Metabolic syndrome, its components, and their association with dietary patterns among early adolescents in Sudan.

BACKGROUND: The prevalence of global metabolic syndrome (MetS) is increasing alongside childhood obesity, and diet plays an important role in metabolic health. OBJECTIVE: This study examined MetS, its components, and dietary pattern associations among Sudanese early adolescents aged 10-15 years (N = 921). METHODS: In this cross-sectional study conducted in 2018-2019, dietary intake was assessed using a food frequency questionnaire; dietary patterns were derived by principal component analysis; and associations with MetS components and weight status were examined using the multiple linear regression analysis. RESULTS: Three patterns emerged: starchy/animal-origin (starchy foods, fish, chicken, eggs, milk/dairy, meat), Western (fast/fried foods, snacks, soda drinks, sweets), and plant-based (legumes, vegetables, fruits, fresh juices) food patterns. Starchy/animal-origin and Western patterns were positively associated with weight status, and the plant-based pattern was inversely associated with weight status (all p < 0.01). After adjusting for gender, residence, age, and parental education, the starchy/animal-origin pattern was associated with greater waist circumference (WC; B = 2.05, 95% CI: 1.50, 2.60, p < 0.01) and higher systolic blood pressure (SBP; B = 0.62, 95% CI: 0.03, 1.21, p = 0.038). The Western pattern was associated with lower WC (B = -0.84, 95% CI: -1.52, -0.15, p = 0.016), whereas the plant-based pattern was associated with lower WC (B = -2.70, 95% CI: -3.28, -2.14, p < 0.01), lower SBP (B = -1.14, 95% CI: -1.75, -0.53, p < 0.01), and lower diastolic blood pressure (B = -0.68, 95% CI: -1.29, -0.07, p = 0.028). CONCLUSION: The starchy/animal-origin pattern showed adverse adiposity, while the plant-based pattern showed more favorable profiles among Sudanese early adolescents. School-based dietary interventions are needed to promote balanced eating and reduce MetS risk.