Association Of Dietary Patterns With Anthropometric Data In Part Of Physical Examination Women In Jinan

ObjectiveTo investigate the dietary patterns and nutritional status of healthy adult women in Jinan, and to learn the possible associations between dietary patterns and anthropometric data, in order to provide nutritional guidelines and dietary intervention for better health management.Methods595healthy adult women who had a physical examination in the medical examination center of one hospital in Jinan from December2010to April2011were randomly selected to complete a questionnaire concerning socio-demographic, lifestyle factors and food-frequency in the last year. Data of diet survey, anthropometric data, including height, weight, waist circumference, hip circumference and blood pressure, and blood index were collected. Simple linear regression analysis and spearman rank correlation were used to analysis the association between consumption of different food groups and anthropometric data. Factor Analysis was used to identify dietary patterns. The factor scores were considered as the outcome variables to determine any association with anthropometric data factors using correlate analysis. The association between dietary patterns and BMI. waist circumference and waist/hip ratio was assessed by t-test,multiple linear regression and structural equation model. Structure equation model was used to explore the dependence relationship between dietary and indicator of medical examination.Results1. Basic InformationThe mean of BMI was22.89±3.17(range:15.4to35.4), the prevalence of overweight (24.0≤BMI<28.0) and obesity (BMI>28.0) were24.87%and8.07%respectively. The mean of waist circumference and waist/hip ratio were78.16±9.11cm (56.0cm-111.0cm) and0.83±0.07(0.66-1.21). Abnormal detection rate of waist circumference and waist-hip ratio were36.64%and30.42%respectively. The ratio of systolic blood pressure≥140mmHg or diastolic blood pressure≥90mmHg was15.97%. The result of simple linear analysis showed that BMI (β=0.128, P=0.000), waist circumference (β=0.382, P=0.000), WHR (β=0.003, P=0.000), systolic blood pressure (β=0.800, P=0.000) and diastolic blood pressure (β=0.456, P=0.000) increased by age.Abnormal detection rate of BMI, waist circumference and waist-hip ratio were32.4%、36.64%and30.42%respectively and the ratio increased along with age. Six dietary patterns were identified in this population:1) traditional pattern,2) oils pattern,3) modern pattern,4) vegetarian pattern,5) snacks pattern,6) alcohol pattern. After adjustment for age, the oils pattern showed positively correlation with BMI and WC.2. Consumption of Different Food GroupsCompared with the daily intake of types of food recommended by Chinese Balanced Diet Pagoda, most women met the recommended daily intake of cereals, vegetables, fruits, eggs and oils, namely under30%subjects consumed those food groups less than recommended intake.40percent of subjects did not meet the recommended intake of poultry meat, beans and bean products. Consumption of aquatic product and dairy products was severely insufficient,75percent participants consumed less than the recommended intake, especially dairy consumption.57.31%percent participants consumed salt more than10g/d. A significant positive correlation had revealed between age and vegetables, aquatic product, coarse grains, nuts and age. Meat, dairy, desserts, beverages and salt intake showed significant negative correlation with age. While grains, beans, fruits, eggs, wine and oil intake has shown null correlation with age. With the increase of age, intake of meat, dairy, desserts reduces while vegetables, fish and shrimp, coarse grains and nuts intake increases. After adjustment for age, intake of vegetables, meat, dairy, disserts, beverages and salt were negatively correlated with age, while oil, salt intake were positively correlated with BMI. After adjustment for age, salt intake has positive correlation with waist circumference, waist to hip ratio and systolic blood pressure, and negative correlation with diastolic pressure.3. Dietary PatternsThe Bartlett Test of Sphericity and the Kaiser-Meyer-Olkin Measure of Sampling Adequacy were used to assess data adequacy for factor analysis. Both the Kaiser-Meyer-Olkin index (0.631) and Bartlett’s test (x2=587.822, P=0.000) indicated that the correlation among the variables was sufficiently strong for a factor analysis. Factors with an eigen value>1was extracted. Factors were retained based on the Scree test. According to eigen value and Scree test, six factors were retained in this study. The identified factors were rotated by orthogonal (varimax) rotation to achieve greater interpretability of the factors. Six factors explained55.45%of the variability. Finally, six dietary patterns were identified. Six dietary patterns were identified in this population:1) traditional pattern (loading heavily on coarse grains, beans, nuts and aquatic product),2) oils pattern (consisting of oils, meat, salt and cereals),3) modern pattern (loading heavily on fruit and dairy products),4) vegetarian pattern (high in vegetables and low in eggs and beverage),5) snacks pattern(high in desserts and beverage),6) alcohol pattern(loading heavily on alcohol).The results of the dietary patterns of different age groups showed that the <40-year-old age group had six dietary patterns. They were beans+aquatic product+nuts+grains pattern, oil+meat+cereals+salt pattern, dairy+fruit pattern, alcoholic+beverage+less grains pattern, dessert+beverage pattern and vegetables+less eggs pattern. Factor analysis of≥40-year-old age group got five dietary patterns. They were grains+beans+nuts+vegetarian pattern, fruits+aquatic product+less cereals pattern, meat+oil+salt pattern, dessert+dairy+beverage pattern, and eggs+less vegetables+less alcohol pattern. This showed that different age groups had different dietary patterns.Subjects with a high score of traditional pattern were elder (P<0.01) and had a high BMI (P<0.05), waist circumference (P<0.05) and WHR (P<0.05) while those with a high intake of the oils pattern had a high BMI (P<0.01). Subjects with a high intake of modern pattern had low WHR. Subjects with a high intake of vegetarian pattern were elder and had high BMI, and blood pressure (P<0.01). Subjects with a high intake of snacks pattern were young (P<0.05) and had low BMI (P<0.05), waist circumference (P<0.05) and WHR (P<0.05). In alcohol pattern, the age of groupQ4is younger than that of groupQl (P<0.01). After adjustment for age, oils pattern was positively correlated with BMI, waist, WHR, systolic and diastolic blood pressure, vegetarian pattern and diastolic blood pressure were positively correlated.4. Structure equation model of dietary and indicator of medical examinationThe paraneters of structural equation model were GFI=0.9706, AGFI=0.9687, RMR=2.5575, PGFI=0.9647which represented a better model fitting.Path coefficient of traditional pattern and hemoglobin factor and liver function factor was0.056and0.1338respectively. Path coefficient of oil pattern and blood pressure factor and metabolism factor was0.9974,1.1287respectively. Path coefficient of alcohol pattern and blood pressure factor, hemoglobin factor and metabolism factor was0.0385,2.3972and0.9928respectively. The results above indicated that these relationships were positive. Path coefficient of modern pattern and blood pressure factor was-0.07. Path coefficient of vegetarian pattern and hemoglobin factor was-0.3303. Path coefficient of snacks pattern and hemoglobin factor was-0.9432. Those coeffiecence indicated the relationship were negative. Conclusion1.According to the levels of BMI among women who participated in the health examination in Jinan, the rate of overweight and obesity was more than or closed to the findings of National Nutrition Survey, the mean value of waist was lower than that in Shandong epidemiological investigation. And the prevalence of hypertension was lower than the average rate of the whole nation.2. Among women who participated in the health examination in Jinan, aquatic product and milk intake was serious poor. And the salt intake was far more than the recommended intake according to Chinese Balanced Diet Pagoda; there were significant differences in varieties and quantities of food intake indifferent groups. Those with higher intake of salt and oil had a higher risk of obesity and hypertension.3. The dietary patterns showed varieties among women who participated in the health examination in Jinan. Women in different age groups had different dietary patterns; the oil pattern was closely related to BMI, waist, WHR and blood pressure. Good eating habits and lower consumption of oils, meat, salt, and refined grains could significantly reduce the risk of obesity and hypertension.4. Blood pressure.factor and liver function factor were greatly influenced by dietary. While blood pressure was related to oils pattern, alchol pattern and modern pattern and liver function factor was related to tradional pattern and alchol pattern.