Association of Dietary Pattern and Physical Activity Level with Triglyceride to High-density Lipoprotein Cholesterol Ratio Among Adults in Jiangsu, China: a Cross-sectional Study with Sex-specific Differences

Our study aims to explore the association between dietary patterns and physical activity levels (PAL) with a triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, and to examine whether the association is sex dependent among Chinese adults. In this cross-sectional study, data were collected through questionnaires, anthropometric measurement, and biochemical tests. Four food patterns ("meat," "healthy," "high-energy," and "traditional Chinese") were established through factor analysis. Physical activity level was categorized as "active," "moderate," and "inactive." Logistic regression models were used to determine the associations between food patterns and PAL with TG/HDL-C ratio. Compared with quartile 1, quartiles 2 and 3 of meat pattern among men were found to be associated with lower risk of high TG/HDL-C ratio (the highest quartile of TG/HDL-C ratio). Similar decreased risk of high TG/HDL-C ratio was also observed in the highest quartile 4 of healthy pattern among women. Active PAL was protective against high TG/HDL-C ratio among both men (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.55-0.86) and women (OR, 0.77; 95% CI, 0.62-0.96). Although no statistically significant interaction was observed, we found that individuals with active PAL and low healthy diet had a similar OR with those with inactive PAL and high healthy diet (0.62 vs 0.68). In conclusion, dietary patterns were associated with TG/HDL-C ratio in a sex-specific way, and active PAL was consistently related to decreased risk of high TG/HDL-C ratio across genders.