Endocrine Abstracts

Background: The aim of this study was to investigate the association between the identified patterns of fruits and vegetables and metabolic syndrome incidence, and to investigate whether lifestyle factors (weight change and smoking) and socioeconomic status (education and occupation status) modify the effect of the patterns on metabolic syndrome risk.

Methods: We prospectively studied 1915 participants of the Tehran Lipid and Glucose study aged 19–74 years who were follow-up for dietary assessment using a validated, semi-quantitative food frequency questionnaire. Linear regression was used to compute energy-adjusted intakes of fruit and vegetables using residual methods. Patterns of fruit and vegetables, based on 17 food groups, were obtained by factor analysis (principal component analysis). To simplify the interpretation, an orthogonal rotation procedure (varimax rotation) was used. Four interpretable factors were retained based on the Cattel test graph (screen plot). Dietary patterns were describe according to foods with loadings > 0.3. Four extracted dietary pattern scores were categorized into tertiles. Additionally, we evaluated the effect modification of lifestyle factors and socioeconomic status on the association between different dietary fruit and vegetable patterns and risk of MetS using Cox regression. A significant interaction was defined as P < 0.20.

Results: We identified four major patterns of fruits and vegetables by factor analysis: ‘fresh fruit pattern’, ‘vegetable pattern’, ‘dried Fruit and cruciferous vegetable pattern’, ‘potatoes and fruit juice pattern’. After control for potential confounders, the highest tertile of ‘vegetable pattern’ was negatively associated with MetS risk (HR: 0.74, 95% CI : 0.60–0.91) and the highest tertile ‘potatoes and fruit juice pattern’ increased risk of MetS (HR: 1.49, 95% CI : 1.23–1.82). Among participants with weight gain < 7% during follow-up, all four identified patterns reduced Mets risk, compared to the reference. When stratified by smoking, ‘vegetable pattern’ and ‘dried Fruit and cruciferous vegetable pattern’ lowered MetS risk among non-smokers. Stratification based on education, resulted in MetS risk reduction across tertiles of ‘fresh fruit pattern’, ‘vegetable pattern’ and ‘dried Fruit and cruciferous vegetable pattern’ in educated participants.

Conclusions: The reduction in metabolic syndrome risk caused by fruits and vegetables intake depends on the modifying effect of lifestyle and socioeconomic factors.

Keywords: metabolic syndrome, fruits, vegetables, lifestyle, socioeconomic status.