Adherence to dietary recommendations and risk of metabolic syndrome: Tehran Lipid and Glucose Study

The "Dietary Guidelines for Americans Adherence Index (DGAI) 2005" was developed based on the latest dietary recommendations to assess the contribution of dietary patterns to chronic diseases. The objective of the study was to evaluate the association of dietary patterns as measured by the modified DGAI 2005 with both the prevalence of metabolic syndrome (MetS) and the MetS risk factors. In this population-based cross-sectional study, 2504 adults (1120 men and 1384 women), aged 19 to 70 years, were randomly selected from the third phase of the Tehran Lipid and Glucose Study. Usual dietary intake was assessed using a food frequency questionnaire, and the DGAI score was calculated for all participants. Metabolic syndrome was defined according to Adult Treatment Panel III diagnostic criteria. Generally, mean values for waist circumference, triglyceride, and blood pressure were significantly higher among male compared with female participants (P < .05). Low high-density lipoprotein cholesterol was the most prevalent MetS risk factor among both men (65.4%) and women (72.5%). After mutual adjustment for confounding variables, those in the highest quartile category of DGAI had a 21% lower prevalence of MetS risk factors clustering than those in the lowest quartile (odds ratio [OR], 0.79; confidence interval [CI], 0.63-0.92; P for trend = .02). Being in the highest quartile category of DGAI score was shown to significantly reduce the prevalence of hyperglycemia (OR, 0.64; CI, 0.47-0.86; P for trend < .001), hypertension (OR, 0.76; CI, 0.70-0.93; P for trend = .05), and low high-density lipoprotein cholesterol (OR, 0.69; CI, 0.54-0.94; P for trend < .001). Consuming a diet consistent with new dietary guidelines was associated with lower risk of MetS prevalence and some of its risk factors. Preventive interventions for MetS risk reduction should focus on the overall dietary pattern.