A "Western" diet heavy in meat, fried foods, and refined grains puts people at higher risk of developing metabolic syndrome, the collection of risk factors for heart problems, stroke, and type 2 diabetes, according to a study reported in the journal Circulation.
The findings confirmed previous research with one interesting twist: Drinking diet soda will not change the health-risk equation (surprisingly, it ups the risk, too), although consuming more dairy might protect you.
A whopping 60.5 percent of the study participants either had metabolic syndrome at the start of the study or developed it during nine years of follow-up.
"This is a red-alert wake-up call," says Dr. Suzanne Steinbaum, at Lenox Hill Hospital in New York City, who was not involved with the study.
"I love that they call this a Western diet," she says. "It's the perspective that we, as Americans, cannot eat any worse."
A person is thought to have metabolic syndrome if he or she has three or more of the following cardiovascular risk factors: large waist circumference, high blood pressure, high fasting glucose levels, low HDL ("good") cholesterol levels, and high triglycerides.
According to US government data collected between 1988 and 1994, 24 percent of adult Americans (47 million people) had metabolic syndrome. That number is probably higher now, the study authors state.
Although obesity and physical inactivity underlie most cases of metabolic syndrome, the role of diet is still not well understood.
The authors of the new study relied on "food frequency" questionnaires that had been filled out by almost 10,000 people participating in the government-sponsored Atherosclerosis Risk in Communities study.
The questionnaire included 66 items related to food consumption.
Participants' dietary preferences were categorized as either "Western-pattern" or "prudent-pattern," depending on the overall responses.
The "Western diet" consisted of more refined grains, processed meat, fried food, red meat, eggs, and soda, and less fish, fruit, vegetables, and whole grains.
The "prudent diet" was heavy on cruciferous vegetables such as broccoli and cabbage; carotenoid vegetables (carrots, pumpkins); fruit; fish and seafood; poultry; whole grains; and low-fat dairy.
The association involving metabolic syndrome with certain specific food items - such as fried foods, regular and diet soda, fruit drinks, nuts and coffee - was also explored.
Persons with the highest scores in the "Western-pattern" diet had an 18 percent increased risk of developing metabolic syndrome, compared with those with the lowest scores in this group.
Individuals with the highest consumption of meat had a 26 percent greater risk of developing metabolic syndrome, compared with those who ate the least amount of meat.
Hamburgers, hot dogs, and processed meats seemed to accelerate the effect.
On the other hand, eating dairy was found to be protective: Individuals consuming the most dairy had a 13 percent lower risk of developing metabolic syndrome, compared to those who consumed the least.
Fried foods - such as fast foods - and diet soda were also associated with metabolic syndrome, while sweetened beverages - soda and fruit drinks - as well as coffee and nuts were not.
The diet soda findings echo those from a previous trial, the study authors say.
"The first time this came up, we didn't believe it," says Dr. Steinbaum. "Take two, and it's now part of another large study."
"We did not expect to find that," adds study co-author Lyn Steffen, Ph.D., at the University of Minnesota.
"I don't know why that is, but I think there is some basic science under way now looking at diet soda and just what it does to promote these metabolic abnormalities," says Dr. Steffen.
"The message hasn't changed," adds Dr. Steffen.
"People should eat according to the dietary guidelines for Americans, which is a diet rich in plant foods," she says. I don't oppose meat, but they should consume red and processed meat once or twice a week, not once or twice a day."
Always consult your physician for more information.
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Metabolic syndrome is a condition that includes the presence of a cluster of risk factors specific for cardiovascular disease.
Metabolic syndrome significantly raises the risk of developing diabetes, heart disease, and/or stroke.
Most people who have metabolic syndrome have insulin resistance. The body makes insulin to move glucose (sugar) into cells for use as energy.
Obesity, commonly found in persons with metabolic syndrome, makes it more difficult for cells to respond to insulin. If the body cannot make enough insulin to override the resistance, the blood sugar level increases and diabetes can result.
Metabolic syndrome may be a beginning of the development of type 2 diabetes.
The cluster of conditions and risk factors related to metabolic syndrome was first named in 1988. Dr. Gerald Reaven proposed that insulin resistance was central to the cause of type 2 diabetes, high blood pressure, and cardiovascular artery disease.
Dr. Reaven called this cluster of abnormalities "Syndrome X." Since that time, Syndrome X has come to be known by various names, including metabolic syndrome, dysmetabolic syndrome, and insulin resistance syndrome. Syndrome X is now widely known as metabolic syndrome.
The American Heart Association (AHA) recognizes metabolic syndrome as a problem of growing concern, especially for those over age 60. Research suggests that about 25 percent of Americans have it.
Because the population of the US is aging and because metabolic syndrome prevalence increases with age, the AHA has estimated that metabolic syndrome soon will become the primary risk factor for cardiovascular disease, ahead of cigarette smoking.
Increasing rates of obesity are also thought to be related to the increasing rates of metabolic syndrome.
Because of the involvement of several interconnected factors in metabolic syndrome, the direct cause is not clearly understood.
The rise in obesity, coupled with a sedentary lifestyle, contribute to risk factors for metabolic syndrome, such as high cholesterol, insulin resistance, and high blood pressure. These risk factors may lead to cardiovascular disease and type 2 diabetes.
Because metabolic syndrome and insulin resistance are closely associated, many healthcare professionals believe that insulin resistance may be a cause of metabolic syndrome.
However, a direct link between the two conditions has not been established.
Others believe that hormone changes, caused by chronic stress, lead to the development of abdominal obesity, insulin resistance, and elevated blood lipids (triglycerides and cholesterol).
Always consult your physician for more information.