Behavioural Factors, Dietary Patterns and Fat Distribution in Young Men: Association with Cardiovascular Risk

Aim. To study the characteristics of nutrition and  lifestyle of young men depending on the distribution of adipose tissue, as well as their relationship with data from various scales for assessing absolute and relative cardiovascular risk (CVR).

Design. A cross-sectional comparative study.

Materials and methods. The study included 150 men aged 20–45 years, average age 36 [32; 41] years. Participants were recruited into three groups of 50 people each based on data of anthropometry and bioimpedance analysis (BIA) of body composition: group 1 — without abdominal obesity (AO), group 2 — with AO and predominantly subcutaneous type of fat tissue distribution, group 3 — with AO and predominantly visceral type of fat tissue distribution. Anthropometric analysis, caliperometry, BIA, and ultrasound were used to assess the proportion of fat tissue and the nature of its distribution. Behavioral risk factors were assessed using questionnaires. The SCORE2, Framingham 2008, Predicting Risk of cardiovascular disease EVENTs (PREVENT), QRISK3, Framingham-30, and Mayo Clinic Heart Disease Risk Calculator scores were used to assess absolute and relative CVR.

Results. In young men aged 20–45 years with and without AO, smoking status was comparable; the overall  level of physical activity (PA) according to the Global Physical Activity Questionnaire was also comparable across the three groups (p = 0.923) — about 70% of patients had a moderate level of PA and 30% had a low level. Men with AO and a predominantly visceral type of fat tissue distribution (group 3) mainly consumed alcohol 1–2 times a week, which was twice as often as in the group of men without AO (group 1) (48 and 22%, respectively, p_1–3 = 0.019). Additionally, the number of alcohol servings per occasion was higher in Group 3 (p_1–3 < 0.001). When assessing food categories using the Food Frequency Questionnaire, differences between the groups were found only in the consumption of processed meat products: men in group 2 consumed them 2–4 times a week in 40% of cases, which is 5 times more often than in group 1 (p_1–2 = 0.001); in group 3, 4% of men consumed processed meat products almost daily (p_1–3 = 0.014). Correlation analysis revealed significant relationships between dietary habits, PA levels, and indicators reflecting body fat composition. Some dietary features that are not included in the risk stratifiers in the studied scores also demonstrated positive correlations with the CVR assessment. In particular, positive correlations were observed between the frequency of alcohol consumption (r_s = 0.189–0.328, p < 0.001–0.037), the number of alcohol servings per occasion (r_s = 0.169–0.203, p = 0.013–0.038) and the values of all studied  risk scores except SCORE-2. Negative correlations were found between the “Leisure-time PA” indicator and the scores reflecting relative risk: QRISK3 (r_s = –0.182, p = 0.03) and Framingham-30 based on body mass index (r_s = –0.172, p = 0.035); and between the “PA at work” indicator and the values of Framingham-30 lipid-based score (r_s = –0.168, p = 0.039).

Conclusion. From the perspective of behavioral factors, the group at risk for cardiovascular diseases includes not only men with diagnosed AO but also young men without AO, as they share comparable smoking status, dietary patterns, and level of PA. The absence of AO in men can create a false impression of metabolic well-being and can diminish motivation for lifestyle modification. Screening for behavioral risks in young men, especially those with a predominantly visceral fat tissue distribution, should extend beyond the assessment of anthropometric indicators and must account for the frequency and quantity of alcohol consumption, the frequency of consuming ultra-processed foods, red meat, and bread, as well as the level of PA.

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