Dietary patterns associated with the prevalence of cardiovascular disease risk factors in Kuwaiti adults

BACKGROUND: Kuwaiti adults have experienced a rapid increase in cardiovascular disease (CVD) and its risk factors. Dietary patterns in the Kuwaiti diet associated with the increasingly higher CVD burden have not been adequately evaluated.

OBJECTIVE: The objective of this study was to identify the major dietary patterns in Kuwaiti adults and examine their associations with CVD risk factors.

DESIGN: This cross-sectional study examined data from the 2008-2009 National Nutrition Survey of the State of Kuwait.

PARTICIPANTS/SETTING: The study included 555 Kuwaiti adults aged ≥20 years who completed a 24-hour dietary recall.

MAIN OUTCOME MEASURES: The outcome measures included CVD risk factors such as obesity (body mass index), abdominal obesity (waist circumference), elevated blood pressure, dyslipidemia (blood lipid levels), diabetes (glucose and glycated hemoglobin levels), and metabolic syndrome.

STATISTICAL ANALYSIS: Dietary patterns were identified using principal component analysis. The associations between dietary patterns and CVD risk factors were analyzed using survey-weighted multivariable linear and logistic regression models.

RESULTS: Three dietary patterns were identified: vegetable-rich, fast food, and refined grains/poultry. Younger adults had higher adherence to the fast-food or refined-grains/poultry dietary patterns, whereas older adults had higher adherence to the vegetable-rich dietary pattern. The fast-food dietary pattern was positively associated with body mass index (β=.94, 95% CI 0.08 to 1.79), waist circumference (β=2.05, 95% CI 0.20 to 3.90 cm), and diastolic blood pressure (β=1.62, 95% CI 0.47 to 2.77 mm Hg). The refined grains/poultry dietary pattern was positively associated with plasma glucose levels (β=1.02, 95% CI 1.002 to 1.04 mg/dL [0.056 to 0.058 mmol/L]). Individuals in the highest tertile of the fast-food or refined-grains/poultry dietary patterns had higher odds of metabolic syndrome than those in the lowest tertile.

CONCLUSIONS: The fast-food and refined grains/poultry dietary patterns were associated with high prevalence of CVD risk factors among Kuwaiti adults. The current findings underscore the need for prospective studies to further explore dietary pattern and CVD risk factor relationships among at-risk Kuwait adults.