Dietary Patterns Are Associated with Metabolic Risk Factors in South Asians Living in the United States

Background: South Asians are at high risk of metabolic syndrome, and dietary patterns may influence this risk. Objectives: We aimed to determine prevalent dietary patterns for South Asians in the United States and their associations with risk factors for metabolic syndrome. Methods: South Asians aged 40-84 y without known cardiovascular disease were enrolled in a community-based cohort called Mediators of Atherosclerosis in South Asians Living in America. A validated food frequency questionnaire and serum samples for fasting and 2-h glucose, insulin, glycated hemoglobin, triglycerides, and total and HDL cholesterol were collected cross-sectionally. We used principal component analysis with varimax rotation to determine dietary patterns, and sequential linear and logistic regression models for associations with metabolic factors. Results: A total of 892 participants were included (47% women). We identified 3 major dietary patterns: animal protein; fried snacks, sweets, and high-fat dairy; and fruits, vegetables, nuts, and legumes. These were analyzed by tertile of factor score. The highest vs. the lowest tertile of the fried snacks, sweets, and high-fat dairy pattern was associated with higher homeostasis model assessment of insulin resistance (HOMA-IR) (beta: 1.88 mmol/L . uIU/L) and lower HDL cholesterol (beta: -4.48 mg/dL) in a model adjusted for age, sex, study site, and caloric intake (P < 0.05). The animal protein pattern was associated with higher body mass index (beta: 0.73 m/kg(2)), waist circumference (beta: 0.84 cm), total cholesterol (beta: 8.16 mg/dL), and LDL cholesterol (beta: 5.69 mg/dL) (all P <0.05). The fruits, vegetables, nuts, and legumes pattern was associated with lower odds of hypertension (OR: 0.63) and metabolic syndrome (OR: 0.53), and lower HOMA-IR (beta: 1.95 mmol/L . uIU/L) (P < 0.05). Conclusions: The animal protein and the fried snacks, sweets, and high-fat dairy patterns were associated with adverse metabolic risk factors in South Asians in the United States, whereas the fruits, vegetables, nuts, and legumes pattern was linked with a decreased prevalence of hypertension and metabolic syndrome.