.92 085(24.0)417(18.4)376(20.2)643(25.6)649(31.5)
≥28.0721(8.3)150(6.6)146(7.9)202(8.0)223(10.8)
), ArticleFig(id=1324044653795877000, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=EN, label=Table 2, caption=

The association of HEI with falls and serious fall injuries [OR (95%CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量跌倒严重跌倒受伤
模型1模型2模型3模型1模型2模型3
HEI(每1分)0.97(0.97~0.98)0.98(0.97~0.99)0.98(0.97~0.99)0.97(0.96~0.98)0.97(0.96~0.99)0.97(0.96~0.98)
P值<0.001<0.001<0.001<0.0010.001<0.001
HEI四分位
Q11.001.001.001.001.001.00
Q20.81(0.70~0.94)0.87(0.75~1.02)0.87(0.75~1.02)0.71(0.56~0.89)0.77(0.60~0.97)0.76(0.60~0.97)
Q30.77(0.67~0.88)0.84(0.73~0.97)0.82(0.71~0.95)0.70(0.56~0.86)0.76(0.61~0.96)0.73(0.58~0.91)
Q40.66(0.57~0.76)0.75(0.64~0.89)0.72(0.60~0.85)0.62(0.49~0.79)0.72(0.55~0.94)0.67(0.51~0.88)
P趋势<0.0010.001<0.001<0.0010.0110.003
), ArticleFig(id=1324044653879763081, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=CN, label=表2, caption=

HEI与跌倒及严重跌倒受伤的关联[OR(95%CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量跌倒严重跌倒受伤
模型1模型2模型3模型1模型2模型3
HEI(每1分)0.97(0.97~0.98)0.98(0.97~0.99)0.98(0.97~0.99)0.97(0.96~0.98)0.97(0.96~0.99)0.97(0.96~0.98)
P值<0.001<0.001<0.001<0.0010.001<0.001
HEI四分位
Q11.001.001.001.001.001.00
Q20.81(0.70~0.94)0.87(0.75~1.02)0.87(0.75~1.02)0.71(0.56~0.89)0.77(0.60~0.97)0.76(0.60~0.97)
Q30.77(0.67~0.88)0.84(0.73~0.97)0.82(0.71~0.95)0.70(0.56~0.86)0.76(0.61~0.96)0.73(0.58~0.91)
Q40.66(0.57~0.76)0.75(0.64~0.89)0.72(0.60~0.85)0.62(0.49~0.79)0.72(0.55~0.94)0.67(0.51~0.88)
P趋势<0.0010.001<0.001<0.0010.0110.003
), ArticleFig(id=1324044653959454858, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=EN, label=Table 3, caption=

Subgroup analysis of HEI associated with falls [OR (95%CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量HEI四分位数P趋势P交互
Q1Q2Q3Q4
年龄(岁)0.668
65~791.000.98(0.73~1.32)0.89(0.68~1.19)0.84(0.61~1.15)0.232
≥801.000.84(0.70~1.00)0.80(0.68~0.95)0.68(0.55~0.84)<0.001
性别0.688
男1.000.81(0.63~1.04)0.77(0.61~0.97)0.74(0.57~0.97)0.032
女1.000.91(0.75~1.10)0.84(0.70~1.02)0.68(0.54~0.86)0.002
居住地0.462
城市/城镇1.001.04(0.84~1.28)0.86(0.71~1.06)0.78(0.62~0.98)0.016
农村1.000.72(0.58~0.90)0.79(0.64~0.98)0.69(0.52~0.92)0.008
居住安排0.958
非独居1.000.78(0.66~0.92)0.77(0.66~0.90)0.68(0.57~0.82)<0.001
独居1.001.51(1.07~2.13)1.06(0.73~1.53)0.79(0.49~1.27)0.553
婚姻状况0.659
已婚1.000.84(0.64~1.09)0.83(0.65~0.07)0.74(0.56~0.97)0.049
离异/丧偶/未婚1.000.89(0.74~1.07)0.81(0.68~0.97)0.70(0.56~0.88)0.001
经济水平0.079
富裕1.000.92(0.60~1.43)0.84(0.56~1.26)0.73(0.48~1.13)0.125
一般1.000.84(0.70~1.00)0.81(0.68~0.96)0.73(0.59~0.89)0.002
困难1.001.04(0.70~1.53)0.89(0.59~1.34)0.58(0.30~1.09)0.190
身体锻炼0.990
从未1.000.83(0.70~1.00)0.76(0.64~0.91)0.73(0.58~0.92)0.002
过去1.000.73(0.39~1.35)0.81(0.48~1.40)0.65(0.36~1.16)0.224
现在1.001.03(0.75~1.40)0.97(0.72~1.31)0.79(0.57~1.09)0.100
), ArticleFig(id=1324044654047535243, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044644543242310, language=CN, label=表3, caption=

HEI与跌倒关联的亚组分析[OR(95%CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量HEI四分位数P趋势P交互
Q1Q2Q3Q4
年龄(岁)0.668
65~791.000.98(0.73~1.32)0.89(0.68~1.19)0.84(0.61~1.15)0.232
≥801.000.84(0.70~1.00)0.80(0.68~0.95)0.68(0.55~0.84)<0.001
性别0.688
男1.000.81(0.63~1.04)0.77(0.61~0.97)0.74(0.57~0.97)0.032
女1.000.91(0.75~1.10)0.84(0.70~1.02)0.68(0.54~0.86)0.002
居住地0.462
城市/城镇1.001.04(0.84~1.28)0.86(0.71~1.06)0.78(0.62~0.98)0.016
农村1.000.72(0.58~0.90)0.79(0.64~0.98)0.69(0.52~0.92)0.008
居住安排0.958
非独居1.000.78(0.66~0.92)0.77(0.66~0.90)0.68(0.57~0.82)<0.001
独居1.001.51(1.07~2.13)1.06(0.73~1.53)0.79(0.49~1.27)0.553
婚姻状况0.659
已婚1.000.84(0.64~1.09)0.83(0.65~0.07)0.74(0.56~0.97)0.049
离异/丧偶/未婚1.000.89(0.74~1.07)0.81(0.68~0.97)0.70(0.56~0.88)0.001
经济水平0.079
富裕1.000.92(0.60~1.43)0.84(0.56~1.26)0.73(0.48~1.13)0.125
一般1.000.84(0.70~1.00)0.81(0.68~0.96)0.73(0.59~0.89)0.002
困难1.001.04(0.70~1.53)0.89(0.59~1.34)0.58(0.30~1.09)0.190
身体锻炼0.990
从未1.000.83(0.70~1.00)0.76(0.64~0.91)0.73(0.58~0.92)0.002
过去1.000.73(0.39~1.35)0.81(0.48~1.40)0.65(0.36~1.16)0.224
现在1.001.03(0.75~1.40)0.97(0.72~1.31)0.79(0.57~1.09)0.100
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中国老年人健康饮食指数与跌倒及跌倒损伤的相关性研究
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刘孔玉 1 , 胡少华 2 , 王晓梅 1 , 董艳 3 , 冉陶陶 1 , 王汉邦 4
现代预防医学 | 健康与社会行为 2026,53(8): 1459-1465
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现代预防医学 |健康与社会行为 2026 , 53 (8) : 1459 -1465
中国老年人健康饮食指数与跌倒及跌倒损伤的相关性研究
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刘孔玉1, 胡少华2, 王晓梅1, 董艳3, 冉陶陶1, 王汉邦4
作者信息
  • 1.安徽医科大学附属阜阳医院手术室,安徽 阜阳 236000
  • 2.安徽医科大学第一附属医院护理部
  • 3.安徽医科大学附属阜阳医院护理部
  • 4.安徽医科大学附属阜阳医院骨科
通讯作者:
王汉邦,E-mail:
作者简介:

刘孔玉(1990—),女,硕士,主管护师,研究方向:老年护理

Association between the healthy eating index and falls and injuries from falls in Chinese older adults
Kong-yu LIU1, Shao-hua HU2, Xiao-mei WANG1, Yan DONG3, Tao-tao RAN1, Han-bang WANG4
Affiliations
  • Department of operation room, the Fuyang Affiliated Hospital of Anhui Medical University, Fuyang, Anhui 236000, China
出版时间: 2026-04-25 doi: 10.20043/j.cnki.MPM.202512191
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目的

探讨健康饮食指数(HEI)和老年人跌倒及跌倒损伤的关系。

方法

基于中国老年健康与家庭幸福调查(CLHLS-HF)2018的数据。HEI评分基于面对面访谈收集的13类食物的消费频率计算,跌倒及跌倒损伤基于自我报告,采用多因素logistic回归、限制性立方样条(RCS)分析HEI与跌倒及跌倒损伤之间的关联,并进行混杂因素调整及亚组分析。

结果

本研究共纳入8 701名65岁及以上老年人,调整潜在混杂变量后,HEI与跌倒(OR=0.98,95%CI:0.97~0.99)及跌倒损伤(OR=0.97,95%CI:0.96~0.98)均呈负相关。RCS分析显示HEI与跌倒(P overall<0.001,P for non-linearity=0.208)、跌倒损伤(P overall<0.001,P for non-linearity=0.059)之间均存在线性剂量-反应关系。亚组分析显示,这种关联在男性(P趋势=0.032)、女性(P趋势=0.002)、80岁及以上个体(P趋势<0.001)、非独居老人(P趋势<0.001)中仍显著。

结论

中国老年人群高HEI与跌倒及跌倒损伤发生风险降低有关,关注HEI水平可能有助于早期识别跌倒高风险人群,为老年人跌倒的早期预防和干预提供新思路。

健康饮食指数  /  跌倒  /  老年人  /  跌倒损伤
Objective

To explore the relationship between the healthy eating index (HEI) and falls and injuries from falls in older adults.

Methods

Data from the 2018 Chinese Longitudinal Healthy Longevity survey and happy family study (CLHLS-HF, wave 2018) were used. HEI scores were calculated based on the consumption frequency of 13 food categories collected through face-to-face interviews. Fall events and fall injuries were based on self-reports. Multivariate logistic regression and restricted cubic spline (RCS) analysis were used to analyze the association between HEI and falls and fall injuries. Confounding factors were adjusted and subgroup analyses were performed.

Results

A total of 8 701 older adults aged 65 years and above were included in this study. After adjusting for potential confounding variables, HEI was significantly negatively correlated with falls (OR=0.98, 95%CI: 0.97-0.99) and fall injuries (OR=0.97, 95%CI: 0.96-0.98). RCS analysis showed a linear dose-response relationship between HEI and falls (P overall<0.001, P for non-linearity=0.208) and fall injuries (P overall<0.001, P for non-linearity=0.059). Subgroup analysis showed that this association remained significant in men (P trend=0.032), women (P trend=0.002), individuals aged 80 years and older (P trend<0.001), and non-living-alone elderly (P trend<0.001).

Conclusion

Higher HEI levels among the elderly in China are associated with a reduced risk of falls and fall injuries. Paying attention to HEI levels may help the early identification of high-risk groups for falls, providing new ideas for the early prevention and intervention of falls in the elderly.

Healthy eating index  /  Falls  /  Older adults  /  Fall injuries
刘孔玉, 胡少华, 王晓梅, 董艳, 冉陶陶, 王汉邦. 中国老年人健康饮食指数与跌倒及跌倒损伤的相关性研究. 现代预防医学, 2026 , 53 (8) : 1459 -1465 . DOI: 10.20043/j.cnki.MPM.202512191
Kong-yu LIU, Shao-hua HU, Xiao-mei WANG, Yan DONG, Tao-tao RAN, Han-bang WANG. Association between the healthy eating index and falls and injuries from falls in Chinese older adults[J]. Modern Preventive Medicine, 2026 , 53 (8) : 1459 -1465 . DOI: 10.20043/j.cnki.MPM.202512191
随着全球人口老龄化的持续加剧,老年人跌倒已成为重大的公共卫生挑战。据世界卫生组织报告,全球65岁及以上老年人跌倒发生率为28%~35%,70岁及以上老年人跌倒发生率高达32%~42%[1]。在中国,意外跌倒是≥65岁人群致命和非致命伤害的主要原因,据统计,我国每年约有1/3的老年人至少发生1次跌倒[2],且2020年—2024年中国老年人跌倒的标准化死亡率呈上升趋势[3]。跌倒不仅会造成出血、骨折等身体损伤,还可能导致长期残疾、心理恐惧和生活质量下降,给家庭和社会带来沉重的经济及照护负担[4-5]。
饮食作为可干预风险因素,在老年人跌倒预防中扮演着关键角色[6]。研究表明,蛋白质、维生素D、蔬菜和水果摄入不足会显著增加老年人跌倒风险[7-8],其中,钙和维生素D缺乏会加剧骨质疏松的进展。既往研究仅聚焦于单一营养素或特定食物成分与跌倒的关联,无法识别食物之间复杂的相互作用和协同效应,相比之下,整体饮食模式能更准确地揭示饮食质量与健康结局的关联。美国农业部发布的健康饮食指数(HEI)综合考虑多种营养素的摄入情况,是评估整体饮食质量的可靠工具[9]。多项研究已证实了HEI与心血管疾病[10]、中风[11]、癌症[12]的相关性。目前,尚无研究探讨中国老年人HEI与跌倒风险的关系。本研究基于CLHLS全国性数据,构建适用于中国老年人的健康饮食指数,深入探讨其与老年人跌倒及跌倒损伤的相关性。
本研究数据来源于中国老年健康与家庭幸福调查(CLHLS-HF),CLHLS是一项基于社区的全国性代表性纵向队列研究,研究对象为中国大陆23个省、市或自治区的65岁及以上老年人,所有问卷均由经过训练的工作人员通过面对面访谈收集。CLHLS的研究设计获得了中国北京大学生物医学伦理委员会(IRB00001052-13074)的批准。本研究选取CLHLS-HF中2018年的调查数据,共计15 874名受访者,排除了缺乏完整饮食信息以计算健康饮食指数以及在跌倒相关变量上缺失数据的参与者后,共纳入了8 701名65岁及以上的参与者。流程图见图1。
收集研究对象的社会人口学信息(性别、年龄、民族、居住地、居住安排、教育水平、职业、经济状况、婚姻状况)和健康相关因素(吸烟、饮酒、身体锻炼、BMI和慢性病状况)。年龄分为两组:65~79岁和≥80岁;居住类型分为两类:“独居”,“非独居”;经济状况分为“困难”、“平均”和“富裕”。根据对问题“您现在是否吸烟/饮酒/经常锻炼”和“您过去是否吸烟/饮酒/经常锻炼”的回答,吸烟、饮酒和锻炼习惯被分为三类:“从未”、“以前”和“当前”。BMI以体重(kg)/[身高(米)]2计算,并根据中国工作组标准分为四个组(体重过轻[<18.5 kg/m2]、正常[18.5 kg/m2≤BMI<24 kg/m2]、超重[24.0 kg/m2≤BMI<28.0 kg/m2]和肥胖[BMI≥28 kg/m2])。慢性病包括高血压、糖尿病、心脏病、中风、脑血管疾病和癌症。
利用简化食物频率问卷进行面对面访谈收集膳食摄人相关数据。HEI是参照既往研究,并根据CLHLS饮食信息进行了调整[13-14]。根据摄入频率计算13类食物(蔬菜、水果、肉类、鱼、鸡蛋、豆制品、茶、大蒜、坚果、蘑菇或藻类、乳制品、腌咸菜和糖)的得分。蔬菜和水果的得分范围为0~3,其中“极少或从不”得分0,“偶尔”得分1,“除冬季外”得分2,“几乎每天”得分3。其他11种食物根据摄入频率计分:“极少或从不”得分0,“不是每月,偶尔”得1分,“不是每周,但至少每月一次”得2分,“不是每天,但至少每周一次”得3分,“几乎每天”得4分,糖、盐腌蔬菜反向计分。将各食物组得分相加,得出参与者的HEI分数。HEI范围为0~50,HEI越高代表饮食越健康。
跌倒是本研究的主要关注结果。通过“过去一年中,您是否跌倒过?”这一问题判断跌倒事件,回答“是”归类为跌倒组;回答“否”归类为非跌倒组。同时如果回答“是”,则进入下一题:“在那次/任何一次的跌倒中,您有没有严重受伤到需要治疗?”,回答肯定的人被归类为严重跌倒受伤组。
本研究的统计分析均在R 4.5.0中完成。参与者的基线特征,连续数据以()描述,组间比较采用Kruskal-Wallis H检验或单因素方差分析(ANOVA);分类数据以率和百分比(%)表示,组间比较采用卡方检验。使用多变量logistic回归探讨HEI与跌倒及严重跌倒受伤之间的关联,构建了3个逻辑回归模型。采用基于R“rms”包的限制性立方样条曲线(RCS)分析HEI与跌倒及严重跌倒受伤之间的剂量-反应关系。基于年龄、性别、婚姻状况、居住地、同居类型、经济状况进行亚组分析,探讨亚组间差异及潜在相互作用效应。检验水准α=0.05。
最终纳入8 701名受试者。平均年龄(84.59±11.81)岁,其中男性3 963人(45.5%),女性4 738人(54.5%);80岁及以上5 415人(62.2%)。老年人跌倒的发生率为22.0%,跌倒导致严重受伤的发生率为7.2%。按HEI评分四分位分层排列:Q1(≤21)、Q2(22~25)、Q3(26~31)和Q4(≥32),跌倒及严重跌倒受伤的发生率逐渐下降。高HEI四分位的参与者更可能为男性、65~79岁、汉族、城市居民、非独居、教育水平较高、非农民、经济水平较好、已婚、BMI较高者。见表1。
采用logistic回归计算HEI与跌倒及严重跌倒受伤风险之间的关联。完全调整的模型中,HEI每增加1单位,跌倒发生率降低1.7%(OR=0.98,95%CI:0.97~0.99)。HEI作为分类变量时,跌倒发生风险随HEI四分位递增呈现下降趋势(P趋势<0.001)。此外,我们还发现,HEI还与严重跌倒受伤风险呈负相关(OR=0.97,95%CI:0.96~0.98)。HEI最高四分位严重跌倒受伤的风险较最低四分位降低32.4%。见表2。
应用RCS曲线分析HEI和跌倒及严重跌倒受伤风险的关系。调整混杂因素后,结果显示HEI与跌倒(P overall<0.001,P for non-linearity=0.208)及严重跌倒受伤(P overall<0.001,P for non-linearity=0.059)之间均存在线性剂量-反应关系。当HEI<26.01时,跌倒及严重跌倒受伤的风险相对较高,当HEI>26.01时,随着HEI水平的上升,跌倒及严重跌倒受伤的风险显著降低。见图2。
亚组分析显示,在80岁及以上年龄组中,调整所有协变量后,与最低水平HEI组(Q1)相比,Q2(OR=0.84,95%CI:0.70~1.00),Q3(OR=0.80,95%CI:0.68~0.95),Q4(OR=0.68,95%CI:0.55~0.84),显示出随HEI四分位递增下降的趋势(P趋势<0.001)。这种关联在男性、女性、非独居、经济状况一般、从未锻炼的参与者中仍显著。见表3。
将HEI的每种食物类别视为单一变量(此处糖类、腌制咸菜均正向计分)建立了逻辑回归模型,以探究HEI中每种食物类别与跌倒的关联。结果显示,在完全调整的模型中,水果、蔬菜、鱼类、豆制品和坚果与跌倒风险呈负相关。糖类与跌倒风险呈正相关。见图3。
既往研究广泛探讨了饮食质量和跌倒风险的关系,但结论并不一致[15]。Ballesteros等[16]研究涉及2 071名60岁及以上参与者,结果发现地中海饮食模式与西班牙老年人跌倒风险较低相关,但与跌倒相关的严重伤害无关。国内学者邴婧莹等[17]研究指出清淡饮食是老年人跌倒的保护因素。Smee等[18]的研究发现健康饮食模式和跌倒风险之间没有明显关联。造成结果不一致的原因可能是饮食模式的组成成分不同及来自不同的地域和人群。HEI基于13类食物的消费频率计算,这是一个广泛认可的指数,反映了个体饮食的整体质量和多样性。本研究基于中国居民膳食指南构建了新的HEI指标,结果发现,HEI与跌倒及严重跌倒受伤之间存在负相关,HEI最高四分位跌倒的发生率较最低四分位降低27.7%,严重跌倒受伤的发生率降低32.4%。RCS分析显示HEI与跌倒及严重跌倒受伤之间存在明确的线性剂量-反应关系,即HEI评分越高,跌倒及严重跌倒受伤发生风险越低。这与前沿研究一致,伊朗的一项队列研究表明HEI与绝经后女性的骨骼肌质量呈正相关[19];相关研究已证实HEI评分与肌少症的负相关关系[14,20],而肌少症显著增加老年人跌倒的风险[21]。此外,多项研究指出HEI能够降低心血管疾病[10]、代谢综合征[22]、中风[11]等慢性疾病的风险,而这些疾病都与跌倒风险增加有关,例如代谢综合征的特征,胰岛素抵抗、高血压和肥胖,可能损害神经功能,导致感觉功能缺失和下肢反应迟缓。
我们进一步探讨了特定食物组与跌倒风险的关联,结果显示水果、蔬菜、鱼类、豆制品、坚果摄入对预防跌倒有积极影响,而糖类摄入则会增加跌倒风险,这一结果进一步印证了健康饮食模式HEI的保护效应。水果和蔬菜中的类胡萝卜素和维生素E等多种活性成分能够减轻体内的氧化应激和慢性炎症,降低骨骼肌力量流失和骨质疏松的风险[23]。鱼类、豆制品的优质蛋白以及坚果中的多不饱和脂肪酸,有助于维持肌肉质量和骨骼肌健康[24]。本研究还发现糖类摄入会增加跌倒风险,这与HoushiarRad等[25]最新的代谢研究相互印证,该研究发现高血糖指数饮食显著增加骨质疏松风险(0R=1.78),可能的机制为高血糖促进晚期糖基化终末产物(AGEs)的产生,这些产物增加了胶原蛋白的交联和人体骨骼的脆弱性;同时,高糖摄入引发血糖急性波动,导致体位性低血压和认知功能下降,进而增加跌倒风险。
亚组分析显示HEI与跌倒风险的关联在80岁及以上高龄老人中尤为显著。可能原因为80岁以上老年人是衰弱、共病和生理储备耗竭的集中人群,营养脆弱度增加,因此从膳食质量改善中的获益也更为显著[26]。同时,研究显示非独居老人的饮食保护效应更强,这一结果与Pieroth等[27]研究结果一致,表明社会支持可能增强饮食益处。此外研究还发现这一关联在从未锻炼的老年人中更突出,Yan等[28]的一项最新的meta分析也指出运动与营养在维持机体功能和肌肉健康上的协同作用,对于长期缺乏锻炼的老年人,优化营养摄入可能是维持肌肉、骨骼功能的主要途径,因此,效果更显著。这些结果提示我们应将干预视角扩展至家庭和社会层面,重点关注高龄、独居、活动不足的老年人,优化膳食质量,提供个性化膳食指导及社区营养支持服务。
本研究具有多种优势。样本取自全国代表性数据库,样本量较大;同时调整了社会人口学、生活方式和慢性病等多种潜在混杂因素;其次,根据中国居民膳食指南构建了健康饮食模式评价指标HEI;亚组分析显示HEI与跌倒在不同人群中存在显著关联,进一步证实了研究结果的稳健性。研究的局限性:本研究为横断面调查,无法确定HEI与跌倒之间的因果关系;HEI基于自我报告的食物频率数据,可能存在报告偏倚,从而在后续分析中引入潜在偏差。
综上,本研究结果表明,中国老年人群HEI与跌倒及严重跌倒受伤的发生具有相关性,遵循健康饮食模式HEI可能有助于降低老年人跌倒及严重跌倒受伤的风险,对老年人跌倒的早期风险筛查及针对性营养干预策略制定具有重要意义。
  • 安徽省高校科研重点项目(2023AH050681)
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2026年第53卷第8期
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doi: 10.20043/j.cnki.MPM.202512191
  • 接收时间:2025-12-11
  • 首发时间:2026-11-02
  • 出版时间:2026-04-25
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  • 收稿日期:2025-12-11
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安徽省高校科研重点项目(2023AH050681)
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    1.安徽医科大学附属阜阳医院手术室,安徽 阜阳 236000
    2.安徽医科大学第一附属医院护理部
    3.安徽医科大学附属阜阳医院护理部
    4.安徽医科大学附属阜阳医院骨科

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