Abstract
Studies on macronutrient intake and obesity have been inconclusive. This study examined the associations between multi-trajectories of macronutrients and the risk of obesity in China. We used data from 7914 adults who participated in the China Health and Nutrition Survey at least three times from 1991 to 2018. We collected detailed dietary data by conducting three 24 h dietary recalls and weighing foods and condiments in household inventories. We identified multi-trajectories using group-based multi-trajectory models and examined their associations with the risk of obesity with multiple Cox regression models. We found four multi-trajectories in rural areas: balanced macronutrient intake (BM), moderate protein, increasing low fat, and decreasing high carbohydrate (MP&ILF&DHC); decreasing moderate protein, decreasing high fat, and increasing moderate carbohydrate (DMP&DHF&IMC); increasing moderate protein, increasing high fat, and decreasing low carbohydrate (IMP&IHF&DLC)—35.1%, 21.3%, 20.1%, and 23.5% of our rural participant population, respectively. Compared with the BM trajectory, the hazard ratios of obesity in the DMP&DHF&IMC and the IMP&IHF&DLC groups were 0.50 (95% confidence interval (CI): 0.27–0.95) and 0.48 (95% CI: 0.28–0.83), respectively, in rural participants. Relatively low carbohydrate and high fat intakes with complementary dynamic trends are associated with a lower risk of obesity in rural Chinese adults.
Highlights
Publisher’s Note: MDPI stays neutralThe World Health Organization (WHO) recently estimated that obesity has nearly tripled worldwide since 1975 and more than 650 million adults were obese in 2016 [1]
In terms of the percentages of energy intake from macronutrients, the percentage of protein intake did not change much, the percentage of fat intake increased from 24.1% to 34.7%, and the percentage of carbohydrate intake decreased from 62.7% to 51.5%
Among urban residents the first group, which we identified as increasing moderate protein (IMP), high fat (HF), and low carbohydrate (LC) (IMP&HF&LC), included 38.7% of the urban participant population
Summary
The World Health Organization (WHO) recently estimated that obesity has nearly tripled worldwide since 1975 and more than 650 million adults were obese in 2016 [1]. This issue has grown to epidemic proportions. Obesity Collaborators, over 4 million people died as a consequence of being overweight or obese [2]. Once considered problems of high-income countries, overweight and obesity are on the rise in low- and middle-income countries. In China, obesity in adults has increased steadily since the early 1980s. An estimated 85 million adults aged 18–69 years in
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