Backgrounds: Unhealthy dietary intake is an important preventable risk factor for obesity and impaired blood glucose (IBG), ultimately increasing the risk of non-communicable diseases.  When compared to individual food intakes, dietary patterns are a stronger predictor of health outcomes and should be systematically evaluated where such evidence is lacking. This study evaluated dietary patterns and their association with the risk of central obesity and IBG among adults.

Methods: A community-based survey was conducted among 501 randomly-selected adults from Eastern Ethiopia. Data was collected using a semi-structured questionnaire during a face-to-face interview that included sociodemographic and lifestyle factors, as well as a validated 89-item food frequency questionnaire (collected over one month). Principal component analysis was used to derive the dietary pattern. While central obesity was assessed using waist and/or hip circumference measurements, fasting blood sugar was used for IBG. A multivariable logistic regression model was fitted with an odds ratio, 95% confidence intervals, and p-values reported.

Results: A total of 501 adults (95.3%) were interviewed, with a mean age of 41 years (±12). Five major dietary patterns explaining 71% of the total variance were identified: “nutrient-dense foods”, “high fat and protein”, “processed foods”, “alcohol drinks”, and “cereal diets”. While 20.4% (17.0—24.2%) had IBG, 14.6% (11.8—17.9) were centrally obese, and 94.6 (92.3—96.3) had an increased risk for cardiovascular complications. Central obesity is associated with upper wealth status (AOR = 6.92; 2.91—16.5), physical inactivity (AOR = 21.1; 2.77—161.4), a diet high in nutrient-dense foods (AOR = 1.75; 0.75—4.06), processed foods (AOR = 1.41; 0.57—3.48), and cereal diets (AOR = 4.06; 1.87—8.82). The risk of IBG was associated with upper wealth status (AOR = 2.36; 1.36—4.10), physical inactivity (AOR = 2.17; 0.91—5.18), upper tercile of nutrient-dense foods (AOR = 1.35; 0.62—2.93), fat and protein diet (AOR = 1.31; 0.66—2.62), and cereal diet consumption (AOR = 3.87; 1.66—9.02).

Conclusion: IBG and central obesity were prevalent and predicted by upper tercile consumption of nutrient-dense foods, high fat and protein diets, processed foods, and cereal diets, which could guide dietary interventions.

Key words:  central obesity; dietary intake; dietary pattern; impaired blood glucose; prediabetes