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Food consumption, nutrient intake and the risk of having metabolic syndrome: the DR's EXTRA Study

Abstract

Background:

The associations of different components of diet with metabolic syndrome (MetS) are largely unknown. We therefore studied the associations of intakes of selected food items and nutrients with the risk of having MetS.

Methods:

The participants were a representative population sample of 1334 individuals (671 women, 663 men) 57–78 years of age. Dietary intake was assessed by a 4-day food record. MetS was defined by the National Cholesterol Education Program criteria.

Results:

Consumption of vegetables, non-root vegetables, legumes and nuts berries and fish had an inverse and consumption of sausage had a direct association with the risk of having MetS in men after adjustment for age, smoking and alcohol consumption. Consumption of vegetables and non-root vegetables had an inverse and consumption of sausage had a direct association with the risk of having MetS in women after these adjustments. However, after further adjustment for maximal oxygen uptake (VO2max) most of these associations vanished. Men in the highest third of consumption of berries, fish, and legumes and nuts had 49, 37 and 44% lower risk of having MetS, respectively, than those in the lowest third after further adjustment for VO2max. Women in the highest third of sausage consumption had a 72% higher risk of having MetS than non-consumers.

Conclusions:

Consumption of legumes and nuts, berries and fish was inversely associated with MetS in men. Consumption of sausage was directly associated with MetS in women. VO2max seems to be a strong confounding factor between food consumption and MetS.

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References

  • American Diabetes Association, Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG et al. (2008). Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care 31 (Suppl 1), S61–S78.

    Article  Google Scholar 

  • Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F (2005). Beneficial effects of a dietary approaches to stop hypertension eating plan on features of the metabolic syndrome. Diabetes Care 28, 2823–2831.

    Article  CAS  Google Scholar 

  • Bo S, Pisu E (2008). Role of dietary magnesium in cardiovascular disease prevention, insulin sensitivity and diabetes. Curr Opin Lipidol 19, 50–56.

    Article  CAS  Google Scholar 

  • Carpentier YA, Portois L, Malaisse WJ (2006). N-3 Fatty acids and the metabolic syndrome. Am J Clin Nutr 83, 1499S–1504S.

    Article  CAS  Google Scholar 

  • Eilat-Adar S, Xu J, Goldbourt U, Zephier E, Howard BV, Resnick HE (2008). Sex may modify the effects of macronutrient intake on metabolic syndrome and insulin resistance in American Indians: the strong heart study. J Am Diet Assoc 108, 794–802.

    Article  Google Scholar 

  • Erber E, Hopping BN, Grandinetti A, Park SY, Kolonel LN, Maskarinec G (2010). Dietary patterns and risk of diabetes: the multiethnic cohort. Diabetes Care 33, 532–538.

    Article  Google Scholar 

  • Erlund I, Koli R, Alfthan G, Marniemi J, Puukka P, Mustonen P et al. (2008). Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol. Am J Clin Nutr 87, 323–331.

    Article  CAS  Google Scholar 

  • Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC (2006). Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am J Clin Nutr 84, 1489–1497.

    Article  CAS  Google Scholar 

  • Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G et al. (2004). Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292, 1440–1446.

    Article  CAS  Google Scholar 

  • Expert Panel on Detection, Evaluation, Treatment of High Blood Cholesterol in Adults (2001). Executive summary of the third report of The National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285, 2486–2497.

    Article  Google Scholar 

  • Folstein MF, Folstein SE, McHugh PR (1975). ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12, 189–198.

    Article  CAS  Google Scholar 

  • Ford ES, Mokdad AH, Giles WH, Brown DW (2003). The metabolic syndrome and antioxidant concentrations: findings from the Third National Health and Nutrition Examination Survey. Diabetes 52, 2346–2352.

    Article  CAS  Google Scholar 

  • Freire RD, Cardoso MA, Gimeno SG, Ferreira SR (2005). Dietary fat is associated with metabolic syndrome in Japanese Brazilians. Diabetes Care 28, 1779–1785.

    Article  CAS  Google Scholar 

  • Galisteo M, Duarte J, Zarzuelo A (2008). Effects of dietary fibers on disturbances clustered in the metabolic syndrome. J Nutr Biochem 19, 71–84.

    Article  CAS  Google Scholar 

  • Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA et al. (1991). Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr 45, 569–581.

    CAS  PubMed  Google Scholar 

  • Hakola L, Komulainen P, Hassinen M, Savonen K, Litmanen H, Lakka TA et al. (2010). Cardiorespiratory fitness in aging men and women: the DR's EXTRA study. Scand J Med Sci Sports, doi:10.1111/j.1600-0838.2010.01127.x.

  • Hassinen M, Lakka TA, Savonen K, Litmanen H, Kiviaho L, Laaksonen DE et al. (2008). Cardiorespiratory fitness as a feature of metabolic syndrome in older men and women: the Dose-Responses to Exercise Training study (DR′s EXTRA). Diabetes Care 31, 1242–1247.

    Article  CAS  Google Scholar 

  • Hu FB, Bronner L, Willett WC, Stampfer MJ, Rexrode KM, Albert CM et al. (2002). Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA 287, 1815–1821.

    Article  CAS  Google Scholar 

  • Hu G, Lindstrom J, Jousilahti P, Peltonen M, Sjoberg L, Kaaja R et al. (2008). The increasing prevalence of metabolic syndrome among Finnish men and women over a decade. J Clin Endocrinol Metab 93, 832–836.

    Article  CAS  Google Scholar 

  • Ilanne-Parikka P, Eriksson JG, Lindstrom J, Peltonen M, Aunola S, Hamalainen H et al. (2008). Effect of lifestyle intervention on the occurrence of metabolic syndrome and its components in the Finnish Diabetes Prevention Study. Diabetes Care 31, 805–807.

    Article  Google Scholar 

  • Jackson AS, Blair SN, Mahar MT, Wier LT, Ross RM, Stuteville JE (1990). Prediction of functional aerobic capacity without exercise testing. Med Sci Sports Exerc 22, 863–870.

    Article  CAS  Google Scholar 

  • Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346, 393–403.

    Article  CAS  Google Scholar 

  • Laaksonen DE, Niskanen L, Lakka HM, Lakka TA, Uusitupa M (2004). Epidemiology and treatment of the metabolic syndrome. Ann Med 36, 332–346.

    Article  CAS  Google Scholar 

  • Lafay L, Mennen L, Basdevant A, Charles MA, Borys JM, Eschwege E et al. (2000). Does energy intake underreporting involve all kinds of food or only specific food items? Results from the Fleurbaix Laventie Ville Sante (FLVS) study. Int J Obes Relat Metab Disord 24, 1500–1506.

    Article  CAS  Google Scholar 

  • LaMonte MJ, Blair SN (2006). Physical activity, cardiorespiratory fitness, and adiposity: contributions to disease risk. Curr Opin Clin Nutr Metab Care 9, 540–546.

    Article  Google Scholar 

  • Lutsey PL, Steffen LM, Stevens J (2008). Dietary intake and the development of the metabolic syndrome: the atherosclerosis risk in communities study. Circulation 117, 754–761.

    Article  Google Scholar 

  • Martini LA, Wood RJ (2006). Vitamin D status and the metabolic syndrome. Nutr Rev 64, 479–486.

    Article  Google Scholar 

  • McKeown NM, Meigs JB, Liu S, Saltzman E, Wilson PW, Jacques PF (2004). Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care 27, 538–546.

    Article  Google Scholar 

  • Orchard TJ, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S et al. (2005). The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med 142, 611–619.

    Article  CAS  Google Scholar 

  • Pietinen P, Hartman AM, Haapa E, Rasanen L, Haapakoski J, Palmgren J et al. (1988). Reproducibility and validity of dietary assessment instruments. I. A self-administered food use questionnaire with a portion size picture booklet. Am J Epidemiol 128, 655–666.

    Article  CAS  Google Scholar 

  • Radloff LS (1977). The CES-D Scale: a Self-Report Depression Scale for Research in the General Population. Appl Psychol Meas 1, 385–401.

    Article  Google Scholar 

  • Rastas M, Seppanen R, Knuts L-R, Hakala P, Karttila V (1997). Nutrient Composition of Foods. Publications of the Social Insurance Institution: Helsinki, Finland.

    Google Scholar 

  • Ruidavets JB, Bongard V, Dallongeville J, Arveiler D, Ducimetière P, Perret B et al. (2007). High consumptions of grain, fish, dairy products and combinations of these are associated with a low prevalence of metabolic syndrome. J Epidemiol Community Health 61, 810–817.

    Article  Google Scholar 

  • Schofield WN (1985). Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 39 (Suppl 1), 5–41.

    PubMed  Google Scholar 

  • Srinath Reddy K, Katan MB (2004). Diet, nutrition and the prevention of hypertension and cardiovascular diseases. Public Health Nutr 7, 167–186.

    CAS  PubMed  Google Scholar 

  • Sundstrom J, Lind L, Vessby B, Andren B, Aro A, Lithell H (2001). Dyslipidemia and an unfavorable fatty acid profile predict left ventricular hypertrophy 20 years later. Circulation 103, 836–841.

    Article  CAS  Google Scholar 

  • Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P et al. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344, 1343–1350.

    Article  CAS  Google Scholar 

  • Vessby B, Unsitupa M, Hermansen K, Riccardi G, Rivellese AA, Tapsell LC et al. (2001). Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study. Diabetologia 44, 312–319.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The study was supported by grants from the Ministry of Education, Finland (116/722/2004, 134/627/2005, 44/627/2006), the City of Kuopio, Kuopio University Hospital, Päivikki and Sakari Sohlberg Foundation, Juho Vainio Foundation, the Academy of Finland (104943, 211119), the Finnish Diabetes Association, the Finnish Heart Association, The Social Insurance Institution of Finland and European Commission FP6 Integrated Project (EXGENESIS) LSHM-CT-2004–005272.

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Correspondence to R Rauramaa.

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Kouki, R., Schwab, U., Hassinen, M. et al. Food consumption, nutrient intake and the risk of having metabolic syndrome: the DR's EXTRA Study. Eur J Clin Nutr 65, 368–377 (2011). https://doi.org/10.1038/ejcn.2010.262

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