Associations of an empirical dietary pattern with cardiometabolic risk factors in Malaysian adolescents

Abstract

Background: This study aimed to identify a dietary pattern (DP) characterised mainly by high intakes of free sugar and other nutrients hypothesised to be associated with obesity such as dietary energy density (DED), percentage of energy from total fat and fibre density in adolescents from three southern states of Peninsular Malaysia, and its associations with cardiometabolic risk factors. Methods: This is a cross-sectional study among 335 adolescents who provided both dietary information assessed using a validated food frequency questionnaire (FFQ) and biochemical parameters including lipid profile, blood glucose, serum insulin and homeostatic model assessment-insulin resistance (HOMA-IR). Anthropometric measurements included weight (kg), height (cm) and waist circumference (cm), while body mass index (BMI) in kg/ m 2 was estimated, respectively. Reduced rank regression (RRR) identified a DP with percentage of energy from sugar and total fat, DED and fibre density intake as response variables. Results: The identified 'high sugar, high fibre, high DED and low fat' DP was characterised by high intakes of sugarsweetened beverages, fruits, sweets and low intakes of meat and cereal. Adolescents in the highest tertile of the identified DP had about 3.0 (OR = 2.7; 95%CI: 1.3, 5.6) and 2.0 (OR = 1.9; 95%CI: 1.0, 3.5) times higher odds of having dyslipideamia or elevated total cholesterol and LDL-cholesterol level, respectively compared to adolescents in the lowest tertile DP after adjusting for sex, school location, maternal education, physical activity, dietary misreporting and BMI z-score. This DP was not significantly associated with overweight and obesity. Conclusions: Higher adherence to a DP characterised mainly by free sugars and DED was associated with greater odds of having dyslipideamia, elevated total cholesterol and LDL-cholesterol levels in Malaysian adolescents.

The Relationships between a Dietary Pattern Linked to Cardiometabolic Risk Factors and Life Satisfaction in Early Adolescence

“…The details of this study were previously described [ 19 ]. In brief, a total of 933 adolescents aged 13 years were enrolled from a total of 21 randomly selected public schools located in three southern states of Peninsular Malaysia in 2016.…”

“…The identification of a dietary pattern characterized by food intakes high in free sugar, fiber, DED and low in fat was previously discussed [ 19 ]. The identified dietary pattern was positively associated with a few indicators of cardiometabolic risk factors, particularly serum lipids [ 19 ].…”

“…The identification of a dietary pattern characterized by food intakes high in free sugar, fiber, DED and low in fat was previously discussed [ 19 ]. The identified dietary pattern was positively associated with a few indicators of cardiometabolic risk factors, particularly serum lipids [ 19 ]. In brief, the dietary pattern in this study was characterized using reduced rank regression analysis (RRR), a data-dimension reduction method that identifies dietary patterns that are specifically relevant to the health outcomes of interest by including a priori knowledge.…”

“…While adherence to a specific dietary pattern may play a role in the development of mental illnesses, there is a dearth of evidence on the relationship between dietary patterns and life satisfaction in young people. Previously, we found a positive relationship between a dietary pattern characterized by foods high in free sugar, dietary energy density (DED), fiber and low in fat and dyslipidemia as well as other cardiometabolic risk factors such as total cholesterol and low-density lipoprotein (LDL) cholesterol in adolescents aged 13 years in Malaysia [ 19 ]. Furthermore, we also found that 32% and 24% of the study adolescents to be either overweight or obese and dyslipidemic, respectively [ 19 ].…”

“…Previously, we found a positive relationship between a dietary pattern characterized by foods high in free sugar, dietary energy density (DED), fiber and low in fat and dyslipidemia as well as other cardiometabolic risk factors such as total cholesterol and low-density lipoprotein (LDL) cholesterol in adolescents aged 13 years in Malaysia [ 19 ]. Furthermore, we also found that 32% and 24% of the study adolescents to be either overweight or obese and dyslipidemic, respectively [ 19 ]. Since there is a possibility of tri-directional association between adiposity, inflammation and mental health, we aimed to assess cross-sectional relationships between poor life satisfaction as a potential indication for early markers of mental illnesses and a dietary pattern linked to cardiometabolic risk factors in the sample of adolescents aged 13 years in Malaysia.…”