A Cross-Sectional Assessment of Dietary Patterns and Their Relationship to Hypertension and Obesity in Indonesia

Oyedolapo A Anyanwu; Sara C Folta; Fang Fang Zhang; Kenneth Chui; Virginia R Chomitz; Martha I Kartasurya; Elena N Naumova

doi:10.1093/cdn/nzac091

A Cross-Sectional Assessment of Dietary Patterns and Their Relationship to Hypertension and Obesity in Indonesia

Curr Dev Nutr. 2022 May 3;6(6):nzac091. doi: 10.1093/cdn/nzac091. eCollection 2022 Jun.

Authors

Oyedolapo A Anyanwu¹, Sara C Folta¹, Fang Fang Zhang¹, Kenneth Chui², Virginia R Chomitz², Martha I Kartasurya³, Elena N Naumova¹

Affiliations

¹ Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
² Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA, USA.
³ Department of Public Health Nutrition, Diponegoro University, Semarang, Indonesia.

Abstract

Background: There is a marked increase in the intake of foods associated with higher risks for hypertension and obesity in Indonesia. However, studies assessing the relationship between dietary patterns and health outcomes are few.

Objective: The purpose of this study was to characterize dietary patterns and investigate their relationship with hypertension and obesity in Indonesia.

Methods: Exploratory factor analysis was used to derive dietary patterns from a brief food scanner filled by 31,160 respondents aged 15 y and older in the Indonesian Family Life Survey wave 5 (IFLS 5). Age- and gender-specific quintiles of consumption were created for each pattern and the association between quintiles of each dietary pattern and the odds for hypertension and obesity were assessed using multivariate logistic regression analyses.

Results: Two dietary patterns were identified: a modern dietary pattern characterized by fast foods, soft drinks, sweet snacks, and salty snacks and a traditional pattern characterized by fish, vegetables, and fruits. Younger age and being male were significantly correlated with higher consumption of the modern pattern (P < 0.0001 and P = 0.03, respectively). Analyses showed no association between hypertension and the modern pattern. However, the traditional pattern revealed lower odds for hypertension among those in the highest quintile compared with the lowest quintile (OR: 0.84; 95% CI: 0.74, 0.95; P-trend < 0.05). Individuals in the highest quintile of each dietary pattern had higher odds of obesity compared with those in the lowest quintile (modern pattern-OR: 1.31; 95% CI: 1.15, 1.49; P-trend < 0.00; traditional pattern-OR: 1.25; 95% CI: 1.10, 1.42; P-trend < 0.01).

Conclusions: More studies using gold-standard measures of dietary intake are needed to better understand the relationship between the modern dietary pattern and hypertension in Indonesia. Also, both modern and traditional dietary patterns in Indonesia may be energy dense, leading to higher risk for obesity.

Keywords: LMICs; dietary patterns; exploratory factor analysis; hypertension; nutrition transitions; obesity.