LAUSR

Objectives To identify the major dietary patterns among indigenous Tibetan urban settled nomads on the Tibetan Plateau, and to investigate the association between overweight/obesity and the rapidly changing dietary patterns in this population. Methods A cross-sectional study of 782 indigenous Tibetan adults (340 males and 442 females) aged 18-84 years was conducted in two urban settled Tibetan communities in 2018. Dietary assessments using food frequency questionnaires and anthropometric measurements were performed. Demographic and lifestyle factors were also asked in the survey. Results The prevalence of general overweight and obesity (by BMI, China criteria) was 31.8% and 26.6%, respectively, and of central obesity (by waist, China criteria) was 40.7%. Three major dietary patterns were extracted using factor analysis: urban pattern, western pattern and traditional pattern. After adjustment for potential confounders, individuals in the upper quintile of urban pattern were more likely to be general obesity (OR = 2.94, 95% CI 1.57-5.49) and central obesity (OR = 1.95, 95% CI 1.13-3.36); whereas those in the upper quintile of western pattern had greater odds for combined overweight and obesity (OR = 1.81, 95% CI 1.03-3.19). Traditional pattern was not associated with increased bodyweight or central obesity after adjustment. Conclusions The present pandemic of overweight and obesity among indigenous Tibetan urban settled nomads was associated with dietary transition in urbanization. Culture-adapted nutrition education is required for healthy eating among this population. Funding Sources National Natural Science Foundation of China.