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Adherence to the DASH diet and prevalence of the metabolic syndrome among Iranian women

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Abstract

Purpose

Epidemiologic data linking adherence to the dietary approaches to stop hypertension (DASH) diet and metabolic abnormalities is sparse and inconsistent. The association between habitual intake of the DASH diet and metabolic syndrome (MetS) has not been investigated in the Middle East. We aimed to determine whether usual adherence to the DASH dietary pattern was associated with MetS in a group of Iranian women.

Methods

This cross-sectional study was conducted in 2012 among a representative sample of Isfahani female nurses. A validated, dish-based semiquantitative food frequency questionnaire was used for assessing usual dietary intakes. The DASH score was constructed based on 8 main foods and nutrients emphasized or minimized in the DASH diet. The MetS was defined according to the Joint Scientific Statement.

Results

After controlling for potential confounders, individuals in the highest tertile of the DASH diet score had 81 % lower odds of MetS than those in the lowest category (OR 0.19; 95 % CI 0.07–0.96). Further, adjustment for body mass index slightly weakened the association (OR 0.37; 95 % CI 0.14–0.91). Participants with the greater adherence to the DASH diet were 54, 73, 78, and 80 % less likely to have enlarged waist circumference, hyperglyceridemia, low HDL-C levels, and high blood pressure, respectively, compared with those in the lowest tertile. No significant association was seen between consumption of a DASH diet and abnormal fasting plasma glucose.

Conclusions

Adherence to the DASH eating plan was inversely associated with the odds of MetS and most of its features among a group of Iranian women.

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References

  1. Suzuki T, Hirata K, Elkind MS et al (2008) Metabolic syndrome, endothelial dysfunction, and risk of cardiovascular events: the Northern Manhattan Study (NOMAS). Am Heart J 156:405–410

    Article  CAS  Google Scholar 

  2. Ford ES (2005) Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. Diabetes Care 28:1769–1778

    Article  Google Scholar 

  3. Ford ES, Li C, Zhao G (2010) Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes 2:180–193

    Article  Google Scholar 

  4. Fakhrzadeh H, Ebrahimpour P, Pourebrahim R, Heshmat R, Larijani B (2006) Metabolic syndrome and its associated risk factors in healthy adults: a population-based study in Iran. Metab Syndr Relat Disord 4:28–34

    Article  CAS  Google Scholar 

  5. Esmaillzadeh A, Mirmiran P, Azadbakht L, Etemadi A, Azizi F (2006) High prevalence of the metabolic syndrome in Iranian adolescents. Obesity (Silver Spring) 14:377–382

    Article  Google Scholar 

  6. Djousse L, Padilla H, Nelson TL, Gaziano JM, Mukamal KJ (2010) Diet and metabolic syndrome. Endocr Metab Immune Disord Drug Targets 10:124–137

    Article  CAS  Google Scholar 

  7. Hu FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13:3–9

    Article  CAS  Google Scholar 

  8. Appel LJ, Moore TJ, Obarzanek E, DASH Collaborative Research Group et al (1997) A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 336:1117–1124

    Article  CAS  Google Scholar 

  9. Liese AD, Bortsov A, Gunther AL et al (2011) Association of DASH diet with cardiovascular risk factors in youth with diabetes mellitus: the SEARCH for Diabetes in Youth study. Circulation 123:1410–1417

    Article  CAS  Google Scholar 

  10. Azadbakht L, Fard NR, Karimi M et al (2011) Effects of the Dietary Approaches to Stop Hypertension (DASH) eating plan on cardiovascular risks among type 2 diabetic patients: a randomized crossover clinical trial. Diabetes Care 34:55–57

    Article  CAS  Google Scholar 

  11. Asemi Z, Tabassi Z, Samimi M, Fahiminejad T, Esmaillzadeh A (2013) Favourable effects of the Dietary Approaches to Stop Hypertension diet on glucose tolerance and lipid profiles in gestational diabetes: a randomised clinical trial. Br J Nutr 109:2024–2030

    Article  CAS  Google Scholar 

  12. Folsom AR, Parker ED, Harnack LJ (2007) Degree of concordance with DASH diet guidelines and incidence of hypertension and fatal cardiovascular disease. Am J Hypertens 20:225–232

    Article  Google Scholar 

  13. Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F (2005) Beneficial effects of a Dietary Approaches to Stop Hypertension eating plan on features of the metabolic syndrome. Diabetes Care 28:2823–2831

    Article  CAS  Google Scholar 

  14. Saneei P, Hashemipour M, Kelishadi R, Rajaei S, Esmaillzadeh A (2013) Effects of recommendations to follow the Dietary Approaches to Stop Hypertension (DASH) diet v. usual dietary advice on childhood metabolic syndrome: a randomised cross-over clinical trial. Br J Nutr 110:2250–2259

    Article  CAS  Google Scholar 

  15. Fitzgerald KC, Chiuve SE, Buring JE, Ridker PM, Glynn RJ (2012) Comparison of associations of adherence to a Dietary Approaches to Stop Hypertension (DASH)-style diet with risks of cardiovascular disease and venous thromboembolism. J Thromb Haemost 10:189–198

    Article  CAS  Google Scholar 

  16. de Koning L, Chiuve SE, Fung TT, Willett WC, Rimm EB, Hu FB (2011) Diet-quality scores and the risk of type 2 diabetes in men. Diabetes Care 34:1150–1156

    Article  Google Scholar 

  17. Fung TT, Chiuve SE, McCullough ML, Rexrode KM, Logroscino G, Hu FB (2008) Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med 168:713–720

    Article  Google Scholar 

  18. Gao B, Zhang L, Wang H (2013) Clustering of major cardiovascular risk factors and the association with unhealthy lifestyles in the Chinese adult population. PLoS ONE 8:e66780

    Article  CAS  Google Scholar 

  19. Esmaillzadeh A, Azadbakht L (2008) Food intake patterns may explain the high prevalence of cardiovascular risk factors among Iranian women. J Nutr 138:1469–1475

    CAS  Google Scholar 

  20. Hassanzadeh A, Rajaie S, Esmaillzadeh A et al. (2014) A dish-based semi-quantitative food frequency questionnaire for assessment of dietary intakes in epidemiologic studies in Iran: design and development. Int J Prev Med 5:29–36

    Google Scholar 

  21. Adibi P, Esmaillzadeh A, Hassanzadeh A et al (2012) The study on the epidemiology of psychological, alimentary health and nutrition (SEPAHAN): overview of methodology. J Res Med Sci 17:S292–S298

    Google Scholar 

  22. United States Department of Health and Human Services NIoH, National Heart Lung, and Blood Institute. Your Guide to Lowering Your Blood Pressure With DASH. http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/. Accessed 5 Dec 2006

  23. Alberti KG, Eckel RH, Grundy SM et al (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645

    Article  CAS  Google Scholar 

  24. Nazare JA, Smith J, Borel AL et al (2013) Changes in both global diet quality and physical activity level synergistically reduce visceral adiposity in men with features of metabolic syndrome. J Nutr 143:1074–1083

    Article  CAS  Google Scholar 

  25. Barnes TL, Crandell JL, Bell RA, Mayer-Davis EJ, Dabelea D, Liese AD (2013) Change in DASH diet score and cardiovascular risk factors in youth with type 1 and type 2 diabetes mellitus: the SEARCH for Diabetes in Youth Study. Nutr Diabetes 3:e91

    Article  CAS  Google Scholar 

  26. Glynn RJ, Rosner B (2005) Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism. Am J Epidemiol 162:975–982

    Article  Google Scholar 

  27. Most MM (2004) Estimated phytochemical content of the dietary approaches to stop hypertension (DASH) diet is higher than in the Control Study Diet. J Am Diet Assoc 104:1725–1727

    Article  Google Scholar 

  28. Esmaillzadeh A, Azadbakht L (2006) Whole-grain intake, metabolic syndrome, and mortality in older adults. Am J Clin Nutr 83:1439–1440

    CAS  Google Scholar 

  29. Azadbakht L, Esmaillzadeh A (2009) Red meat intake is associated with metabolic syndrome and the plasma C-reactive protein concentration in women. J Nutr 139:335–339

    Article  CAS  Google Scholar 

  30. Esmaillzadeh A, Mirmiran P, Azizi F (2005) Evaluation of waist circumference to predict cardiovascular risk factors in an overweight Tehranian population: findings from Tehran Lipid and Glucose Study. Int J Vitam Nutr Res 75:347–356

    Article  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by a joint grant from the Isfahan University of Medical Sciences and Lorestan University of Medical Sciences, Islamic Republic of Iran. The financial support for conception, design, data analysis, and manuscript drafting comes from Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Conflict of interest

None of the authors had any personal or financial conflict of interest.

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Correspondence to Ahmad Esmaillzadeh.

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Saneei, P., Fallahi, E., Barak, F. et al. Adherence to the DASH diet and prevalence of the metabolic syndrome among Iranian women. Eur J Nutr 54, 421–428 (2015). https://doi.org/10.1007/s00394-014-0723-y

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  • DOI: https://doi.org/10.1007/s00394-014-0723-y

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