Background: Although individual foods and nutrients have been associated with the metabolic syndrome, whether dietary patterns identified by factor analysis are also associated with this syndrome is not known. Objective: We aimed to evaluate the association of major dietary patterns characterized by factor analysis with insulin resistance and the metabolic syndrome among women. Design: Usual dietary intakes were assessed in a cross-sectional study of 486 Tehrani female teachers aged 40 -60 y. Anthropometric and blood pressure measurements were performed, and fasting blood samples were taken for biomarker assessment. The metabolic syndrome was defined according to Adult Treatment Panel III guidelines, and insulin resistance was defined as the highest quartile of the homeostasis model assessment scores. Results: We identified 3 major dietary patterns by factor analysis: the healthy dietary pattern, the Western dietary pattern, and the traditional dietary pattern. After control for potential confounders, subjects in the highest quintile of healthy dietary pattern scores had a lower odds ratio for the metabolic syndrome (odds ratio: 0.61; 95% CI: 0.30, 0.79; P for trend 0.01) and insulin resistance (0.51; 0.24, 0.88; P for trend 0.01) than did those in the lowest quintile. Compared with those in the lowest quintile, women in the highest quintile of Western dietary pattern scores had greater odds for the metabolic syndrome (1.68; 1.10, 1.95; P for trend 0.01) and insulin resistance (1.26; 1.00, 1.78; P for trend 0.01). Higher consumption of traditional dietary pattern was significantly associated only with abnormal glucose homeostasis (1.19; 1.04, 1.59; P 0.05). Conclusion: Significant associations exist between dietary patterns identified by factor analysis, the metabolic syndrome, and insulin resistance.Am J Clin Nutr 2007;85:910 -8.

Few studies have examined the contribution of major dietary patterns to markers of systemic inflammation. This study was conducted to evaluate the association of major dietary patterns with markers of systemic inflammation among Iranian women. In a cross-sectional study of 486 healthy women aged 40-60 y, we assessed usual dietary intakes by means of an FFQ. Dietary patterns were identified by factor analysis. Anthropometric measurements were made and blood samples from fasting were taken for measuring inflammatory markers. The healthy pattern (high in fruits, vegetables, tomato, poultry, legumes, tea, fruit juices, and whole grains) was inversely related to plasma concentrations of C-reactive protein (CRP) (beta = -0.09, P < 0.001), E-selectin (beta = -0.07, P < 0.05), and soluble vascular cell adhesion molecule-1 (sVCAM-1) (beta = -0.08, P < 0.001) after control for potential confounders; with further adjustment for BMI and waist circumference (WC), the associations remained significant for CRP (beta = -0.05, P < 0.05) and sVCAM-1 (beta = -0.04, P < 0.05). In contrast, the western pattern score (high in refined grains, red meat, butter, processed meat, high-fat dairy, sweets and desserts, pizza, potato, eggs, hydrogenated fats, and soft drinks) was positively related to CRP (beta = 0.08, P < 0.001), serum amyloid A (SAA) (beta = 0.11, P < 0.05), IL-6 (beta = 0.09, P < 0.001), soluble intercellular adhesion molecule-1 (beta = 0.05, P < 0.05), and sVCAM-1 concentrations (beta = 0.07, P < 0.05). However, after additional control for BMI and WC, the associations remained significant only for SAA (beta = 0.06, P < 0.05) and IL-6 (beta = 0.07, P < 0.001). The traditional dietary pattern (high in refined grains, potato, tea, whole grains, hydrogenated fats, legumes, and casserole) was positively associated with the plasma IL-6 concentration (beta = 0.04, P < 0.05) when we controlled for confounders including BMI and WC. The findings suggest an independent association between major dietary patterns and plasma concentrations of markers of inflammation.

Higher intakes of fruit and vegetables are associated with a lower risk of the metabolic syndrome; the lower risk may be the result of lower CRP concentrations. These findings support current dietary recommendations to increase daily intakes of fruit and vegetables as a primary preventive measure against cardiovascular disease.

OBJECTIVE -To determine the effects of soy consumption on markers of inflammation and endothelial function in postmenopausal women with the metabolic syndrome.RESEARCH DESIGN AND METHODS -This randomized cross-over clinical trial included 42 postmenopausal women with the metabolic syndrome. Participants were randomly assigned to consume a control diet (Dietary Approaches to Stop Hypertension [DASH]), soy protein diet, or soy nut diet, each for 8 weeks. Red meat in the DASH diet (one serving/day) was replaced by soy protein in the soy protein diet and by soy nut in the soy nut diet.RESULTS -For nitric oxide levels, the difference from the control diet was 9.8% (P Ͻ 0.01) on the soy nut and Ϫ1.7% (P ϭ 0.10) on the soy protein diets. The difference from the control diet for serum E-selectin was Ϫ11.4% (P Ͻ 0.01) on the soy nut consumption and Ϫ4.7% (P ϭ 0.19) on the soy protein diet. Soy nut consumption reduced interleukin-18 compared with the control diet (difference from the control diet: Ϫ9.2%, P Ͻ 0.01), but soy protein did not (difference from the control diet: Ϫ4.6%, P ϭ 0.14). For C-reactive protein, the difference from the control diet was Ϫ8.9% (P Ͻ 0.01) on the soy nut diet and Ϫ1.6% (P Ͻ 0.01) on the soy protein diet.CONCLUSIONS -Short-term soy nut consumption reduced some markers of inflammation and increased plasma nitric oxide levels in postmenopausal women with the metabolic syndrome. Diabetes Care 30:967-973, 2007T he metabolic syndrome is a heterogeneous condition accompanied by visceral adiposity, dyslipidemia, hypertension, and insulin resistance (1,2). Elevated blood levels of inflammatory markers such as C-reactive protein (CRP), interleukin (IL)-2, IL-6, IL-18, and tumor necrosis factor (TNF)-␣ and endothelial dysfunction are associated with features of the metabolic syndrome (3-7). Inflammation, insulin resistance, and endothelial function are strongly correlated in individuals with the metabolic syndrome and may influence each other and exacerbate metabolic deterioration (8,9). Estrogen deficiency in postmenopausal women may further aggravate these conditions (10); endothelium-dependent vasodilation declines with aging, particularly in women after menopause (11). Therefore, postmenopausal women with the metabolic syndrome are at greater risk of endothelial dysfunction.Diet plays an important role in the development of the metabolic syndrome, partly through its effects on proinflammatory markers (12). Several studies have examined the effects of diet on serum levels of inflammatory markers and endothelial function (13-17); some have focused on the effects of soy consumption (18 -24). Soy contains fiber, polyunsaturated fat, and phytoestrogens, which are individually associated with lower levels of inflammatory markers and improved endothelial function (12,16,17). Most studies on the effects of soy consumption on these markers have been performed in healthy (18 -20,22-24) or hypercholesterolemic (21) postmenopausal women. We are aware of no study regarding such effects among women with the met...