Abstract P605: Neo-Traditional Diets Are Associated With Lower Odds of Metabolic Syndrome Among Adults in Puerto Rico

Abstract

Prolonged marginalization of traditional food cultures has diminished local food production and increased dependence on highly processed imports in Puerto Rico (PR), contributing to low-quality diets and cardiometabolic disease. Recent efforts have been made to decolonize diets by increasing local food intake; however, what dietary patterns (DPs) exist and how they are associated with cardiometabolic disease risk remain unknown. This study aimed to 1 ) identify food-system-specific DPs and 2 ) determine associations with metabolic syndrome (MetS), a multicomponent cardiometabolic risk factor, among adults in PR. We hypothesized that a neo-traditional DP would emerge, characterized by use of minimally processed local foods and associated with lower odds of MetS. Data were obtained from adults (30-75 y) in the PR Observational Study of Psychosocial, Environmental, and Chronic Disease Trends ( n = 989). DPs were derived using partial least squares analysis on food frequency questionnaire data, with nutrients significantly associated with local food purchasing (fiber, magnesium [Mg], saturated fat) as response variables. MetS was classified using harmonized criteria from clinical and laboratory measures (waist circumference, fasting glucose, systolic/diastolic blood pressure, triglycerides, HDL cholesterol) and medication use. Fully adjusted generalized linear models tested associations between tertiles of DPs and MetS. Approximately half (52%) of participants were classified with MetS. Four DPs were extracted, described as neo-traditional (local plants and seafood), transitioning (beans and coffee), industrial: meat-centric (red/processed meats and fast foods), and industrial: sugar-centric (rice and sugary beverages). Individuals in the highest (vs. lowest) tertile of the neo-traditional DP were more likely to purchase local (not imported) fruits, vegetables, and seafood; those in the transitioning DP were more likely to reside in rural areas; those in the meat-centric DP were more likely to purchase local meats; and those in the sugar-centric DP had lower educational attainment and household income. Individuals in the highest (vs. lowest) tertile of the neo-traditional DP were 0.69 (0.49, 0.97) times less likely to have MetS ( P = 0.035); they also had 4.1 (1.3) cm lower mean (SE) waist circumference ( P = 0.002). In contrast, individuals in the highest (vs. lowest) tertile of the meat-centric DP had higher mean waist circumference (102 vs. 99 cm, P = 0.01), fasting glucose (106 vs. 98 mg/dL, P = 0.019), and systolic blood pressure (123 vs. 119 mmHg, P = 0.022). The sugar-centric and transitioning DPs were not significantly associated with MetS or its components. A neo-traditional diet in PR holds promise in supporting local food production and augmenting cardiometabolic health. Results can guide local food promotion as a healthful, decolonizing approach in island settings.