Objective: To examine the relationship between dietary patterns and metabolic syndrome. Design: Population-based cross-sectional study. The K-means clustering method was used to identify dietary patterns and logistic regression models were used to compare the adjusted prevalence rates of metabolic syndrome factors, stratifying by obesity status. Setting: The 1992-3 Italian Bollate Eye Study, a population-based survey carried out in the town of Bollate (Milan), Italy. Subjects: A total of 1052 non-diabetic Italian subjects, 527 men and 525 women, aged 42-74 years. Results: Five dietary clusters were identified: common, animal products, starch, vegetal/fat and vitamin/fibre. After adjusting for potential confounders, the starch group showed the highest prevalence of metabolic syndrome (36 %) followed by the animal products group (30 %); the vitamin/fibre (20 %) and vegetal/fat groups (19 %) showed the lowest prevalence. The starch group had more dyslipidaemia (higher TAG and lower HDL cholesterol levels) and the animal products group had a higher prevalence of impaired fasting glucose. The vitamin/fibre group had the lowest prevalence of abdominal obesity. The beneficial effect of the vegetal/ fat and vitamin/fibre dietary patterns seemed stronger among the obese. Conclusions: Our results confirm the deleterious effect of a very-low-fat, highcarbohydrate diet and also of high intakes of animal products. The consumption of a diet high in vegetal fats or rich in fruits and vegetables is associated with a healthier metabolic profile. Reducing obesity is essential to prevent metabolic syndrome, but even among the obese dietary habits are important for preserving healthy lipid and glycaemic profiles.
Keywords
Metabolic syndromeDietary patterns Obesity Dyslipidaemia Cluster analysis Metabolic syndrome indicates a group of markersabdominal obesity, atherogenic dyslipidaemia, increased blood pressure and high plasma glucose levels -whose presence points to a very high risk of developing diabetes or CVD. These outcomes can be effectively prevented by early syndrome management, particularly including lifestyle modifications (1) .It is widely recognised that a healthy balanced diet is one of the principal elements in the prevention of diabetes and CVD, but it is still unclear which dietary pattern is the most beneficial for the successful management of metabolic syndrome and its complications, especially regarding the proportion and type of carbohydrates and fat (2)(3)(4) . Furthermore, the possible influence of conditions such as overweight and obesity on the relationship between diet and the metabolic syndrome needs to be evaluated (5) .We used the database of the Italian Bollate Eye Study (6)(7)(8) to examine the relationships between dietary patterns and metabolic syndrome factors in an adult population.
MethodsWe used data from the 1992-3 Italian Bollate Eye Study, which was designed to investigate the prevalence and risk factors of major eye diseases in a population consisting of a random sample of all individu...