Zhang Yuan, Wei Yonglan, Tang Dan, Lu Jiaojiao, Zhang Ning, Hu Yifan, He Ruifeng, Guan Han, Xu Jingru, Wang Songmei, Zhao Xing, Baima Kangzhuo, Xiao Xiong
West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, People's South Road, Chengdu, 610041, Sichuan, China.
The Chengdu Center for Disease Control and Prevention, Chengdu, China.
Eur J Nutr. 2023 Feb;62(1):465-476. doi: 10.1007/s00394-022-02997-7. Epub 2022 Sep 11.
Dietary behavior is an important part of lifestyle interventions for obesity and its cardiovascular comorbidities. However, little is known about associations between dietary patterns and obesity phenotypes in Southwest China, a region with unique dietary patterns and significant heterogeneity in obesity.
Data from the baseline survey of the China Multi-Ethnic Cohort in Southwest China were analyzed (n = 64,448). Dietary intakes during the past year were measured with the semi-quantitative Food Frequency Questionnaire (s-FFQ). Principal component factor analysis (PCFA) was used to identify dietary patterns. Multinomial logistic regressions were used to examine the associations between dietary patterns and obesity phenotypes and stratified analyses were performed to assess whether the associations differed across demographic variables.
Three dietary patterns were identified and then named according to their apparent regional gathering characteristics: the Sichuan Basin dietary pattern (characterized by high intakes of various foods), the Yunnan-Guizhou Plateau dietary pattern (characterized by agricultural lifestyles), and the Qinghai-Tibet Plateau dietary pattern (characterized by animal husbandry lifestyles), respectively. Higher adherence to the Sichuan Basin dietary pattern was positively associated with metabolically healthy overweight/obesity (MHO, OR 1.13, 95% CI 1.05-1.21) but negatively associated with metabolically unhealthy normal weight (MUNW, OR 0.78, 95% CI 0.65-0.95). Higher adherence to the other two dietary patterns was positively associated with MHO and metabolically unhealthy overweight/obesity (MUO). Besides, differences in socioeconomic status also affected the relationship between dietary patterns and obesity phenotypes.
Adherence to the more diverse Sichuan basin dietary pattern performed a mixed picture, while the other two may increase the risk of obesity phenotypes, which indicates nutritional interventions are urgently needed.
饮食行为是肥胖及其心血管合并症生活方式干预的重要组成部分。然而，在中国西南部这个饮食模式独特且肥胖存在显著异质性的地区，关于饮食模式与肥胖表型之间的关联知之甚少。
对中国西南多民族队列基线调查的数据（n = 64448）进行分析。采用半定量食物频率问卷（s-FFQ）测量过去一年的饮食摄入量。主成分因子分析（PCFA）用于识别饮食模式。多项逻辑回归用于检验饮食模式与肥胖表型之间的关联，并进行分层分析以评估这些关联在不同人口统计学变量之间是否存在差异。
识别出三种饮食模式，并根据其明显的区域聚集特征分别命名为：四川盆地饮食模式（以各类食物摄入量高为特征）、云贵高原饮食模式（以农业生活方式为特征）和青藏高原饮食模式（以畜牧生活方式为特征）。较高程度遵循四川盆地饮食模式与代谢健康超重/肥胖（MHO，比值比1.13，95%置信区间1.05 - 1.21）呈正相关，但与代谢不健康正常体重（MUNW，比值比0.78，95%置信区间0.65 - 0.95）呈负相关。较高程度遵循其他两种饮食模式与MHO以及代谢不健康超重/肥胖（MUO）呈正相关。此外，社会经济地位的差异也影响饮食模式与肥胖表型之间的关系。
遵循更多样化的四川盆地饮食模式呈现出复杂的情况，而其他两种饮食模式可能会增加肥胖表型的风险，这表明迫切需要进行营养干预。
