Shrestha Archana, Koju Rajendra Prasad, Beresford Shirley A A, Gary Chan Kwun Chuen, Karmacharya Biraj Man, Fitzpatrick Annette L
Department of Epidemiology , University of Washington , Seattle, Washington , USA.
Department of Cardiology, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal; Department of Global Health, University of Washington, Seattle, Washington, USA.
Heart Asia. 2016 Mar 23;8(1):46-53. doi: 10.1136/heartasia-2015-010666. eCollection 2016.
About one-fourth of Nepalese adults are overweight or obese but no studies have examined their risk factors, especially pertaining to diet. The present study aimed to identify dietary patterns in a suburban Nepalese community and assess their associations with overweight and obesity prevalence.
This cross-sectional study used data from 1073 adults (18 years or older) participating in the baseline survey of the Dhulikhel Heart Study. We derived major dietary patterns from a principal component analysis of reported intake from a Food Frequency Questionnaire. Overweight was defined as Body Mass Index (BMI) of 25 kg/m(2) or higher and obesity was defined as BMI of 30 kg/m(2) or higher. Statistical analysis was conducted using generalised estimating equations with multivariate logistic regression (with household as cluster) adjusting for age, sex, ethnicity, religion, marital status, income, education, alcohol consumption, smoking, physical activity and systolic blood pressure.
Four dietary patterns were derived: mixed, fast food, refined grain-meat-alcohol and solid fats-dairy. The refined grain-rice-alcohol pattern was significantly associated with overweight (adjusted OR 1.19, 95% CI 1.03 to 1.39; p=0.02) after adjusting for demographic and traditional cardiovascular risk factors. In adults of 40 years or older, the fast food pattern was associated with obesity controlling for demographic and traditional risk factors (adjusted OR 1.69, 95% CI 1.19 to 2.39; p value=0.003).
Our results suggest that refined grains-meat-alcohol intake is associated with higher prevalence of overweight, and fast food intake is associated with higher prevalence of obesity in older adults (40 years or above) in suburban Nepalese adults.
约四分之一的尼泊尔成年人超重或肥胖，但尚无研究调查其风险因素，尤其是与饮食相关的因素。本研究旨在确定尼泊尔一个郊区社区的饮食模式，并评估其与超重和肥胖患病率的关联。
这项横断面研究使用了来自参与杜利凯尔心脏研究基线调查的1073名成年人（18岁及以上）的数据。我们通过对食物频率问卷中报告的摄入量进行主成分分析得出主要饮食模式。超重定义为体重指数（BMI）为25千克/平方米或更高，肥胖定义为BMI为30千克/平方米或更高。采用广义估计方程和多变量逻辑回归（以家庭为聚类）进行统计分析，对年龄、性别、种族、宗教、婚姻状况、收入、教育程度、饮酒、吸烟、身体活动和收缩压进行调整。
得出四种饮食模式：混合模式、快餐模式、精制谷物 - 肉类 - 酒精模式和固体脂肪 - 乳制品模式。在调整人口统计学和传统心血管危险因素后，精制谷物 - 大米 - 酒精模式与超重显著相关（调整后的比值比为1.19，95%置信区间为1.03至1.39；p = 0.02）。在40岁及以上的成年人中，快餐模式在控制人口统计学和传统危险因素后与肥胖相关（调整后的比值比为1.69，95%置信区间为1.19至2.39；p值 = 0.003）。
我们的结果表明，在尼泊尔郊区成年人中，精制谷物 - 肉类 - 酒精的摄入与超重患病率较高相关，快餐摄入与40岁及以上老年人的肥胖患病率较高相关。
