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Association of major dietary patterns and different obesity phenotypes in Southwest China: the China Multi-Ethnic Cohort (CMEC) Study

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Abstract

Purpose

Dietary behavior is an important part of lifestyle interventions for obesity and its cardiovascular comorbidities. However, little is known about associations between dietary patterns and obesity phenotypes in Southwest China, a region with unique dietary patterns and significant heterogeneity in obesity.

Methods

Data from the baseline survey of the China Multi-Ethnic Cohort in Southwest China were analyzed (n = 64,448). Dietary intakes during the past year were measured with the semi-quantitative Food Frequency Questionnaire (s-FFQ). Principal component factor analysis (PCFA) was used to identify dietary patterns. Multinomial logistic regressions were used to examine the associations between dietary patterns and obesity phenotypes and stratified analyses were performed to assess whether the associations differed across demographic variables.

Results

Three dietary patterns were identified and then named according to their apparent regional gathering characteristics: the Sichuan Basin dietary pattern (characterized by high intakes of various foods), the Yunnan-Guizhou Plateau dietary pattern (characterized by agricultural lifestyles), and the Qinghai-Tibet Plateau dietary pattern (characterized by animal husbandry lifestyles), respectively. Higher adherence to the Sichuan Basin dietary pattern was positively associated with metabolically healthy overweight/obesity (MHO, OR 1.13, 95% CI 1.05–1.21) but negatively associated with metabolically unhealthy normal weight (MUNW, OR 0.78, 95% CI 0.65–0.95). Higher adherence to the other two dietary patterns was positively associated with MHO and metabolically unhealthy overweight/obesity (MUO). Besides, differences in socioeconomic status also affected the relationship between dietary patterns and obesity phenotypes.

Conclusions

Adherence to the more diverse Sichuan basin dietary pattern performed a mixed picture, while the other two may increase the risk of obesity phenotypes, which indicates nutritional interventions are urgently needed.

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Abbreviations

MHNW:

Metabolically healthy normal weight

MHO:

Metabolically healthy overweight/obesity

MUNW:

Metabolically unhealthy normal weight

MUO:

Metabolically unhealthy overweight/obesity

BMI:

Body mass index

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

HDL-C:

High-density lipoprotein cholesterol

LDL-C:

Low-density lipoprotein cholesterol

WC:

Waist circumference

WHR:

Waist-height ratio

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Acknowledgements

We sincerely thank all the participants and staff of the CMEC study. We gratefully acknowledge Professor Xiaosong Li, the former principal investigator of CMEC research, for his leadership and tremendous contribution to the establishment of CMEC. Professor Li passed away in 2019.

Funding

This work was primarily supported by the National Natural Science Foundation of China (Grant No. 82273740, No. 81903415). The CMEC study was funded by the National Key Research and Development Program of China (Grant No. 2017YFC0907305, 2017YFC0907300). The sponsors had no role in the design, analysis, interpretation, or writing of this article.

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Author notes

  1. Yuan Zhang and Yonglan Wei have contributed equally to this work.

Authors and Affiliations

  1. West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, People’s South Road, Chengdu, 610041, Sichuan, China

    Yuan Zhang, Dan Tang, Jiaojiao Lu, Ning Zhang, Yifan Hu, Xing Zhao & Xiong Xiao

  2. The Chengdu Center for Disease Control and Prevention, Chengdu, China

    Yonglan Wei

  3. Tibet Centre for Disease Control and Prevention, Lhasa, China

    Ruifeng He

  4. School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China

    Han Guan

  5. Chongqing Municipal Centre for Disease Control and Prevention, Chongqing, China

    Jingru Xu

  6. School of Public Health, Kunming Medical University, Kunming, China

    Songmei Wang

  7. Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China

    Kangzhuo Baima

  8. School of Medicine, Tibet University, No.10, East Tibet University Road, Lhasa, 850000, China

    Kangzhuo Baima

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  1. Yuan Zhang
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Contributions

YZ and YW designed the study. YZ and XX analyzed the data and drafted the paper. All other authors were involved in the collection of the data. All authors made significant contributions to drafting and revising the manuscript and have approved the final version for publication.

Corresponding authors

Correspondence to Kangzhuo Baima or Xiong Xiao.

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The authors declare that they have no potential conflicts of interest.

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This study was approved by the Sichuan University Medical Ethical Review Board [ID:K2016038]. All procedures in the study were consistent with the 1964 Declaration of Helsinki and its subsequent amendments. All subjects agreeing to take part in the study signed informed written consent.

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Zhang, Y., Wei, Y., Tang, D. et al. Association of major dietary patterns and different obesity phenotypes in Southwest China: the China Multi-Ethnic Cohort (CMEC) Study. Eur J Nutr 62, 465–476 (2023). https://doi.org/10.1007/s00394-022-02997-7

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