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  • Original Article
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Vegetable-rich food pattern is related to obesity in China

Abstract

Objective:

To investigate the association between a vegetable-rich food pattern and obesity among Chinese adults.

Design:

A food pattern rich in vegetables is associated with lower risk of obesity and non-communicable chronic disease in Western countries. A similar food pattern is found in the Chinese population but the cooking method is different. A cross-sectional household survey of 2849 men and women aged 20 years and over was undertaken in 2002 in Jiangsu Province (response rate, 89.0%). Food intake was assessed by food frequency questionnaire. Factor analysis was used to identify food patterns. Nutrient intake was measured by food weighing plus consecutive individual 3-day food records. Height, weight and waist circumference were measured.

Results:

The prevalence of general obesity (BMI 28 kg m−2) was 8.0% in men and 12.7% in women, central obesity was 19.5% (90 cm) and 38.2% (80 cm), respectively. A four-factor solution explained 28.5% of the total variance in food frequency intake. The vegetable-rich food pattern (whole grains, fruits and vegetables) was positively associated with vegetable oil and energy intake. Prevalence of obesity/central obesity increased across the quartiles of vegetable-rich food pattern. After adjusting for sociodemographic factors and four distinct food patterns, the vegetable-rich pattern was independently associated with obesity. Compared with the lowest quartile of vegetable-rich pattern, the highest quartile had higher risk of general obesity (men, prevalence ratio (PR): 1.82, 95% confidence interval (CI): 1.05–3.14; women, PR: 2.25, 95% CI: 1.45–3.49).

Conclusion:

The vegetable-rich food pattern was associated with higher risk of obesity/central obesity in Chinese adults in both genders. This association can be linked to the high intake of energy due to generous use of oil for stir-frying the vegetables.

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References

  1. Wang Y, Mi J, Shan XY, Wang QJ, Ge KY . Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes (Lond) 2007; 31: 177–188.

    Article  CAS  Google Scholar 

  2. Popkin BM, Paeratakul S, Zhai F, Ge K . Dietary and environmental correlates of obesity in a population study in China. Obes Res 1995; 3 (Suppl 2): 135s–143s.

    Article  Google Scholar 

  3. Zhai FY, He YN, Ma GS, Li YP, Wang ZH, Hu YS et al. Study on the current status and trend of food consumption among Chinese population. Zhonghua Liu Xing Bing Xue Za Zhi 2005; 26: 485–488.

    PubMed  Google Scholar 

  4. WHO/FAO. Diet Nutrition and the Prevention of Chronic Diseases: Report of a Joint WHO/FAO Expert Consultation. World Health Organization: Geneva, 2003.

  5. Newby PK, Tucker KL . Empirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev 2004; 62: 177–203.

    Article  CAS  Google Scholar 

  6. Newby PK, Muller D, Hallfrisch J, Andres R, Tucker KL . Food patterns measured by factor analysis and anthropometric changes in adults. Am J Clin Nutr 2004; 80: 504–513.

    Article  CAS  Google Scholar 

  7. Newby PK, Weismayer C, Akesson A, Tucker KL, Wolk A . Longitudinal changes in food patterns predict changes in weight and body mass index and the effects are greatest in obese women. J Nutr 2006; 136: 2580–2587.

    Article  CAS  Google Scholar 

  8. Hu FB, Rimm EB, Stampfer MJ, Ascherio A, Spiegelman D, Willett WC . Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr 2000; 72: 912–921.

    Article  CAS  Google Scholar 

  9. van Dam RM, Rimm EB, Willett WC, Stampfer MJ, Hu FB . Dietary patterns and risk for type 2 diabetes mellitus in US men. Ann Intern Med 2002; 136: 201–209.

    Article  Google Scholar 

  10. Fung TT, Schulze M, Manson JE, Willett WC, Hu FB . Dietary patterns, meat intake, and the risk of type 2 diabetes in women. Arch Intern Med 2004; 164: 2235–2240.

    Article  Google Scholar 

  11. Wu K, Hu FB, Fuchs C, Rimm EB, Willett WC, Giovannucci E . Dietary patterns and risk of colon cancer and adenoma in a cohort of men (United States). Cancer Causes Control 2004; 15: 853–862.

    Article  Google Scholar 

  12. Wu K, Hu FB, Willett WC, Giovannucci E . Dietary patterns and risk of prostate cancer in US men. Cancer Epidemiol Biomarkers Prev 2006; 15: 167–171.

    Article  Google Scholar 

  13. Nettleton JA, Steffen LM, Mayer-Davis EJ, Jenny NS, Jiang R, Herrington DM et al. Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr 2006; 83: 1369–1379.

    Article  CAS  Google Scholar 

  14. Meyerhardt JA, Niedzwiecki D, Hollis D, Saltz LB, Hu FB, Mayer RJ et al. Association of dietary patterns with cancer recurrence and survival in patients with stage III colon cancer. JAMA 2007; 298: 754–764.

    Article  CAS  Google Scholar 

  15. Shi Z, Hu X, Yuan B, Pan X, Dai Y, Holmboe-Ottesen G . Association between dietary patterns and anaemia in adults from Jiangsu Province in China. Br J Nutr 2006; 96: 906–912.

    Article  CAS  Google Scholar 

  16. Cai H, Shu XO, Gao YT, Li H, Yang G, Zheng W . A prospective study of dietary patterns and mortality in Chinese women. Epidemiology 2007; 18: 393–401.

    Article  Google Scholar 

  17. Shin KO, Oh SY, Park HS . Empirically derived major dietary patterns and their associations with overweight in Korean preschool children. Br J Nutr 2007; 98: 416–421.

    Article  CAS  Google Scholar 

  18. Harriss LR, English DR, Powles J, Giles GG, Tonkin AM, Hodge AM et al. Dietary patterns and cardiovascular mortality in the Melbourne Collaborative Cohort Study. Am J Clin Nutr 2007; 86: 221–229.

    Article  CAS  Google Scholar 

  19. Shimazu T, Kuriyama S, Hozawa A, Ohmori K, Sato Y, Nakaya N et al. Dietary patterns and cardiovascular disease mortality in Japan: a prospective cohort study. Int J Epidemiol 2007; 36: 600–609.

    Article  Google Scholar 

  20. Jiangsu Bureau of Statistics. Statistical Yearbook of Jiangsu 2002. China Statistics Press: Beijing.

  21. Bei-Fan Z . Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Asia Pac J Clin Nutr 2002; 11 (Suppl 8): S685–S693.

    Article  Google Scholar 

  22. Alberti KG, Zimmet P, Shaw J . The metabolic syndrome—a new worldwide definition. Lancet 2005; 366: 1059–1062.

    Article  Google Scholar 

  23. Zhao W, Hasegawa K, Chen J . The use of food-frequency questionnaires for various purposes in China. Public Health Nutr 2002; 5: 829–833.

    Article  Google Scholar 

  24. Li YP, He YN, Zhai FY, Yang XG, Hu XQ, Zhao WH et al. Comparison of assessment of food intakes by using 3 dietary survey methods. Zhonghua Yu Fang Yi Xue Za Zhi 2006; 40: 273–280.

    PubMed  Google Scholar 

  25. Yang Y . Chinese Food Composition Table 2004. Peking University Medical Press: Beijing, 2005.

    Google Scholar 

  26. Barros AJ, Hirakata VN . Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 2003; 3: 21.

    Article  Google Scholar 

  27. Chen Z, Shu XO, Yang G, Li H, Li Q, Gao YT et al. Nutrient intake among Chinese women living in Shanghai, China. Br J Nutr 2006; 96: 393–399.

    Article  CAS  Google Scholar 

  28. Bray GA, Popkin BM . Dietary fat affects obesity rate. Am J Clin Nutr 1999; 70: 572–573.

    Article  CAS  Google Scholar 

  29. Hu G, Pekkarinen H, Hanninen O, Tian H, Jin R . Comparison of dietary and non-dietary risk factors in overweight and normal-weight Chinese adults. Br J Nutr 2002; 88: 91–97.

    Article  CAS  Google Scholar 

  30. Feng Y, Hong X, Li Z, Zhang W, Jin D, Liu X et al. Prevalence of metabolic syndrome and its relation to body composition in a Chinese rural population. Obesity (Silver Spring) 2006; 14: 2089–2098.

    Article  Google Scholar 

  31. Hu FB . Obesity and mortality: watch your waist, not just your weight. Arch Intern Med 2007; 167: 875–876.

    Article  Google Scholar 

  32. Zhang X, Shu XO, Yang G, Li H, Cai H, Gao YT et al. Abdominal adiposity and mortality in Chinese women. Arch Intern Med 2007; 167: 886–892.

    Article  Google Scholar 

  33. Moreno DA, Lopez-Berenguer C, Garcia-Viguera C . Effects of stir-fry cooking with different edible oils on the phytochemical composition of broccoli. J Food Sci 2007; 72: S064–S068.

    Article  Google Scholar 

  34. Weinhouse S, Bal DG, Adamson R, Dwyer J, Kleinman RE, Kritchevsky D et al. American Cancer Society guidelines on diet, nutrition, and cancer. The work study group on diet, nutrition, and cancer. CA Cancer J Clin 1991; 41: 334–338.

    Article  CAS  Google Scholar 

  35. Dai Q, Shu XO, Jin F, Gao YT, Ruan ZX, Zheng W . Consumption of animal foods, cooking methods, and risk of breast cancer. Cancer Epidemiol Biomarkers Prev 2002; 11: 801–808.

    PubMed  Google Scholar 

  36. Guallar-Castillon P, Rodriguez-Artalejo F, Fornes NS, Banegas JR, Etxezarreta PA, Ardanaz E et al. Intake of fried foods is associated with obesity in the cohort of Spanish adults from the European Prospective Investigation into Cancer and Nutrition. Am J Clin Nutr 2007; 86: 198–205.

    Article  CAS  Google Scholar 

  37. Xie B, Chou CP, Spruijt-Metz D, Reynolds K, Clark F, Palmer PH et al. Weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents. Prev Med 2006; 42: 229–234.

    Article  Google Scholar 

  38. Shi Z, Lien N, Nirmal Kumar B, Holmboe-Ottesen G . Perceptions of weight and associated factors of adolescents in Jiangsu Province, China. Public Health Nutr 2007; 10: 298–305.

    Article  Google Scholar 

Download references

Acknowledgements

We thank the participating Regional Centers for Disease Control and Prevention in Jiangsu province, including the Nanjing, Xuzhou, Jiangyin, Taicang, Suining, Jurong, Sihong and Haimen Centres, for their support of the data collection. This work was supported by Jiangsu Provincial Health Bureau. Zumin Shi was supported by a fellowship from Newcastle Institute of Public Health—Hunter Medical Research Institute through the New South Wales Health Department Capacity Building and Infrastructure Grant.

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Correspondence to Z Shi.

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Shi, Z., Hu, X., Yuan, B. et al. Vegetable-rich food pattern is related to obesity in China. Int J Obes 32, 975–984 (2008). https://doi.org/10.1038/ijo.2008.21

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