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Deshpande S, Mandlik R, Khadilkar AV, Bhawra J, Kinnunen TI. Micronutrient deficiency, dietary diversity, and sociodemographic and lifestyle determinants of dietary diversity among pregnant slum-dwelling women in Pune, India. BMC Nutr 2024; 10:108. [PMID: 39085982 PMCID: PMC11293030 DOI: 10.1186/s40795-024-00915-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Increasing dietary diversity is a sustainable solution to combat micronutrient deficiencies. Given the large slum population in urban India, double burden of malnutrition, nutritional transition among slum-dwellers, and limited studies focusing on dietary intake and diversity among pregnant slum-dwellers, this study aimed to 1) describe macro- and micronutrient intakes and compare them with guidelines, 2) describe dietary diversity and intake of unhealthy foods and, 3) investigate the sociodemographic and lifestyle determinants of adequate dietary diversity among pregnant slum-dwellers in Pune, Maharashtra, India. METHODS This study presents cross-sectional data of 454 pregnant slum-dwelling women completing mid-pregnancy visit collected from a larger cohort study. Sociodemographic and lifestyle data were collected at baseline (< 12 weeks gestation). Dietary data (24-h dietary recall) were collected in mid-pregnancy (23 ± 2 weeks). Nutrient intakes were compared with the Estimated Average Requirements (EAR) for pregnant Indian women. Dietary diversity score (DDS, range 0-10) and unhealthy food (sweet snacks, sweet beverages, fried and salty food) group score (range 0-3) were calculated as per FAO guidelines. Multivariate logistic regression was conducted to examine determinants of adequate dietary diversity (DDS ≥ 5). RESULTS The average age of women was 25 (4.5) years. The median (Q1, Q3) total energy and protein intakes were 1771 (1456, 2185) kcal/d and 44.7 (34.7, 55.0) g/d, respectively. Total energy and protein were consumed as per EAR by 37% and 54% of women, respectively. Forty percent of women exceeded the recommended energy intake from carbohydrates. Diets of slum-dwelling women were lacking in multiple micronutrients (especially iron, zinc, riboflavin, thiamine, folate). The mean DDS was 4.2 ± 1.2 and 36.5% of the women had DDS ≥ 5. All women consumed mainly cereal-based starchy staples; 80% consumed pulses and legumes, and 60% consumed other vegetables. Fifty-nine percent of women consumed ≥ 2 unhealthy food groups. Higher educational and occupational status of the primary earning members of the family and lower parity were determinants of adequate dietary diversity. CONCLUSION The diets of pregnant slum-dwelling women were lacking in numerous micronutrients. Dietary counselling programs need to be tailored to the socioeconomic backgrounds of pregnant slum-dwelling women and involve their family members to improve reach and effectiveness.
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Affiliation(s)
- Swapna Deshpande
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.
- Growth and Paediatric Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India.
| | - Rubina Mandlik
- Growth and Paediatric Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Anuradha V Khadilkar
- Growth and Paediatric Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
| | - Jasmin Bhawra
- Growth and Paediatric Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- CHANGE Research Lab, School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Canada
| | - Tarja I Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
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Sharma A, Chanda S, Porwal A, Wadhwa N, Santhanam D, Ranjan R, Shah H, Adyanthaya S, Meena R. Effect of social and behavioral change interventions on minimum dietary diversity among pregnant women and associated socio-economic inequality in Rajasthan, India. BMC Nutr 2024; 10:82. [PMID: 38845052 PMCID: PMC11154971 DOI: 10.1186/s40795-024-00887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Maternal dietary diversity is a key to improving the birth and child health outcomes. Besides socio-economic factors, the nutrition specific program- Social and Behavioural Change Communication (SBCC) interventions aimed to improve maternal dietary diversity has varied levels of impact on the socio-economic groups in poor resource setups. OBJECTIVE To measure the factors associated with the minimum dietary diversity (MDD) among pregnant women in selected districts of Rajasthan with special emphasis on the SBCC components. Additionally, it measures the socio-economic gaps in the behaviour of consumption of diversified diet during pregnancy. METHODS Data from a cross sectional survey of 6848 pregnant women, who have received a continuous SBCC counselling and registered under a state introduced conditional cash transfer program, during May to June, 2023, in five intervention districts -Banswara, Baran, Dunagrpur, Pratapgarh and Udaipur in Rajasthan was used. A 24 h recall based food consumption behaviour has been gathered to measure the MDD of pregnant women. Study has used descriptive statistics, multivariate regressions, and multivariate decomposition analysis to address the research objectives. RESULTS Study finds that only 55.2% of pregnant women are consuming diverse diet in the study duration with mean dietary diversity score is 4.8 (+/- 1.5). Logistic regression finds that SBCC components such as frontline workers (aOR = 1.3, CI: 1.1-1.4), community motivators (aOR = 1.9, CI: 1.7-2.1), and participation in MCHND (aOR = 1.0, CI: 0.9-1.2) have significant and higher likelihood on consumption of MDD food on previous day. A higher education and belonging from richer wealth quintile also show higher association for consumption of MDD. Multivariate decomposition shows, among richest and poorest wealth categories there is 19% point difference (58% difference due to coefficient vs. 42% difference due to composition) in MDD consumption. This is positively contributed by the caste and educational categories of women. CONCLUSION Despite a predominant vegetarian diet consuming population, better maternal dietary diversity was observed among those exposed to higher dose of SBCC intervention package. Educational status and caste of the respondent were significantly associated with minimum dietary diversity and contributed to the socio-economic inequality highlighting the importance of tailored and sustained SBCC interventions.
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Affiliation(s)
- Anshita Sharma
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India.
| | - Srei Chanda
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Akash Porwal
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Namita Wadhwa
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Divya Santhanam
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Raghwesh Ranjan
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Hemang Shah
- Child Health and Development, Children's Investment Fund Foundation, Delhi, India
| | - Shachi Adyanthaya
- Child Health and Development, Children's Investment Fund Foundation, Delhi, India
| | - Ramavatar Meena
- Directorate of Integrated Child Development Services, Jaipur, Rajasthan, India
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Wiśniewska-Ślepaczuk K, Żak-Kowalska K, Moskal A, Kowalski S, Al-Wathinani AM, Alhajlah M, Goniewicz K, Goniewicz M. Nutritional Profiles and Their Links to Insulin Resistance and Anthropometric Variables in a Female Cohort. Metabolites 2024; 14:252. [PMID: 38786729 PMCID: PMC11122850 DOI: 10.3390/metabo14050252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024] Open
Abstract
This study investigates the relationship between dietary habits and metabolic health among women, emphasizing the role of anthropometric parameters as proxies for insulin resistance. We analyzed data from 443 women categorized into two groups based on the presence or absence of clinically diagnosed insulin resistance. Our assessments included dietary quality, socio-demographic characteristics, and a series of anthropometric measurements such as body weight, Body Mass Index (BMI), Waist-Hip Ratio (WHR), Abdominal Volume Index (AVI), and Body Adiposity Index (BAI). The results indicated significant disparities in these parameters, with the insulin-resistant group exhibiting higher average body weight (78.92 kg vs. 65.04 kg, p < 0.001), BMI (28.45 kg/m2 vs. 23.17 kg/m2, p < 0.001), and other related measures, suggesting a strong influence of dietary patterns on body composition and metabolic risk. The study underscores the importance of dietary management in addressing insulin resistance, advocating for personalized dietary strategies to improve metabolic health outcomes in women. This approach highlights the need for integrating dietary changes with lifestyle modifications and socio-demographic considerations to combat metabolic risks effectively.
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Affiliation(s)
| | - Karolina Żak-Kowalska
- New Medical Techniques Specialist Hospital of the Holy Family, 36-060 Rudna Mała, Poland;
| | - Adrian Moskal
- Hospital Emergency Department, Voivodship Hospital in Krosno, 38-400 Krosno, Poland;
| | - Sebastian Kowalski
- Department of Emergency Medicine, Medical University of Lublin, 20-081 Lublin, Poland;
| | - Ahmed M. Al-Wathinani
- Department of Emergency Medical Services, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mousa Alhajlah
- Applied of Computer Science College, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Krzysztof Goniewicz
- Department of Security Studies, Polish Air Force University, 08-521 Deblin, Poland;
| | - Mariusz Goniewicz
- Department of Emergency Medicine, Medical University of Lublin, 20-081 Lublin, Poland;
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Kuppusamy P, Prusty RK, Khan SA. Assessing the prevalence and predictors of anemia among pregnant women in India: findings from the India National Family Health Survey 2019-2021. Curr Med Res Opin 2024; 40:51-58. [PMID: 37888841 DOI: 10.1080/03007995.2023.2276851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/25/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Anemia is more prevalent in low- and middle-income countries including India. Anemia in pregnancy is associated with increased risk of maternal health problems and adverse birth outcomes. This study estimates the prevalence and associated risk factors of anemia among pregnant women in India. METHODS This cross-sectional study is based on secondary data from the India National Family Health Survey-V (NFHS-5) conducted during 2019-2021. We extracted data of 27,317 currently pregnant women to estimate the prevalence and contributory factors associated with anemia using descriptive statistics and logistic regression analysis. RESULTS The prevalence of anemia among pregnant women in India was 52.2%. Anemia was higher among adolescent women (61.5%), those with no education (59.2%), those belonging to poorest wealth index (61.9%), scheduled tribes (59.3%), and those from the eastern region of India (62.1%). Further, it was more prevalent among women with a habit of smoking, tobacco, or alcohol (63.0%), and women with shorter birth intervals (59.7%). Among Indian states, anemia prevalence was higher in the state of Bihar (63.1%) and the union territory of Ladakh (71.4%). Logistic regression models show that women with no education (aOR = 1.41, 95% CI = 1.27-1.57), belonging to a poorest wealth quintile (aOR = 1.69, 95% CI = 1.51-1.90), and those with a habit of smoking, tobacco, or alcohol (aOR = 1.39, 95% CI = 1.18-1.63) were more anemic than their counterparts. Additionally, women with no education showed a four-times higher risk of severe anemia (aOR = 4.79, 95% CI = 2.75-8.36) than their highly educated counterparts. CONCLUSION Anemia affects half of all pregnant women in India. Anemia prevalence is higher among adolescents, illiterate, poor, and tribal communities. Social norm-based interventions and strengthening the community health facilitators should be implemented to reduce the high burden of anemia in India.
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Affiliation(s)
- Periyasamy Kuppusamy
- Clinical Research Laboratory, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Ranjan K Prusty
- Department of Biostatistics, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Shagufta A Khan
- Clinical Research Laboratory, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
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Langer B, Gupta RK, Kumari R, Mahajan R. Food Insecurity and its Association with Dietary Diversity: A Cross-Sectional Study in Rural Households in Jammu. Indian J Community Med 2024; 49:70-75. [PMID: 38425949 PMCID: PMC10900475 DOI: 10.4103/ijcm.ijcm_811_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/06/2023] [Indexed: 03/02/2024] Open
Abstract
Background Food insecurity is a matter of public health concern as it is associated with adverse health outcomes particularly among vulnerable population. Accessibility and availability of nutritious and culturally appropriate food is paramount to achieve zero hunger. To assess the prevalence of household food insecurity, to estimate the household dietary diversity and its association with household food insecurity. Material and Methods Using multistage sampling 381 rural households were surveyed. Household Food Insecurity Access Scale and House hold Dietary Diversity Scale were used as study instruments. Chi square test was used to compare the two groups and P < 0.05 was considered to be statistically significant. Results Prevalence of household insecurity was 33.3% (127) among the surveyed households and 8.1% (31) had severe food insecurity. The mean HFIS score was 6.85 ± 4.82. The household Dietary diversity score was 8.14 ± 1.54 for food secure and 6.51 ± 1.38 for severely food insecure households. There was a statistically significant difference in intake of milk and milk products, fruits, eggs and meat/poultry among food secure and insecure households (P < 0.001 respectively). Conclusion Food insecurity was high in rural households and was associated with lower dietary intake of foods from protein group, necessitating a need to reinforce the food security programmes in rural India with focus to enhance protein rich diet.
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Affiliation(s)
- Bhavna Langer
- Department of Community Medicine, GMC Jammu, Jammu and Kashmir, India
| | - Rajiv Kumar Gupta
- Department of Community Medicine, GMC Jammu, Jammu and Kashmir, India
| | - Rashmi Kumari
- Department of Community Medicine, GMC Jammu, Jammu and Kashmir, India
| | - Richa Mahajan
- Department of Community Medicine, GMC Jammu, Jammu and Kashmir, India
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Mohammed F, Abdirizak N, Jibril A, Oumer A. Correlates of minimum dietary diversity among pregnant women on antenatal care follow up at public health facility in Puntland, Somalia. Sci Rep 2023; 13:21935. [PMID: 38081930 PMCID: PMC10713561 DOI: 10.1038/s41598-023-48983-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
In Somalia, where a poorly diversified diet is leading to adverse pregnancy and neonatal outcomes, there is a significant dearth of evidence that needs to be studied. Hence, this study was to identify factors associated with minimum dietary diversity among pregnant women in Somalia. A facility-based survey was conducted among 361 pregnant women attending antenatal care (ANC) using a structured questionnaire. Dietary diversity was measured using consumption of 10-food groups. Bivariable and multivariable binary logistic regression analyses were used, along with odds ratios and 95% confidence intervals. About 48.2% (42.9-53.5) of women had an inadequately diversified diet. The risk of having an inadequately diversified diet was higher among rural residents (AOR = 1.20; 0.30-4.75), multigravida (AOR = 2.85; 1.43-5.68), young women (AOR = 2.15; 0.82-5.61), extended families (AOR = 1.19; 0.68-2.10), with infrequent ANC visits (AOR = 4.12; 2.06-8.27), fewer frequent meals (AOR = 1.84; 1.09-3.10) and from food-insecure households (AOR = 3.84; 2.28-6.49) as compared to their counterparts. Consumption of poorly diversified diet was prevalent and associated with dietary diversity was prevalent among women which could be strongly predicted by parity, ante-natal care and food security, which needs to be targeted for interventions.
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Affiliation(s)
- Feiruza Mohammed
- Faculty of Nutrition, University of Health Science, Bossaso, Puntland, Somalia
| | | | - Abdulfetah Jibril
- United Nations High Commissioner for Refugees, Bossaso, Puntland, Somalia
| | - Abdu Oumer
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia.
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Zhang L, Chang H, Chen Y, Ruan W, Cai L, Song F, Liu X. Socio-Demographic Factors Associated with Rural Residents' Dietary Diversity and Dietary Pattern: A Cross-Sectional Study in Pingnan, China. Nutrients 2023; 15:2955. [PMID: 37447281 DOI: 10.3390/nu15132955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
There is limited evidence regarding the factors correlated with dietary diversity (DD) and dietary pattern (DP) in rural residents of China. This study aims to identify the DD and DP of rural residents and their association with socio-demographic factors. A cross-sectional survey was conducted in Pingnan, China. The Food Frequency Questionnaire (FFQ) was applied to evaluate dietary intake. Latent class analysis (LCA) was used to identify patterns of six food varieties, including vegetables-fruits, red meat, aquatic products, eggs, milk, and beans-nuts. Generalized linear models and multiple logistic regression models were used to determine factors associated with the DD and DP. Three DPs were detected by LCA, namely "healthy" DP (47.94%), "traditional" DP (33.94%), and "meat/animal protein" DP (18.11%). Females exhibited lower DD (β = -0.23, p = 0.003) and were more likely to adhere to "traditional" DP (OR = 1.46, p = 0.039) and "meat/animal protein" DP (OR = 2.02, p < 0.001). Higher educational levels and annual household income (AHI) were positively associated with higher DD (p < 0.05) and less likely to have "traditional" DP and "meat/animal protein" DP (p < 0.05). Non-obese people exhibited higher DD (β = 0.15, p = 0.020) and were less likely to have "meat/animal protein" DP (OR = 0.59, p = 0.001). Our study reveals that females, those with lower educational levels and AHI, and obese people are more likely to have a lower DD and are more likely to adhere to "traditional" DP and "meat/animal protein" DP. The local, regional, and even national performance of specific diet-related health promotion measures and interventions must target these vulnerable populations to improve a healthier DD and DP.
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Affiliation(s)
- Lingling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Huajing Chang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Yating Chen
- Department of Health Management, School of Health Management, Fujian Medical University, Fuzhou 350122, China
| | - Wenqian Ruan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Longhua Cai
- Department of Health Management, School of Health Management, Fujian Medical University, Fuzhou 350122, China
| | - Fang Song
- Editorial Department of Medicine and Society, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiaojun Liu
- Department of Health Management, School of Health Management, Fujian Medical University, Fuzhou 350122, China
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Yang M, Zhang Z, Wang Z. Does Internet use connect smallholder farmers to a healthy diet? Evidence from rural China. Front Nutr 2023; 10:1122677. [PMID: 37153910 PMCID: PMC10157090 DOI: 10.3389/fnut.2023.1122677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/30/2023] [Indexed: 05/10/2023] Open
Abstract
Introduction Undernutrition and micronutrient malnutrition remain problems of significant magnitude among small-scale subsistence farmers, posing a serious threat to their health and well-being. Developing a healthy diet can effectively reduce this threat. Fortunately, the Internet can speed up the process. Methods Based on survey data from 5,114 farm households in nine provinces in China, this study quantitatively assesses the impact of Internet use on the dietary quality of smallholder farmers using OLS regression models and PSM models. Results/Discussion (1) Internet use can significantly contribute to dietary diversity and dietary rationality among smallholder farmers, thus optimizing their dietary structure. (2) Internet use significantly increased the average consumption amounts of milk and its products (2.9 g), fruits (21.5 g), eggs (7.5 g), and vegetables (27.1 g), while also decreasing the intake of salts (1.5 g) and oil (3.8 g). (3) The pull of internet use to improve diet quality is more significant for smallholder households with lower levels of education, older heads of households, and higher household incomes. (4) A possible mechanism is that Internet use increases household income and information access skills of rural residents, thus improving their dietary quality. In summary, governments should further promote Internet penetration in rural areas for health purposes.
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Affiliation(s)
- Mingwei Yang
- Research Center for Economy of Upper Reaches of the Yangtse River, Chongqing Technology and Business University, Chongqing, China
- Qinghai University Library, Qinghai University, Xining, Qinghai, China
- *Correspondence: Mingwei Yang,
| | - Zhiyong Zhang
- Research Center for Economy of Upper Reaches of the Yangtse River, Chongqing Technology and Business University, Chongqing, China
| | - Zheng Wang
- Research Center for Economy of Upper Reaches of the Yangtse River, Chongqing Technology and Business University, Chongqing, China
- School of Economics and Management, Taiyuan Normal University, Taiyuan, China
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Cui J, Zhaxi D, Sun X, Teng N, Wang R, Diao Y, Jin C, Chen Y, Xu X, Li X. Association of dietary pattern and Tibetan featured foods with high-altitude polycythemia in Naqu, Tibet: A 1:2 individual-matched case-control study. Front Nutr 2022; 9:946259. [PMID: 36211499 PMCID: PMC9538783 DOI: 10.3389/fnut.2022.946259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/01/2022] [Indexed: 12/01/2022] Open
Abstract
This study focused on the association of dietary patterns and Tibetan featured foods with high-altitude polycythemia (HAPC) in Naqu, Tibet, to explore the risk factors of HAPC in Naqu, Tibet, to raise awareness of the disease among the population and provide evidence for the development of prevention and treatment interventions. A 1:2 individual-matched case-control study design was used to select residents of three villages in the Naqu region of Tibet as the study population. During the health examination and questionnaire survey conducted from December 2020 to December 2021, a sample of 1,171 cases was collected. And after inclusion and exclusion criteria and energy intake correction, 100 patients diagnosed with HAPC using the “Qinghai criteria” were identified as the case group, while 1,059 patients without HAPC or HAPC -related diseases were identified as the control group. Individuals were matched by a 1:2 propensity score matching according to gender, age, body mass index (BMI), length of residence, working altitude, smoking status, and alcohol status. Dietary patterns were determined by a principal component analysis, and the scores of study subjects for each dietary pattern were calculated. The effect of dietary pattern scores and mean daily intake (g/day) of foods in the Tibetan specialty diet on the prevalence of HAPC was analyzed using conditional logistic regression. After propensity score matching, we found three main dietary patterns among residents in Naqu through principal component analysis, which were a “high protein pattern,” “snack food pattern,” and “vegetarian food pattern.” All three dietary patterns showed a high linear association with HAPC (p < 0.05) and were risk factors for HAPC. In the analysis of the relationship between Tibetan featured foods and the prevalence of HAPC, the results of the multifactorial analysis following adjustment for other featured foods showed that there was a positive correlation between the average daily intake of tsampa and the presence of HAPC, which was a risk factor. Additionally, there was an inverse correlation between the average daily intake of ghee tea and the presence of HAPC, which was a protective factor.
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Affiliation(s)
- Jiaxue Cui
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Duoji Zhaxi
- Institute of High Altitude Medicine, People’s Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
| | - Xianzhi Sun
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Nan Teng
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Ruiqi Wang
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yizhuo Diao
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Chenxin Jin
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yongxing Chen
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Xiaoguang Xu
- Institute of High Altitude Medicine, People’s Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
- Department of Neurosurgery, Second Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Xiaoguang Xu,
| | - Xiaofeng Li
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
- Xiaofeng Li,
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