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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 4, July/August 2019
AFRICA
233
higher in lean than in overweight women. In women, small effect
sizes (~ 0.35–0.44) were found for most FAs, except for C24:0,
which had a medium effect size of 0.45.
The factor analysis identified two dietary FA and six plasma
phospholipid FA patterns according to the Kaiser criterion and
scree-plot visual inspection. Results are shown in Table 3. Eleven
dietary FAs and 26 phospholipid FAs were entered into the
analysis. The factors generated explained 89% of the cumulative
variance in dietary FA patterns and 73% in plasma phospholipid
FA patterns. The Kaiser’s measure of sampling adequacy was
0.84 and 0.78 for the dietary FA and plasma phospholipid FA
patterns, respectively. Loadings with absolute values higher than
0.5 were considered relevant for the contribution to each FA
pattern. The patterns are characterised and named according to
the highest loadings of the specific FAs present in a given pattern.
Among dietary FAs, the first extracted pattern presented with
high positive loadings of saturated FAs, MUFAs,
α
-linolenic
acid (C18:3n-3) and n-6 FAs, and therefore was named the
Table 4. Associations of dietary fatty acid patterns with adiposity and the MetS in 711 black South African adults in regression models
Linear regression models
Logistic regression models
Body mass index
Waist circumference
Waist:height ratio
Metabolic syndrome
β
a
(95% CI)
a
p
-value
β
(95% CI)
p
-value
β
(95% CI)
p
-value
OR (95% CI)
b
p
-value
Crude model
c
Non-marine
0.05 (–0.02, 0.13)
0.15
0.07 (–0.004, 0.14)
0.07
0.06 (–0.02, 0.13)
0.14
1.13 (0.96, 1.32)
0.14
Marine
–0.015 (–0.09, 0.06)
0.69
0.007 (–0.07, 0.08)
0.85
0.004 (–0.07, 0.08)
0.92
0.99 (0.84, 1.16)
0.88
R
2
(%)
0.03
0.02
0.03
0. 43
Adjusted model
1
d
Non-marine
0.04 (–0.02, 0.11)
0.20
0.06 (–0.01, 0.13)
0.09
0.04 (–0.02, 0.11)
0.19
1.12 (0.95, 1.33)
0.19
Marine
–0.02 (–0.09, 0.05)
0.55
0.004 (–0.07, 0.08)
0.91 –0.0015 (–0.07, 0.07)
0.97
0.98 (0.82, 1.16)
0.78
R
2
(%)
20.48
6.35
17.25
17.69
Fully adjusted model
e
Non-marine
0.04 (–0.02, 0.11)
0.21
0.06 (–0.01, 0.13)
0.09
0.04 (–0.03, 0.11)
0.25
1.15 (0.96, 1.38)
0.12
Marine
–0.02 (–0.10, 0.04)
0.47
0.002 (–0.07, 0.07)
0.96 –0.005 (–0.07, 0.06)
0.88
0.94 (0.78, 1.14)
0.53
R
2
(%)
26.68
13.34
22.72
20.39
a
Standardised betas and standardised 95% confidence intervals (CI).
b
OR, odds ratio and 95% CI.
c
Crude model; consisted of plasma phospholipid fatty acid patterns
only.
d
Adjusted model
1
; crude model and additionally adjusted for age and gender.
e
Fully adjusted model; adjusted model
1
, additionally adjusted for lifestyle confound-
ers (physical activity, self-reported smoking, total dietary energy and alcohol intake (Kcal) and level of education).
Table 5. Associations of plasma phospholipid fatty acid patterns with adiposity and the MetS in 711 black South African adults in regression models
Linear regression models
Logistic regression models
Body mass index
Waist circumference
Waist:height ratio
Metabolic syndrome
β
a
(95% CI)
a
p
-value
β
(95% CI)
p
-value
β
(95% CI)
p
-value Exponent of
β
(95% CI)
p
-value
Crude model
b
High-Satfat
0.37 (0.31, 0.44)
<
0.0001 0.28 (0.21, 0.35)
<
0.0001 0.31 (0.24, 0.38)
<
0.0001
1.62 (1.34, 1.96)
<
0.0001
n-3 VLC-PUFA 0.21 (0.15, 0.28)
<
0.0001 0.22 (0.15, 0.28)
<
0.0001 0.22 (0.15, 0.28.)
<
0.0001
1.76 (1.44, 2.15)
<
0.0001
High-LA
0.04 (–0.02, 0.11)
0.20.
–0.05 (–0.12, 0.02)
0.16 –0.04 (–0.10, 0.03)
0.29
1.09 (0.92, 1.30)
0.33
n-6 VLC-PUFA 0.05 (–0.0, 0.12)
0.13
0.06 (–0.005, 0.13)
0.07
0.07 (0.001, 0.14)
0.045
1.28 (1.08, 1.53)
0.006
n-9 LC-MUFA –0.05 (–0.11, 0.02)
0.17 –0.10 (–0.16, –0.03)
0.007 –0.09 (–0.16, –0.02)
0.009
0.63 (0.52, 0.75)
<
0.0001
n-3 EFA
–0.12 (–0.18, –0.05)
0.0007 –0.06 (–0.13, 0.006)
0.07 –0.09 (–0.16, –0.02)
0.009
0.81 (0.68, 0.96)
0.02
R
2
(%)
19.72
13.87
15.62
18.30
Adjusted model
1
d
High-Satfat
0.29 (0.22, 0.35)
<
0.0001 0.25 (0.18, 0.32)
<
0.0001 0.23 (0.16, 0.30)
<
0.0001
1.44 (1.17, 1.76)
0.0004
n-3 VLC-PUFA 0.18 (0.12, 0.24)
<
0.0001 0.20 (0.13, 0.27)
<
0.0001 0.18 (0.12, 0.24)
<
0.0001
1.70 (1.37, 2.10)
<
0.0001
High-LA
0.03 (–0.04, 0.09)
0.43 –0.04 (–0.11, 0.03)
0.26 –0.04 (–0.11, 0.02)
0.21
1.10 (0.89, 1.30)
0.43
n-6 VLC-PUFA 0.029 (–0.03, 0.09)
0.36
0.05 (–0.016, 0.12)
0.13
0.05 (–0.02, 0.11)
0.16
1.26 (1.04, 1.51)
0.02
n-9 LC-MUFA –0.04 (–0.10, 0.02)
0.20 –0.10 (–0.16, –0.03)
0.005 –0.09 (–0.15, –0.02)
0.007
0.61 (0.5, 0.73)
<
0.0001
n-3 EFA
–0.06 (–0.13, 0.001)
0.05.
–0.060 (–0.13, 0.010)
0.09 –0.05 (–0.12, 0.011)
0.10
0.84 (0.69, 1.01)
0.07
R
2
(%)
30.78
16.73
25.76
29.74
Fully adjusted model
e
High-Satfat
0.27 (0.20, 0.34)
<
0.0001 0.22 (0.15, 0.30)
<
0.0001 0.20 (0.13, 0.27)
<
0.0001
1.54 (1.21, 1.95)
0.0004
n-3 VLC-PUFA 0.14 (0.08, 0.20)
<
0.0001 0.16 (0.087, 0.23)
<
0.0001 0.15 (0.08, 0.21)
<
0.0001
1.72 (1.38, 2.16)
<
0.0001
High-LA
–0.004 (–0.070, 0.06)
0.90 –0.06 (–0.13, 0.01)
0.11 –0.06 (–0.13, 0.01)
0.07
1.14 (0.93, 1.4)
0.22
n-6 VLC-PUFA 0.029 (–0.04, 0.09)
0.37
0.05 (–0.02, 0.12)
0.14
0.05 (–0.02, 0.11)
0.15
1.25 (1.02, 1.54)
0.03
n-9 LC-MUFA
0.002 (–0.06, 0.07)
0.957 –0.06 (–0.13, 0.02)
0.13 –0.05 (–0.11, 0.02)
0.17
0.61 (0.50, 0.75)
<
0.0001
n-3 EFA
–0.06 (–0.13, 0.005)
0.07 –0.06 (–0.13, 0.014)
0.12 –0.05 (–0.12, 0.02)
0.17
0.81 (0.66, 0.99)
0.04
R
2
(%)
33.69
20.38
28.38
31.09
a
Standardised betas and standardised 95% confidence intervals (CI).
b
Crude model; consisted of plasma phospholipid fatty acid patterns only.
c
Adjusted model
1
; crude
model and additionally adjusted for age and gender.
d
Adjusted model
2
; adjusted model
1
, additionally adjusted for lifestyle confounders (physical activity, self-reported
smoking, total dietary energy and alcohol intake (KJ) and level of education).
e
Fully adjusted model; adjusted model
1
, additionally adjusted for contraceptive use.
High-Satfat, saturated fatty acid pattern; n-3 VLC-PUFA, n-3 very-long-chain polyunsaturated fatty acid pattern; high-LA, high linoleic acid pattern; n-6 VLC-PUFA,
n-6 very-long-chain polyunsaturated fatty acid pattern; n-9 LC-MUFA, long-chain mono-unsaturated fatty acid pattern; n-3 EFA, n-3 essential fatty acid pattern.