Diet Composition and Risk of Overweight and Obesity in Women Living in the Southwestern United States

Objective It is unknown whether dietary patterns or macronutrient composition contribute to the observed differences in rates of overweight and obesity among Hispanic and non-Hispanic white women in the United States. We assessed the association of dietary patterns and macronutrient composition with overweight and obesity in Hispanic and non-Hispanic white women. Design Cross-sectional analysis of dietary data from a case-control study of breast cancer. Participants Population-based control participants (871 Hispanic and 1,599 non-Hispanic white women) from the southwestern United States who completed the diet and other components of the interview and whose anthropometric measurements were available. Main outcome measures Body mass index (BMI; calculated as kg/m 2 ), weight status (overweight, BMI 25 to 29.9; obese, BMI>30). Statistical analyses performed Dietary patterns were defined using factor analysis. Associations of dietary patterns and macronutrient composition with overweight and obesity as compared with normal weight were assessed with logistic regression. Results Hispanic women reported consuming more energy, a greater proportion of energy from fat and vegetable protein, less alcohol, and less energy from animal protein compared with non-Hispanic white women. Western and dieter patterns were associated with higher prevalence of overweight and obesity; the Prudent dietary pattern was associated with a 29% lower prevalence of overweight and a halving of the prevalence of obesity similarly in Hispanic and non-Hispanic white women. Higher proportions of energy from protein (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.28 to 2.56) and animal protein (OR 2.10 95% CI 1.47 to 2.98) were associated with a greater risk of overweight; greater proportions of energy from fat (OR 2.28, 95% CI 1.27 to 4.08), protein (3.55 95% CI 2.38 to 5.29), or animal protein (3.44 95% CI 2.31 to 5.14) were associated with higher risk of obesity among non-Hispanic white women only. Conclusions A Western dietary pattern was associated with greater risk and a Prudent diet with reduced risk of overweight and obesity. To reduce risk of overweight and obesity, Hispanic women should maintain healthful aspects of a native Hispanic diet, and non-Hispanic white women should replace animal protein with vegetable protein.