Association between Dietary Patterns and Metabolic Syndrome and Modification Effect of Altitude: A Cohort Study of Tibetan Adults in China

Abstract

Little is known about the longitudinal association between dietary patterns (DPs) and metabolic disorders in people living at high altitude areas, such as Tibetans. We constructed the first open cohort, with 1832 Tibetans, and collected data in 2018 and in 2022. The metabolic syndrome (MetS) prevalence was 30.1% (32.3% in men and 28.3% in women). Three different DPs were identified: modern DP (pulses, poultry, offal, and processed meat), urban DP (vegetables, refined grain, beef/mutton, and eggs), and pastoral DP (Tibetan cheese, tsamba, butter/milk tea, and desserts). Participants within the third tertile of the urban DP had a 3.42-fold (95% CI 1.65–7.10) higher risk of MetS than those with the first tertile. Modern DP was positively associated with elevated blood pressure (BP) and elevated triglycerides (TAG), while it was inversely associated with low HDL-C. The urban DP was associated with a higher risk of low HDL-C, but a lower risk of impaired fasting blood glucose (FBG). The pastoral DP was a risk factor for impaired FBG, but protective for central obesity and elevated BP. Associations of modern DP with elevated BP, and pastoral DP with low HDL-C, were modified by altitude. In conclusion, among Tibetan adults, DPs were associated with MetS and its components, and the associations were modified by altitude among Tibetans.

Association between Dietary Patterns and Metabolic Syndrome Risk Factors: A Cross-Sectional Study of Christian Orthodox Church Fasters and Non-Fasters in Greece

“…MetS is diagnosed when three or more of the following joint criteria are met: (i) elevated waist circumference (according to race-specific cut off points); (ii) elevated fasting glucose levels (≥100 mg/dL); (iii) reduced high-density lipoprotein (HDL) cholesterol [<40 mg/dL (1.0 mmol/L) in males, and <50 mg/dL (1.3 mmol/L) in females]; (iv) increased triglyceride (TG) levels (≥150 mg/dL, 1.7 mmol/L); and (v) elevated blood pressure (BP) levels (systolic BP ≥ 130 and/or diastolic BP ≥ 85 mm Hg) [ 18 ]. According to the literature, following a Western type of diet has been linked with increased incidence of MetS, while a Mediterranean diet has been in favor of reducing all independent risk factors of MetS [ 19 , 20 , 21 , 22 ]. Also, plant-based diets [ 23 , 24 , 25 ] and vegetarian dietary patterns [ 26 , 27 ] have been linked with positive outcomes of reducing all related MetS risk factors.…”