Association of dietary patterns with continuous metabolic syndrome in children and adolescents; a nationwide propensity score-matched analysis: the CASPIAN-V study

Abstract

ObjectiveThis study aims to determine the association of dietary patterns with metabolic syndrome (MetS) and its components in children and adolescents.MethodsThis nationwide study was conducted in 2015 among 4200 students aged 7–18 years, who lived in 30 provinces in Iran. The analysis was conducted based on the propensity score using a matched case–control study design. Three dietary patterns were obtained conducting a principal component analysis with a varimax rotation on 16 dietary groups. Continuous MetS score was computed by standardizing the residuals (z-scores) of MetS components by regressing them according to age and sex. The gold standard diagnosis of MetS was considered based on the International Diabetes Federation criteria. Moreover, for the purpose of data analysis, matched logistics analysis was used.ResultsThe study participants consisted of 3843 children and adolescents (response rate 91.5%) with mean (SD) age of 12.45 (3.04) years. Totally 49.4% of students were girls and 71.4% lived in urban areas. Three dietary patterns were obtained: Healthy, Western, and Sweet. Prevalence of MetS was 5% (boy 5.5 and girl 4.5%). Results of multivariate analysis show that students with Sweet dietary patterns were at higher risk for abdominal obesity (OR 1.29; 95% CI 1.01–1.66), elevated blood pressure (OR 1.35; 95% CI 1.01–1.81) and MetS (OR 1.33; 95% CI 1.02–1.74). The two other dietary patterns were not associated with MetS and its components.ConclusionSweet dietary pattern increase the risk of MetS and some its components in Iranian children and adolescents. This finding provides valuable information for effective preventive strategies of MetS based on diet rather than medication to maintain healthy lifestyle habits.

Dietary Patterns and Childhood Obesity Risk: A Systematic Review

“…The studies were all cross-sectional studies, with the exception of one case-control study. 70 The studies were conducted in nine different countries and the majority of studies were from Asian countries (Iran, 70 China, 61,65,66,69,71 and Lebanon 64,67 ), with four from American countries (Mexico, 58 Brazil, 60,63 and Colombia 62 ), two from European countries (Norway 57,59 ), one from Australia, 19 and one from Polynesia (Samoan island of Upolu 68 ).…”

“…Mean age among the study participants ranged from 1 to 19 years. Six studies were with children aged between 1 and 6 years, 58,61,62,65,69,70 five studies with children aged between 5 and 18 years, 19,60,67,68,71 two studies with children aged between 9 and 13 years, 57,59 and three studies with adolescents in the age group between 11 and 19 years. 63,64,66 Seven studies included >1000 participants.…”

“…63,64,66 Seven studies included >1000 participants. 58,61,62,65,66,70,71 The total sample from the 16 selected studies included 44,793 children and adolescents. The total sample from Asian countries was n = 22,263, 61,[64][65][66][67][69][70][71] the American countries was n = 19,145, 58,60,62,63 the European countries was n = 1351, 57,59 Australia was n = 288, 19 and was n = 305 from the Samoan island of Upolu.…”

“…Of the 16 selected studies, 1 used CA, 58 7 used FA, 19,61,[64][65][66][67]71 and 8 used PCA. 57,59,60,62,63,68,69,70 Using PCA or FA or CA to identify dietary patterns, the majority of the studies included in this review extracted two, 64,67-69,71 three, 19,60,63,65,66,70 or four patterns. 57,59,61 The cumulative proportion of the total variance in dietary intake explained by the patterns of these studies ranged from 16.36% 69 to 38.18%, 70 accounting for only a limited portion of the between-person variance in diet.…”

“…57,59,60,62,63,68,69,70 Using PCA or FA or CA to identify dietary patterns, the majority of the studies included in this review extracted two, 64,67-69,71 three, 19,60,63,65,66,70 or four patterns. 57,59,61 The cumulative proportion of the total variance in dietary intake explained by the patterns of these studies ranged from 16.36% 69 to 38.18%, 70 accounting for only a limited portion of the between-person variance in diet. Of note, the identification of three factors in the analysis by Yang et al 66 that accounted for 65.6% of the cumulative proportion of the total variance is out of the range of what was reported in the aforementioned studies.…”