The association between traditional tibetan pastoral dietary patterns and obesity in Qinghai Province

Objective This study aimed to identify different dietary patterns among the Tibetan population and explore their relationship with the risk of obesity. Methods Based on the established open cohort of the plateau population, a cross-sectional analysis was conducted with 1 913 Tibetan adults who were recruited for the first time in 2018 and 2022. Questionnaire surveys and physical examination data were collected. The K-means clustering method was utilized to identify different dietary patterns. Modified Poisson regression as employed to analyze the relationship between dietary patterns and overweight, obesity, and overweight/obesity. Results The prevalence of overweight/obesity among the Tibetan population was 60.2%. Two dietary pattern groups were identified: the pastoral dietary group (n=1 221), characterized by consumption of tsampa and Tibetan cheese, and the modern dietary group (n=692), characterized by the consumption of vegetables and refined carbohydrates. Compared to the modern dietary group, the risk of being overweight and overweight/obesity in the pastoral dietary pattern population was reduced by 16.4% (RR=0.836, 95% CI: 0.715-0.978, P=0.025) and 10.6% (RR=0.894, 95% CI: 0.816-0.979, P=0.015) respectively, indicating a significant protective effect. Furthermore, an interaction effect was observed between dietary factors and altitude. The risk of overweight in the pastoral dietary group was 22.4% lower (RR=0.776, 95% CI: 0.649-0.928, P=0.005) than in the modern dietary group among the individuals living at high-altitude. Conclusions Two dietary patterns were identified among the Tibetans, and the pastoral dietary pattern was associated with a reduced risk of overweight/obesity, especially at high altitudes. This finding highlights the combined impact of traditional dietary patterns and environmental factors on health and provides scientific evidence for developing targeted health intervention strategies for high-altitude pastoral residents.