Table 1.
Summary of characteristics of included studies on dietary patterns and obesity or weight outcomes.
| Number | Pattern | Study Type | Participants | Population | Outcome | Food Measurements | Associations Identified |
|---|---|---|---|---|---|---|---|
| Cao et al., 2020 [50] | Trajectory of the “traditional” DP and “modern” DP | Longitudinal | 6943 (48.4% males) | Adults aged over 20 years in the China Health and Nutrition Survey (CHNS) between 1991 and 2009 | BMI, overweight/obesity in 2009 | 3 day 24 h recall |
High and stable traditional DP trajectory: ↓ BMI; high and rapid increase in the modern DP: ↑ BMI |
| Cempaka et al., 2019 [32] | “Dysregulated iron metabolism-related” DP | Cross sectional | 208 (50.4% males) | Taiwanese adults aged 20–65 years | Central obesity, fat mass | FFQ | Central obesity; visceral fat mass (%) |
| Chan et al., 2012 [33] | “Vegetables–fruit” DP; “snacks–drinks–milk products” DP; “meat–fish” DP | Cross sectional | 3707 (52.5% males) | Adults aged 65 years and above living in Hong Kong | BMI, WC, HC, waist-to-hip ratio | FFQ | Meat–fish DP: ↑ BMI, waist-to-hip ratio, and WC in men; ↑ BMI, WC, and HC in women; “snacks–drinks–milk products” DP: ↓ waist-to-hip ratio in men |
| Chen et al., 2021 [34] | “Lacto-ovo-vegetarian” DP; “meat-fish” DP; “junk food” DP | Cross sectional | 3795 (37.2% males) | Community-dwelling older adults aged over 60 years in Shenyang, Liaoning province | Sarcopenic obesity, WC, obesity | FFQ | Lacto-ovo-vegetarian DP: ↓ sarcopenic obesity |
| Li et al., 2017 [51] | Mean cumulative DP scores during 1991–2011 for “traditional” and “modern” DPs | Longitudinal | 9499 (48% males) | CHNS between 1991 and 2011 | Overweight/obesity (BMI > 25 kg/m2), abdominal obesity in 2009 | 3 day 24 h recall | Traditional DP: ↓ general and abdominal obesity; modern DP: ↑ general and abdominal obesity |
| Li et al., 2022 [35] | “Animal-based and processed food” DP; “traditional food” DP; “ovo-lacto vegetarian food” DP | Cross sectional | 1136 (100% males) | Males aged over 65 years in Sichuan province | BMI, overweight/obesity, WC | FFQ | Traditional DP: ↓ overweight/obesity; animal-based and processed food DP: ↑ overweight/obesity |
| Meng et al., 2014 [36] | “Western food” DP; “high-protein and -calcium” DP; “fruits and snacks” DP; “staple food and vegetables” DP | Cross sectional | 1535 (47.4% males) | Adults aged ≥ 18 years old in Shanghai | Overweight/obesity | FFQ | Staple food and vegetables DP: ↑ obesity |
| Mu et al., 2014 [37] | “Western food” DP; “high-protein and -calcium” DP; “calcium food” DP; “Chinese traditional” DP | Cross sectional | 1319 (38.7% males) | College freshmen aged 16–20 years in Anhui province | Overweight/obesity | FFQ |
Western food DP: ↑ overweight/obesity; traditional DP: ↓ overweight/obesity |
| Muga et al., 2017 [38] | “Vegetable–fruit” DP, “processed meat” DP | Cross sectional | 62,965 (52% males) | Taiwanese adults aged over 40 years | Overweight/obesity | FFQ |
Vegetable–fruit DP: ↓ overweight/obesity; meat and processed DP: ↑ overweight/obesity |
| Shi et al., 2008 [39] | “Traditional” DP; “vegetable-rich” DP; “macho” DP; “sweet tooth” DP | Cross sectional | 2849 (45.9% males) | Adults aged over 20 years in the Jiangsu Nutrition Study (JIN) | Overweight/obesity | FFQ | Vegetable-rich DP: ↑ general obesity |
| Shi et al., 2011 [52] | “Traditional” DP; “vegetable-rich” DP; “macho” DP; “sweet tooth” DP | Longitudinal | 1231 (41.4% males) | JIN 2002–2007 | Weight gain during the survey period | FFQ |
Traditional DP: ↓ weight gain; vegetable-rich DP: ↑ weight gain |
| Shu et al., 2015 [40] | “Animal food” DP; “traditional Chinese” DP; “Western fast-food” DP; “high-salt” DP | Cross sectional | 2560 (53% males) | Adults aged 45–60 years from Zhejiang province | BMI, WC, waist-to-hip ratio (WHR), abdominal obesity | FFQ |
Animal DP: ↑ BMI, WC, and abdominal obesity; traditional Chinese DP: ↓ BMI, WC, and abdominal obesity; |
| Wang et al., 2021 [41] | “Traditional” DP; “fruit–egg” DP; “nut–wine” DP | Cross sectional | 1739 (46.2% males) | Adult participants aged over 18 years in Jiangsu province | Overweight/obesity | FFQ | Traditional DP: ↑ overweight and obesity in men but not in women |
| Xu et al., 2015 [42] | “Traditional” DP; “modern” DP | Cross sectional | 2745 (47.4% males) | 2009 CHNS participants aged ≥ 60 years | Obesity | 3 d food recalls |
Traditional DP: ↓ overweight and general obesity; modern DP: ↑ central obesity in men, ↓ underweight in women |
| Xu et al., 2016 [53] | “Traditional” and “modern” DPs as above over four survey years | Longitudinal | 6348 (47.3% males) | CHNS 2004–2011 waves of participants aged ≥ 60 years | BMI, weight and WC changes over four survey years | 3 d food recalls |
Traditional DP: ↓ BMI, weight, and WC; modern DP: ↑ BMI, weight, and WC |
| Ye et al., 2018 [43] | “Healthy traditional” DP; “animal and plant protein” DP; “condiments” DP; “fruits, eggs, and juice” DP; “alcohol, milk, and tea” DP | Cross sectional | 3376 (41.4% males) | Adult participants aged over 35 years in Nanjing | Abdominal obesity | FFQ | Healthy traditional DP: ↓ abdominal obesity |
| Yu et al., 2015 [44] | “Traditional southern” DP; “traditional northern” DP; “Western” DP | Cross sectional | 474,192 (59% males) | Adults aged 30–79 years from the China Kadoorie Biobank | BMI, WC, general obesity, central obesity | FFQ | Traditional southern DP: ↓ general and central obesity; Traditional northern DP: ↑ general obesity and central obesity; Western DP: ↑ general obesity and central obesity; |
| Zhang et al., 2012 [45] | “Vegetable” DP; “sweets and fats” DP; “legume” DP; “poultry, beef, and mutton” DP | Cross sectional | 556 (50.5% males) | Newlywed couples aged under 35 years in Shanghai | Weight gain | FFQ | Sweets and fats DP: ↑ weight gain after marriage in men; poultry, beef, and mutton DP: ↓ weight gain after marriage |
| Zhang et al., 2014 [46] | “Animal food” DP; “plant food” DP; “seafood” DP | Cross sectional | 2116 (46.6% males) | Adults aged over 18 years in the “China National Nutrition and Health Status Monitoring” cohort | Abdominal obesity | FFQ |
Animal food DP: ↑ abdominal obesity; seafood DP: ↓ abdominal obesity |
| Zhang et al., 2015 [47] | “Traditional southern” DP; “traditional northern” DP; “snack” DP; “high-protein” DP | Cross sectional | 2363 (100% females) | Women aged 18–44 years in the 2011 CHNS | Obesity, BMI, WC | 3 d food recalls |
Traditional southern DP: ↓ general and abdominal obesity; traditional northern DP: ↑ general and abdominal obesity |
| Zhang et al., 2016 [48] | “Modern” DP; “traditional” DP; “tuber” DP | Cross sectional | 1604 (41.4% males) | Adults aged 18–80 years in Yunnan province | Obesity, BMI, WC | 3 d food recalls | Modern DP: ↑ general and central obesity; tuber DP: ↓ general and central obesity but ↑ underweight |
| Zhang et al., 2021 [54] | Three trajectories of a “southern” DP and a “modern” DP; four trajectories of a “meat” DP | Longitudinal | 9299 (49.6% males) | Adults aged 18 years or older from the CHNS between 1991 and 2018 | Overweight/obesity at each wave of survey collection | 3 d food recalls |
Highest initial score and a slight decrease trajectory of the meat DP: ↑ overweight/obesity; maintaining high southern DP and modern DP scores: ↓ overweight/obesity |
| Zou et al., 2017 [49] | “Cereal, animal, and plant food” DP; “high-protein food” DP; “plant food” DP; “poultry” DP; “beverage” DP | Cross sectional | 1613 (46.8% males) | Adults from cities, townships, and residential villages in Zhejiang Province | BMI, overweight/obesity | 24 h recall | Cereal, animal, and plant food DP and beverage DP: ↑ obesity |
CHNS—China Health and Nutrition Survey; CI—confidence interval; DP—dietary pattern; FFQ—food frequency questionnaire; JIN—Jiangsu Nutrition Study; OR—odds ratio; PR—prevalence ratio; RRR—relative risk ratio; WC—waist circumference; “↑”—increase; “↓”—decrease.