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Obesity, Physical Activity, Diet · Journal article
Frontiers in Nutrition · September 9, 2026
Early or partial results. Treat as a signal, not a conclusion.
This cross-sectional study identified three dietary patterns among Sudanese adolescents and found associations between plant-based diet and lower waist circumference and blood pressure, while starchy/animal-origin diet was associated with higher waist circumference and systolic blood pressure. The design and use of surrogate endpoints limit causal inference and practice applicability; findings are hypothesis-generating and require prospective or intervention confirmation.
Cross-sectional study. Early adolescents aged 10–15 years in Sudan. Intervention: Dietary patterns (starchy/animal-origin, Western, plant-based). Compared with: No explicit comparator; associations between dietary patterns and metabolic markers examined. n = 921. Sudan.
Starchy/animal-origin pattern associated with greater waist circumference (B=2.05, 95% CI: 1.50–2.60, p<0.01) and higher systolic blood pressure (B=0.62, 95% CI: 0.03–1.21, p=0.038) Plant-based pattern associated with lower waist circumference (B=−2.70, 95% CI: −3.28 to −2.14, p<0.01), lower systolic blood pressure (B=−1.14, 95% CI: −1.75 to −0.53, p<0.01), and lower diastolic blood pressure (B=−0.68, 95% CI: −1.29 to −0.07, p=0.028) Western pattern associated with lower waist circumference (B=−0.84, 95% CI: −1.52 to −0.15, p=0.016)
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Clinicians should recognize these associations as preliminary; the cross-sectional design cannot establish causation or inform clinical management. School-based interventions may be justified based on mechanistic plausibility, but effectiveness requires prospective or randomized trial evidence in this population.
Cross-sectional observational study in a single geographic setting with surrogate endpoints (blood pressure, waist circumference) rather than clinical metabolic syndrome diagnosis or hard outcomes; findings require confirmation in prospective or intervention studies.
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Clinicians should recognize these associations as preliminary; the cross-sectional design cannot establish causation or inform clinical management. School-based interventions may be justified based on mechanistic plausibility, but effectiveness requires prospective or randomized trial evidence in this population.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background The prevalence of global metabolic syndrome (MetS) is increasing alongside childhood obesity, and diet plays an important role in metabolic health. Objective This study examined MetS, its components, and dietary pattern associations among Sudanese early adolescents aged 10–15 years ( N = 921). Methods In this cross-sectional study conducted in 2018–2019, dietary intake was assessed using a food frequency questionnaire; dietary patterns were derived by principal component analysis; and associations with MetS components and weight status were examined using the multiple linear regression analysis. Results Three patterns emerged: starchy/animal-origin (starchy foods, fish, chicken, eggs, milk/dairy, meat), Western (fast/fried foods, snacks, soda drinks, sweets), and plant-based (legumes, vegetables, fruits, fresh juices) food patterns. Starchy/animal-origin and Western patterns were positively associated with weight status, and the plant-based pattern was inversely associated with weight status (all p < 0.01). After adjusting for gender, residence, age, and parental education, the starchy/animal-origin pattern was associated with greater waist circumference (WC; B = 2.05, 95% CI: 1.50, 2.60, p < 0.01) and higher systolic blood pressure (SBP; B = 0.62, 95% CI: 0.03, 1.21, p = 0.038). The Western pattern was associated with lower WC (B = −0.84, 95% CI: −1.52, −0.15, p = 0.016), whereas the plant-based pattern was associated with lower WC (B = −2.70, 95% CI: −3.28, −2.14, p < 0.01), lower SBP (B = −1.14, 95% CI: −1.75, −0.53, p < 0.01), and lower diastolic blood pressure (B = −0.68, 95% CI: −1.29, −0.07, p = 0.028). Conclusion The starchy/animal-origin pattern showed adverse adiposity, while the plant-based pattern showed more favorable profiles among Sudanese early adolescents. School-based dietary interventions are needed to promote balanced eating and reduce MetS risk.
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