Dietary patterns derived by reduced rank regression, macronutrients as response variables, and variation by economic status: NHANES 1999-2018

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2024

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Coxall, S.C.
Albers, F.E.
Li, S.X.
Shi, Z.
Hodge, A.M.
Lynch, B.M.
Melaku, Y.A.

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European Journal of Nutrition, 2024; 63(8):3207-3221

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Samuel C. Coxall, Frances EM. Albers, Sherly X. Li, Zumin Shi, Allison M. Hodge, Brigid M. Lynch, Yohannes Adama Melaku

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PURPOSE: Macronutrient intakes vary across people and economic status, leading to a disparity in diet-related metabolic diseases. This study aimed to provide insight into this by: (1) identifying dietary patterns in adults using reduced rank regression (RRR), with macronutrients as response variables, and (2) investigating the associations between economic status and macronutrient based dietary patterns, and between dietary patterns with central obesity (waist circumference) and systemic inflammation (C-reactive protein [CRP]). METHODS: 41,849 US participants from the National Health and Nutrition Examination Survey (NHANES), 1999-2018 were included. The percentages of energy from protein, carbohydrates, saturated fats, and unsaturated fats were used as response variables in RRR. Multivariable generalized linear models with Gaussian distribution were employed to investigate the associations. RESULTS: Four dietary patterns were identified. Economic status was positively associated with both the high fat, low carbohydrate [βHighVsLow = 0.22; 95% CI: 0.16, 0.28] and high protein patterns [β(HighVsLow) = 0.07; 95% CI: 0.03, 0.11], and negatively associated with both the high saturated fat [βHighVsLow = -0.06; 95% CI: -0.08, -0.03] and the low alcohol patterns [β(HighVsLow) = -0.08; 95% CI; -0.10, -0.06]. The high saturated fat pattern was positively associated with waist circumference [β(Q5VsQ1) = 1.71; 95% CI: 0.97, 2.44] and CRP [β(Q5VsQ1 )= 0.37; 95% CI: 0.26, 0.47]. CONCLUSION: Macronutrient dietary patterns, which varied by economic status and were associated with metabolic health markers, may explain associations between economic status and health.

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Published online 17 Sep 2024

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© The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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