Abstract
BackgroundBased on data regarding nutrition transition in the Middle East and North Africa, this study aim to investigate the general structure and secular trend of dietary patterns reported from the Tehran Lipid and Glucose Study (TLGS) and adherence to these dietary patterns among Iranian population from 2006 till 2017.MethodsWe investigated on four examination waves of TLGS, including wave 1 (2006–2008), wave 2 (2009–2011), wave 3 (2012–2014), and wave 4 (2015–2017), using a validated and reliable food frequency questionnaire. Generalized Estimating Equations was used to assess secular trends in anthropometric, biochemical, and dietary variables across the study period. To identify general structure and secular trend of dietary patterns during each waves, principle component analysis (PCA) and K-mean cluster analysis were used, respectively.ResultsAfter adjusting for potential confounders including age, sex, body mass index, and total energy intake, the carbohydrate and protein intake gradually increased and the total fat intake decreased during study period (P-value< 0.001), although total energy intake remained stable. During the study period, participants consumed noticeably less refined grains, solid fat, dairy products, and simple sugars. Snack and dessert consumption increased and meat intakes showed no significant changes during a decade (all P-values< 0.001). Three dietary patterns extracted using PCA, included: Healthy dietary pattern characterized by higher intakes of vegetable, fruit, dairy products, liquid oil, nuts and seeds, and honey and jam; Western dietary pattern featured by refined grain, solid fat, meat, snack and dessert, potato, and soft drink, and the Mixed dietary pattern, highlighted by tea and coffee, and simple sugar. Based on cluster analysis, 27.8% of participants in wave 4 followed a Western dietary pattern, and 34.1% followed the Mixed dietary pattern. The Healthy dietary pattern was stable among the study population during the last decade.ConclusionsThe structure and the type of foods that participants preferred to eat changed since 2006, a new secular trend in dietary patterns, including a stability of Healthy dietary pattern, a decline of the Western dietary pattern and an increase in the Mixed dietary pattern was obsereved in our investigation.
Highlights
Nutrition transition in the Middle East and North Africa (MENA) region, has been a result of the rapid demographic changes, social development, and urbanization [1, 2], demonstrated as a set of gradual dietary changes from healthy diets to a pattern of westernized foods [3]
According to the Global Burden of Disease (GBD) report, the mean daily intake of some healthy foods including fruit, vegetables, fiber, and legume increased in the MENA region from 1990 to 2017, the burden of chronic diseases such as hypertension, type 2 diabetes, and cardiovascular disease rose, simultaneously [4,5,6], a finding indicating that concentrating on a single food per se cannot explain the link between fast rising trend in non-communicable diseases in the current decade and higher intakes of some healthy foods
Since the present study examined participants for a decade, all anthropometric measurements were adjusted for age, and nutrient intakes and dietary food groups were further adjusted for sex, Body mass index (BMI), and energy intakes of participants
Summary
Nutrition transition in the Middle East and North Africa (MENA) region, has been a result of the rapid demographic changes, social development, and urbanization [1, 2], demonstrated as a set of gradual dietary changes from healthy diets to a pattern of westernized foods [3]. Lim et al demonstrated that approximately 40% of participants still follow a traditional Korean diet which remained relatively stable since 1998 to 2010; the secular trend of Western dietary patterns decreased from 30% in 1998 to 10% in 2010 [10]. Based on data regarding nutrition transition in the Middle East and North Africa, this study aim to investigate the general structure and secular trend of dietary patterns reported from the Tehran Lipid and Glucose Study (TLGS) and adherence to these dietary patterns among Iranian population from 2006 till 2017
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