Skip to main content
Log in

The major European dietary patterns and metabolic syndrome

  • Published:
Reviews in Endocrine and Metabolic Disorders Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. WHO. Available at: http://www.who.int/whr/2004/annex/topic/en/annex_2_en.pdf. Accessed June, 2013.

  2. Weiss R, Bremer AA, Lustig RH. What is metabolic syndrome, and why are children getting it? Ann N Y Acad Sci. 2013;1281(1):123–40.

    Article  PubMed  CAS  Google Scholar 

  3. Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, et al. Early life risk factors for obesity in childhood: cohort study. Br Med J. 2005;330(7504):1357.

    Article  Google Scholar 

  4. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med. 2011;364(25):2392–404.

    Article  PubMed  CAS  Google Scholar 

  5. Hu FB. Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes Rev. 2013;14(8):606–19.

    Article  PubMed  CAS  Google Scholar 

  6. Casazza K, Dulin-Keita A, Gower BA, Fernandez JR, et al. Differential influence of diet and physical activity on components of metabolic syndrome in a multiethnic sample of children. J Am Diet Assoc. 2009;109(2):236–44.

    Article  PubMed  Google Scholar 

  7. Goodman E, Daniels SR, Morrison JA, Huang B, Dolan LM. Contrasting prevalence of and demographic disparities in the World Health Organization and National Cholesterol Education Program Adult Treatment Panel III definitions of metabolic syndrome among adolescents. J Pediatr. 2004;145(4):445–51.

    Article  PubMed  Google Scholar 

  8. Zimmet P, George K, Alberti MM, Kaufman F, Tajima N, Silink M, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes. 2007;8(5):299–306.

    Article  PubMed  Google Scholar 

  9. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, et al. 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. 2009;120(16):1640–5.

    Article  PubMed  CAS  Google Scholar 

  10. International Association for the Study of Obesity (IASO). Available at: http://www.iaso.org/resources/world-map-obesity/?map=children. Accessed April/16.

  11. Daniels SR, Greer FR. Lipid screening and cardiovascular health in childhood. Pediatrics. 2008;122(1):198–208.

    Article  PubMed  Google Scholar 

  12. Daniels SR. The consequences of childhood overweight and obesity. Future Child. 2006;16(1):47–67.

    Article  PubMed  Google Scholar 

  13. Deckelbaum RJ, Williams CL. Childhood obesity: the health issue. Obes Res. 2001;9:239S–43.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  15. Rodriguez G, Moreno LA. Is dietary intake able to explain differences in body fatness in children and adolescents? Nutr Metab Cardiovasc Dis. 2006;16(4):294–301.

    Article  PubMed  Google Scholar 

  16. McNaughton SA, Bates CJ, Mishra GD. Diet quality is associated with all-cause mortality in adults aged 65 years and older. J Nutr. 2012;142:320–5.

    Article  PubMed  CAS  Google Scholar 

  17. Kennedy ET, Ohls J, Carlson S, Fleming K. The healthy eating index: design and applications. J Am Diet Assoc. 1995;95:1103–8.

    Article  PubMed  CAS  Google Scholar 

  18. Mursu J, Steffen LM, Meyer KA, Duprez D, Jacobs DR Jr. Diet quality indexes and mortality in postmenopausal women: the Iowa Women’s Health Study. Am J Clin Nutr. 2013 [Epub ahead of print].

  19. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. Engl J Med. 2003;348(26):2599–608.

    Article  Google Scholar 

  20. Estruch R, Ros E, Salas-Salvado J, Covas M, Corella D, Aros F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90.

    Article  PubMed  CAS  Google Scholar 

  21. Nettleton JA, Schulze MB, Jiang R, Jenny NS, Burke GL, Jacobs Jr DR. A priori-defined dietary patterns and markers of cardiovascular disease risk in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr. 2008;88:185–94.

    PubMed  CAS  Google Scholar 

  22. Mozaffarian D, Appel LJ, Van Horn L. Components of a cardioprotective diet: new insights. Circulation. 2011;123(24):2870–91.

    Article  PubMed  Google Scholar 

  23. Joung H, Hong S, Song Y, Ahn BC, Park MJ. Dietary patterns and metabolic syndrome risk factors among adolescents. Korean J Pediatr. 2012;55(4):128–35.

    Article  PubMed  CAS  Google Scholar 

  24. Campos Pastor MM, Serrano Pardo MD, Fernandez Soto ML, Luna Del Castillo JD, Escobar-Jimenez F. Impact of a ‘school-based’ nutrition intervention on anthropometric parameters and the metabolic syndrome in Spanish adolescents. Ann Nutr Metab. 2012;61(4):281–8.

    Article  PubMed  CAS  Google Scholar 

  25. Van Horn L, Obarzanek E, Friedman LA, Gernhofer N, Barton B. Children’s adaptations to a fat-reduced diet: the Dietary Intervention Study in Children (DISC). Pediatrics. 2005;115(6):1723–33.

    Article  PubMed  Google Scholar 

  26. Dorgan JF, Liu L, Barton BA, Deshmukh S, Snetselaar LG, Van Horn L, et al. Adolescent diet and metabolic syndrome in young women: results of the Dietary Intervention Study in Children (DISC) follow-up study. J Clin Endocrinol Metab. 2011;96(12):E1999–2008.

    Article  PubMed  CAS  Google Scholar 

  27. Lim H, Son JY, Choue R. Effects of medical nutrition therapy on body fat and metabolic syndrome components in premenopausal overweight women. Ann Nutr Metab. 2012;61(1):47–56.

    Article  PubMed  CAS  Google Scholar 

  28. Baxheinrich A, Stratmann B, Lee-Barkey YH, Tschoepe D, et al. Effects of a rapeseed oil-enriched hypoenergetic diet with a high content of alpha-linolenic acid on body weight and cardiovascular risk profile in patients with the metabolic syndrome. Br J Nutr. 2012;108(4):682–91.

    Article  PubMed  CAS  Google Scholar 

  29. Carvalho RF, Uehara SK, Rosa G. Microencapsulated conjugated linoleic acid associated with hypocaloric diet reduces body fat in sedentary women with metabolic syndrome. Vasc Health Risk Manag. 2012;8:661–7.

    Article  PubMed  CAS  Google Scholar 

  30. Neuhouser ML, Howard B, Lu J, Tinker LF, et al. A low-fat dietary pattern and risk of metabolic syndrome in postmenopausal women: the Women’s Health Initiative. Metabolism. 2012;61(11):1572–81.

    Article  PubMed  CAS  Google Scholar 

  31. Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB. The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol. 2011;57(11):1299–313.

    Article  PubMed  CAS  Google Scholar 

  32. DiMeglio DP, Mattes RD. Liquid versus solid carbohydrate: effects on food intake and body weight. Int J Obes. 2000;24(6):794–800.

    Article  CAS  Google Scholar 

  33. Forshee RA, Storey ML. Total beverage consumption and beverage choices among children and adolescents. Int J Food Sci Nutr. 2003;54(4):297–307.

    Article  PubMed  Google Scholar 

  34. de Ruyter JC, Olthof MR, Seidell JC, Katan MB. A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med. 2012;367(15):1397–406.

    Article  PubMed  Google Scholar 

  35. Ebbeling CB, Feldman HA, Chomitz VR, Antonelli TA, Gortmaker SL, Osganian SK, et al. A randomized trial of sugar-sweetened beverages and adolescent body weight. N Engl J Med. 2012;367(15):1407–16.

    Article  PubMed  CAS  Google Scholar 

  36. Barrio-Lopez MT, Martinez-Gonzalez MA, Fernandez-Montero A, Beunza JJ, Zazpe I, Bes-Rastrollo M. Prospective study of changes in sugar-sweetened beverage consumption and the incidence of the metabolic syndrome and its components: the SUN cohort. Br J Nutr. 2013;27:1–10.

    Article  Google Scholar 

  37. Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA. 2004;292(8):927–34.

    Article  PubMed  CAS  Google Scholar 

  38. Lim JS, Mietus-Snyder M, Valente A, Schwarz J, et al. The role of fructose in the pathogenesis of NAFLD and the metabolic syndrome. Nat Rev Gastroenterol Hepatol. 2012;7(5):251–64.

    Article  Google Scholar 

  39. Schuit AJ, van Loon AJ, Tijhuis M, et al. Clustering of lifestyle risk factors in a general adult population. Prev Med. 2002;35(3):219–24.

    Article  PubMed  Google Scholar 

  40. Bes-Rastrollo M, van Dam RM, Martinez-Gonzalez MA, Li TY, et al. Prospective study of dietary energy density and weight gain in women. Am J Clin Nutr. 2008;88(3):769–77.

    PubMed  CAS  Google Scholar 

  41. Nordmann AJ, Suter-Zimmermann K, Bucher HC, Shai I, Tuttle KR, Estruch R, et al. Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. Am J Med. 2011;124(9):841–51.

    Article  PubMed  Google Scholar 

  42. Sofi F, Abbate R, Gensini GF, Casini A, et al. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr. 2010;92(5):1189–96.

    Article  PubMed  CAS  Google Scholar 

  43. Gillingham LG, Harris-Janz S, Jones PJ. Dietary monounsaturated fatty acids are protective against metabolic syndrome and cardiovascular disease risk factors. Lipids. 2011;46(3):209–28.

    Article  PubMed  CAS  Google Scholar 

  44. Nettleton JA, Katz R. N-3 long-chain polyunsaturated fatty acids in type 2 diabetes: a review. J Am Diet Assoc. 2005;105(3):428–40.

    Article  PubMed  CAS  Google Scholar 

  45. Riediger ND, Othman RA, Suh M, Moghadasian MH, et al. A systemic review of the roles of n-3 fatty acids in health and disease. J Am Diet Assoc. 2009;109(4):668–79.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

Authors do not have any financial or other relationship that might lead to a potential conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Miguel Ángel Martínez-González.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Martínez-González, M.Á., Martín-Calvo, N. The major European dietary patterns and metabolic syndrome. Rev Endocr Metab Disord 14, 265–271 (2013). https://doi.org/10.1007/s11154-013-9264-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11154-013-9264-6

Keywords

Navigation