Association of Lifestyle Risk Factors with Metabolic Syndrome Components: A Cross‑sectional Study in Eastern India

Pragya Verma, Ratan K Srivastava, Dharmendra Jain

Abstract


Background: Approximately 20%–25% of the world adult population and nearly 30% of Indians have metabolic syndrome disorder. Our objective was designed to fnd out the association between important nutrients and potential lifestyle risk factors such as diet, physical inactivity, and smoking
and alcohol consumption with the number of metabolic syndrome components.

Methods: This was a cross‑sectional study. A total of 205 patients of metabolic syndrome were enrolled for this study. Diagnosis of metabolic syndrome was done on the basis of National Cholesterol Education
Program Adult Treatment Panel III criteria (NCEP ATP III 2004). Dietary data were collected with the validated food frequency questionnaire and 24 h dietary recall method, and the nutrient intake was calculated with the specially designed software.

Results: Unhealthy dietary habits were seen more among the participants who had more than 3 risk factors. Results showed the odds of taking >5 times junk foods was 3 times higher (odds ratio [OR]: 2.97; 95% confdence interval [CI]: 1.61–5.47), and sweet dishes was 2.3 times higher (OR: 2.33; 95% CI: 1.28–4.24) among the participants who had 4–5 risk factors. However, milk and dairy products > 4 servings/ day (OR: 0.54; 95% CI: 0.175–1.67) and pulses and legumes more than 2 servings/day (OR: 0.57; 95% CI: 0.25–1.29) was protective against hypertension. Mean carbohydrate, saturated fat, and sodium intake was signifcantly higher in the participants who had 4–5 metabolic risk factors
compared to 3 risk factors (P < 0.0001).

Conclusions: It was concluded that low intake of fruits, vegetables, and higher intake of flesh food and inadequate physical activity signifcantly associated with the metabolic syndrome risk factors.

Keywords: Dietary pattern, hypertension, lifestyle risk factors, metabolic syndrome, physical activity


Full Text:

PDF

References


George A, Zimmet P, Shaw J. The IDF consensus worldwide

definition of the metabolic syndrome. International Diabetes

Federation; 2006. Available from: http://www.idf.org/webdata/

docs/IDF_Meta_def_final.pdf. [Last accessed on 2012 Nov 29].

National Institute of Nutrition. Dietary Guidelines for Indians – A

Manual. 2nd ed. Hyderabad: National Institute of Nutrition; 2012.

National Cholesterol Education Program (NCEP) Expert

Panel on Detection, Evaluation, and Treatment of High Blood

Cholesterol in Adults (Adult Treatment Panel III). 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) final report. Circulation

;106:3143‑421.

Sattar N, Gaw A, Scherbakova O, Ford I, O’Reilly DS,

Haffner SM, et al. Metabolic syndrome with and without

C‑reactive protein as a predictor of coronary heart disease and

diabetes in the west of Scotland coronary prevention study.

Circulation 2003;108:414‑9.

McNeill AM, Rosamond WD, Girman CJ, Golden SH,

Schmidt MI, East HE, et al. The metabolic syndrome and 11‑year

risk of incident cardiovascular disease in the atherosclerosis risk

in communities study. Diabetes Care 2005;28:385‑90.

Greenstone CL. The metabolic syndrome: A lifestyle medicine

foe worthy of a seek and destroy mission. Am J Lifestyle Med

;2:109‑12.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH,

Franklin BA, et al. Diagnosis and management of the metabolic

syndrome: An American Heart Association/National Heart,

Lung, and Blood Institute Scientific Statement. Circulation

;112:2735‑52.

Misra A, Khurana L. Obesity and the metabolic syndrome

in developing countries. J Clin Endocrinol Metab

;93 11 Suppl 1:s9‑30.

Prasad DS, Kabir Z, Dash AK, Das BC. Prevalence and risk factors

for metabolic syndrome in Asian Indians: A community study

from urban Eastern India Kalinga Institute of Medical Sciences,

Bhubaneswar, Orissa. India J Cardiovasc Dis Res 2008;3:204‑11.

Feldeisen SE, Tucker KL. Nutritional strategies in the prevention

and treatment of metabolic syndrome. Appl Physiol Nutr Metab

;32:46‑60.

Hegsted DM, Kritchevsky D. Diet and serum lipid concentrations:

Where are we? Am J Clin Nutr 1997;65:1893‑6.

Poehlman ET, Toth MJ, Bunyard LB, Gardner AW,

Donaldson KE, Colman E, et al. Physiological predictors of

increasing total and central adiposity in aging men and women.

Arch Intern Med 1995;155:2443‑8.

Wirfält E, Hedblad B, Gullberg B, Mattisson I, Andrén C,

Rosander U, et al. Food patterns and components of the

metabolic syndrome in men and women: A cross‑sectional

study within the malmö diet and cancer cohort. Am J Epidemiol

;154:1150‑9.

Salmerón J, Ascherio A, Rimm EB, Colditz GA, Spiegelman D,

Jenkins DJ, et al. Dietary fiber, glycemic load, and risk of

NIDDM in men. Diabetes Care 1997;20:545‑50.

Hu FB. Dietary pattern analysis: A new direction in nutritional

epidemiology. Curr Opin Lipidol 2002;13:3‑9.

Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F.

Beneficial effects of a dietary approaches to stop hypertension

eating plan on features of the metabolic syndrome. Diabetes

Care 2005;28:2823‑31.

Gopalan C, Sastri R, Balasubramaniyam SC. Nutritive Value of

Indian Foods. Hyderabad: National Institute of Nutrition, ICMR;

p. 2‑161.

Cho YA, Kim J, Cho ER, Shin A. Dietary patterns and the

prevalence of metabolic syndrome in Korean women. Nutr

Metab Cardiovasc Dis 2011;21:893‑900.

Sonnenberg L, Pencina M, Kimokoti R, Quatromoni P, Nam BH,

D’Agostino R, et al. Dietary patterns and the metabolic

syndrome in obese and non‑obese Framingham women. Obes

Res 2005;13:153‑62.

Ren J, Kelley RO. Cardiac health in women with

metabolic syndrome: Clinical aspects and pathophysiology.

Obesity (Silver Spring) 2009;17:1114‑23.

American Heart Association Nutrition Committee,

Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S,

et al. Diet and lifestyle recommendations revision 2006:

A scientific statement from the American Heart Association

Nutrition Committee. Circulation 2006;114:82‑96.

Yoo S, Nicklas T, Baranowski T, Zakeri IF, Yang SJ,

Srinivasan SR. Comparison of dietary intakes associated with

metabolic syndrome risk factors in young adults: The Bogalusa

Heart Study. Am J ClinNutr 2004;80:841‑8.

Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB,

Willett WC, et al. Fruit and vegetable intakes, C‑reactive protein,

and the metabolic syndrome. Am J Clin Nutr 2006;84:1489‑97.

Panagiotakos DB, Pitsavos C, Skoumas Y, Stefanadis C. The

association between food patterns and the metabolic syndrome

using principal components analysis: The ATTICA study. J Am

Diet Assoc 2007;107:979‑87.

Panagiotakos DB, Pitsavos C, Skoumas Y, Stefanadis C. The

association between food patterns and the metabolic syndrome

using principal components analysis: The ATTICA study. J Am

Diet Assoc 2007;107:979‑87.

Choi HK, Willett WC, Stampfer MJ, Rimm E, Hu FB. Dairy

consumption and risk of type 2 diabetes mellitus in men:

A prospective study. Arch Intern Med 2005;165:997‑1003.

Ludwig DS, Peterson KE, Gortmaker SL. Relation between

consumption of sugar‑sweetened drinks and childhood obesity:

A prospective, observational analysis. Lancet 2001;357:505‑8.

Dhingra R, Sullivan L, Jacques PF, Wang TJ, Fox CS,

Meigs JB, et al. Soft drink consumption and risk of

developing cardiometabolic risk factors and the metabolic

syndrome in middle‑aged adults in the community. Circulation

;116:480‑8.

Panagiotakos DB, Pitsavos C, Chrysohoou C, Skoumas J,

Tousoulis D, Toutouza M, et al. Impact of lifestyle habits on the

prevalence of the metabolic syndrome among Greek adults from

the ATTICA study. Am Heart J 2004;147:106‑12.

Narasimhan S, Nagarajan L, Vaidya R, Gunasekaran G,

Rajagopal G, Parthasarathy V, et al. Dietary fat intake and its

association with risk of selected components of the metabolic

syndrome among rural South Indians. Indian J Endocrinol Metab

;20:47‑54.

Carpentier YA, Portois L, Malaisse WJ. N‑3 fatty acids and the

metabolic syndrome. Am J Clin Nutr 2006;83:1499S‑504S.

Humphries S, Kushner H, Falkner B. Low dietary

magnesium is associated with insulin resistance in a sample

of young, nondiabetic black Americans. Am J Hypertens

;12:747‑56.

Abby S, Harris I, Harris K. Homocysteine and cardiovascular

disease. J Am Board Fam Pract 2000;11:391‑8.

World Health Organization. Diet, Nutrition and the Prevention

of Non‑Communicable Diseases: Report of a Joint WHO/FAO

Expert Consultation; 2003. p. 916. Available from: http://www.

who.int/dietphysicalactivity/publications/trs916/download/

en/. [Last accessed on 2014 Aug 20].

McKeown NM, Meigs JB, Liu S, Saltzman E, Wilson PW,

Jacques PF, et al. Carbohydrate nutrition, insulin resistance, and

the prevalence of the metabolic syndrome in the Framingham

offspring cohort. Diabetes Care 2004;27:538‑46