以NHANES資料模擬飲食模式探討健康飲食指數交互作用與發炎生物標記之關聯

Abstract

系統性發炎是心血管疾病、代謝性疾病以及自體免疫疾病等多種慢性病的重要誘因，其發展過程往往沒有明顯症狀，因此早期的預防與控制格外關鍵。在眾多引發發炎的因素中，飲食為最容易調整的日常習慣之一，其影響越來越受到關注。然而，多數現有研究仍集中在探討單一飲食成分對發炎的影響，較少深入分析多種營養成分之間的交互作用。

因此，本研究旨在模擬六種不同飲食型態下的七日膳食計畫，探討膳食成分間的顯著交互作用，並結合模擬資料分析發炎標記，識別有效的抗發炎飲食型態。資料來源為美國國家健康與營養調查（NHANES），透過混合整數線性規劃（MILP）產生六種飲食模式：葷食、三種程度的彈性素食（75%、50%、25%）、海鲜素食與全素食，其飲食模式不同在於透過以植物性蛋白替代動物性蛋白。另外，飲食品質則以2015年健康飲食指數（HEI-2015）進行評估。

統計結果顯示五組具有顯著交互效應的膳食成分組合：高水果與低鈉、高蔬菜與高深綠蔬菜豆類、中等乳品與高水果、高全穀類、以及低鈉攝取。這些組合具有協同作用，可顯著降低發炎指標SIRI與NLR。進一步分析模擬資料發現，植物性飲食（全素食與海鲜素食）較其他飲食模式更常出現上述有利組合，且擁有較高的HEI總分。研究結果指出，植物性飲食營養較為均衡且豐富，可能作為有效的抗發炎飲食建議依據。

Inflammation is a key risk factor for chronic diseases, such as cardiovascular, metabolic, and autoimmune conditions. As it often develops silently, early prevention is essential. Diet is a modifiable factor influencing inflammation, but few studies have focused on the interaction between dietary components.

Therefore, the objective of this study is to simulate 7-day meal plans for six distinct food patterns, explore significant pairwise interactions between dietary components, and integrate these interactions into simulated data to identify effective dietary patterns for reducing inflammation. The data from the National Health and Nutrition Examination Survey (NHANES) are used in this study. Meal plans were generated using mixed-integer linear programming (MILP) for six food patterns: omnivore, three levels of flexitarian (75%, 50%, 25%), pescatarian, and vegetarian, which replaced animal protein with plant-based protein. The Healthy Eating Index 2015 (HEI-2015) was used to assess diet quality.

Five significant interaction combinations were revealed: high total fruits and low sodium intake, high vegetables and high greens and beans intake, medium dairy with high total fruits, high whole grains, and low sodium intake. These components act synergistically to reduce inflammation, as shown by decreased SIRI and NLR. In the simulated data, plant-based diets (vegetarian and pescatarian) showed the highest occurrence of these favorable combinations and had higher HEI scores across patterns. These findings suggest that plant-based diets, particularly vegetarian and pescatarian, are balanced, nutrient-rich, and may serve as effective anti-inflammatory patterns.