Dietary patterns and indicators of cardiometabolic risk among rural adolescents : A cross-sectional study at 15-year follow-up of the MINIMat cohort

• Background: Diet being a modifiable factor, its relationship with cardiometabolicrisk is of public health interest. The vast majority of studies on associations ofdietary patterns with cardiometabolic risk indicators among adolescents are fromhigh-income countries and urban settings. We sought to describe dietary patternsand examine their associations with selected cardiometabolic risk indicators–waist circumference (WC), systolic blood pressure, fasting lipid profile and insulinresistance–along with its gender stratification among adolescents in a low-income,rural setting.Methods: This cross-sectional study utilized data from the 15-year follow-up ofthe Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort insoutheast Bangladesh. The children who were born as singletons to the mothersrandomized in the MINIMat trial and had valid birth anthropometrics were eligiblefor the follow-up. We employed a single, qualitative 24-hour recall to assess diet.Dietary patterns were derived from simple K-means cluster analysis, and calculationof dietary diversity score (DDS) using a validated instrument. Anthropometricparameters and systolic blood pressure were recorded. Fasting plasma triglyceride,total cholesterol, low- and high-density lipoproteins, insulin and glucose levels weremeasured. We calculated insulin resistance using the Homeostasis Model Assessmentequation (HOMA-IR). Three right-skewed outcome variables were natural log (Ln)transformed: WC, triglyceride and HOMA-IR. Omnibus and gender-specific multiplelinear regression models were fitted.Results: Among 2,253 adolescents (52.1% girls, 7.1% overweight/obese), we identifiedfour diet clusters: Traditional, Fish-dominant, Meat-dominant, and High-variety.No significant associations were found between the clusters and indicators. Ongender-stratification, triglyceride levels were lower among boys in the Fish-dominant (Ln-triglyceride βadjusted: −0.09; 95% confidence interval (CI): −0.15, −0.02) andMeat-dominant (Ln-triglyceride βadjusted: −0.08; 95% CI: −0.15, −0.004) clusters thanamong boys in the Traditional cluster. Compared to boys in the bottom quartile of DDS, boys in the top quartile had 2.1 mm of Hg (95% CI: 0.5, 3.6) higher systolic bloodpressure and 1.9% (95% CI: 0.01–3.8%) higher WC.Conclusion: While statistically significant, the gender-specific differences intriglyceride, systolic blood pressure, and waist circumference across dietarypatterns were small. Associations between dietary patterns and cardiometabolic riskindicators may require a time lag beyond mid-adolescence to manifest in a ruralsetting. Prospective studies are warranted to delineate the magnitude and directionof those associations. 

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Nyckelord

dietary patterns

cardiometabolic risk markers

blood pressure

lipid profile

waist circumference

rural adolescents

low- and middle-income country (LMIC)

Bangladesh

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)