Association of Tibetan Habitual Food and Metabolic Syndrome Among Tibetan People in China: A Cross-Sectional Study

Abstract

Background: The association between habitual food intake in Tibet and metabolic syndrome (MetS) is largely unclear.

Objective: To examine the association between Tibetan habitual food intake and MetS among Tibetan adults.

Methods: A population-based cross-sectional study, named the China Multi-Ethnic Cohort (CMEC) study, was conducted between 2018 and 2019. We used data from all Tibetans in the CMEC in the current study. The participants, 1,954 men and 3,060 women aged 18-79 years, were from Lhasa, Tibet Autonomous Region, Tibet. The habitual dietary intake was assessed using a food frequency questionnaire (FFQ). MetS was defined according to ATP III guidelines. Multivariate logistic regression was used to estimate the association between five Tibetan habitual foods and MetS.

Results: Tsampa, butter tea, and Qing cha intake were associated with reduced prevalence of MetS. Compared with the lowest quartile of each food, odds ratios (ORs) and their 95% confidence intervals (95% CIs) of medium and high Tsampa intake were 0.59 (0.41-0.85) and 0.53 (0.36-0.77), ORs (95% CIs) of butter tea were 0.67 (0.52-0.88) and 0.61 (0.46-0.81), and Qing cha were 0.85 (0.71-1.03) and 0.75 (0.60-0.93), respectively. When exploring the joint effects of these three foods on MetS, the adjusted ORs and their 95% CIs were 0.65 (0.49-0.87) for the middle intake group and 0.59 (0.42-0.83) for the high intake group as compared with the never/rarely group (p = 0.022 for trend). Associations of MetS with Tibetan noodles and raw beef were not observed.

Conclusion: Tsampa, butter tea, and Qing cha were negatively associated with MetS. The recommendation of increasing the intake of these foods may be beneficial for MetS prevention.

Keywords: Qing cha; Tibetan population; Tsampa; butter tea; metabolic syndrome.

FIGURE 1

The prevalence of MetS along with age by tsampa (A), Tibetan noodles (B), butter tea (C), Qing cha (D), and raw beef (E) intake frequency. There were a limited number of participants older than 70 years old who were consuming butter tea, thus this age group was not shown in panel (C).

FIGURE 2

Adjusted mean waist circumference, triglyceride, and high-density lipoprotein according to the frequency of Tsampa, butter tea, and Qing cha consumption. Mean values for waist circumference, triglyceride, and high-density lipoprotein were adjusted for age, marital status, educational level, annual household income, smoking status, alcohol intake, physical activity, and consumption of red meat, dairy products, eggs, fresh vegetables, and fruits.

FIGURE 3

Adjusted mean waist circumference (A), triglyceride (B), high-density lipoprotein (C), and adjusted OR (D) of MetS according to the food consumption score. Mean values for waist circumference, triglyceride, high-density lipoprotein, and OR of MetS were adjusted for age, marital status, educational level, annual household income, smoking status, alcohol intake, physical activity, and consumption of red meat, dairy products, eggs, fresh vegetables, and fruits.