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Open AccessArticle

A Dietary Pattern with High Sugar Content Is Associated with Cardiometabolic Risk Factors in the Pomak Population

Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
MRC Unit for Lifelong Health & Ageing, Institute of Cardiovascular Science, University College London, London WC1E 7HB, UK
Institute of Translational Genomics, Helmholtz Zentrum Munchen, German Research Center for Environmental Health, D-85764 Neuherberg, Germany
Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Headington, Oxford OX3 7LE, UK
Wellcome Sanger Institute, The Morgan Building, Wellcome Trust Genome Campus, Hinxton, Cambridge CB10 1HH, UK
Genomics England, Queen Mary University of London, Dawson Hall, Charterhouse Square, London EC1M 6BQ, UK
Echinos Medical Centre, Xanthi 67300, Greece
Dromokaiteio Psychiatric Hospital of Athens, Chaidari, Athens 12461, Greece
Medical School, National and Kapodistrian University of Athens, Goudi, Athens 11527, Greece
Department of Human Metabolism, University of Sheffield, Sheffield S10 2TN, UK
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Nutrients 2019, 11(12), 3043;
Received: 20 November 2019 / Revised: 9 December 2019 / Accepted: 10 December 2019 / Published: 13 December 2019
The present study describes the geographically isolated Pomak population and its particular dietary patterns in relationship to cardiovascular risk factors. We collected a population-based cohort in a cross-sectional study, with detailed anthropometric, biochemical, clinical, and lifestyle parameter information. Dietary patterns were derived through principal component analysis based on a validated food-frequency questionnaire, administered to 1702 adult inhabitants of the Pomak villages on the Rhodope mountain range in Greece. A total of 69.9% of the participants were female with a population mean age of 44.9 years; 67% of the population were overweight or obese with a significantly different prevalence for obesity between men and women (17.5% vs. 37.5%, respectively, p < 0.001). Smoking was more prevalent in men (45.8% vs. 2.2%, p < 0.001), as 97.3% of women had never smoked. Four dietary patterns emerged as characteristic of the population, and were termed “high in sugars”, “quick choices”, “balanced”, and “homemade”. Higher adherence to the “high in sugars” dietary pattern was associated with increased glucose levels (p < 0.001) and increased risk of hypertension (OR (95% CI) 2.61 (1.55, 4.39), p < 0.001) and nominally associated with high blood glucose levels (OR (95% CI) 1.85 (1.11, 3.08), p = 0.018), compared to lower adherence. Overall, we characterize the dietary patterns of the Pomak population and describe associations with cardiovascular risk factors. View Full-Text
Keywords: dietary patterns; cardiovascular risk; isolated population; Pomak; HELIC dietary patterns; cardiovascular risk; isolated population; Pomak; HELIC
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Farmaki, A.-E.; Rayner, N.W.; Kafyra, M.; Matchan, A.; Ntaoutidou, K.; Feritoglou, P.; Athanasiadis, A.; Gilly, A.; Mamakou, V.; Zengini, E.; Karaleftheri, M.; Zeggini, E.; Dedoussis, G. A Dietary Pattern with High Sugar Content Is Associated with Cardiometabolic Risk Factors in the Pomak Population. Nutrients 2019, 11, 3043.

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