Dietary Patterns and Metabolic Risk Factors in Northwest Ethiopia: Unveiling Nutritional Determinants of Non-Communicable Diseases.

A recent study published in Scientific Reports examined the connections between dietary patterns and metabolic risk factors in adults from Northwest Ethiopia.

Metabolic risk factors such as abdominal obesity, high body mass index (BMI), and hypertension are major contributors to the growing burden of non-communicable diseases (NCDs) worldwide, particularly in developing countries. These factors can lead to metabolic disorders and chronic diseases like diabetes and cardiovascular diseases (CVDs). Hypertension affects over one billion people globally, and obesity rates are alarmingly high.

Dietary habits play a significant role in influencing these risk factors. Studies show a shift towards unhealthy, processed food consumption due to food security concerns and cultural changes.

Further research is crucial to understand how regional dietary patterns in developing countries like Ethiopia impact metabolic risk factors and to guide effective nutrition interventions and policies for NCD prevention.

Study methods

A community-based cross-sectional survey was conducted from May to June 2021 in Bahir Dar, Northwest Ethiopia. 423 adults were recruited from residential houses using a systematic random sampling technique.

Participants

Eligible participants were adults aged 18 to 65, residing in the area for at least six months.

Data collection

Adults’ nutrition was assessed using a validated food frequency questionnaire (FFQ), which included fourteen food groups: vegetables, fruits, cereals, meat, dairy, and fast foods. Participants were asked about their frequency of consuming these food groups in the past month. Physical measurements like weight, hip/waist circumference, height, and blood pressure were performed using standardized tools. Blood pressure measurements were taken twice, and the average was used for analysis.

Metabolic Risk Factors

Metabolic risk factors are a cluster of conditions that increase an individual’s risk of developing NCDs. These include:

• High blood pressure ≥ 140/90 mmHg.

• High blood sugar levels

• Overweight/obesity – BMI was calculated, with 25–30 kg/m² values classified as overweight and ≥ 30 as obesity.

• Excess body fat, particularly around the waist

• Abnormal cholesterol levels

• Abdominal obesity – Waist-to-hip ratio (WHR) was also calculated, with ≥ 0.85 for females and ≥ 0.90 for males indicating abdominal obesity.

Dietary Patterns and Metabolic Risk Factors

Several studies have investigated the association between dietary patterns and metabolic risk factors. A meta-analysis of 44 studies found that the Mediterranean diet, which is characterized by high intake of fruits, vegetables, whole grains, and olive oil, was associated with a lower risk of developing metabolic syndrome, a cluster of metabolic risk factors that increases the risk of NCDs.

Interventions to Improve Dietary Habits

There are a number of interventions that can be implemented to improve dietary habits and reduce the risk of NCDs. These include:

• Educating individuals and communities about healthy eating

• Providing access to healthy food choices

• Implementing policies that support healthy eating

Data analysis

Data were coded and analyzed using Epi Data software and SPSS. Principal Component Analysis (PCA) was used to identify dietary patterns, and logistic regression analysis examined associations between dietary patterns and metabolic risk factors. Variables showing associations in bivariable analysis were adjusted in multivariable logistic regression to identify significant predictors.

Ethical considerations

The study adhered to ethical guidelines and received approvals from relevant committees.

Results

The present study conducted in Northwest Ethiopia identified four principal dietary patterns among 415 adults: the ‘westernized’ and ‘traditional’ patterns.

The Westernized pattern was marked by higher consumption of meat, dairy, fruits, fast foods, alcoholic drinks, fish, and sweet foods. Conversely, the traditional pattern was characterized by frequent intake of vegetables, legumes, roots, cereals, tubers, coffee, and oils.

The prevalence of metabolic risk factors like hypertension, overweight/obesity, and abdominal obesity varied across the population. Notably, hypertension was significantly lower in adults who adhered more to the Westernized dietary pattern. Specifically, those in this pattern’s third and fourth quantiles were 72% and 65% less likely to have hypertension, respectively, than those in the first. However, no significant associations were observed between the dietary patterns and other metabolic risk factors like overweight/obesity and abdominal obesity.

Demographically, younger, married, and middle-income adults were more inclined toward the westernized pattern, while females and middle-income individuals were more associated with the traditional pattern. These associations highlight the influence of socioeconomic and lifestyle factors on dietary choices in the region.

Discussion

The study’s findings add to the growing body of evidence on the impact of dietary habits on health outcomes, particularly in developing countries. Identifying these specific dietary patterns in Northwest Ethiopia provides valuable insights into local food consumption trends and their implications for metabolic health. This knowledge is crucial for formulating targeted interventions and policies to combat the rising burden of NCDs in the region, driven partly by dietary factors.

The results underscore the complexity of dietary habits and their association with health outcomes, which are influenced by geography, culture, socioeconomic status, and individual lifestyle choices. This complexity necessitates further research to unravel the intricate relationships between diet and health, especially in rapidly changing societies.

Conclusion

This study reveals the existence of two distinct dietary patterns, ‘westernized’ and ‘traditional,’ among adults in Northwest Ethiopia. The Westernized pattern, characterized by high intake of fruits, meat, and fast foods, was significantly associated with lower hypertension rates, particularly in individuals adhering to higher quantiles of this pattern.

Interestingly, no significant association was observed between the traditional pattern, characterized by high consumption of cereals and vegetables, and metabolic risks such as hypertension or obesity.

The insights gained from this study are crucial for developing region-specific dietary interventions to tackle the rising burden of non-communicable diseases (NCDs) in Northwest Ethiopia. Future research should focus on elucidating the underlying mechanisms linking dietary patterns to metabolic health outcomes.