A latent class analysis of dietary behaviours associated with metabolic syndrome: a retrospective observational cross-sectional study
Abstract Background: Obesity defined solely by body mass index may not reflect the true heterogeneity of the obese population. This study aimed to classify the dietary behaviours of obese individuals and to explore the relationship between patterns of dietary behaviour and cardiometabolic risk factors. Methods: A total of 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 were enrolled in the study. Dietary behaviours were assessed in three domains with nine categories, including choice of food (frequently 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 categories. Associations between latent class and metabolic syndrome were assessed by logistic regression. Results: 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) accompanied by metabolic syndrome (odds ratio 2.88, 95% confidence interval 1.16–7.13). Conclusions: Our 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.