Nutr Res Pract.  2020 Dec;14(6):621-636. 10.4162/nrp.2020.14.6.621.

Inverse association of improved adherence to dietary guidelines with metabolic syndrome: the Seoul Metabolic Syndrome Management program

Affiliations
  • 1Institute of Health and Environment, Seoul National University, Seoul 08826, Korea
  • 2Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
  • 3The Korean Dietetic Association, Seoul 07345, Korea
  • 4Metabolic Syndrome Management Center of Seoul Metropolitan Government, Seoul 02751, Korea
  • 5Health Care Policy Division, Citizen's Health Bureau, Seoul Metropolitan Government, Seoul 04524, Korea
  • 6Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul 02841, Korea

Abstract

BACKGROUND/OBJECTIVES
The Seoul Metabolic Syndrome Management (SMESY) program is a 1-yr lifestyle modification program targeting metabolic syndrome (MetS) in Seoul residents. This study investigated the associations between adherence to dietary guidelines and MetS among the SMESY program participants.
SUBJECTS/METHODS
Data of 54,385 participants aged 20–64 yrs who completed the SMESY program in 2015, had information on adherence to dietary guidelines, and were not medicated for diabetes, hypertension, or dyslipidemia were analyzed. Participants underwent MetS screening and completed a lifestyle questionnaire including adherence to 10 dietary guidelines before and after participation. Participants were classified according to the number of MetS risk factors at baseline (MetS group, ≥ 3; risk group, 1–2; healthy group, none). Adherence to dietary guidelines was determined from the number of “yes” responses regarding the fulfillment of each guideline on ≥ 5 days/week. Multiple logistic regression was used to evaluate associations between newly diagnosed MetS and changes in adherence to dietary guidelines.
RESULTS
In the MetS group, MetS prevalence decreased after the SMESY program (men, −41.9%p; women, −48.7%p), and all risk factors were significantly improved (P < 0.0001). All groups exhibited improved adherence to all dietary guidelines after participation (P < 0.0001). In the MetS group with positively changed adherence scores, the MetS prevalence decreased by −44.1%p for men and −49.5%p for women, whereas the prevalence in those with negative changes decreased by −38.1%p for men and −48.6%p for women. In the risk group, those with positively changed adherence scores had significantly decreased odds ratios (ORs) for newly diagnosed MetS compared with those with negative changes (OR, 0.70; 95% confidence interval [CI], 0.61–0.80 for men; OR, 0.88; 95% CI, 0.79–0.99 for women).
CONCLUSIONS
The SMESY program may effectively reduce the risk of MetS among adults with risk factors by improving adherence to dietary guidelines.

Keyword

Dietary guidelines; Dietary guidelines; guideline adherence; guideline adherence; metabolic syndrome; metabolic syndrome

Reference

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