Higher Imported Food Patterns Are Associated with Obesity and Severe Obesity in Tuvalu: A Latent Class Analysis

• Published in: Current developments in nutrition 2024-02, Vol.8 (2), p.102080-102080, Article 102080
• Main Authors: López-Gil, José Francisco, Wu, Stephanie M, Lee, Tai-Lin (Irene), Shih, Chih-Wei, Tausi, Selotia, Sosene, Vine, Maani, Pauke P, Tupulaga, Malo, Hsu, Yu-Tien, Chang, Chia-Rui, Shiau, Shi-Chian, Lo, Yuan-Hung, Wei, Chih-Fu, Lin, Po-Jen, Hershey, Maria Soledad
• Format: Article
• Language: English
• Subjects: Adults; Analysis; Body weight; climate; Developing countries; diet; food systems; global health; International trade; Local food; nutrition and health; Obesity; Original Research; public health nutrition; Type 2 diabetes; World health
• ISSN: 2475-2991; 2475-2991
• DOI: 10.1016/j.cdnut.2024.102080

Tuvalu is a Pacific Island country within the small island developing states that has observed a significant and alarming increase in obesity rates over the past 40 years, affecting ∼60 %−70 % of the current population. This study aimed to investigate the association between food patterns and the proportion of obesity in a Pacific Island country. The 2022 COMmunity-based Behavior and Attitude survey in Tuvalu (COMBAT) included 985 adults with complete data on sociodemographic information and the frequency of consumption of 25 common foods. A latent class analysis determined 4 food patterns. Bayesian multilevel logistic and linear regression models estimated the association between food patterns and the proportion of obesity [body mass index (BMI) ≥30 kg/m2], severe obesity (BMI ≥40 kg/m2), and weight (kg), adjusting for potential confounders and accounting for clustering by region. The latent class analysis revealed 4 food patterns with an entropy of 0.94 and an average posterior probability of class assignment for each individual of 0.97, described as follows: 1) local: locally produced foods with moderate food diversity (proportion of individuals = 28 %); 2) diverse-local: local with greater food diversity (17 %); 3) restricted-imported: more imported with restricted diversity (29 %); and 4) imported: heavily imported with high diversity (26 %). Compared to those following the diverse-local pattern, the odds of having obesity were greater for those classified with the imported pattern [odds ratio (OR): 2.52; 95 % credible interval (CrI): 1.59, 3.99], restricted-imported pattern (OR: 1.89; 95 % CrI: 1.59, 3.99), and local pattern (OR: 1.54; 95 % CrI: 0.94, 2.50). Similar trends were observed for severe obesity while body weight was positively associated with both restricted-imported and imported food patterns. The high consumption of imported foods, together with the low consumption of plant-based foods and protein-rich foods, could be a relevant modifiable lifestyle factor explaining the high levels of obesity and severe obesity in Tuvalu, a Pacific Island country.