Abstract

BackgroundThe optimal dietary pattern for reducing the extent of metabolic syndrome (MetS) has not been well established yet. The aim of this study was to evaluate dietary patterns and adherence to WHO healthy diet in children and adolescents and their associations with MetS.MethodsSubjects of this cohort study were selected from among children and adolescents of the Tehran Lipid and Glucose Study participants, aged 6–18 years (n = 424). Dietary measurements were collected using a valid and reliable food frequency questionnaire. MetS was defined as the existence of at least 3 risk factors according to the Cook criteria. Diet was assessed based on dietary components of the WHO healthy diet. Dietary patterns were defined by principal component analysis.ResultsThe mean ± SD age of participants (42% boys and 57% girls) was 13.5 ± 3.7 years. The most consistency with the WHO healthy diet was observed for cholesterol, free sugar and protein consumption in both genders, and the least was for n-3 poly-unsaturated fatty acid, trans-fatty acid and salt. Intake of SFA up to 12% of energy intake (third quartile) reduced the risk of MetS, compared to the first quartile. Subjects in the third quartile of n-6 poly-unsaturated fatty acid intake (6.2% of energy) showed the lowest odds ratio of MetS compared to the first quartile (OR: 0.18, CI: 0.04–0.66). In the adjusted model, the risk of MetS reduced across quartiles of MUFA intake by 60% (OR: 1, 0.40, 0.40, 0.42; P trend = 0.05). No significant trends were observed in the risk of MetS components across quartiles of the WHO healthy diet components. Three major dietary patterns were identified, the healthy, unhealthy and cereal/meat. An increased risk of MetS was observed in the highest quartile of unhealthy dietary pattern score compared to the lowest quartile (OR: 1, 0.81, 0.93, 2.49; P trend = 0.03).ConclusionsOur results demonstrated that the majority of our population did not meet some components of WHO healthy diet recommendations. The quality and quantity of fatty acid intakes were associated with risk of MetS. Adherence to unhealthy dietary pattern was associated with two-fold increase in MetS risk.

Highlights

  • The optimal dietary pattern for reducing the extent of metabolic syndrome (MetS) has not been well established yet

  • The highest compliance was for cholesterol (100%), free sugar (> 80%) and protein intake (> 75%) in both genders, and the least was observed for n-3 poly-unsaturated fatty acid (PUFA) (< 2%), Trans-fatty acids (TFA) (< 7%) and salt (< 16%), without a significant difference between boys and girls

  • The mean intake of total fat, saturated fatty acids (SFA) and TFAs were higher than World Health Organization (WHO) recommendations; the most inconsistency was for TFAs which was received 2 fold higher than recommended

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Summary

Introduction

The optimal dietary pattern for reducing the extent of metabolic syndrome (MetS) has not been well established yet. The World Health Organization (WHO) has issued dietary recommendations and guidelines on nutrition to help reduce the risk of chronic diseases and promote good health [11, 12], one of which is the Healthy Diet fact sheet [8] that includes practical advices on maintaining a healthy diet; recommending a shift in fat consumption away from SFAs to un-saturated fats and limiting total fat to less than 30% of total energy intake This factsheet indicates elimination of free sugars to less than 10% of total energy intake and industrial trans-fats. We aimed to investigate the association of dietary patterns and adherence to WHO healthy diet and their association with MetS in Iranian children and adolescents of 6–18 years during 3.6 years of follow up

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