Dietary patterns associated with anthropometric indicators of abdominal fat in adults Padrões alimentares associados a indicadores antropométricos de adiposidade abdominal em adultos Patrones alimentarios asociados a los indicadores antropométricos de adiposidad abdominal en adultos


This study aimed to identify dietary patterns and assess their association with abdominal fat. A cross-sectional study was conducted in the Central West Region of Brazil with a probabilistic sample of 208 adults of both sexes. Data on food intake was obtained using a food frequency questionnaire and factor analysis (principal components) was conducted to identify dietary patterns. Waist circumference (WC) and waistto-hip ratio (WHR) were used to assess abdominal fat. The association between dietary patterns and body fat distribution was examined using multiple linear regression analysis adjusted for confounders. Three dietary patterns were identified: Western, regional traditional, and prudent. A positive association was found between the Western pattern and WC (p = 0.04) and WHR (p = 0.001) and between the regional traditional pattern and WHR (p = 0.05) among women. A slight association was also found between the latter pattern and WC (p = 0.07) also among women. An association was found between the Western and regional traditional dietary patterns and a larger concentration of abdominal fat among women. Food Consumption; Statistical Factor Analysis; Waist Circumference; Waist-Hip Ratio; Adults Resumo Este estudo teve o objetivo identificar padrões alimentares e analisar a associação com a adiposidade abdominal. Estudo transversal, realizado na Região Centro-Oeste do Brasil, com amostra probabilística de 208 adultos, de ambos os sexos. O consumo alimentar foi obtido por questionário de frequência alimentar e aplicada análise fatorial (componentes principais) para identificar padrões alimentares. A circunferência da cintura (CC) e a relação cintura quadril (RCQ) foram indicadores de adiposidade abdominal. A associação dos padrões alimentares com adiposidade abdominal foi analisada em modelos de regressão linear múltipla ajustados por fatores de confusão. Identificaram-se três padrões alimentares: ocidental, tradicional regional e prudente. O padrão ocidental associouse positivamente com CC (p = 0,04) e RCQ (p = 0,001) e o padrão tradicional regional associouse também com RCQ (p = 0,05), e marginal a associação com a CC (p = 0,07) somente em mulheres. Os padrões ocidental e tradicional regional associaram à maior adiposidade abdominal em mulheres. Consumo de Alimentos; Análise Fatorial; Circunferência da Cintura; Relação CinturaQuadril; Adultos DIETARY PATTERNS AND ABDOMINAL FAT 503 Cad. Saúde Pública, Rio de Janeiro, 30(3):502-510, mar, 2014 Introduction Central adiposity is the accumulation of intra-abdominal fat in the trunk region. It is an important risk factor for disorders such as type 2 diabetes and cardiovascular disease and is considered to play a more significant role in the development of these diseases than the total amount of body fat 1,2,3,4. Accurate methods for assessing central adiposity, such as computed tomography scans and magnetic resonance imaging are costly and difficult to apply to epidemiological studies 5. The World Health Organization (WHO) recommends anthropometric measurements as an adequate and accurate assessment method and waist circumference (WC) and waist-to-hip ratio (WHR) have been shown to be accurate indicators of abdominal fat 6. A number of studies on the association between dietary factors, particularly those related to nutrients and energy, and fat distribution have been conducted 7,8. However, the use of this approach limits investigation to the association between health outcomes and food intake 9. Studies of dietary patterns have been shown to provide promising models for analyzing these associations because they have a greater focus on dietary recommendations and guidelines 10. Dietary patterns can be defined as sets of foods commonly consumed by a specific population and may be described using food intake reports or methods for estimating food availability 11. This approach provides a more realistic reflection of the food habits of the group of interest because it reveals the overall dietary pattern rather than isolated estimates of energy and nutrient intake or general food intake 12,13. Factor analysis is a statistical method that is widely used to identify dietary patterns (or factors) that are not directly observable by aggregating original data on the consumption of several food items based on the existing dependency arrangement (represented by correlation and covariance between food items) 11,14. Published studies on the eating habits of the population of the Central West Region of Brazil have yet to identify dietary patterns among adults. The objective of the present study was therefore to identify dietary patterns among adults and evaluate their association with estimates of abdominal fat derived from anthropometric measurements. Materials and methods A sub-sample of a population-based survey conducted to estimate the prevalence of arterial hypertension among adults in Cuiabá the capital city of the State of Mato Grosso located in the Central West Region of Brazil 15 was used. All 686 adults of both sexes between 20 and 50 years of age were considered eligible for the evaluation using a food frequency questionnaire (FFQ) of which a total of 208 participants were randomly selected to answer questions on food consumption. The quantity of participants selected from each of the four zones of the city of Cuiabá was determined using the proportions adopted by the main study so as to ensure full coverage of the social makeup of the city. The study comprises a secondary analysis of food consumption data obtained by a FFQ validation study developed for use with adults in Cuiabá 16. The food items used to identify dietary patterns were obtained from a semiquantitative FFQ which included 81 food items and was based on a FFQ validated for use in the adult population of Cuiabá 16. Eight frequency of consumption options were offered: more than three times a day; twice to three times a day; once a day; five to six times a week; twice to four times a week; once a week; once to three times a month; and never or hardly ever. Frequency of consumption reported in the FFQ was converted into a daily frequency equivalent where proportionate values were attributed to the above frequency options based on a value of 1.0 for once-a-day; for example, twice to four times a week was equated to 0.43 times/ day. The chemical composition of each food item was defined based on the nutritional composition data contained in the NutWin software (Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil) which uses the food database of the United States Department of Agriculture with added food items from Brazilian Food Composition Table 17. Guarana powder, garlic, onion and pepper were excluded from the analysis due to their low frequency of consumption or because they are used as spices and consumed with other prepared foods. The remaining 77 food items were divided into 21 food groups (Table 1) based on similarities in nutrient composition, particular dietary habits in the study population and frequency of consumption. Some of the commonly consumed food items reported by more than 80% were set apart (rice, beans, bread, sugar, coffee and butter/margarine). Weight, height and waist and hip circumferences were measured using standard methods 18. Height was measured using a Seca 206 Vilela AAF et al. 504 Cad. Saúde Pública, Rio de Janeiro, 30(3):502-510, mar, 2014 Table 1 Food groups used in the factor analysis derived from the food frequency questionnaire. Cuiabá, State of Mato Grosso, Brazil, 2007. Food group Foods from the food frequency questionnaire

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@inproceedings{Vilela2014DietaryPA, title={Dietary patterns associated with anthropometric indicators of abdominal fat in adults Padrões alimentares associados a indicadores antropométricos de adiposidade abdominal em adultos Patrones alimentarios asociados a los indicadores antropométricos de adiposidad abdominal en adultos}, author={Ana Am{\'e}lia Freitas Vilela and Rosely Sichieri and Ros{\^a}ngela Alves Pereira and Diana Barbosa Cunha and Paulo Rog{\'e}rio Melo Rodrigues and M{\'a}rcia Gonçalves Ferreira}, year={2014} }