The major European dietary patterns and metabolic syndrome

Abstract

Metabolic syndrome (MetS) is a cluster of risk factors that significantly increases the risk of cardiovascular disease. The lack of universally accepted diagnosis criteria makes it difficult to know the real prevalence of MetS in both adult and pediatric population. Lifestyle, especially nutritional habits and physical activity, have been suggested to be independent risk factors for the development of MetS. Recent studies highlight the need to prioritize overall dietary patterns, rather than isolated nutrients, to better appraise the associations between nutritional habits and MetS. In this review we summarize recently published intervention trials and systematic reviews that evaluated the association between overall dietary patterns and the risk of MetS. Westernized dietary patterns, characterized by a high consumption of meat or meat products, snacks, baked desserts and sugar-sweetened beverages, which provide high amounts of saturated fatty acids and simple carbohydrates as added sugars, have been associated with higher risk of MetS. In contrast, more traditional dietary patterns, including the Mediterranean dietary pattern (MDP), characterized by a high consumption of vegetables, fruits, whole cereals and fish are associated with a reduced risk of MetS. The main characteristics of the MDP include a high consumption of nuts and olive oil, resulting in a relatively fat-rich pattern that provides high amounts of mono- and polyunsaturated fatty acids, bioactive polyphenols and dietary fiber. Strong evidence is accumulating to support that a closer conformity with the MDP is inversely associated with the incidence of MetS, cardiovascular risk factors, diabetes and cardiovascular disease.

Can Mediterranean Diet Counteract Metabolic Syndrome Diffusion?

“…Despite this disagreement all formulations identified five diagnostic parameters: high plasmatic levels of triglycerides, low plasmatic levels of High Density Lipoprotein cholesterol (HDL-C), hypertension, elevated fasting glucose or hyperglycemia and abdominal obesity. Diagnostic differences among various directives mainly concerned the combinations of these parameters [4] . Generally abdominal obesity was considered a "conditio sine qua non" in the diagnosis of MetS.…”

“…This appears related to Westernization of dietary habits, with a corresponding increase in the consumption of meat or meat products, snacks, baked desserts and sugar-sweetened beverages, which provide high amounts of saturated fatty acids (SFA) and simple carbohydrates as added sugars [4,[11][12][13][14][15] . Otherwise epidemiological evidence suggests that a diet high in intake of fruits, vegetables, fish and whole grains can improve all the risk factors related to MetS [4,9,16] . Besides it is well known that a reduction of SFA dietary intake is strictly related to both improvement of blood lipid profile and cardiovascular events incidence reduction.…”

“…Moreover, commonly, various foods are consumed together leading to a complex interaction among the various nutrients. For all these reasons the assessment of the interaction between dietary factors and metabolic diseases as well as MetS should be focused to the overall dietary pattern [4] .…”

“…Likely whole grain, fruit, vegetable and legumes provide an optimal mix of bioactive components, vitamins, minerals, phytochemicals and antioxidants, the latter contained in wine, too. MD cardioprotective effects are well known and widely documented by either epidemiological studies and clinical trials [31][32][33][34][35][36] , and in the last decade has been identified also an important protective role of this dietary pattern against development of the MetS [3,4,29] . Ten years ago the ATTICA, a cross-sectional study examining 2,282 Greek subjects without any evidence of CVD or T2DM, showed that adherence to a MD pattern was associated with a 20% lower risk to develop MetS [37] .…”

“…Alternatively numerous environmental correlates have been identified and lifestyles, especially dietary habits and physical inactivity, are universally recognized as the main risk factors. Particularly, epidemiological evidences suggest that diet is probably more relevant for the development of MetS than is sedentary lifestyles [4,[8][9][10] .…”