Dietary Patterns and Metabolic Syndrome Among Adults with Overweight and Obesity (FS18-03-19).

Objectives: Metabolic syndrome (MetS) is a cluster of risk factors that are highly correlated with obesity, cardiovascular disease, and type 2 diabetes. Studies suggest that a Western diet high in fat, red meat, and added sugar is predictive of MetS, but connections between dietary patterns high in fruits, vegetables and seafoods, such as the Mediterranean diet, with this condition remain under-investigated. We aimed to assess the relation of Western and Mediterranean diet patterns with MetS among overweight or obese adults.

Methods: Adults (= 151, 25-45y) with body mass index ≥25.0 kg/m were included in this study. MetS was evaluated using International Diabetes Federation guidelines. Waist circumference was measured with inelastic tape. Lipid and glucose concentrations were assessed with a chemical analyzer. Blood pressure was evaluated with an automatic blood pressure monitor. Habitual diet was evaluated with the National Cancer Institute's Diet History Questionnaire II (DHQII, Past Year with Portion Size). Diet variables were selected from the Food Patterns Equivalents Database. Statistical analyses included Mann-Whitney U tests and principal component analysis (PCA).

Results: MetS was present among 30% of the sample. Meat ( = 0.03) and added sugar ( = 0.04) intakes were greater among those with MetS, while seafood ( = 0.03) and alcohol ( = 0.02) were lower. Four components comprising 64% of dietary pattern variation included: 1) High in starchy vegetables, meat, and cheese; 2) High in non-starchy vegetables, seafood, and alcohol; 3) High in milk and added sugar but low in vegetables; and 4) High in alcohol and sodium, but low in protein and vegetables. PCA biplot grouped by prevalence of MetS indicated that seafood and non-starchy vegetables were inversely related to MetS, whereas meat, starchy vegetables, cheese, milk, added sugar, and sodium were positively correlated with MetS.

Conclusions: A Western diet pattern high in meat, starchy vegetables, dairy, sodium, and added sugar was related to MetS, while a Mediterranean diet pattern characterized by seafood, non-starchy vegetables, and moderate alcohol was protective against MetS. These findings highlight the links between dietary habits and MetS among adults with overweight or obesity.

Funding Sources: The Hass Avocado Board and the USDA National Institute of Food and Agriculture, Hatch project 1009249.