Metabolic syndrome and its relation to dietary patterns among a selected urbanised and semi-urbanised Tibetan population in transition from nomadic to settled living environment

Abstract

Objective: To explore the scope of metabolic syndrome (MetS) and its relationship to the major dietary patterns among an urbanised and semi-urbanised Tibetan population in transition from nomadic to settled settings. Design: Cross-sectional. Setting: Community-based. Participants: Urbanised and semi-urbanised Tibetan adults (n 920, aged 18–90 years), who have moved from nomadic to settled living environments, answered questionnaires on food consumption frequency and lifestyle characteristics through structured face-to-face interviews and completed anthropometric measurement and metabolic biomarker tests. Results: MetS prevalence was 30·1 % in males and 32·1 % in females. Low HDL-cholesterol and central obesity were the leading metabolic abnormalities (86·3 and 55·8 %, respectively). Three major dietary patterns – urban, western and pastoral – were identified. Beef/mutton was an important food group for all three identified dietary patterns. In addition, the urban dietary pattern was characterised by frequent consumption of vegetables, tubers/roots and refined carbohydrates; the western pattern was characterised by sweetened drinks, snacks and desserts; and the pastoral pattern featured tsamba (roasted Tibetan barley), Tibetan cheese, butter tea/milk tea and whole-fat dairy foods. Individuals in the highest quintile of urban dietary pattern scores were found to be at a higher risk of developing MetS (OR 2·43, 95 % CI 1·41, 4·18) and central obesity (OR 1·91, 95 % CI 1·16, 3·14) after controlling for potential confounders. Conclusions: MetS was common among urbanised and semi-urbanised Tibetan adult population in transition. The urban dietary pattern, in particular, was a risk factor for MetS. To prevent MetS, nutrition interventions need to be tailored to address the variety of local diet patterns to promote healthy eating.

Prevalence, Management, and Associated Factors of Obesity, Hypertension, and Diabetes in Tibetan Population Compared with China Overall

“…Current evidence has shown the roles of dietary factors and the diagnostic criteria of diabetes. Our study has identified the metabolic protective role of traditional Tibetan diets, in which tsamba, a whole grain rich in β glucagon functioning in glucose regulation, is an important component [ 6 , 68 , 69 ].…”

“…However, the mortality rates in cardiovascular diseases and diabetes in China in 2018 were 364.6 and 19.1 per 100,000, respectively, based on a recent national report [ 5 ]. In addition, recent epidemiological studies in different settings have revealed an unexpectedly high prevalence of obesity and related NCDs [ 6 , 7 , 8 ]. Nevertheless, the obesity and NCD patterns among the overall Tibetan populations were understudied.…”

Association of Tibetan Habitual Food and Metabolic Syndrome Among Tibetan People in China: A Cross-Sectional Study

“…Total weekly intake was endowed with the scores of 0, 1, 2, and 3 according to the classification as never, low, medium, and high. To obtain the combined effect of Tsampa, butter tea, and Qing cha on MetS, these numbers were added together ranging from 0 to 9, and then divided into four categories: never/rarely (0-2), low score (3-5), middle score (6, 7), and high score (8,9). To examine the potential effect modification between the consumption of each food, we tested models with interaction terms.…”

“…There are limited studies regarding the association between dietary patterns in Tibet and MetS with inconsistent results. One study reported a null association between the risk of MetS and the traditional Tibetan and urbanized diet, while another showed that urban dietary pattern was a risk factor for MetS, both of which had small sample sizes and defects in research design with inadequate control of confounding factors (7,8). Further, due to different dietary assessment items, different definitions of MetS [e.g., ATP III vs. International Diabetes Federation (IDF)], and different populations investigated, it is difficult to directly compare the effects of the Tibetan diet on MetS from various studies.…”

The Role of Bioactive Compounds from Dietary Spices in the Management of Metabolic Syndrome: An Overview

“…The meeting outcomes also concluded that the presence of three out of five risk factors would diagnose MetS, with the five criteria being elevated blood pressure, central obesity, elevated TG, elevated FBG, and reduced HDL [ 14 ]. MetS and its relation to dietary patterns were recently studied, and it was concluded that nutrition interventions need to be tailored to address the MetS occurrence in various ethnic groups [ 15 ].…”