Dietary patterns and lipid profiles among Iranian adults: a cross-sectional analysis of the Kavar cohort study

Abstract Dietary pattern analysis is increasingly used to better reflect the complexity of habitual dietary intake and its relationship with cardiometabolic health. However, evidence from Middle Eastern populations remains limited, and inconsistencies across studies highlight the need for population-specific investigations. To identify major dietary patterns and examine their associations with cardiometabolic risk factors among apparently healthy Iranian adults. In this cross-sectional study, 3050 adults from the Kavar cohort study in southern Iran were included. Dietary intake was assessed using a validated food frequency questionnaire. Major dietary patterns were derived through principal component analysis with varimax rotation, and factor scores were calculated as standardized continuous variables. Associations between dietary patterns and cardiometabolic risk factors were evaluated using multivariable linear and binary logistic regression models, adjusting for age, sex, body mass index, physical activity, smoking status, tobacco use, alcohol consumption, and illicit drug use, and total energy intake. Five dietary patterns were identified, explaining 45.8% of the total variance in dietary intake. Greater adherence to the animal-based/high-fat and Western/fast-food dietary patterns was significantly associated with higher total cholesterol and LDL cholesterol concentrations in the fully adjusted linear regression models. However, these two patterns were not significantly associated with hypercholesterolaemia in the binary logistic regression models. In contrast, greater adherence to the mixed traditional dietary pattern was positively associated with these lipid markers in both the linear and binary logistic regression analyses. An inverse association was observed between the Sweet and Beverage pattern and triglyceride levels. No significant associations were found between the refined grain–based pattern and cardiometabolic risk factors. Five distinct dietary patterns were identified in this population. Western/fast food, animal-based/high-fat, and mixed traditional patterns were associated with less favorable lipid profiles, particularly elevated total cholesterol and LDL levels.