Association between dietary patterns and metabolic syndrome in a sample of portuguese adults

Nutrition Journal

Ana Cristina Santos¹  Carla Lopes¹  Rita Gaio³  Maria João Fonseca² 

[1] Department of Clinical Epidemiology, Predictive Medicine and Public Health and Cardiovascular Research & Development Unit, University of Porto Medical School, Porto, Portugal;Institute of Public Health, University of Porto, Rua das Taipas nº 135, Porto, 4050-600, Portugal;Department of Mathematics, Science Faculty, University of Porto, Portugal. Centre for Mathematics, University of Porto, Porto, Portugal (CMUP

关键词: Portugal;    Metabolic syndrome;    Finite mixture model;    a posteriori dietary patterns;   

Others  :  824042
DOI  :  10.1186/1475-2891-11-64

 received in 2012-03-21, accepted in 2012-08-01,  发布年份 2012

【 摘 要 】

Background

There is scarce evidence regarding the association between diet and metabolic syndrome (MetS) in Portuguese population. We aim to evaluate the association between a posteriori dietary patterns (DPs) and MetS and its features.

Methods

Using random digit dialing, a sample of 2167 adults was selected between 1999 and 2003, in Porto. During a face-to-face interview, a questionnaire was applied, anthropometric measures were taken, blood pressure measured and a fasting blood sample collected. Diet was assessed using a validated food frequency questionnaire, and four DPs were identified in each sex by multivariate finite mixture models.

Results

After adjustment for age and daily energy intake, comparing to the “healthy” DP, women with the “low fruit and vegetables” DP had a higher odds of high waist circumference (OR = 1.88 95% CI 1.17-3.01) and low HDL-cholesterol (OR = 1.78 95% IC 1.12-2.82) and women in the “red meat and alcohol” DP had higher odds of high waist circumference (OR = 1.45 95% CI 1.01-2.07) and of MetS (OR = 1.57 95% CI 1.07-2.29); men with the “fish” DP had a higher odds of high triglycerides (OR = 1.57 95% CI 1.05-2.35). After further adjustments (education, physical activity, smoking, alcohol drinking, BMI, and menopausal status) no significant associations remained.

Conclusions

Four distinct DPs were identified in a community sample of Portuguese adults and there was no association with the prevalence of MetS.

【 授权许可】

   
2012 Fonseca et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009, 120(16):1640-1645.
• [2]Alberti KG, Zimmet P, Shaw J: Metabolic syndrome–a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med 2006, 23(5):469-480.
• [3]Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F: Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005, 112(17):2735-2752.
• [4]Balkau B, Vernay M, Mhamdi L, Novak M, Arondel D, Vol S, Tichet J, Eschwege E: The incidence and persistence of the NCEP (National Cholesterol Education Program) metabolic syndrome. The French D.E.S.I.R. study. Diabetes Metab 2003, 29(5):526-32.
• [5]Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination Survey. JAMA 2002, 287:356-359.
• [6]Santos AC, Barros H: Impact of metabolic syndrome definitions on prevalence estimates: a study in a Portuguese community. Diab Vasc Dis Res 2007, 4(4):320-327.
• [7]Muzio F, Mondazzi L, Harris WS, Sommariva D, Branchi A: Effects of moderate variations in the macronutrient content of the diet on cardiovascular disease risk factors in obese patients with the metabolic syndrome. Am J Clin Nutr 2007, 86(4):946-951.
• [8]Newby PK, Tucker KL: Empirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev 2004, 62(5):177-203.
• [9]Babio N, Bullo M, Salas-Salvado J: Mediterranean diet and metabolic syndrome: the evidence. Public Health Nutr 2009, 12(9A):1607-1617.
• [10]Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB: The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol 2011, 57(11):1299-1313.
• [11]Willet W: Nutritional Epidemiology. 2nd edition. New York: Oxford University Press; 1998.
• [12]Klein S, Burke LE, Bray GA, Blair S, Allison DB, Pi-Sunyer X, Hong Y, Eckel RH: Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation 2004, 110(18):2952-2967.
• [13]Nordmann AJ, Nordmann A, Briel M, Keller U, Yancy WS Jr, Brehm BJ, Bucher HC: Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med 2006, 166(3):285-293.
• [14]Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER 3rd, Simons-Morton DG, Karanja N, Lin PH: Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001, 344(1):3-10.
• [15]Salas-Salvado J, Farres X, Luque X, Narejos S, Borrell M, Basora J, Anguera A, Torres F, Bullo M, Balanza R: Effect of two doses of a mixture of soluble fibres on body weight and metabolic variables in overweight or obese patients: a randomised trial. Br J Nutr 2008, 99(6):1380-1387.
• [16]Willett W, Manson J, Liu S: Glycemic index, glycemic load, and risk of type 2 diabetes. Am J Clin Nutr 2002, 76(1):274S-280S.
• [17]Yuan G, Al-Shali KZ, Hegele RA: Hypertriglyceridemia: its etiology, effects and treatment. CMAJ 2007, 176(8):1113-1120.
• [18]Ramos E, Lopes C, Barros H: Investigating the effect of nonparticipation using a population-based case–control study on myocardial infarction. Ann Epidemiol 2004, 14(6):437-441.
• [19]Folstein MF, Folstein SE, McHugh PR: Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12(3):189-198.
• [20]Camoes M, Severo M, Santos AC, Barros H, Lopes C: Testing an adaptation of the EPIC physical activity questionnaire in Portuguese adults: a validation study that assesses the seasonal bias of self-report. Ann Hum Biol 2010, 37(2):185-197.
• [21]Lopes C: Reproducibility and validity of a semi-quantitative food-frequency questionnaire. Porto: University of Porto: Diet and acute myocardial infarction: a population-based case–control study; 2000.
• [22]Lopes C, Aro A, Azevedo A, Ramos E, Barros H: Intake and adipose tissue composition of fatty acids and risk of myocardial infarction in a male Portuguese community sample. J Am Diet Assoc 2007, 107(2):276-286.
• [23]Fahey MT, Thane CW, Bramwell GD, Coward WA: Conditional Gaussian mixture modelling for dietary pattern analysis. J R Stat Soc 2007, 170(1):149-166.
• [24]Gaio AR, Costa JP, Santos AC, Ramos E, Lopes C: A univariate mixture model for dietary pattern analysis in small samples. Stat Med 2000, 00:1-6.
• [25]Oliveira A, Rodriguez-Artalejo F, Gaio R, Santos AC, Ramos E, Lopes C: Major habitual dietary patterns are associated with acute myocardial infarction and cardiovascular risk markers in a southern European population. J Am Diet Assoc 2011, 111(2):241-250.
• [26]Rita Gaio A, Costa JP, Santos AC, Ramos E, Lopes C: A restricted mixture model for dietary pattern analysis in small samples. Stat Med 2012, 31(19):2137-50.
• [27]Baxter AJ, Coyne T, McClintock C: Dietary patterns and metabolic syndrome–a review of epidemiologic evidence. Asia Pac J Clin Nutr 2006, 15(2):134-42.
• [28]Deshmukh-Taskar PR, O'Neil CE, Nicklas TA, Yang SJ, Liu Y, Gustat J, Berenson GS: Dietary patterns associated with metabolic syndrome, sociodemographic and lifestyle factors in young adults: the Bogalusa Heart Study. Public Health Nutr 2009, 12(12):2493-503.
• [29]Kim JA, Kim SM, Lee JS, Oh HJ, Han JH, Song Y, Joung H, Park HS: Dietary patterns and the metabolic syndrome in Korean adolescents: 2001 Korean National Health and Nutrition Survey. Diabetes Care 2007, 30(7):1904-5.
• [30]Hill RJ, Davies PS: The validity of self-reported energy intake as determined using the doubly labelled water technique. J Nutr 2001, 85(4):415-30.