Association between Carbohydrate Intake and the Prevalence of Metabolic Syndrome in Korean Women

Association of Dietary Patterns with Metabolic Syndrome among Middle-Aged Adults in Shiraz, Iran: Shiraz Heart Study (SHS)

Introduction

Metabolic syndrome (MetS) is a noncommunicable disease with a high burden, including the development of type 2 diabetes mellitus, cardiovascular events, and death. It is characterized by abdominal obesity, elevated blood pressure, increased fasting plasma glucose levels, hypertriglyceridemia, and reduced levels of high-density lipoprotein (HDL) cholesterol. MetS is preventable by modifying lifestyle and dietary patterns, which are major contributing factors. This research aimed to investigate the dietary patterns of the Shiraz Heart Study (SHS) and their associations with the occurrence of MetS and its components among middle-aged residents of Shiraz.

Methods

Based on data from the Shiraz Heart Study (SHS), a prospective cohort study, the nutritional status of 1,675 participants was assessed using a food frequency questionnaire (FFQ). Three food patterns were extracted from the analysis named as vegan, western, and carbohydrate. Subjects were categorized into three levels for three major dietary patterns: low, moderate, and high, based on their adherence to each pattern. After adjusting the effect of co-founder variables, the relationship between dietary patterns, and the risk of developing MetS was analyzed.

Results

Of the 1,675 participants, 728 (43.5%) of them were male. The prevalence of MetS was 47.2%. Multivariate logistic regression analysis showed that high adherence to the vegan pattern was negatively associated with the occurrence of MetS (P value <0.001), while low adherence to the western pattern was also negatively associated (P value <0.05).

Conclusion

Healthier diets, such as vegan diets, are significantly related to lower rates of MetS among the 40-70-year-old people in Shiraz, Iran.

Carbohydrate Intake Levels and the Risk of Metabolic Syndrome in Korean Populations: A Prospective Study

In Korea and other Asian countries, traditional high-carbohydrate diets are increasingly associated with metabolic syndrome (MetS) and its complications. As dietary patterns shift, there is a growing need to assess the effect of these changes on health outcomes related to MetS. This study aimed to investigate the prospective relationship between carbohydrate consumption and the risk of MetS and its components. We analyzed data from 7902 participants from the Korean Association Resource, part of the Korean Genome and Epidemiology Study Dietary intakes, including carbohydrates and fiber, were assessed using a validated semi-quantitative food frequency questionnaire, allowing for the calculation of the proportion of total energy from carbohydrates (P_CARB) and the carbohydrate-to-fiber ratio to assess carbohydrate quality. Blood samples were collected after at least eight hours of fasting for laboratory analysis. We employed Cox proportional hazards models to estimate hazard ratios and 95% confidence intervals, focusing on the relationship between the P_CARB and the risk of developing MetS and its individual components, while adjusting for carbohydrate quality. In the fully adjusted model, which accounted for carbohydrate quality as a covariate, individuals in the highest percentile of the P_CARB showed a significantly increased risk of MetS, hypertriglyceridemia, hypo-high density lipoprotein cholesterolemia, dyslipidemia, and high blood pressure, compared to those in the lowest P_CARB group. Spline curve analyses indicated that the risks for MetS and its components consistently escalated with increasing P_CARB, with all p-values for nonlinearity exceeding 0.05. The findings suggest that higher levels of P_CARB are associated with an increased risk of MetS and related conditions, except for high fasting glucose. These results highlight the importance of dietary awareness and potential adjustments for populations consuming high-carbohydrate diets.

Consumption of foods and beverages rich in added sugar associated with incident metabolic syndrome: the Coronary Artery Risk Development in Young Adults (CARDIA) study

AIMS

Numerous studies report positive associations between total carbohydrate (CHO) intake and incident metabolic syndrome (MetS), but few differentiate quality or type of CHO relative to MetS. We examined source of CHO intake, including added sugar (AS), AS-rich CHO foods, and sugar-sweetened beverages (SSBs) associated with incident MetS in adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study.

METHODS AND RESULTS

Among 3154 Black American and White American women and men aged 18-30 years at baseline, dietary intake was assessed by diet history three times over 20 years. Sources of AS-rich CHO foods and beverages include sugar-rich refined grain products, candy, sugar products, and SSBs. Incident MetS was created according to standard criteria. Time-dependent Cox proportional hazards regression analysis evaluated the associations of incident MetS across quintiles of cumulative intakes of AS-rich CHO foods and beverages, AS, and SSBs adjusted for potential confounding factors over 30 years of follow-up. The associations of AS-rich CHO foods and beverages, AS, and SSB intakes with incident MetS were consistent. Compared with the lowest intake, the greatest intakes of AS-rich CHOs, AS, and SSBs were associated with 59% (Ptrend < 0.001), 44% (Ptrend = 0.01), and 34% (Ptrend = 0.03) higher risk of developing MetS, respectively. As expected, diet quality was lower across increasing quintiles of AS-rich CHO foods and beverages, AS, and SSBs (all Ptrend < 0.001).

CONCLUSION

Our study findings are consistent with an elevated risk of developing MetS with greater consumption of AS, AS-rich CHO foods, and SSBs, which support consuming fewer AS-rich CHO foods and SSBs.

Low-carbohydrate dietary score and the incidence of metabolically unhealthy phenotype based on BMI status: a cohort study

There is scarce research focusing on the relationship between the low-carbohydrate dietary score and the development of a metabolically unhealthy phenotype. Therefore, this cohort study was designed to assess the association between the low-carbohydrate dietary score and the risk of metabolically unhealthy phenotypes (MUP). This study included 1299 adults with healthy metabolic profiles who were followed for 5.9 years. Results indicated an inverse association between the second tertile of the low-carbohydrate dietary score and the risk of developing metabolically unhealthy obesity (MUO) (HR: 0.76, 95% CI: 0.59-0.98). In addition, we found an inverse association between the healthy low-carbohydrate dietary score and the risk of MUO (HR: 0.77, 95% CI: 0.60-0.99). Our results revealed a nonlinear inverse association between the low-carbohydrate dietary score and the risk of MUP only in subjects with overweight or obesity. This relationship was independent of animal protein and fat intake. Also, we found that a lower intake of unhealthy carbohydrates was associated with a lower risk of MUP only in subjects with overweight or obesity.

Lifestyle Factors Influencing Metabolic Syndrome after Adjusting for Socioeconomic Status and Female Reproductive Health Indicators: A National Representative Survey in Korean Pre- and Postmenopausal Women

Metabolic syndrome (MetS) is increasing markedly among postmenopausal women. Although studies suggest multiple risk factors for its development, few have investigated changes in socioeconomic status (SES), female reproductive health indicators (menarche age, experience of pregnancy, delivery, breastfeeding, and postmenopausal status), and lifestyle factors. This study investigated lifestyle factors affecting MetS prevalence among pre- and post-menopausal women after adjusting for SES and female reproductive health indicators. Data from the Korea National Health and Nutrition Examination Survey VII (2016-2018) on 2856 pre- and postmenopausal women aged 40-59 years were analyzed. Differences in SES (e.g., age, education, and household income), female reproductive health indicators (e.g., age of menarche and menopause), and lifestyle (e.g., total calorie intake, fats, and proteins, percentage of energy from carbohydrates, fats, and proteins, smoking, physical activity, and obesity) between MetS and non-MetS groups were calculated by performing χ2 or t-tests. Consequently, current smoking, physical inactivity, overweight, and obesity were significantly associated with increased MetS after adjusting for SES and female reproductive health indicators using logistic regression analysis. Hence, health policies and programs focusing on modifiable MetS risk factors-encouraging healthy eating habits, smoking cessation, and regular exercise-must be formulated to prevent the development of MetS in pre- and postmenopausal women.

Body mass index as a dominant risk factor for metabolic syndrome among indonesian adults: a 6-year prospective cohort study of non-communicable diseases

BACKGROUND

Non-communicable diseases (NCDs), notably cardiovascular disease and type 2 diabetes mellitus, are largely driven by metabolic syndrome (MetS), a cluster of critical risk factors. Despite extensive research, the progression of MetS, especially in Indonesia, has received limited attention. This research tracks adult MetS risk dynamics in a populous Bogor District cohort, providing crucial insights into its evolving nature.

METHODS

This prospective open cohort study analysed secondary data from the Special Research - Cohort Study of Non-Communicable Diseases by the Ministry of Health, Republic of Indonesia from 2011 to 2018. The final sample was 1,376 Indonesian adult participants, all residents of Bogor District. MetS outcome, dietary assessment, physical activity, and biomarkers were analysed every two consecutive years.

RESULTS

The risk of overweight and obese participants developing MetS was 2.4 and 4.4 times higher, respectively (95% CI: 1.176-3.320 and 3.345-5.740) than those with body mass index (BMI) in the normal range. Participants who reported less intentional physical exercise had a MetS risk 1.5 times higher (95% CI: 1.034-2.109) than those with more intentional physical exercise. The role of diet is also significant, evidenced by a 30% reduction in MetS risk for people with fat intakes in the 2nd quartile compared to the 1st quartile (95% CI: 0.505-0.972). Meanwhile, a carbohydrate intake in the 2nd quartile increased the risk of MetS 1.5 times (95% CI: 1.063-2.241) in comparison with the 1st quartile.

CONCLUSIONS

Notably, participants with underweight BMI exhibited the highest cumulative survival of MetS, while those with obese BMI recorded the lowest cumulative survival. There is an urgent need for strategic interventions to enhance the existing early detection and NCD monitoring program. This involves a targeted focus on promoting a community-based healthy lifestyle in the Bogor District. The study emphasizes the importance of tailored public health measures to address specific risk factors identified in the local context, aiming to mitigate the prevalence and impact of MetS in the population.

Macronutrients quality indices and risk of metabolic syndrome and its components in Iranian adults

BACKGROUND/AIM

Evidence from recent studies suggested that the quality of dietary macronutrients can play a possible role in predicting the risk of metabolic disorders. In the current study, we aimed to assess the association of carbohydrate quality index (CQI) and protein score with the risk of metabolic syndrome (MetS) in Iranian adults.

METHODS

This prospective study was conducted within the framework of the Tehran Lipid and Glucose Study on 1738 individuals aged between 40 and 70 years old, who were followed up for a mean of 6.1 years. A food frequency questionnaire was used to determine CQI and protein scores. The multivariable adjusted Cox regression model was used to calculate the hazard ratio (HR) of MetS across quartiles of protein score and CQI, and its components.

RESULTS

The mean ± standard deviation (SD) age and body mass index of the study population (42.5% men) were 49.3 ± 7.5 years and 27.0 ± 4.0 kg/m2, respectively. Mean ± SD scores of CQI and protein for all participants were 12.6 ± 2.4 and 10.3 ± 3.5, respectively. During the study follow-up, 834(48.0%) new cases of MetS were ascertained. In the multivariable-adjusted model, the risk of MetS was decreased across quartiles of CQI (HR = 0.83;95%CI:0.69-1.00, Ptrend=0.025) and protein score (HR = 0.75; 95% CI:0.60-0.94, Ptrend=0.041). Also, Of CQI components, the whole grain/total grains ratio showed a significant inverse association with the risk of MetS (HR = 0.75;95%CI:0.60-0.94, Ptrend=0.012).

CONCLUSION

Our findings revealed that a dietary pattern with higher CQI and protein score may be related to a reduced risk of MetS in adults.

Association of daily carbohydrate intake with intermuscular adipose tissue in Korean individuals with obesity: a cross-sectional study

BACKGROUND/OBJECTIVES

The prevalence of obesity, a worldwide pandemic, has been increasing steadily in Korea. Reports have shown that increased intermuscular adipose tissue (IMAT) is associated with an increased risk of cardiovascular disease, independent of body mass index. However, the relationship between dietary intake and IMAT accumulation in the Korean population remains undetermined. The objective of this study was to evaluate regional fat compartments using advanced magnetic resonance imaging (MRI) techniques. We also aimed to investigate the association between IMAT amounts and dietary intake, including carbohydrate intake, among Korean individuals with obesity.

SUBJECTS/METHODS

This cross-sectional study, performed at a medical center in South Korea, recruited 35 individuals with obesity (15 men and 20 women) and classified them into 2 groups according to sex. Anthropometry was performed, and body fat distribution was measured using MRI. Blood parameters, including glucose and lipid profiles, were analyzed using commercial kits. Linear regression analysis was used to test whether the IMAT was associated with daily carbohydrate intake.

RESULTS

Carbohydrate intake was positively associated with IMAT in all individuals, with adjustments for age, sex, height, and weight. No significant differences in blood indicators were found between the sexes.

CONCLUSIONS

Regardless of sex and age, higher carbohydrate intake was strongly correlated with greater IMAT accumulation. This suggests the need to better understand sex differences and high carbohydrate diet patterns in relation to the association between obesity and metabolic risk, which may help reduce obesity prevalence.

Dietary Patterns Are Associated with the Gut Microbiome and Metabolic Syndrome in Mexican Postmenopausal Women

Postmenopausal women are at an increased risk of developing metabolic syndrome (MetS) due to hormonal changes and lifestyle factors. Gut microbiota (GM) have been linked to the development of MetS, and they are influenced by dietary habits. However, the interactions between dietary patterns (DP) and the GM of postmenopausal women, as well as their influence on MetS, still need to be understood. The present study evaluated the DP and microbiota composition of postmenopausal Mexican women with MetS and those in a control group. Diet was assessed using a food frequency questionnaire, and the GM were profiled using 16S rRNA gene sequencing. Greater adherence to a "healthy" DP was significantly associated with lower values of MetS risk factors. GM diversity was diminished in women with MetS, and it was negatively influenced by an "unhealthy" DP. Moreover, a higher intake of fats and proteins, as well as lower amounts of carbohydrates, showed a reduction in some of the short-chain fatty acid-producing genera in women with MetS, as well as increases in some harmful bacteria. Furthermore, Roseburia abundance was positively associated with dietary fat and waist circumference, which may explain 7.5% of the relationship between this macronutrient and MetS risk factors. These findings suggest that GM and diet interactions are important in the development of MetS in postmenopausal Mexican women.

Associations between Dietary Patterns and Metabolic Syndrome: Findings of the Korean National Health and Nutrition Examination Survey

Metabolic syndrome (MetS) is a multifactorial cluster of metabolic disorders related to cardiovascular disease and type 2 diabetes mellitus. Diet and dietary patterns are significant factors in the development and management of MetS. The associations between dietary patterns (i.e., high-carbohydrate [HCHO], high-fat [HF], and high-protein [HP] diets) and the prevalence of MetS in Koreans were examined using data from the Korean National Health and Nutrition Examination Survey, collected between 2018 and 2020. The study included data from 9069 participants (3777 men and 5292 women). The percentage of participants with MetS was significantly higher in the HCHO diet group than in the normal diet group in women. Women with HCHO diet were positively associated with elevated blood pressure and triglyceride levels based on a comparison with the normal diet group (p = 0.032 and p = 0.005, respectively). Men with an HF diet were negatively associated with elevated fasting glucose levels based on a comparison with the normal diet group (p = 0.014). Our findings showed that HCHO intake was strongly associated with a higher risk of MetS, especially elevated blood pressure and triglyceride levels in women, and an HF diet was negatively associated with elevated fasting glucose levels in men. Further prospective studies of the impact of dietary carbohydrate, fat, and protein proportions on metabolic health are needed. The optimal types and proportions of these dietary components, as well as the underlying mechanisms through which suboptimal proportions can lead to MetS, should also be investigated.

Effects of Interaction between SLC35F3 and Carbohydrate Intake on the Incidence of Metabolic Syndrome in Korean Middle-Aged Adults

Solute carrier family 35 member F3 (SLC35F3) mediates intracellular thiamine transport, which is crucial for carbohydrate metabolism as thiamine is required for key pathways such as glycolysis and the tricarboxylic acid cycle. This study aimed to investigate the impact of the interaction between SLC35F3 and dietary carbohydrate intake on the incidence of metabolic syndrome (MetS). The study included 3923 Korean adults over 40 years of age from the Korean Genome and Epidemiology Study. The association between dietary carbohydrate intake, SLC35F3 rs10910387 genotypes, and MetS incidence was studied using multivariable Cox proportional hazard models. Over an average of 8.5 years of follow-ups, we documented 1471 MetS cases. MetS incidence was 1.88 times greater in men with the TT genotype and the highest carbohydrate intake than in those with the CC genotype and lowest carbohydrate intake (Hazard Ratio (HR) 1.88, 95% confidence interval (CI) 1.03-3.41). MetS incidence were 2.22 and 2.53 times higher in women with the TT genotype and carbohydrate intake tertile 2 and 3, respectively, than those with the CC genotype and carbohydrate intake tertile 1 (HR 2.22, 95% CI 1.12-4.42; HR 2.53, 95% CI 1.38-4.61). In summary, we report a novel interaction between SLC35F3 rs10910387 genotypes and dietary carbohydrate intake on MetS in Koreans.

Association of self-rated chewing function and oral health status with metabolic syndrome

PURPOSE

The study aimed to examine the association of self-rated chewing function, the number of teeth and periodontal status with metabolic syndrome.

METHODS

The participants were 11,119 adults aged 40-74 years who underwent specific health checkups, including an oral health examination, in 2018 in Japan. This study used the standard questions of the specific health checkups to obtain information on self-rated chewing function. A multinomial logistic regression analysis was performed with metabolic syndrome status as the dependent variable, and age, sex, lifestyle questions, self-rated chewing function, number of teeth, and periodontal status as the independent variables.

RESULTS

Number of teeth and periodontal status were significantly associated with metabolic syndrome after adjusting for confounding variables. Self-rated chewing function was significantly associated with metabolic syndrome in the crude analysis, but not after adjustment for confounding variables. Both number of teeth and periodontal status were significantly associated with self-rated chewing function.

CONCLUSION

There was no significant direct association between self-rated chewing function and metabolic syndrome. Self-rated chewing function may be an indicator of poor oral condition that links to metabolic syndrome.

Adherence to lifelines diet score and risk factors of metabolic syndrome among overweight and obese adults: A cross-sectional study

Background

Metabolic syndrome (MetS) is one of the most significant public health issues worldwide, and diet quality is an important controllable environmental factor influencing the incidence of MetS. Numerous dietary scores have been established to assess compliance with dietary recommendations or eating patterns, many of which are not entirely food-based. Hence, Lifelines Diet Score (LLDS) was developed in response to the shortcomings of existing tools. This study aimed to assess any possible links between total food quality and cardiometabolic risk factors among overweight and obese adults.

Methods

This cross-sectional study included 338 overweight and obese individuals [body mass index (BMI) > 25 kg/m2] aged 20-50 years in Tabriz, Iran. To collect dietary data, we used a validated semi-quantitative Food Frequency Questionnaire (FFQ) for Iranian population. Enzymatic-colorimetric methods were used to assess serum glucose and lipids, and enzyme-linked immunosorbent assay (ELISA) kits were used to measure insulin levels. In addition, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated.

Results

BMI and hip circumference (HC) were significantly different (P < 0.05) amongst LLDS tertiles. Adherence to the highest tertile of LLDS was associated with lower SBP, and the subjects in higher LLDS tertiles significantly had lower systolic blood pressure (SBP) (P = 0.04). Triglyceride (TG) levels were also lower in the third tertile of LLDS with a near-significant P-value (P = 0.05).

Conclusion

According to our results, a higher diet quality score, determined by LLDS, can be associated with a lower risk of MetS. Further experimental and longitudinal studies are needed to better understand this relationship.