Abstract
BackgroundIntake of snack foods has been previously associated with an elevated risk of chronic disease; however, studies on snack foods and metabolic syndrome (MetS) while considering the modifying effect of socioeconomic status (SES) and lifestyle factors on this association are lacking. We aimed to investigate the association between snack foods intake and the MetS risk, and the mediatory effects of SES and lifestyle factors on the forenamed association among adults who participated in the Tehran Lipid and Glucose Study (2006–2018).MethodsThis is a prospective study of 1915 participants (male, 40.5%), aged 19–74 year who were free of MetS at baseline. Dietary intakes were gathered using a validated, semi-quantitative food frequency questionnaire at baseline (2006–2008), and with 3-year intervals afterwards. Alternative approach was used for snack foods from all available questionnaires during follow-up. Snack foods were divided into 4 categories, including total snacks, biscuits and cakes, candies and chocolate, and salty snacks. Total snack foods intake and its subgroup (serving/week) were modeled as tertiles. MetS was diagnosed according to the Joint Interim Statement criteria. Physical activity level (PAL) categorized as low/medium and high levels. Information regarding smoking (Smoker/Non-smoker), education (higher/lower education), and occupation (employed/non-employed) was gathered using questionnaire. The Cox regression was used, regarding interaction between snack foods, SES, and PAL on the MetS risk.ResultsA total of 591 incident MetS cases were diagnosed during 8.9 years of follow-up. The median total snack foods intake was 5.2 serving/week (IQR: 3.0–9.1). Total snack foods intake was positively associated with the MetS risk after adjusting for potential confounders (adjusted for age and gender, energy intake, total fiber intake, smoking status, PAL, education levels, family history of diabetes, family history of CVD events, and BMI). After adjustment for confounders, among snacks’ subgroups, candies and chocolate intake was positively associated with MetS risk. Moreover, among lower-educated and non-employed participants, candies and chocolate intake was positively associated with the MetS risk, by 38 and 43% respectively. Stratification based on PAL resulted a positive association between intake of total snack foods and candies and chocolates and risk of MetS among participants with low PAL.ConclusionSnack foods, especially candies and chocolate, increased the risk of MetS, among individuals with a low PAL.
Highlights
It is well established that metabolic syndrome (MetS), a cluster of interrelated metabolic abnormalities, can occur from early childhood to late adulthood [1].Mirmiran et al Nutr J (2021) 20:70The National Cholesterol Education Program Adult Treatment Panel III has stated MetS as a promoter of cardiovascular disease (CVD) risk factors, which subsequently increases the risk of morbidity and all-cause mortality [2]
Higher total snack foods were positively associated with fasting plasma glucose, triglyceride concentrations, waist circumference, systolic and diastolic blood pressure at baseline
No significant changes were observed with regards to gender, physical activity levels (PAL), family history of diabetes, and family history of CVD across tertiles of total snack foods intake
Summary
It is well established that metabolic syndrome (MetS), a cluster of interrelated metabolic abnormalities, can occur from early childhood to late adulthood [1].Mirmiran et al Nutr J (2021) 20:70The National Cholesterol Education Program Adult Treatment Panel III has stated MetS as a promoter of cardiovascular disease (CVD) risk factors, which subsequently increases the risk of morbidity and all-cause mortality [2]. As indicated in several studies, the increasing trend of MetS is known to be associated with sedentary lifestyle behaviors, in addition to an ongoing nutrition transition, as a result of modernization that manifest itself through a higher intake of industrial and processed foods and is a major factor in the development of noncommunicable diseases among populations [4, 5]. Intake of snack foods has been previously associated with an elevated risk of chronic disease; studies on snack foods and metabolic syndrome (MetS) while considering the modifying effect of socioeconomic status (SES) and lifestyle factors on this association are lacking. We aimed to investigate the association between snack foods intake and the MetS risk, and the mediatory effects of SES and lifestyle factors on the forenamed association among adults who participated in the Tehran Lipid and Glucose Study (2006–2018)
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