title: Dietary Patterns Are Associated with Metabolic Outcomes among Adult Samoans in a Cross-Sectional Study.
abstract: Background:The Samoan population has been undergoing a nutrition transition toward more imported and processed foods and a more sedentary lifestyle.Objectives:We aimed to identify dietary patterns in Samoa and to evaluate their associations with metabolic outcomes.Methods:The sample of this cross-sectional study includes 2774 Samoan adults recruited in 2010 (1104 with metabolic syndrome compared with 1670 without). Principal component analysis on food items from a 104-item food-frequency questionnaire was used to identify dietary patterns. Adjusted least squares means of each component of metabolic syndrome were estimated by quintiles of factor scores for each dietary pattern. Metabolic syndrome status was regressed on quintiles of scores by using log-binomial models to obtain prevalence ratios.Results:We identified a modern pattern, a mixed-traditional pattern, and a mixed-modern pattern. The modern pattern included a high intake of imported and processed foods, including pizza, cheeseburgers, margarine, sugary drinks, desserts, snacks, egg products, noodles, nuts, breads, and cakes and a low intake of traditional agricultural products and fish. The mixed-traditional pattern had a high intake of neotraditional foods, including fruits, vegetables, soup, poultry, and fish, and imported and processed foods, including dairy products, breads, and cakes. The mixed-modern pattern was loaded with imported and processed foods, including pizza, cheeseburgers, red meat, egg products, noodles, and grains, but also with neotraditional foods, such as seafood and coconut. It also included a low intake of fish, tea, coffee, soup, and traditional agricultural staples. Higher adherence to the mixed-modern pattern was associated with lower abdominal circumference (P-trend < 0.0001), lower serum triglycerides (P-trend = 0.03), and higher serum HDL cholesterol (P-trend = 0.0003). The mixed-modern pattern was inversely associated with prevalence of metabolic syndrome (the highest quintile: prevalence ratio = 0.79; 95% CI: 0.69, 0.91;P-trend = 0.006).Conclusion:Mixed dietary patterns containing healthier foods, rather than a largely imported and processed modern diet, may help prevent metabolic syndrome in Samoa.
authors.affiliation: Departments of Epidemiology and.
authors.forename: Dongqing
authors.identifier: 0000-0003-3369-5972
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Chronic Disease Epidemiology, School of Public Health, and.
authors.forename: Nicola L
authors.initials: NL
authors.lastname: Hawley
authors.affiliation: Yale College, Yale University, New Haven, CT.
authors.forename: Avery A
authors.initials: AA
authors.lastname: Thompson
authors.affiliation: Oceania University of Medicine, Apia, Samoa.
authors.forename: Viali
authors.initials: V
authors.lastname: Lameko
authors.affiliation: Samoa Bureau of Statistics, Apia, Samoa; and.
authors.forename: Muagatutia Sefuiva
authors.initials: MS
authors.lastname: Reupena
authors.affiliation: International Health Institute and Department of Epidemiology, Brown University, Providence, RI.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: McGarvey
authors.affiliation: Departments of Epidemiology and abaylin@umich.edu.|Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI.
authors.forename: Ana
authors.initials: A
authors.lastname: Baylin
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004032:Diet; D004034:Diet Surveys; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D012307:Risk Factors; D018947:Samoa / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: Samoa; dietary pattern; eating pattern; metabolic syndrome; nutrition transition; nutritional epidemiology; principal component analysis