Adherence to the 2015 Dietary Guidelines for Americans (DGA) and Risk of Healthy and Unhealthy Obesity among Canadian Adults.
Notice bibliographique
Résumé
Recently, the scientific community has recognized the importance of differentiating between obesity phenotypes; however, less attention has been given to this issue in nutritional epidemiology. The objective of this study was to examine whether closer adherence to the recommendations proposed in the Scientific Report of the 2015 Dietary Guidelines for Americans (DGA), as measured by an updated 2015 DGA Adherence Index (DGAI), is differentially associated with risk of obesity with and without an accompanying chronic disease, including diabetes, hypertension and heart disease (i.e., healthy and unhealthy obesity). Weighted multinomial logistic regression‐GLM was used to examine the associations between the a priori 19‐score DGAI and healthy and unhealthy obesity among 11,748 participants aged≥18 years in the Canadian Community Health Survey 2.2. All models were additionally adjusted for the energy misreporting status to account for this systematic bias. The mean 2015 DGAI score was 8.82 (±0.051)(Possible Max:19) and its two subscores (“food intake” and “healthy choice”) were 3.92(±0.038) (Possible Max:11) and 4.90 (±0.028) (Possible Max:8), respectively, which indicates that our population was adherent to less than 50% of recommendations. After adjusting for age, sex and energy misreporting, adherence to the 2015 DGA recommendations decreased the odds of being unhealthy obese monotonically from Odds Ratio (OR): 2.413 (1.732–3.361) in quartile 1 (poorest diet), to 2.088 (1.505–2.898) in quartile 2, and 1.412 (1.01–1.973) in the third quartile of the 2015 DGAI score, compared to the fourth quartile category (healthiest diet) (p‐trend<0.0001). The odds of being obese without a chronic disease (healthy obese) also decreased from 2.29 (1.482–3.539) in quartile 1, to 2.328 (1.485–3.649) in quartile 2, and 1.629 (0.932–2.849) in the third quartile category of the 2015 DGAI, as compared to the fourth quartile (p‐trend<0.0001). In the same model, individuals in the first quartile of the 2015 DGAI (poorest diets) showed 1.424 (1.031–1.966) times higher risk of being lean with at least one accompanying chronic disease, compared to those in the fourth quartile (healthiest diet). Our findings suggest that individuals with the obesity phenotype coupled with an accompanying metabolic disorder may benefit the most from following the 2015 DGA, even though unhealthy lean and healthy obese phenotypes are also reduced markedly as a result of closer compliance to the 2015 DGA, albeit not as strongly as unhealthy obesity phenotype. Therefore, differentiating unhealthy obesity from healthy obesity has important implications for public health and clinical management of obesity. Even though none of the participants met all the 2015 DGA recommendations, our results support the value of compliance to the 2015 DGA for reducing the cumulative prevalence of chronic diseases at the population level. Owing to the similarity of the North American dietary recommendations, these findings suggest that the 2015 DGA may be adapted to improve dietary behaviours in the Canadian context. Support or Funding Information This research was supported by funds to the Canadian Research Data Centre Network from the Social Science and Humanities Research Council, the Canadian Institute for Health Research (CIHR), the Canadian Foundation for Innovation and Statistics Canada. M. J. is supported by the Canadian Institute of Health Research (CIHR) Vanier Canada Graduate Scholarship, the CIHR/Cancer Care Ontario (CCO) Population Intervention for Chronic Disease Prevention (PICDP): a Pan‐Canadian Fellowship, and the Ontario Graduate Scholarship (OGS). M. L. is the Earle W. McHenry professor and is supported by the chair‐endowed unrestricted research funds, University of Toronto.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,010 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».