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      New challenges in dietary pattern analysis: combined dietary patterns and calorie adjusted factor analysis in type 2 diabetic patients

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          Abstract

          Background

          Some variability for dietary pattern analysis due to subjective procedures (e.g. arbitrary food categorization and number of factors extraction) was reported. The aim of this study was to present or design a new approach to challenge the conventional dietary pattern analysis through new classification of dietary patterns according to the possibility of the high adherence to more than one dietary pattern and calorie adjusted factor extracting.

          Methods

          This cross-sectional study conducted on 734 type2 diabetic patients. Factor analysis defined three major dietary patterns (Western like, Asian like and Traditional like) and the associations of each pattern were assessed with glycemic control and lipid profiles among tertiles of each pattern. In order to compare variables in highest tertile of three defined dietary patterns, eight new different groups were classified according to the high adherence to one or more patterns and ANOVA and ANCOVA were used to compare them. Also, calorie adjusted factor extracting were done to find out if the same factor loadings would be extract.

          Results

          Among three major dietary patterns, only Western like showed a significant association with fasting blood sugar (p = 0.03, 12.49 ± 5.99), serum total cholesterol (p = 0.02, 8.71 ± 3.81) and LDL cholesterol (p = 0.04, 5.04 ± 2.40). While comparison of new classified patterns, showed no significant differences, except a high blood glucose in Western like- Asian like versus traditional like dietary pattern (p = 0.04). Also, calorie adjusted factor extracting showed different factor loadings.

          Conclusions

          Results showed that the conventional dietary pattern analysis method may have substantial limitations in interpreting the results and may lead to inappropriate conclusions.

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          Most cited references5

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          Dairy consumption is inversely associated with the prevalence of the metabolic syndrome in Tehranian adults.

          Although previous studies showed some benefits from dairy consumption with respect to obesity and insulin resistance syndrome, epidemiologic data on the association between dairy intakes and metabolic syndrome are sparse. The objective was to evaluate the relation between dairy consumption and metabolic syndrome in Tehranian adults. Dairy consumption and features of metabolic syndrome were assessed in a population-based cross-sectional study of 827 subjects (357 men and 470 women) aged 18-74 y. Metabolic syndrome was defined according to guidelines of the Adult Treatment Panel III. Multivariate logistic regression adjusted for lifestyle and nutritional confounders was used in 4 models. Mean (+/-SD) consumption of milk, yogurt, and cheese was 0.7 +/- 0.2, 1.06 +/- 0.6, and 0.9 +/- 0.3 servings/d, respectively. Subjects in the highest quartile of dairy consumption had lower odds of having enlarged waist circumference [odds ratio (OR) by quartile: 1, 0.89, 0.74, 0.63; P for trend < 0.001], hypertension (OR by quartile: 1, 0.88, 0.79, 0.71; P for trend < 0.02), and metabolic syndrome (OR by quartile: 1, 0.83, 0.74, 0.69; P for trend < 0.02). The values of ORs became weaker after further adjustment for calcium intake. Dairy consumption is inversely associated with the risk of having metabolic syndrome. It seems that this relation is somewhat attributed to calcium.
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            Adherence to the Mediterranean diet is associated with total antioxidant capacity in healthy adults: the ATTICA study.

            Greater adherence to the Mediterranean diet has been associated with a lower incidence of cardiovascular disease and cancer. We studied the effect of the Mediterranean diet on total antioxidant capacity (TAC) in 3042 participants who had no clinical evidence of cardiovascular disease. During 2001-2002, a random sample of 1514 men and 1528 women aged 18-89 y from the Attica area of Greece was selected. TAC was measured with an immune-diagnostic assay. Food consumption was evaluated with a validated food-frequency questionnaire, and adherence to the Mediterranean diet was assessed on the basis of a diet score that incorporated the inherent characteristics of this diet. TAC was positively correlated with diet score. The participants in the highest tertile of the diet score had, on average, 11% higher TAC levels than did the participants in the lowest tertile, even after adjustment for relevant confounders (P < 0.01). On the other hand, the participants in the highest tertile of the diet score had, on average, 19% lower oxidized LDL-cholesterol concentrations than did the participants in the lowest tertile (P < 0.01). An additional analysis showed that TAC was positively correlated with the consumption of olive oil (rho = 0.54, P = 0.002) and of fruit and vegetables (rho = 0.34 and rho = 0.31, respectively; P < 0.001 for both), whereas it was inversely associated with the consumption of red meat (rho = -0.35, P = 0.02). Greater adherence to the Mediterranean diet is associated with elevated TAC levels and low oxidized LDL-cholesterol concentrations, which may explain the beneficial role of this diet on the cardiovascular system.
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              Dietary patterns and risk of colorectal cancer in Tehran Province: a case–control study

              Background Colorectal cancer is the third and fourth leading cause of cancer incidence and mortality among men and women, respectively in Iran. However, the role of dietary factors that could contribute to this high cancer incidence remains unclear. The aim of this study was to determine major dietary patterns and its relationship with colorectal cancer. Methods This case–control study was conducted in four hospitals in Tehran city of Iran. A total of 71 patients (35 men and 36 women, aged 40–75 years) with incident clinically confirmed colorectal cancer (CRC) and 142 controls (70 men and 72 women, aged 40–75 years) admitted to hospital for acute, non-neoplastic diseases were recruited and interviewed. Dietary data were assessed by 125-item semi-quantitative food frequency questionnaire. Multivariate logistic regression was used to estimate the relationship between dietary patterns and risk of colorectal cancer. Results Two major dietary patterns (Healthy pattern and Western pattern) were derived using principal component analysis. Each dietary pattern explained 11.9% (Healthy pattern) and 10.3% (Western pattern) of the variation in food intake, respectively. After adjusting for confounding factors, the Healthy dietary pattern was significantly associated with a decreased risk of colorectal cancer (OR= 0.227; 95% CI=0.108–0.478) while an increased risk of colorectal cancer was observed with the Western dietary pattern (OR=2.616; 95% CI= 1.361-5.030). Conclusion Specific dietary patterns, which include healthy and western patterns, may be associated with the risk of colorectal cancer. This diet-disease relationship can be used for developing interventions that aim to promote healthy eating for the prevention of chronic disease, particularly colorectal cancer in the Iranian population.
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                Author and article information

                Contributors
                Journal
                J Diabetes Metab Disord
                J Diabetes Metab Disord
                Journal of Diabetes and Metabolic Disorders
                BioMed Central
                2251-6581
                2014
                10 July 2014
                : 13
                : 71
                Affiliations
                [1 ]Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Tehran, Iran
                Article
                2251-6581-13-71
                10.1186/2251-6581-13-71
                4100028
                ecfb16de-98b5-4ffa-a27b-56113fc5608a
                Copyright © 2014 Shadman et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 5 March 2014
                : 2 July 2014
                Categories
                Research Article

                factor analysis,diabetes mellitus,type 2
                factor analysis, diabetes mellitus, type 2

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