Osteopathic physicians have characteristically promoted healthy dietary practices as a fundamental component of patient self-management. Increasingly, long-term follow-up studies of various diets have demonstrated the wisdom of this approach. Metabolic syndrome, affecting 47 million US adults, is defined by the presence of three or more of the following cardiovascular disease risk factors: abdominal obesity, high blood pressure, glucose intolerance, and elevated high-density lipoprotein cholesterol or triglycerides. It is also associated with increased risk of type 2 diabetes mellitus, cardiovascular disease, and mortality.
The Atherosclerosis Risk in Communities study gathered survey data from 9514 adults during a 9-year period to determine the role of diet in the origin of metabolic syndrome. Unique to this study, researchers evaluated the effect of the whole diet pattern on subjects prospectively, rather than singling out specific foods or only one gender in a cross-sectional design as in other longitudinal studies.
Researchers used a 66-item food frequency questionnaire and principal-components analysis to derive “Western” versus “prudent” dietary patterns. The Western diet consisted primarily of refined grains, processed meat, fried food, eggs, red meat, and diet soda. The prudent diet was predominantly fish, poultry, whole grains, fruits, cruciferous and carotinoid vegetables, and low-fat dairy products.
Within 9 years, metabolic syndrome occurred in 3782 participants (40%). After adjusting for various demographic and behavioral characteristics, a Western dietary pattern was found to be adversely associated (18% increased risk) with the occurrence of metabolic syndrome. Individually, meat, fried food, and diet soda were strongly associated with the occurrence of metabolic syndrome, whereas dairy consumption was protective. No associations were found between the occurrence of metabolic syndrome and a prudent dietary pattern or, individually, whole grains, refined grains, fruits, vegetables, nuts, coffee, or sweetened beverages. —M.A.S.
Lutsey PL et al. Circulation.. (2008). ;117:754-761.