Association Between Diet Quality and Prevalence of Obesity, Dyslipidemia, and Insulin Resistance Among Filipino Immigrant Women in Korea: The Filipino Women's Diet and Health Study.

Hee Sun Kim,Sung Hoon Yu,Jung Eun Lee,Heejin Lee,Grace H Chung,Sangmo Hong,Chang Beom Lee,Sherlyn Mae P Provido,Minji Kang

doi:10.3389/fpubh.2021.647661

Abstract

Objectives: Diet quality may be a key modifiable factor for the prevention of non-communicable disease. We aimed to investigate the association between diet quality and prevalence of obesity, dyslipidemia, and insulin resistance among Filipino immigrant women in Korea.Methods: A total of 413 participants from the 2014–2016 baseline population of the Filipino Women's Diet and Health Study (FiLWHEL) were examined. Individual dietary intakes were evaluated through 24-h recalls and then converted into two dietary quality assessments: Minimum Dietary Diversity for Women (MDD-W) developed by the Food and Agriculture Organization (FAO) and the Data Derived Inflammation Index (DDII) originally developed by our group. Fasting blood levels of triglycerides, high-density lipoprotein cholesterols, glucose, and insulin were measured. We used logistic regression models for odds ratios (ORs) with 95% confidence intervals (CIs).Results: We found a statistically significant association between MDD-W scores and decreased prevalence of abdominal obesity; ORs (95% CIs) of the 3rd vs. 1st tertiles were 0.58 (0.36–0.94; p for trend = 0.029). Increased DDII was associated with elevated prevalence of dyslipidemia and insulin resistance; ORs (95% CIs) of the 5th vs. 1–3rd quintiles were 6.44 (2.56–16.20) for triglycerides (TG), 3.90 (1.92–7.90) for low-density lipoprotein (LDL) cholesterol, 3.36 (1.81–6.24) for total cholesterol (TC), 6.25 (2.53–15.41) for abnormal TG/HDL ratios, 3.59 (1.96–6.59) for HbA1c, 2.61 (1.11–6.17) for fasting blood glucose levels, 9.67 (4.16–22.48) for insulin levels, and 9.73 (4.46–21.25) for homeostasis model assessment of insulin resistance (HOMA-IR) (p for trend <0.001 for all, except 0.033 for fasting blood glucose).Conclusions: Greater dietary diversity was inversely associated with the prevalence of abdominal obesity in Filipino immigrant women. Proinflammatory scores based on diet and lifestyle factors were associated with an increased prevalence of dyslipidemia and insulin resistance. Further, epidemiological studies on the relationship between dietary acculturation and chronic disease are warranted.

Highlights

With the rise of non-communicable disease—mainly obesity, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) [1,2,3]—in both developed and developing countries, significant changes were made in the public health priorities for their prevention
Given that Filipino immigrant women are susceptible to lower dietary diversity and metabolic diseases, we aimed to examine whether Minimum Dietary Diversity for Women (MDD-W), a developing country-specific score, and Derived Inflammatory Index (DDII), a Korean-specific score, were associated with obesity and other metabolic comorbidities among Filipino immigrant women in Korea
We examined the associations between MDDW and DDII and indicators of obesity, dyslipidemia, and insulin resistance in the Filipino Women’s Diet and Health Study (FiLWHEL)

Summary

Introduction

With the rise of non-communicable disease—mainly obesity, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) [1,2,3]—in both developed and developing countries, significant changes were made in the public health priorities for their prevention. Modern dietary guidelines aim to prevent nutrient deficiencies and aim to prevent chronic disease. Conventional “nutrient-based” guidelines showed considerable limitations when extending to chronic disease prevention; the translation of “nutrient-based” into “food-based” guidelines has been accentuated recently [4,5,6]. The growing burden of non-communicable diseases has led to demand for a holistic approach to food consumption that can manage the double burden of malnutrition, under-, and over-nutrition. “Food-based” guidelines attempt to reflect the synergistic contributions of dietary patterns, including food composition, preparation methods, and underlying social interactions. To ensure the compliance and effectiveness of established guidelines, quantitative measurements such as diet quality scores have been developed using both empirical and a priori methods such as Mediterranean diet score, Healthy Eating Index (HEI), and Alternative Healthy Eating Index (AHEI) [7, 8]

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