Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
권호 표지
DOI QR코드

DOI QR Code

A healthy dietary pattern consisting of a variety of food choices is inversely associated with the development of metabolic syndrome

  • Baik, Inkyung (Department of Foods and Nutrition, College of Natural Sciences, Kookmin University) ;
  • Lee, Myoungsook (Department of Food and Nutrition, Research Institute of Obesity Sciences, Sungshin Women's University) ;
  • Jun, Nu-Ri (Department of Foods and Nutrition, College of Natural Sciences, Kookmin University) ;
  • Lee, Jae-Yeon (Department of Foods and Nutrition, College of Natural Sciences, Kookmin University) ;
  • Shin, Chol (Department of Internal Medicine, Korea University Ansan Hospital)
  • Received : 2012.10.17
  • Accepted : 2013.04.02
  • Published : 2013.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

There are limited data on healthy dietary patterns protective against metabolic syndrome (MetSyn) development. We identified dietary patterns among middle-aged and older adults and investigated the associations with the incidence of MetSyn. A population-based prospective cohort study included 5,251 male and female Koreans aged 40-69 years. At baseline, all individuals were free of MetSyn, other major metabolic diseases, and known cardiovascular disease or cancer. Cases of MetSyn were ascertained over a 6-year of follow-up. Dietary patterns and their factor scores were generated by factor analysis using the data of a food frequency questionnaire. We performed pooled logistic regression analysis to estimate multivariable-adjusted relative risk (RR) and 95% confidence interval (CI) for associations between factor scores and MetSyn risk. Two dietary patterns were identified; (1) a healthy dietary pattern, which included a variety of foods such as fish, seafood, vegetables, seaweed, protein foods, fruits, dairy products, and grains; and (2) an unhealthy dietary pattern, which included a limited number of food items. After controlling for confounding factors, factor scores for the healthy dietary pattern were inversely associated with MetSyn risk (P-value for trend < 0.05) while those for the unhealthy dietary pattern had no association. Individuals in the top quintile of the healthy diet scores showed a multivariable-adjusted RR [95% CI] of 0.76 [0.60-0.97] for MetSyn risk compared with those in the bottom quintile. The beneficial effects were derived from inverse associations with abdominal obesity, low HDL-cholesterol levels, and high fasting glucose levels. Our findings suggest that a variety of healthy food choices is recommended to prevent MetSyn.

Keywords

References

  1. Fung TT, Willett WC, Stampfer MJ, Manson JE, Hu FB. Dietary patterns and the risk of coronary heart disease in women. Arch Intern Med 2001;161:1857-62. https://doi.org/10.1001/archinte.161.15.1857
  2. van Dam RM, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Dietary patterns and risk for type 2 diabetes mellitus in U.S. men. Ann Intern Med 2002;136:201-9. https://doi.org/10.7326/0003-4819-136-3-200202050-00008
  3. Dixon LB, Balder HF, Virtanen MJ, Rashidkhani B, Männistö S, Krogh V, van Den Brandt PA, Hartman AM, Pietinen P, Tan F, Virtamo J, Wolk A, Goldbohm RA. Dietary patterns associated with colon and rectal cancer: results from the Dietary Patterns and Cancer (DIETSCAN) Project. Am J Clin Nutr 2004;80:1003-11. https://doi.org/10.1093/ajcn/80.4.1003
  4. Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB. The effect of the Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol 2011;57:1299-1313. https://doi.org/10.1016/j.jacc.2010.09.073
  5. Lutsey PL, Steffen LM, Stevens J. Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study. Circulation. 2008;117:754-761. https://doi.org/10.1161/CIRCULATIONAHA.107.716159
  6. Sonnenberg L, Pencina M, Kimokoti R, Quatromoni P, Nam BH, D'Agostino R, Meigs JB, Ordovas J, Cobain M, Millen B. Dietary patterns and the metabolic syndrome in obese and nonobese Framingham women. Obes Res 2005;13:153-162. https://doi.org/10.1038/oby.2005.20
  7. Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Dietary patterns, insulin resistance, and prevalence of the metabolic syndrome in women. Am J Clin Nutr 2007;85:910-18. https://doi.org/10.1093/ajcn/85.3.910
  8. Berg CM, Lappas G, Strandhagen E, Wolk A, Torén K, Rosengren A, Aires N, Thelle DS, Lissner L. Food patterns and cardiovascular disease risk factors: the Swedish INTERGENE research program. Am J Clin Nutr 2008;88:289-97. https://doi.org/10.1093/ajcn/88.2.289
  9. Noel SE, Newby PK, Ordovas JM, Tucker KL. A traditional rice and beans pattern is associated with metabolic syndrome in Puerto Rican older adults. J Nutr 2009;139:1360-67. https://doi.org/10.3945/jn.109.105874
  10. Song Y, Joung H. A traditional Korean dietary pattern and metabolic syndrome abnormalities. Nutr Metab Cardiovasc Dis 2012;22:456-62. https://doi.org/10.1016/j.numecd.2010.09.002
  11. Yeh CJ, Chang HY, Pan WH. Time trend of obesity, the metabolic syndrome and related dietary pattern in Taiwan: from NAHSIT 1993-1996 to NAHSIT 2005-2008. Asia Pac J Clin Nutr 2011;20:292-300.
  12. Tortosa A, Bes-Rastrollo M, Sanchez-Villegas A, Basterra- Gortari FJ, Nuñez-Cordoba JM, Martinez-Gonzalez MA. the Mediterranean diet inversely associated with the incidence of metabolic syndrome: the SUN prospective cohort. Diabetes Care 2007;30:2957-59. https://doi.org/10.2337/dc07-1231
  13. Rumawas ME, Meigs JB, Dwyer JT, McKeown NM, Jacques PF. Mediterranean-style dietary pattern, reduced risk of metabolic syndrome traits, and incidence in the Framingham Offspring Cohort. Am J Clin Nutr 2009;90:1608-14. https://doi.org/10.3945/ajcn.2009.27908
  14. Mizoue T, Yamaji T, Tabata S, Yamaguchi K, Ogawa S, Mineshita M, Kono S. Dietary patterns and glucose tolerance abnormalities in Japanese men. J Nutr 2006;136:1352-58. https://doi.org/10.1093/jn/136.5.1352
  15. He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, Greenland P. Accumulated evidence on fish consumption and coronary heart disease mortality: a meta-analysis of cohort studies. Circulation 2004;109:2705-11. https://doi.org/10.1161/01.CIR.0000132503.19410.6B
  16. Shimazu T, Kuriyama S, Hozawa A, Ohmori K, Sato Y, Nakaya N, Nishino Y, Tsubono Y, Tsuji I. Dietary patterns and cardiovascular disease mortality in Japan: a prospective cohort study. Int J Epidemiol 2007;36:600-9. https://doi.org/10.1093/ije/dym005
  17. Bazzano LA, He J, Ogden LG, Loria C, Vupputuri S, Myers L, Whelton PK. Legume consumption and risk of coronary heart disease in US men and women: NHANES I Epidemiologic Follow-up Study. Arch Intern Med 2001;161:2573-8. https://doi.org/10.1001/archinte.161.21.2573
  18. Zhang X, Shu XO, Gao YT, Yang G, Li Q, Li H, Jin F, Zheng W. Soy food consumption is associated with lower risk of coronary heart disease in Chinese women. J Nutr 2003;133:2874-8. https://doi.org/10.1093/jn/133.9.2874
  19. Baik I, Shin C. Prospective study of alcohol consumption and metabolic syndrome. Am J Clin Nutr 2008;87:1455-63. https://doi.org/10.1093/ajcn/87.5.1455
  20. Baik I, Cho NH, Kim SH, Han BG, Shin C. Genome-wide association studies identify genetic loci related to alcohol consumption in Korean men. Am J Clin Nutr 2011;93:809-16. https://doi.org/10.3945/ajcn.110.001776
  21. Ahn Y, Kwon E, Shim JE, Park MK, Joo Y, Kimm K, Park C, Kim DH. Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study. Eur J Clin Nutr 2007;61:1435-41. https://doi.org/10.1038/sj.ejcn.1602657
  22. Kim J, Jo I. Grains, vegetables, and fish dietary pattern is inversely associated with the risk of metabolic syndrome in South Korean adults. J Am Diet Assoc 2011;111:1141-9. https://doi.org/10.1016/j.jada.2011.05.001
  23. National Rural Living Science Institute. Food composition table 5th ed. Suwon, Korea: Rural Development Administration of Korea 1996.
  24. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr; International Diabetes Federation Task Force on Epidemiology and Prevention; Hational Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the Study of Obesity. 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;120:1640-5. https://doi.org/10.1161/CIRCULATIONAHA.109.192644
  25. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB, Oh SJ, Park CY, Yoo HJ. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 2007;75:72-80. https://doi.org/10.1016/j.diabres.2006.04.013
  26. Al-Attar SA, Pollex RL, Ban MR, Young TK, Bjerregaard P, Anand SS, Yusuf S, Zinman B, Harris SB, Hanley AJ, Connelly PW, Huff MW, Hegele RA. Association between the FTO rs9939609 polymorphism and the metabolic syndrome in a non-Caucasian multi-ethnic sample. Cardiovasc Diabetol 2008;13;7:5.
  27. Cho YS, Go MJ, Kim YJ, Heo JY, Oh JH, Ban HJ, Yoon D, Lee MH, Kim DJ, Park M, Cha SH, Kim JW, Han BG, Min H, Ahn Y, Park MetSyn, Han HR, Jang HY, Cho EY, Lee JE, Cho NH, Shin C, Park T, Park JW, Lee JK, Cardon L, Clarke G, McCarthy MI, Lee JY, Lee JK, Oh B, Kim HL. A large-scale genome-wide association study of Asian populations uncovers genetic factors influencing eight quantitative traits. Nat Genet 2009;41:527-34. https://doi.org/10.1038/ng.357
  28. The Korean Nutrition Society. Dietary reference intakes for Koreans 2010.
  29. Dhingra R, Sullivan L, Jacques PF, Wang TJ, Fox CS, Meigs JB, D'Agostino RB, Gaziano JM, Vasan RS. Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation 2007;116:480-8. https://doi.org/10.1161/CIRCULATIONAHA.107.689935
  30. Pereira MA, Jacobs DR Jr, Van Horn L, Slattery ML, Kartashov AI, Ludwig DS. Dairy consumption, obesity, and the insulin resistance syndrome in young adults: the CARDIA Study. JAMA 2002;287:2081-9. https://doi.org/10.1001/jama.287.16.2081
  31. Snijder MB, van der Heijden AA, van Dam RM, Stehouwer CD, Hiddink GJ, Nijpels G, Heine RJ, Bouter LM, Dekker JM. Is higher dairy consumption associated with lower body weight and fewer metabolic disturbances? The Hoorn Study. Am J Clin Nutr 2007;85:989-95. https://doi.org/10.1093/ajcn/85.4.989
  32. Baik I, Abbott RD, Curb JD, Shin C. Intake of fish and n-3 fatty acids and future risk of metabolic syndrome. J Am Diet Assoc 2011;110:1018-26.
  33. Zemel MB, Richards J, Mathis S, Milstead A, Gebhardt L, Silva E: Dairy augmentation of total and central fat loss in obese subjects. Int J Obes (Lond) 2005;29:391-7. https://doi.org/10.1038/sj.ijo.0802880
  34. Wien MA, Sabaté JM, Iklé DN, Cole SE, Kandeel FR. Almonds vs complex carbohydrates in a weight reduction program. Int J Obes Relat Metab Disord 2003;27:1365-72. https://doi.org/10.1038/sj.ijo.0802411

Cited by

  1. Dairy products consumption and metabolic syndrome in adults: systematic review and meta-analysis of observational studies vol.5, pp.1, 2015, https://doi.org/10.1038/srep14606
  2. Dietary patterns and cognitive function in Korean older adults vol.54, pp.2, 2015, https://doi.org/10.1007/s00394-014-0713-0
  3. Usability of a smartphone food picture app for assisting 24-hour dietary recall: a pilot study vol.9, pp.2, 2015, https://doi.org/10.4162/nrp.2015.9.2.207
  4. Longitudinal associations between micronutrient consumption and leukocyte telomere length vol.30, pp.2, 2016, https://doi.org/10.1111/jhn.12403
  5. Meat and milk intake in the rice-based Korean diet: impact on cancer and metabolic syndrome vol.75, pp.03, 2016, https://doi.org/10.1017/S0029665116000112
  6. The Effect of the Sodium to Potassium Ratio on Hypertension Prevalence: A Propensity Score Matching Approach vol.8, pp.8, 2016, https://doi.org/10.3390/nu8080482
  7. Flavonoid intake is inversely associated with obesity and C-reactive protein, a marker for inflammation, in US adults vol.7, pp.5, 2017, https://doi.org/10.1038/nutd.2017.22
  8. Fruit and vegetable consumption and risk of the metabolic syndrome: a meta-analysis pp.1475-2727, 2017, https://doi.org/10.1017/S136898001700310X
  9. Nut consumption in relation to all-cause and cause-specific mortality: a meta-analysis 18 prospective studies pp.2042-650X, 2017, https://doi.org/10.1039/C7FO00915A
  10. Relative Risk of Dietary Patterns and Other Obesity Factors in Korean Males above 40 Years of Age vol.42, pp.11, 2013, https://doi.org/10.3746/jkfn.2013.42.11.1753
  11. Greater Healthful Food Variety as Measured by the US Healthy Food Diversity Index Is Associated with Lower Odds of Metabolic Syndrome and its Components in US Adults vol.145, pp.3, 2014, https://doi.org/10.3945/jn.114.199125
  12. Meat Consumption and Risk of Metabolic Syndrome: Results from the Korean Population and a Meta-Analysis of Observational Studies vol.10, pp.4, 2018, https://doi.org/10.3390/nu10040390
  13. Dairy product consumption and its association with metabolic disturbance in a prospective study of urban adults vol.119, pp.6, 2018, https://doi.org/10.1017/S0007114518000028
  14. Sugar-Sweetened Beverage Consumption in Relation to Obesity and Metabolic Syndrome among Korean Adults: A Cross-Sectional Study from the 2012–2016 Korean National Health and Nutrition Examination Survey (KNHANES) vol.10, pp.10, 2018, https://doi.org/10.3390/nu10101467
  15. Using an introduced index to assess the association between food diversity and metabolic syndrome and its components in Chinese adults vol.18, pp.1, 2018, https://doi.org/10.1186/s12872-018-0926-x
  16. Moderate coffee consumption is inversely associated with the metabolic syndrome in the Korean adult population pp.1475-2662, 2018, https://doi.org/10.1017/S0007114518002635
  17. Dietary patterns and their association with the components of metabolic syndrome: A cross-sectional study of adults from northeast Thailand vol.7, pp.2046-1402, 2018, https://doi.org/10.12688/f1000research.15075.1
  18. Effects of processed red meat consumption on the risk of type 2 diabetes and cardiovascular diseases among Korean adults: the Korean Genome and Epidemiology Study pp.1436-6215, 2018, https://doi.org/10.1007/s00394-018-1799-6
  19. Dietary patterns and the risk of metabolic syndrome in Chinese adults: a population-based cross-sectional study vol.21, pp.13, 2018, https://doi.org/10.1017/S1368980018001088
  20. The Association Between Metabolic Syndrome, Obesity-Related Outcomes, and ADHD in Adults With Comorbid Affective Disorders vol.22, pp.5, 2018, https://doi.org/10.1177/1087054716659137
  21. Associations of vegetable and fruit consumption with metabolic syndrome. A meta-analysis of observational studies vol.21, pp.09, 2018, https://doi.org/10.1017/S1368980018000381
  22. Fish consumption and its possible preventive role on the development and prevalence of metabolic syndrome - a systematic review vol.6, pp.1, 2014, https://doi.org/10.1186/1758-5996-6-112
  23. Relationship Between Nut Consumption and Metabolic Syndrome: A Meta-Analysis of Observational Studies pp.1541-1087, 2019, https://doi.org/10.1080/07315724.2018.1561341
  24. 초등학교 2학년 일부 아동의 단맛 선호와 동기 요인과의 관련성 vol.27, pp.3, 2013, https://doi.org/10.9799/ksfan.2014.27.3.383
  25. Framingham Risk Score에 의한 한국 성인 남성의 영양소 및 식품 섭취의 다양성 평가 vol.27, pp.3, 2014, https://doi.org/10.9799/ksfan.2014.27.3.484
  26. Association between dietary patterns and metabolic syndrome in individuals with normal weight: a cross-sectional study vol.14, pp.1, 2013, https://doi.org/10.1186/s12937-015-0045-9
  27. The risk of metabolic syndrome and nutrition vol.12, pp.1, 2013, https://doi.org/10.14341/omet201513-10
  28. 일부 중학생의 단 식품류 섭취에 영향을 미치는 요인 분석 vol.28, pp.4, 2013, https://doi.org/10.9799/ksfan.2015.28.4.658
  29. Association between dietary patterns in the remote past and telomere length vol.69, pp.9, 2015, https://doi.org/10.1038/ejcn.2015.58
  30. Association between dietary patterns and metabolic syndrome in Chinese adults: a propensity score-matched case-control study vol.6, pp.None, 2013, https://doi.org/10.1038/srep34748
  31. Systematic Review of the Association between Dairy Product Consumption and Risk of Cardiovascular-Related Clinical Outcomes vol.7, pp.6, 2016, https://doi.org/10.3945/an.115.011403
  32. Comparison of sweetness preference and motivational factors between Korean and Japanese children vol.50, pp.1, 2013, https://doi.org/10.4163/jnh.2017.50.1.53
  33. Burdens of Cardiometabolic Diseases Attributable to Dietary and Metabolic Risks in Korean Adults 2012–2013 vol.58, pp.3, 2013, https://doi.org/10.3349/ymj.2017.58.3.540
  34. Gender difference of metabolic syndrome and its association with dietary diversity at different ages vol.8, pp.43, 2013, https://doi.org/10.18632/oncotarget.20625
  35. Dietary patterns and their association with the components of metabolic syndrome: A cross-sectional study of adults from northeast Thailand vol.7, pp.None, 2013, https://doi.org/10.12688/f1000research.15075.2
  36. Sex differences in factors associated with metabolic syndrome among Korean adults without diabetes mellitus: results from the Korea National Health and Nutrition Examination Survey from 2010 to 2013 vol.36, pp.2, 2013, https://doi.org/10.1093/fampra/cmy053
  37. Dairy Product Consumption in the Prevention of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Prospective Cohort Studies vol.10, pp.2, 2013, https://doi.org/10.1093/advances/nmy083
  38. Associations between the dietary patterns of pregnant Malaysian women and ethnicity, education, and early pregnancy waist circumference: A prospective cohort study vol.13, pp.3, 2019, https://doi.org/10.4162/nrp.2019.13.3.230
  39. Dietary Patterns and Metabolic Syndrome in Adult Subjects: A Systematic Review and Meta-Analysis vol.11, pp.9, 2013, https://doi.org/10.3390/nu11092056
  40. Fruit and vegetable consumption and the metabolic syndrome: a systematic review and dose-response meta-analysis vol.122, pp.7, 2013, https://doi.org/10.1017/s000711451900165x
  41. Does Nut Consumption Reduce Mortality and/or Risk of Cardiometabolic Disease? An Updated Review Based on Meta-Analyses vol.16, pp.24, 2019, https://doi.org/10.3390/ijerph16244957
  42. Inaccurate data in meta-analysis; ‘A posteriori dietary patterns and metabolic syndrome in adults: a systematic review and meta-analysis of observational studies’ vol.23, pp.6, 2013, https://doi.org/10.1017/s1368980019002908
  43. Association between Soy Food and Dietary Soy Isoflavone Intake and the Risk of Cardiovascular Disease in Women: A Prospective Cohort Study in Korea vol.13, pp.5, 2013, https://doi.org/10.3390/nu13051407
  44. TCF7L2 polymorphisms, nut consumption, and the risk of metabolic syndrome: a prospective population based study vol.18, pp.1, 2021, https://doi.org/10.1186/s12986-021-00542-7