Dietary patterns among Afghan adults and their associations with overweight and obesity: a cross-sectional study in Kandahar, Afghanistan.

BACKGROUND

Although obesity is on the rise in Afghanistan, to date no studies have investigated associations with diet and dietary patterns. Therefore, the present study aimed to assess the different dietary patterns consumed among Afghan adults living in Kandahar province and evaluate the correlations between those predominant dietary patterns and anthropometric measures.

METHODS

A cross-sectional study was conducted in Kandahar, Afghanistan, where data on sociodemographic characteristics, anthropometric measurements and diet were collected. A total of 711 men and women aged between 20 and 75 years were included in the final analysis. Dietary data were collected in 2018-2019 using a food frequency questionnaire and dietary patterns were identified by principal component analysis. Dietary pattern scores were then categorised into tertiles, where tertile 1 represented a lower adherence and tertile 3 the highest adherence to the pattern. Bonferroni adjusted P value of 0.004 was considered statistically significant.

RESULTS

Three dietary patterns were derived: a Western (WDP, rich in sweet beverages and refined grains), a Fruits and vegetables (FVDP), and a Traditional (TDP, rich in potatoes, fats and oil, and whole grains) dietary pattern. In this population, men had significantly higher adherence to WDP and TDP than women. Participants with higher socioeconomic status had significantly higher adherence to WDP and TDP and lower adherence to the FVDP. In linear regression models adjusted for potential confounders, BMI and waist and hip circumferences were positively correlated with WDP and FVDP and inversely correlated with the TDP, in particular among men and people with high SES, although none of these associations reached the Bonferroni-corrected threshold for statistical significance.

CONCLUSIONS

Three distinct dietary patterns were identified among Afghan adults from Kandahar. Weak positive associations were found between the Western dietary pattern and general and central obesity. Associations of fruits and vegetables and traditional dietary patterns with obesity deserve further evaluation in a larger sample and with more detailed dietary intake assessment methods that also consider preparation methods and food processing.