Nutrient patterns and their relation to general and abdominal obesity in Iranian adults: findings from the SEPAHAN study.
BACKGROUND
Few studies have linked major dietary nutrient patterns to chronic diseases. Despite the growing evidence of associations between dietary patterns and obesity, we are aware of no study that examined the association between patterns of nutrient intake and obesity.


OBJECTIVE
To identify major nutrient patterns in Iranian adults and investigate their association with general and abdominal obesity.


METHODS
In this cross-sectional study that was conducted under the framework of the Study on the Epidemiology of Psychological Alimentary Health and Nutrition (SEPAHAN), dietary data were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire in 8691 subjects aged 18-55 years. Complete data of 6724 and 5203 adults were available for general and abdominal obesity, respectively. Data on anthropometric measures were collected through a self-administered questionnaire. General obesity was defined as body mass index ≥ 30 kg/m(2), and abdominal obesity as waist circumference > 102 cm for men and >88 cm for women. Daily intakes of 38 nutrients and bioactive compounds were calculated for each participant. Factor analysis, followed by a varimax rotation, was applied to derive major nutrient patterns.


RESULTS
Three major nutrient patterns were identified: (1) The first pattern was high in fatty acids (including saturated, monounsaturated and polyunsaturated fatty acids), cholesterol, vitamin B12, vitamin E, zinc, choline, protein, pyridoxine, phosphorus and pantothenic acid; (2) the second pattern was high in thiamine, betaine, starch, folate, iron, selenium, niacin, calcium, and manganese; and (3) the third pattern was high in glucose, fructose, sucrose, vitamin C, potassium, total dietary fiber, copper and vitamin K. Men in the highest quintile of the second pattern were less likely to be generally obese in the fully adjusted model [odds ratio (OR) 0.39, 95 % confidence interval (CI) 0.20-0.76]. After adjustment for potential confounders, a significant positive association was observed between the third pattern and general obesity among men (OR 1.77, 95 % CI 1.04-3.04), but not women (OR 1.18, 95 % CI 0.74-1.88). No overall association was seen between patterns of nutrient intake and abdominal obesity in both genders.


CONCLUSIONS
Major nutrient patterns were significantly associated with general, but not abdominal obesity among male participants of the SEPAHAN study. Further studies in other populations, along with future prospective studies, are required to confirm these findings.
Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, PO Box 81745, Isfahan, Iran.|Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Amin
A
Salehi-Abargouei
Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. esmaillzadeh@hlth.mui.ac.ir.|Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, PO Box 81745, Isfahan, Iran. esmaillzadeh@hlth.mui.ac.ir.
Ahmad
A
Esmaillzadeh
Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, PO Box 81745, Isfahan, Iran.
Leila
L
Azadbakht
Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Ammar Hassanzadeh
AH
Keshteli
Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.|Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Awat
A
Feizi
Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide Discipline of Medicine, Adelaide, SA, 5000, Australia.
Christine
C
Feinle-Bisset
Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Peyman
P
Adibi
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D003430:Cross-Sectional Studies; D004032:Diet; D004041:Dietary Fats / Q000032:analysis; D004043:Dietary Fiber / Q000032:analysis; D004044:Dietary Proteins / Q000032:analysis; D002149:Energy Intake; D015444:Exercise; D005227:Fatty Acids / Q000032:analysis; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D018977:Micronutrients / Q000032:analysis; D008875:Middle Aged; D015596:Nutrition Assessment; D064427:Nutritive Sweeteners / Q000032:analysis; D056128:Obesity, Abdominal / Q000453:epidemiology*; D015995:Prevalence; D011795:Surveys and Questionnaires; D055105:Waist Circumference; D055815:Young Adult
D004041:Dietary Fats; D004043:Dietary Fiber; D004044:Dietary Proteins; D005227:Fatty Acids; D018977:Micronutrients; D064427:Nutritive Sweeteners
Anthropometry; Diet; Factor analysis; Fat accumulation; Nutrient intake; Obesity