Identification of dietary patterns in urban population of Argentina: study on diet-obesity relation in population-based prevalence study

  • Pou, Sonia Alejandra (Instituto de Investigaciones en Ciencias de la Salud (INICSA), Universidad Nacional de Cordoba, CONICET) ;
  • del Pilar Diaz, Maria (Instituto de Investigaciones en Ciencias de la Salud (INICSA), Universidad Nacional de Cordoba, CONICET) ;
  • De La Quintana, Ana Gabriela (Escuela de Nutricion, Facultad de Ciencias Medicas, Universidad Nacional de Cordoba) ;
  • Forte, Carla Antonella (Escuela de Nutricion, Facultad de Ciencias Medicas, Universidad Nacional de Cordoba) ;
  • Aballay, Laura Rosana (Estadistica y Bioestadistica, Escuela de Nutricion, Facultad de Ciencias Medicas, Universidad Nacional de Cordoba)
  • Received : 2016.07.19
  • Accepted : 2016.08.16
  • Published : 2016.12.01


BACKGROUND/OBJECTIVES: In Argentina, obesity prevalence rose from 14.6% in 2005 to 20.8% in 2013. Although the number of studies on noncommunicable diseases and dietary patterns as a unique dietary exposure measure has increased, information on this topic remains scarce in developing countries. This is the first population-based study investigating the association between diet and obesity using a dietary pattern approach in Argentina. We aimed (a) to identify current dietary patterns of the population of $C{\acute{o}}rdoba$ city, (b) to investigate its association with obesity prevalence, and (c) to identify and describe dietary patterns from the subgroup of people with obesity. SUBJECTS/METHODS: The $C{\acute{o}}rdoba$ Obesity and Diet Study (CODIES) was conducted in $C{\acute{o}}rdoba$ city by using a random sample of n = 4,327 subjects between 2005 and 2012. Empirically derived dietary patterns were identified through principal component factor analysis. A multiple logistic regression analysis was used to investigate the association of dietary patterns with obesity. RESULTS: Four dietary patterns were identified, called "Starchy-Sugar", "Prudent", "Western", and "Sugary drinks". High scores for the "Western" pattern (with strongest factor loading on meats/eggs, processed meats, and alcohol) showed a positive association with obesity (OR: 1.33, 95% CI: 1.06-1.67, for third versus first tertile of factor score). "Meats/Cheeses" and "Snacks/Alcohol" patterns emerged in people with obesity. CONCLUSIONS: The findings suggest that high adherence to the "Western" pattern promoted obesity in this urban population. In addition, people with obesity showed characteristic dietary patterns that differ from those identified in the overall population.


obesity;eating pattern;epidemiology;Cross-sectional study;Argentina


Supported by : National Science and Technology Agency (FONCyT), Science and Technology Secretariat of the University of Cordoba (SECyT-UNC)


  1. Aballay LR, Eynard AR, Diaz MP, Navarro A, Munoz SE. Overweight and obesity: a review of their relationship to metabolic syndrome, cardiovascular disease, and cancer in South America. Nutr Rev 2013;71:168-79.
  2. Direccion de Estadisticas e Informacion de Salud (AR). Estadisticas vitales, informacion basica - ano 2013, serie 5 - numero 57 [Internet]. Buenos Aires: Ministerio de Salud de la Republica Argentina; 2014 [cited 2016 May 16]. Available from:
  3. Gallus S, Lugo A, Murisic B, Bosetti C, Boffetta P, La Vecchia C. Overweight and obesity in 16 European countries. Eur J Nutr 2015;54:679-89.
  4. Wang Y, Beydoun MA. The obesity epidemic in the United States--gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis. Epidemiol Rev 2007;29:6-28.
  5. Popkin BM, Slining MM. New dynamics in global obesity facing lowand middle-income countries. Obes Rev 2013;14 Suppl 2:11-20.
  6. Heber D. An integrative view of obesity. Am J Clin Nutr 2010;91: 280S-283S.
  7. Milagro FI, Mansego ML, De Miguel C, Martinez JA. Dietary factors, epigenetic modifications and obesity outcomes: progresses and perspectives. Mol Aspects Med 2013;34:782-812.
  8. Randi G, Edefonti V, Ferraroni M, La Vecchia C, Decarli A. Dietary patterns and the risk of colorectal cancer and adenomas. Nutr Rev 2010;68:389-408.
  9. World Health Organization. Global Status Report on Noncommunicable Diseases 2014. Geneva: World Health Organization; 2014.
  10. Aballay LR, Osella AR, Celi A, Del Pilar Diaz M. Overweight and obesity: prevalence and their association with some social characteristics in a random sample population-based study in Cordoba city, Argentina. Obes Res Clin Pract 2009;3:I-II.
  11. Aballay LR, Osella AR, De La Quintana AG, Diaz MP. Nutritional profile and obesity: results from a random-sample population-based study in Cordoba, Argentina. Eur J Nutr 2016;55:675-85.
  12. Filozof C, Gonzalez C, Sereday M, Mazza C, Braguinsky J. Obesity prevalence and trends in Latin-American countries. Obes Rev 2001;2:99-106.
  13. Navarro A, Osella AR, Guerra V, Munoz SE, Lantieri MJ, Eynard AR. Reproducibility and validity of a food-frequency questionnaire in assessing dietary intakes and food habits in epidemiological cancer studies in Argentina. J Exp Clin Cancer Res 2001;20:365-70.
  14. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381-95.
  15. Edefonti V, Bravi F, Garavello W, La Vecchia C, Parpinel M, Franceschi S, Dal Maso L, Bosetti C, Boffetta P, Ferraroni M, Decarli A. Nutrient-based dietary patterns and laryngeal cancer: evidence from an exploratory factor analysis. Cancer Epidemiol Biomarkers Prev 2010;19:18-27.
  16. Pou SA, Diaz MP, Osella AR. Applying multilevel model to the relationship of dietary patterns and colorectal cancer: an ongoing case-control study in Cordoba, Argentina. Eur J Nutr 2012;51:755-64.
  17. Edefonti V, Decarli A, La Vecchia C, Bosetti C, Randi G, Franceschi S, Dal Maso L, Ferraroni M. Nutrient dietary patterns and the risk of breast and ovarian cancers. Int J Cancer 2008;122:609-13.
  18. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev 2012;70:3-21.
  19. Chatenoud L, Bertuccio P, Bosetti C, Malvezzi M, Levi F, Negri E, La Vecchia C. Trends in mortality from major cancers in the Americas: 1980-2010. Ann Oncol 2014;25:1843-53.
  20. Linetzky B, De Maio F, Ferrante D, Konfino J, Boissonnet C. Sex-stratified socio-economic gradients in physical inactivity, obesity, and diabetes: evidence of short-term changes in Argentina. Int J Public Health 2013;58:277-84.
  21. Schargrodsky H, Hernandez-Hernandez R, Champagne BM, Silva H, Vinueza R, Silva Aycaguer LC, Touboul PJ, Boissonnet CP, Escobedo J, Pellegrini F, Macchia A, Wilson E; CARMELA Study Investigators. CARMELA: assessment of cardiovascular risk in seven Latin American cities. Am J Med 2008;121:58-65.
  22. Christine PJ, Diez Roux AV, Wing JJ, Alazraqui M, Spinelli H. Temporal trends in BMI in Argentina by socio-economic position and province-level economic development, 2005-2009. Public Health Nutr 2015;18:817-26.
  23. Navarro A, Munoz SE, Lantieri MJ, del Pilar Diaz M, Cristaldo PE, de Fabro SP, Eynard AR. Meat cooking habits and risk of colorectal cancer in Cordoba, Argentina. Nutrition 2004;20:873-7.
  24. Pou SA, Niclis C, Aballay LR, Tumas N, Roman MD, Munoz SE, Coquet JB, Diaz MP. Cancer and its association with dietary patterns in Cordoba (Argentina). Nutr Hosp 2014;29:618-28.
  25. Munoz SE, Navarro A, Lantieri MJ, Fabro ME, Peyrano MG, Ferraroni M, Decarli A, La Vecchia C, Eynard AR. Alcohol, methylxanthinecontaining beverages, and colorectal cancer in Cordoba, Argentina. Eur J Cancer Prev 1998;7:207-13.
  26. Cunha DB, de Almeida RM, Sichieri R, Pereira RA. Association of dietary patterns with BMI and waist circumference in a low-income neighbourhood in Brazil. Br J Nutr 2010;104:908-13.
  27. Flores M, Macias N, Rivera M, Lozada A, Barquera S, Rivera-Dommarco J, Tucker KL. Dietary patterns in Mexican adults are associated with risk of being overweight or obese. J Nutr 2010;140:1869-73.
  28. Tumas N, Niclis C, Aballay LR, Osella AR, Diaz MP. Traditional dietary pattern of South America is linked to breast cancer: an ongoing case-control study in Argentina. Eur J Nutr 2014;53:557-66.
  29. Pou SA, Niclis C, Eynard AR, Diaz MP. Dietary patterns and risk of urinary tract tumors: a multilevel analysis of individuals in rural and urban contexts. Eur J Nutr 2014;53:1247-53.
  30. De Stefani E, Deneo-Pellegrini H, Boffetta P, Ronco AL, Aune D, Acosta G, Mendilaharsu M, Brennan P, Ferro G. Dietary patterns and risk of cancer: a factor analysis in Uruguay. Int J Cancer 2009;124:1391-7.
  31. De Stefani E, Ronco AL, Deneo-Pellegrini H, Boffetta P, Aune D, Acosta G, Brennan P, Ferro G, Mendilaharsu M. Dietary patterns and risk of advanced prostate cancer: a principal component analysis in Uruguay. Cancer Causes Control 2010;21:1009-16.
  32. De Stefani E, Boffetta P, Correa P, Deneo-Pellegrini H, Ronco AL, Acosta G, Mendilaharsu M. Dietary patterns and risk of cancers of the upper aerodigestive tract: a factor analysis in Uruguay. Nutr Cancer 2013;65:384-9.
  33. Popkin BM. Synthesis and implications: China's nutrition transition in the context of changes across other low- and middle-income countries. Obes Rev 2014;15 Suppl 1:60-7.
  34. Basu S, McKee M, Galea G, Stuckler D. Relationship of soft drink consumption to global overweight, obesity, and diabetes: a crossnational analysis of 75 countries. Am J Public Health 2013;103: 2071-7.
  35. Haidari F, Shirbeigi E, Cheraghpour M, Mohammadshahi M. Association of dietary patterns with body mass index, waist circumference, and blood pressure in an adult population in Ahvaz, Iran. Saudi Med J 2014;35:967-74.
  36. Cho YA, Shin A, Kim J. Dietary patterns are associated with body mass index in a Korean population. J Am Diet Assoc 2011;111: 1182-6.
  37. Rouhani MH, Salehi-Abargouei A, Surkan PJ, Azadbakht L. Is there a relationship between red or processed meat intake and obesity? A systematic review and meta-analysis of observational studies. Obes Rev 2014;15:740-8.
  38. Willett WC. Dietary fat plays a major role in obesity: no. Obes Rev 2002;3:59-68.
  39. Wang Y, Beydoun MA. Meat consumption is associated with obesity and central obesity among US adults. Int J Obes (Lond) 2009;33: 621-8.
  40. Suter PM, Tremblay A. Is alcohol consumption a risk factor for weight gain and obesity? Crit Rev Clin Lab Sci 2005;42:197-227.
  41. Kant AK. Dietary patterns and health outcomes. J Am Diet Assoc 2004;104:615-35.
  42. Dugee O, Khor GL, Lye MS, Luvsannyam L, Janchiv O, Jamyan B, Esa N. Association of major dietary patterns with obesity risk among Mongolian men and women. Asia Pac J Clin Nutr 2009;18:433-40.
  43. Kaiser KA, Brown AW, Bohan Brown MM, Shikany JM, Mattes RD, Allison DB. Increased fruit and vegetable intake has no discernible effect on weight loss: a systematic review and meta-analysis. Am J Clin Nutr 2014;100:567-76.
  44. Zemel MB, Miller SL. Dietary calcium and dairy modulation of adiposity and obesity risk. Nutr Rev 2004;62:125-31.
  45. Dougkas A, Reynolds CK, Givens ID, Elwood PC, Minihane AM. Associations between dairy consumption and body weight: a review of the evidence and underlying mechanisms. Nutr Res Rev 2011;24:72-95.
  46. Kratz M, Baars T, Guyenet S. The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. Eur J Nutr 2013;52:1-24.
  47. Melnik BC. Milk--the promoter of chronic Western diseases. Med Hypotheses 2009;72:631-9.
  48. Lissner L. Measuring food intake in studies of obesity. Public Health Nutr 2002;5:889-92.