Major dietary patterns and their relationship to obesity among urbanized adult Tibetan pastoralists.

Abstract

This study investigated major dietary patterns and their relationship to obesity among urbanized Tibetan pastoralists. Using a cross-sectional design, this study assessed 782 urbanized Tibetan pastoralists aged 18-84 y. A food frequency questionnaire and anthropometric measurements were conducted in 2018. Principal component analysis was used to identify dietary patterns. Logistic regression was applied to compare the risks for overweight (BMI >=24 kg/m2), obesity (BMI >=28 kg/m2), and central obesity (waist circumference >=80 cm for women and >=85 cm for men) across quintiles of dietary pattern scores after controlling for gender, age, education, medical insurance, smoking status, alcohol consumption and physical activity. This study identified three major dietary patterns: an urban pattern characterized by high intake of vegetables, tubers/roots, and refined carbohydrates; a western pattern characterized by sugary drinks, snacks, and desserts; and a pastoral pattern characterized by tsamba (roasted Tibetan barley), Tibetan cheese, and buttered/milk tea. Subjects in the highest quintile of urban pattern scores were more likely to be overweight (OR=2.58, 95% CI 1.48-4.49) (p-for-trend=0.001), obese (2.94, 1.57-5.49) (p-for-trend=0.001), and centrally obese (1.94, 1.12-3.36) (p-for-trend=0.019) compared to those in the lowest quintile with confounders controlled. The western dietary pattern was positively associated with overweight (p-for-trend=0.037). No clear association was observed for the pastoral dietary pattern. Urban and western dietary patterns independently predict the likelihood of being overweight. Improved nutrition education may contribute to healthier eating behaviors, thus reducing or preventing obesity.