The association between dietary habits and metabolic syndrome: findings from the Shahedieh-cohort study - BMC Nutrition - BioMed Central

Objective

Metabolic syndrome (MetS) is simply a analyzable upset with an expanding prevalence globally. Limited information are disposable astir the relation betwixt dietary habits and the prevalence of MetS. The contiguous cross-sectional survey aimed to analyse the relation betwixt dietary habits and MetS successful a ample colonisation illustration from Iranians.

Methods

The survey was conducted connected 9261 adults aged 35–70 years who attended the baseline signifier of Shahedieh cohort study, Yazd, Iran. Dietary habits including repast frequency, fried nutrient consumption, adding brackish to prepared meal, barbecued nutrient consumption, utilized lipid benignant and reuse lipid fig were assessed by a modular questionnaire. MetS was defined utilizing the National Cholesterol Education Program Adult Treatment Panel III criteria. Logistic regression was utilized successful antithetic adjusted models to analyse the narration betwixt dietary habits and MetS: (Model I: adjusted for age, enactment and energy. Model II: Model I + adjusted for wealthiness people scale and carnal activity. Model III: Model II + adjusted for cardiovascular diseases and liver diseases).

Results

The subjects who ate barbecued-food much than 3 times/ period had 1.18 times greater likelihood for MetS than idiosyncratic who ate this little than once/ period (OR: 1.18, 95% CI: 1.01–1.38). After further accommodation for different confounding variables, the relation remained significant. No important relation was recovered betwixt different dietary habits and likelihood of MetS.

Conclusion

Higher intakes of barbecued-food depletion were related to the prevalence of MetS. Larger longitudinal studies successful different colonisation groups are needed to corroborate these associations.

Metabolic syndrome (MetS) is simply a clustering of metabolic and anthropometric abnormalities, including abdominal obesity, hypertension, accrued humor glucose, elevated triglyceride (TG) and decreased high-density lipoprotein cholesterin (HDL-c) that is associated with an accrued hazard of coronary bosom disease, stroke, benignant 2 diabetes and intelligence disorders [1, 2]. The planetary prevalence of MetS is expanding dramatically, and its prevalence among adults was astir 25% successful 2017 [3]. The prevalence of MetS among Iranians is precocious and is estimated to beryllium astir 30.4% [4]. MetS is simply a large wellness attraction occupation and reduces the prime of life, therefore, uncovering effectual strategies to forestall and negociate this illness is indispensable [5, 6].

The pathophysiology of MetS is complex, and familial arsenic good arsenic biology factors are progressive [7]. Diet is 1 of the astir important modifiable biology factors [8]. Some studies [9, 10] but not each [11, 12] bespeak that mediocre eating habits tin pb to the improvement and progression of MetS. A caller survey indicated that subjects with MetS had a higher depletion of fatty and sweeter nutrient and undesirable eating habits specified arsenic faster eating and predominant overeating than steadfast radical [9]. Adding brackish to the food, not regularly eating salads, precocious nutrient consumption, a precocious intake of fried foods and adherence to the occidental diets are associated with hazard of MetS [10, 12]. However, constricted information are disposable astir immoderate different dietary habits including repast frequence oregon barbecued nutrient depletion and MetS. Therefore, the purpose of this survey was evaluating the narration betwixt immoderate dietary habits and prevalence of MetS among a ample illustration of adults who unrecorded successful cardinal portion of Iran.

Study colonisation and information collection

The contiguous survey is simply a cross-sectional investigation of subjects successful the recruitment signifier of the Shahedieh cohort survey (this survey was begun successful 2015 and volition beryllium completed successful 2025), and is simply a portion of the PERSIAN multi-center cohort survey performed connected a typical illustration of the Iranian big colonisation of 35–70 years aged from 2015 to 2016 [13]. The details of the survey protocol of the PERSIAN cohort was published antecedently [14]. In enrollment of this cohort study, 10,000 radical 35–70 years residing successful 3 areas of Yazd, Iran were recruited by multistage clump random. Inclusion criteria included men and women aged 35–70 years that were progressive and energetic capable to enactment successful the study, being of Iranian descent and surviving successful the designated areas for astatine slightest 9 months of the year. The individuals with carnal oregon intelligence disabilities who were incapable to implicit the enrollment process were excluded from the cohort study. History of diseases was assessed by a physician. In this cross-sectional study, the individuals with a past of crab oregon autoimmune diseases were excluded (n = 739), and yet 9261 individuals were included successful analyses. The written informed consent was obtained from each the participants and the morals committee of Shahid Sadoughi University of Medical Sciences approved the survey (approval code: IR.SSU.SPH.REC.1397.161). All methods were carried retired successful accordance with applicable guidelines and regulations.

Demographic assessments

Data connected property and enactment were obtained done by look to look interview. The participants reported their carnal enactment level successful the past year, and the information obtained from questionnaire was converted into the metabolic equivalent of task hours per week (MET-h/wk) [15]. Wealth people scale (WSI) is estimated by aggregate correspondence investigation of variables (own car, car type, the fig of books the subordinate has work successful the past year, the full fig of planetary trips the subordinate has taken during lifetime, the fig of planetary pilgrimage trips the subordinate has taken, the fig of planetary non-pilgrimage trips the subordinate has taken and the fig of trips the subordinate has made wrong Iran successful the past 10 years).

Anthropometric and humor unit measurements

Weight was measured utilizing a integer standard (SECA, exemplary 755, Germany) with minimum covering and without shoes with an accuracy of 0.1 kg. Height was measured accurately without shoes by a portion measurement attached to the partition without immoderate bumps with a precision of 0.5 cm. Body Mass Index (BMI) (kg/m²) was calculated arsenic the value (kg) divided by tallness squared (m²). Mid-distance betwixt the iliac crest and lowest rib was considered to measurement waist circumference (WC). Blood unit (BP) was measured doubly by an experienced caregiver utilizing a integer automatic humor unit show (Model M6 Comfort; Omron), with a 5-minute interval betwixt readings.

Dietary intakes assessments

Dietary intakes were assessed utilizing a 121-item semi-quantitative nutrient frequence questionnaire (FFQ), and the participants were asked astir their dietary intakes implicit the past year. The survey participants were interviewed by trained nutritionists. Two types of questions were asked from the participants astir each nutrient item: 1) the frequence of nutrient depletion (number of times per month, week, oregon time the nutrient was consumed) successful the erstwhile year, and 2) the magnitude of the nutrient that was usually consumed each clip (portion size based connected the modular serving sizes commonly consumed by Iranians). All reported intakes were converted to g/day utilizing household measures of consumed foods. Finally, the Nutritionist IV bundle was utilized to cipher nutrients intakes [16].

Dietary habits evaluation

Information connected dietary habits was obtained astatine the aforesaid clip arsenic humor samples were collected. Dietary habits including repast frequence (< 3 meals/day, 3 meals/day, 4–6 meals/day and >  6 meals/day), fried nutrient depletion (< 1 time/month, 1–3 times/month, 1–3 times/week and daily), adding brackish to prepared nutrient (no, sometimes, yes), barbecued nutrient depletion (< 1 time/month, 1–3 times/month and >  3 time/month), utilized lipid benignant (solid oil, semi coagulated lipid oregon margarine, liquid oil, frying oil), (none, once, much than twice) were assessed done a modular questionnaire during the past year.

Biochemical assessment

After 10–12 hours of fasting, 25 ml of the patient’s humor illustration was collected. Blood samples were centrifuged to abstracted serum. Serum fasting humor glucose (FBG), triglyceride (TG), and high-density lipoprotein cholesterin (HDL-c) were measured utilizing an auto-analyzer (Analyzer BT1500) utilizing Pars Azmun modular kits.

Metabolic syndrome definition

MetS was defined based connected National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. According to the NCEP ATP III definition, metabolic syndrome is contiguous if 3 oregon much of the pursuing 5 criteria are met: waist circumference implicit 40 in. (men) oregon 35 in. (women), humor unit adjacent to oregon greater than 130/85 mmHg, TG level adjacent to oregon greater than 150 mg/dl, HDL-c level little than 40 mg/dl (men) oregon 50 mg/dl (women) and FBG adjacent to oregon greater than 100 mg/dl [17].

Statistical analysis

The quantitative (age, carnal activity, BMI, WC, FBG, and dietary intakes) and qualitative information (gender, cardiovascular oregon liver diseases presence) were compared crossed categories for dietary habits utilizing one-way ANOVA and chi-square tests, respectively. Tukey trial was applied arsenic a station hoc analysis. To find the relation betwixt dietary habits and metabolic syndrome, we utilized logistic regression successful antithetic models. In exemplary I, we adjusted lone property and full vigor intake; successful exemplary II, BMI, gender, smoking, and carnal enactment were additionally adjusted. Final adjustments were performed for the past of cardiovascular diseases and liver diseases. Data were analyzed utilizing the Statistical Package for Social Sciences (SPSS, mentation 15.0). P values little than 0.05 were considered statistically significant.

The wide characteristics of survey participants crossed categories of dietary habits are reported successful Table 1. The findings of Tukey’s investigation amusement that depletion of barbecued nutrient and fried foods and also, adding brackish to prepared meals was much communal among young people. Furthermore, the WSI was importantly antithetic among the categories of fried nutrient consumption, barbecued nutrient consumption, and utilized lipid type. For example, radical who utilized much barbecued foods and besides utilized frying lipid successful nutrient mentation had a higher WSI.

The organisation of MetS and its components are presented successful Table 2. The results of Tukey’s investigation showed that TG levels were higher successful radical who consumed barbecue nutrient much than 3 times a period compared to those who consumed it little than 1 a month, portion HDL-C levels were importantly lower. In addition, important differences were seen for SBP and WC among categories of adding brackish to a prepared meal. Surprisingly, individuals who added brackish to prepared nutrient had importantly little waist circumference and systolic humor pressure.

Dietary macronutrient and micronutrient intakes of survey participants according to categories of dietary habits are shown successful Tables 3 and 4, respectively. After Tukey Analysis, the idiosyncratic successful the past categories of repast frequency, fried nutrient consumption, and adding brackish to a prepared repast had importantly higher vigor intake. There were important differences successful protein, fiber, vitamin A, folate, potassium, and sodium crossed categories of repast frequency. The individuals with regular depletion of fried nutrient received little amounts of protein, carbohydrate, and fiber. The intake of fat, folate, and potassium was higher successful radical who ate barbecued nutrient much than 3 times/month than successful different people, portion the intake of carbohydrates and sodium was little successful them.

Multivariate-adjusted likelihood ratios of the associations betwixt dietary habits and metabolic syndrome are presented successful Table 5. Participants who ate barbecued nutrient much than 3 times a period had a greater likelihood of MetS than those who ate barbecued nutrient little than erstwhile a period (OR: 1.185, 95% CI: 1.015–1.383, P = 0.051). These associations remained important aft accommodation for for age, sex, energy, WSI and carnal enactment (OR: 1.200, 95% CI: 1.025–1.405, P = 0.028). Further accommodation for cardiovascular and liver diseases did not alteration the association. (OR: 1.190, 95% CI: 1.014–1.396, P = 0.034). No important associations were observed betwixt likelihood of MetS with different dietary habits specified arsenic repast frequence (OR: 1.296, 95% CI: 0.886–1.895, P = 0.85), fried nutrient depletion (OR: 0.902, 95% CI: 0.708–1.150, P = 0.771), adding brackish to prepared nutrient (OR: 1.011, 95% CI: 0.865–1.180, P = 0.781), utilized lipid benignant (OR: 1.096, 95% CI: 0.932–1.288, P = 0.268), and reuse lipid fig (OR: 1.051, 95% CI: 0.761–1.451, P = 0.764) successful exemplary I, II and III.

In the contiguous cross-sectional survey we recovered that the greater depletion of barbecued-food was positively associated with greater likelihood of MetS among Iranian adults. However, determination was nary important relation betwixt repast frequency, fried nutrient consumption, utilized lipid type, reuse of lipid number, and adding brackish to prepared nutrient with MetS.

Our findings showed that the depletion of barbecued-food accrued the likelihood of MetS. The studies investigating the relation betwixt barbecued-food depletion with MetS and each of its components are scarce. In a survey that conducted by Liu et al. [18], higher depletion of barbecued-red nutrient accrued the hazard of benignant 2 diabetes by 1.23 times. It has been recovered that chemicals produced by cooking nutrient astatine precocious temperatures (grilling/barbecuing) tin induce inflammation, oxidative stress, and insulin resistance, and consequently pb to harm of the interior vascular partition and improvement of atherosclerosis. All of these processes summation the hazard of processing precocious humor unit and the likelihood of MetS [19]. In contrast, Heller et al. [20] examined the effect of regular depletion of 8 oz. of barbecued-hamburgers and 6 oz. of barbecued-steak connected lipid illustration of adults. The results of this survey showed that regular depletion of barbecued-meat for 15 days accrued HDL-c and decreased full cholesterin and debased density lipoprotein-cholesterol (LDL-c). However, the abbreviated duration of the study, nonaccomplishment to set imaginable confounders, and the tiny fig of participants were large limitations that tin not beryllium relied connected the results of this study. Some hazardous chemicals specified arsenic heterocyclic aromatic amines (HAAs) and polycyclic aromatic hydrocarbons (PAHs) are produced successful foods prepared astatine precocious temperatures (barbecuing/grilling) [21,22,23]. These chemicals tin induce pro-inflammatory cytokines, alteration insulin secretion, and consequently summation the hazard of diabetes and metabolic syndrome [24, 25]. In addition, cooking nutrient astatine precocious temperatures produces precocious glycation extremity products (AGEs) that are associated with oxidative stress, inflammation, and insulin absorption successful animals and humans, which successful crook supply the ground for metabolic disorders [26, 27]. More investigations are needed to clarify the mechanistic pathways linking high-temperature cooking with metabolic syndrome.

We recovered nary relation betwixt adding brackish to prepared nutrient and MetS. In contrast, a survey that conducted by Sarebanhassanabadi et al. [10] showed that eating brackish with nutrient increases the hazard of MetS. Other studies person besides reported an relation betwixt sodium intake/excretion with nutrient and MetS and its components [28, 29]. A imaginable crushed for this discrepancy is the differences successful methods of evaluating brackish intake. Baudrand et al. [28, 29] and Oh et al. [28, 29] utilized urinary sodium (that has higher accuracy compared to the FFQ) to estimation the sodium intake. In addition, differences successful plan of the study, illustration size and mean property of participants are different imaginable reasons for this discrepancy. The studies investigating the relation betwixt fried nutrient depletion and hazard of MetS are scarce. Similar to our findings, Sayon-Orea et al. [30] showed nary important relation betwixt fried nutrient depletion with prevalence of MetS. However, immoderate studies person reported that eating fried foods increases the insulin absorption and hazard benignant 2 diabetes [31, 32]. The studies with contradictory results [31, 32] did not analyse the relation betwixt fried foods intake with incidence oregon likelihood of MetS and had antithetic hypotheses, objectives and survey design.

The contiguous cross-sectional survey has immoderate strengths and limitations that should beryllium considered. First, the contiguous survey comprised a ample illustration size that reduces the bias successful interpreting the results. Second, successful information analysis, we utilized antithetic accommodation models to set imaginable confounding factors specified arsenic property and gender. However, successful the plan of cross-sectional, it is not imaginable to measurement causal relationships. In addition, due to the fact that FFQ is simply a memory-based dietary appraisal method, it whitethorn origin immoderate errors successful reporting precise intakes.

In conclusion, the contiguous survey demonstrated a nonstop relation betwixt barbecued nutrient depletion with the likelihood of MetS. On the different hand, we did not find immoderate important narration betwixt repast frequency, fried nutrient consumption, adding brackish to prepared food, utilized lipid type, and reuse lipid fig with likelihood of MetS. To corroborate these relationships, further investigations particularly prospective cohort studies are needed.

References

Author notes

1. Zahra Fallah and Mina Darand contributed arsenic to this work.

Authors and Affiliations

1. Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Shohadaye gomnam BLD. ALEM square, Yazd, Iran

   Zahra Fallah, Amin Salehi-Abargouei & Sayyed Saeid Khayyatzadeh

2. Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

   Zahra Fallah, Amin Salehi-Abargouei & Sayyed Saeid Khayyatzadeh

3. Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

   Mina Darand

4. Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

   Masoud Mirzaei

5. Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, UK

   Gordon A. Ferns

Contributions

S.Kh and M.M: designed and conducted the study; Z. F and M.D.: wrote the manuscript. M. M and A.S.A: critically revised the manuscript; S.Kh: supervised the study. A.S.A: progressive successful survey analysis. The last mentation of the manuscript was approved by each authors.

Corresponding author

Correspondence to Sayyed Saeid Khayyatzadeh.

Ethics support and consent to participate

All methods of this survey were carried retired nether the Declaration of Helsinki’s ethical rule for aesculapian probe involving quality subjects. Ethical support to behaviour this survey was obtained from the ethical committee of Shahid Sadoughi University of Medical Science (IR.SSU.SPH.REC.1399.046). Written informed consent was obtained from each participants earlier the information collection.

Consent for publication

Not applicable.

Competing interests

The authors person declared nary competing interests.

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