Joint Association of Dietary Pattern and Physical Activity Level with Cardiovascular Disease Risk Factors among Chinese Men: A Cross-Sectional Study

Dong Wang,Yanping Li,Yuna He,Guansheng Ma,Fengying Zhai,Xiaoguang Yang,Dechun Luan,Heiner K Berthold

doi:10.1371/journal.pone.0066210

Abstract

The purpose of this cross-sectional study was to investigate the joint associations of physical activity level (PAL) and dietary patterns in relation to cardiovascular disease (CVD) risk factors among Chinese men. The study population consisted of 13 511 Chinese males aged 18–59 years from the 2002 China National Nutrition and Health Survey. Based on dietary data collected by a food frequency questionnaire, four dietary patterns were identified and labeled as “Green Water” (high consumption of rice, vegetables, seafood, pork, and poultry), “Yellow Earth” (high consumption of wheat flour products and starchy tubers), “New Affluent” (high consumption of animal sourced foods and soybean products), and “Western Adopter” (high consumption of animal sourced foods, cakes, and soft drinks). From the information collected by a 1-year physical activity questionnaire, PAL was calculated and classified into 4 categories: sedentary, low active, active, and very active. As compared with their counterparts from the New Affluent pattern, participants who followed the Green Water pattern had a lower likelihood of abdominal obesity (AO; 50.2%), hypertension (HT; 37.9%), hyperglycemia (HG; 41.5%), elevated triglyceride (ETG; 14.5%), low HDL (LHDL; 39.8%), and metabolic syndrome (MS; 51.9%). When compared to sedentary participants, the odds ratio of participants with very active PAL was 0.62 for AO, 0.85 for HT, 0.71 for HG, 0.76 for ETG, 0.74 for LHDL, and 0.58 for MS. Individuals who followed both very active PAL and the Green Water pattern had a lower likelihood of CVD risk factors (AO: 65.8%, HT: 39.1%, HG: 57.4%, ETG: 35.4%, LHDL: 56.1%, and MS: 75.0%), compared to their counterparts who followed both sedentary PAL and the New Affluent pattern. In addition, adherence to both healthy dietary pattern and very active PAL presented a remarkable potential for CVD risk factor prevention.

Highlights

Cardiovascular disease (CVD) is the leading cause of death in the world [1]
Based on the 2002 CNNHS data, we developed the Chinese version of physical activity level (PAL) and associated PAL with prevalence of obesity among the Chinese population [19]; to date, we do not know if and how the dietary patterns and PAL are related to CVD risk factors in a nationally representative sample of Chinese adults
The Yellow Earth pattern adopters were characterized by living in rural areas with a lower education and economic level; they had a higher consumption of wheat flour, tubers, and other cereals, and a lower consumption of fresh vegetables, fruit, and animal sourced food, and were more likely to smoke

Summary

Introduction

In China, accompanying the rapid economic development and urbanization, the prevalence of CVD has increased dramatically from 3.1% in 1993 to 8.6% in 2008 [2]. To curb this trend, one of the most important [3] and costeffective [4] strategies is to control CVD risk factors such as hypertension (HT), dyslipidemia, metabolic syndrome (MS), and obesity, preventing and delaying the development of subclinical atherosclerosis and other myocardial and vascular changes over time [3] and avoiding ultimate onset of CVD. Dietary pattern and physical activity level (PAL) analysis, which provide overall estimation of these two lifestyle factors, have begun to emerge in epidemiology research [5,6,7,8]

Methods

Results

Conclusion