Metabolic syndrome and its relation to dietary patterns among a selected urbanised and semi-urbanised Tibetan population in transition from nomadic to settled living environment

Objective: To explore the scope of metabolic syndrome (MetS) and its relationship to the major dietary patterns among an urbanised and semi-urbanised Tibetan population in transition from nomadic to settled settings. Design: Cross-sectional. Setting: Community-based. Participants: Urbanised and semi-urbanised Tibetan adults (n 920, aged 18-90 years), who have moved from nomadic to settled living environments, answered questionnaires on food consumption frequency and lifestyle characteristics through structured face-to-face interviews and completed anthropometric measurement and metabolic biomarker tests. Results: MetS prevalence was 30.1 % in males and 32.1 % in females. Low HDL-cholesterol and central obesity were the leading metabolic abnormalities (86.3 and 55.8 %, respectively). Three major dietary patterns - urban, western and pastoral - were identified. Beef/mutton was an important food group for all three identified dietary patterns. In addition, the urban dietary pattern was characterised by frequent consumption of vegetables, tubers/roots and refined carbohydrates; the western pattern was characterised by sweetened drinks, snacks and desserts; and the pastoral pattern featured tsamba (roasted Tibetan barley), Tibetan cheese, butter tea/milk tea and whole-fat dairy foods. Individuals in the highest quintile of urban dietary pattern scores were found to be at a higher risk of developing MetS (OR 2.43, 95 % CI 1.41, 4.18) and central obesity (OR 1.91, 95 % CI 1.16, 3.14) after controlling for potential confounders. Conclusions: MetS was common among urbanised and semi-urbanised Tibetan adult population in transition. The urban dietary pattern, in particular, was a risk factor for MetS. To prevent MetS, nutrition interventions need to be tailored to address the variety of local diet patterns to promote healthy eating.