Eating patterns and dyslipidemia in adolescents from a capital in northeastern Brazil: A causal inference analysis

Purpose: To analyze the association between dietary patterns and dyslipidemia in adolescents. Methods: This is a cross-sectional study conducted with 363 adolescents of both genders, aged 17-18 years, from public schools in Sao Luis, in the state of Maranhão, Brazil. Adolescents with alteration in at least one of the following conditions were considered to have dyslipidemia: total cholesterol (TC), low-density lipoprotein (LDL-c), high-density lipoprotein (HDL-c), triglycerides (TG), Castelli I and II Indices, and non-HDL-c. Food consumption was assessed through the food frequency questionnaire, and dietary patterns were identified using the principal component analysis. The directed acyclic graph was elaborated to select the variables that were controlled in the analysis of the effect of dietary patterns on dyslipidemias, and the final sample of the study was weighted by the inverse probability of selection for these variables, using a doubly robust method. Results: Adolescents were 17.3 ± 0.5 years, mostly women (55.6%), brown (66.6%), with one to three minimum wages (38.3%), and maternal education from 8 to 12 years (46.4%). Three dietary patterns were identified: Western, Healthy, and Traditional. Most adolescents had dyslipidemia, and inadequate HDL-c levels were the main dyslipidemia found (44.9%). There was no significant difference in the occurrence of dyslipidemia among the three dietary patterns identified (healthy: -0.015; CI: -0.11; 0.08; p = 0.773; traditional: 0.04; CI: -0.06; 0.13; p = 0.542; Western: -0.064, CI: -0.16; 0.03; p = 0.201). Conclusions: The prevalence of dyslipidemia is high among adolescents from one city in a poor Brazilian region, but it was not explained by the dietary patterns identified in this study.