Identification of dietary patterns associated with obesity in a nationally representative survey of Canadian adults: application of a priori, hybrid, and simplified dietary pattern techniques.
Background:Analyzing the effects of dietary patterns is an important approach for examining the complex role of nutrition in the etiology of obesity and chronic diseases.Objectives:The objectives of this study were to characterize the dietary patterns of Canadians with the use of a priori, hybrid, and simplified dietary pattern techniques, and to compare the associations of these patterns with obesity risk in individuals with and without chronic diseases (unhealthy and healthy obesity).Design:Dietary recalls from 11,748 participants (≥18 y of age) in the cross-sectional, nationally representative Canadian Community Health Survey 2.2 were used. A priori dietary pattern was characterized with the use of the previously validated 2015 Dietary Guidelines for Americans Adherence Index (DGAI). Weighted partial least squares (hybrid method) was used to derive an energy-dense (ED), high-fat (HF), low-fiber density (LFD) dietary pattern with the use of 38 food groups. The associations of derived dietary patterns with disease outcomes were then tested with the use of multinomial logistic regression.Results:An ED, HF, and LFD dietary pattern had high positive loadings for fast foods, carbonated drinks, and refined grains, and high negative loadings for whole fruits and vegetables (≥|0.17|). Food groups with a high loading were summed to form a simplified dietary pattern score. Moving from the first (healthiest) to the fourth (least healthy) quartiles of the ED, HF, and LFD pattern and the simplified dietary pattern scores was associated with increasingly elevated ORs for unhealthy obesity, with individuals in quartile 4 having an OR of 2.57 (95% CI: 1.75, 3.76) and 2.73 (95% CI: 1.88, 3.98), respectively (P-trend < 0.0001). Individuals who adhered the most to the 2015 DGAI recommendations (quartile 4) had a 53% lower OR of unhealthy obesity (P-trend < 0.0001). The associations of dietary patterns with healthy obesity and unhealthy nonobesity were weaker, albeit significant.Conclusions:Consuming an ED, HF, and LFD dietary pattern and lack of adherence to the recommendations of the 2015 DGAI were associated with a significantly higher risk of obesity with and without accompanying chronic diseases.
Department of Nutritional Sciences, Faculty of Medicine, and.
Mahsa
M
Jessri
Department of Statistics, North Carolina State University, Raleigh, NC; and.|Scientific Discovery and Genomics, SAS Institute, Cary, NC.
Russell D
RD
Wolfinger
Biostatistics Division, Canada Research Chair in Statistical Methods for Health Care, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Wendy Y
WY
Lou
Department of Nutritional Sciences, Faculty of Medicine, and mary.labbe@utoronto.ca.
Mary R
MR
L'Abbé
D000328:Adult; D002170:Canada; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects*; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D015596:Nutrition Assessment; D018673:Nutrition Policy; D009765:Obesity / Q000209:etiology*; D000067329:Obesity, Metabolically Benign / Q000209:etiology; D016017:Odds Ratio; D012307:Risk Factors
D004041:Dietary Fats; D004043:Dietary Fiber
Canadian; Dietary Guidelines for Americans Adherence Index; chronic diseases; dietary patterns; obesity; partial least squares; simplified dietary pattern