Secular trend in dietary patterns of Iranian adults from 2006 to 2017: Tehran lipid and glucose study

Background Based on data regarding nutrition transition in the Middle East and North Africa, this study aim to investigate the general structure and secular trend of dietary patterns reported from the Tehran Lipid and Glucose Study (TLGS) and adherence to these dietary patterns among Iranian population from 2006 till 2017. Methods We investigated on four examination waves of TLGS, including wave 1 (2006-2008), wave 2 (2009-2011), wave 3 (2012-2014), and wave 4 (2015-2017), using a validated and reliable food frequency questionnaire. Generalized Estimating Equations was used to assess secular trends in anthropometric, biochemical, and dietary variables across the study period. To identify general structure and secular trend of dietary patterns during each waves, principle component analysis (PCA) and K-mean cluster analysis were used, respectively. Results After adjusting for potential confounders including age, sex, body mass index, and total energy intake, the carbohydrate and protein intake gradually increased and the total fat intake decreased during study period (P-value< 0.001), although total energy intake remained stable. During the study period, participants consumed noticeably less refined grains, solid fat, dairy products, and simple sugars. Snack and dessert consumption increased and meat intakes showed no significant changes during a decade (allP-values< 0.001). Three dietary patterns extracted using PCA, included:Healthy dietary patterncharacterized by higher intakes of vegetable, fruit, dairy products, liquid oil, nuts and seeds, and honey and jam;Western dietary patternfeatured by refined grain, solid fat, meat, snack and dessert, potato, and soft drink, and theMixed dietary pattern, highlighted by tea and coffee, and simple sugar. Based on cluster analysis, 27.8% of participants in wave 4 followed a Western dietary pattern, and 34.1% followed the Mixed dietary pattern. The Healthy dietary pattern was stable among the study population during the last decade. Conclusions The structure and the type of foods that participants preferred to eat changed since 2006, a new secular trend in dietary patterns, including a stability ofHealthydietary pattern, a decline of theWesterndietary pattern and an increase in theMixeddietary pattern was obsereved in our investigation.