Dietary behaviours associated with metabolic syndrome: a latent class analysis

Abstract Background Obese individuals have a number of dietary behaviours that might contribute to their weight-related health risks. However, obesity defined solely by body mass index may not reflect the true heterogeneity of the obese population. The aims of this study were to classify the dietary behaviours of obese individuals into subgroups and to explore the relationship between their patterns of dietary behaviour and cardiometabolic risk factors. Methods The study participants were 259 patients who visited an outpatient weight management clinic at a tertiary hospital and underwent a dietary behaviour assessment between January 2014 and February 2019. Dietary behaviours were assessed in three domains with nine categories, including choice of food (frequent eating out, instant/fast/takeaway food), eating behaviour (irregular meals, frequent snacking, including eating at night, emotional eating, and overeating/binge eating), and nutrient intake (high fat/high calorie foods, salty food, and poorly balanced diet). Latent class analysis (LCA) was used to classify the subjects according to these nine categories of dietary behaviour. Associations between latent class and metabolic syndrome were assessed in a logistic regression model. Results Based on their dietary behaviour, the subjects were classified into three LCA-driven classes, including a referent class of healthy eaters (n=118), a class of emotional eaters (n=53), and a class of irregular unhealthy eaters (n=88). Compared with the referent class, emotional eaters had a significantly higher body mass index (beta=3.40, P<0.001) and metabolic syndrome (odds ratio 2.88, 95% confidence interval 1.16–7.13). Conclusions Our finding of three LCA-driven obesity phenotypes could be useful for assessment and management of obesity and metabolic syndrome. The association between higher BMI and metabolic syndrome was stronger in emotional eaters than in healthy eaters and irregular unhealthy eaters. Emotional eaters might benefit from emotional regulation strategies.