Sex Differences in Dietary Patterns of Adults and Their Associations with the Double Burden of Malnutrition: A Population-Based National Survey in the Philippines

Abstract

A dietary pattern transition is a risk factor for the double burden of malnutrition (DBM), but related information is limited. This study aimed to identify sex differences in dietary patterns of adults in a low–middle income country and to examine their association with DBM. A total of 8957 adults (4465 men and 4492 non-pregnant and non-lactating women) who participated in the 2013 Philippine National Nutrition Survey were included in the analysis. Logistic regression models were formulated to investigate the relationship between dietary patterns and DBM. The factor analysis derived seven dietary patterns for males and six patterns for females. Results showed that approximately 30% of Filipino adults suffered from DBM. The rice pattern was associated with lower odds of DBM for males only. The meat and sugar pattern in males and the protein-rich foods, cereal, and sugar pattern in females decreased DBM likelihood. An inverse relationship was observed for the vegetables and corn patterns, wherein females had an increased risk for DBM. Our findings suggest that rice-based and meat-containing patterns could play protective roles in DBM development among adults in the Philippines. Understanding sex-specific dietary patterns can be utilized to guide public health nutrition interventions in the prevention of malnutrition in all its forms.

Burden and trends of stroke attributable to dietary risk factors from 1990 to 2019 in the Belt and Road Initiative countries: an analysis from the global burden of disease study 2019

“…A study found that stroke mortality in Philippines has remained high over the past decade, which is similar to our findings ( 29 ). In low- and middle-income countries, dietary patterns are changing considerably, such as the replacement of staple-based diets with increased fat, meat and salt intakes ( 30 ). Numerous epidemiological studies have focused on dietary habits, as one of the modifiable risk factors and their impact on stroke risk, found a strong association between low-quality diet and stroke risk, however adherence to Mediterranean-style diet pattern has been pointed out to decrease the risk of first stroke ( 12 , 31 ).…”

Dietary Patterns and Nutritional Value in Non-Communicable Diseases

“…The exploitation of dietary patterns in low- and middle-income countries has uncovered a transition of traditional diets towards westernized diets, as well as the contribution of this dietary shift to obesity, malnutrition, and other NCDs. A data analysis of 8957 adults from the 8th Philippine National Nutrition Survey (PNNS) estimated a 30% prevalence of the double burden of malnutrition (DBM), indicating the coexistence of undernutrition and overnutrition in the same population [ 12 ]. Seven dietary patterns were extracted in this study, with a rice pattern and a meat and sugar pattern in males and a protein-rich food, cereal, and sugar pattern in females being associated with lower odds of DBM.…”

“…Seven dietary patterns were extracted in this study, with a rice pattern and a meat and sugar pattern in males and a protein-rich food, cereal, and sugar pattern in females being associated with lower odds of DBM. Vegetable and corn patterns showed an increased risk of DBM in women [ 12 ]. In a study aiming to explore the dietary patterns of children in South Africa, aged 1–10 years, and their relationship with socio-demographic factors, a greater adherence to unhealthy patterns in a higher socio-economic status and in the presence of an obese mother was observed [ 13 ].…”