Background Overweight and obesity are prevalent worldwide, and diet is an important impact factor of overweight and obesity. Dietary patterns characterize how foods and nutrients are consumed in combinations, and are more predictive in analysis of the relationship of diet with obesity than individual foods or nutrients.
Objective This study is designed to identify dietary patterns and explore their associations with overweight/obesity and central obesity among adult residents in Shanghai.
Methods The socio-demographic characteristics, dietary intakes, and height and weight were retrieved from 1045 adults aged 18 years and over who participated the "China Health and Nutrition Survey 2015 (CHNS)" in six districts of Shanghai. The participants were selected by multi-stage stratified cluster random sampling method with probability proportional to size. The overweight/obesity prevalence was standardized to the sixth national population census data. Factor analysis was used to explore the dietary patterns. Dietary pattern scores were divided into three groups (T1, T2, and T3, form low to high) by tertiles, and logistic regression analysis was performed to evaluate the association of dietary patterns with overweight/obesity and central obesity.
Results The prevalence rates of overweight/obesity and central obesity were 52.0% and 43.4% respectively. The standardized prevalence rates were 44.1% and 35.3% respectively. Men, the elderly ≥ 60 years, suburban residents, residents with primary school or below education or moderate/high labor intensity, and married residents had higher prevalence rates of overweight/obesity (57.2%, 59.0%, 59.9%, 60.9%, 63.2%, and 53.3%), respectively. The elderly ≥ 60 years, residents with primary school or below education or moderate/high labor intensity, and married residents had higher prevalence rates of central obesity (49.4%, 51.9%, 54.7%, and 44.9%), respectively. We identified five dietary patterns by factor analysis, explaining 46.51% of the diet variation:"vegetable, fruit, and meat", "fruit and dairy", "condiment and alcohol", "grain, tuber, and poultry", and "soybean" patterns respectively. For male, there were significant differences in the intakes of energy, protein, fat, and the proportions of energy intake from protein and carbohydrate among the T3 groups of the five dietary patterns (all P < 0.05). For female, there were significant differences in the intakes of energy, protein, fat, and carbohydrate, and the proportions of energy intake from protein and carbohydrate among the T3 groups of the five dietary patterns (all P < 0.05). After being adjusted for potential confounders, the results of logistic regression analysis showed that the "vegetable, fruit, and meat" pattern was positively correlated with central obesity in male (T2:T1, OR=1.719, 95%CI:1.072-2.756), the "fruit and dairy" pattern was negatively correlated with central obesity in female (T3:T1, OR=0.569, 95%CI:0.347-0.933), and the "soybean" pattern was negatively correlated with central obesity in female (T2:T1, OR=0.599, 95%CI:0.387-0.928).
Conclusion The prevalence rates of overweight/obesity and central obesity are high, and the dietary patterns of adult residents in Shanghai are diversified. "Vegetable, fruit, and meat" pattern may be the risk factor of central obesity in male, "fruit and dairy" and "soybean" patterns may be the protective factors of central obesity in female.
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