Peng Wen, Liu Yongnian, Liu Yan, Zhao Hong, Chen Hongru
Department of Public Health, Medical College, Qinghai University, Xining City, China.
Department of Basic Medicine, Medical College, Qinghai University, Xining City, China.
Asia Pac J Clin Nutr. 2019;28(3):507-519. doi: 10.6133/apjcn.201909_28(3).0010.
This study investigated major dietary patterns and their relationship to obesity among urbanized Tibetan pastoralists.
Using a cross-sectional design, this study assessed 782 urbanized Tibetan pastoralists aged 18-84 y. A food frequency questionnaire and anthropometric measurements were conducted in 2018. Principal component analysis was used to identify dietary patterns. Logistic regression was applied to compare the risks for overweight (BMI >=24 kg/m2), obesity (BMI >=28 kg/m2), and central obesity (waist circumference >=80 cm for women and >=85 cm for men) across quintiles of dietary pattern scores after controlling for gender, age, education, medical insurance, smoking status, alcohol consumption and physical activity.
This study identified three major dietary patterns: an urban pattern characterized by high intake of vegetables, tubers/roots, and refined carbohydrates; a western pattern characterized by sugary drinks, snacks, and desserts; and a pastoral pattern characterized by tsamba (roasted Tibetan barley), Tibetan cheese, and buttered/milk tea. Subjects in the highest quintile of urban pattern scores were more likely to be overweight (OR=2.58, 95% CI 1.48-4.49) (p-for-trend=0.001), obese (2.94, 1.57-5.49) (p-for-trend=0.001), and centrally obese (1.94, 1.12-3.36) (p-for-trend=0.019) compared to those in the lowest quintile with confounders controlled. The western dietary pattern was positively associated with overweight (p-for-trend=0.037). No clear association was observed for the pastoral dietary pattern.
Urban and western dietary patterns independently predict the likelihood of being overweight. Improved nutrition education may contribute to healthier eating behaviors, thus reducing or preventing obesity.
本研究调查了城市化藏族牧民的主要饮食模式及其与肥胖的关系。
采用横断面设计，本研究评估了782名年龄在18 - 84岁的城市化藏族牧民。2018年进行了食物频率问卷调查和人体测量。主成分分析用于识别饮食模式。在控制了性别、年龄、教育程度、医疗保险、吸烟状况、饮酒量和身体活动后，应用逻辑回归比较饮食模式得分五分位数间超重（BMI≥24 kg/m²）、肥胖（BMI≥28 kg/m²）和中心性肥胖（女性腰围≥80 cm，男性腰围≥85 cm）的风险。
本研究确定了三种主要饮食模式：以蔬菜、块茎/根类和精制碳水化合物高摄入量为特征的城市模式；以含糖饮料、零食和甜点为特征的西方模式；以及以糌粑（烤青稞）、藏式奶酪和酥油茶/奶茶为特征的牧区模式。在控制混杂因素后，城市模式得分最高五分位数的受试者比最低五分位数的受试者更易超重（OR = 2.58，95% CI 1.48 - 4.49）（趋势p值 = 0.001）、肥胖（2.
