Background In Eastern Europe, cardiovascular disease (CVD) mortality is high, but the causes of this remain poorly understood. Metabolic syndrome (MetS) is a risk factor for CVD and is thought to be partly determined by diet. However, few studies have examined the associations between dietary quality and MetS in Eastern European populations
Methods This cross-sectional study used data from the baseline wave of the prospective Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study—21,142 randomly selected adults aged 45–69 years. MetS was defined using the ATP III definition (at least three of the following: central obesity (waist circumference ≥102 cm in men; ≥88 cm in women), high blood pressure (≥130/85 mmHg), high triglycerides (≥1.7 mmol/L), low HDL-C (<1.03 mmol/L in men; <1.29 mmol/L in women), high plasma blood glucose (≥6.1 mmol/L)). Dietary intake was obtained using a self-reported food frequency questionnaire in the preceding 3 months, and the Healthy Diet Indicator (HDI) was derived using WHO 2003 recommendations (intake of polyunsaturated/saturated fatty acids, fruit and vegetables, fibre, cholesterol, sugar, and protein; each component has a score ranging from 0 (worst) to 10 (best adherence) and the total score ranges from 0 (worst) to 70 (best dietary quality)). Anthropometric data and blood samples were collected during clinic visits, and other data by structured questionnaire. Logistic regression was used to examine the association between HDI and MetS (using Stata 12). All models were adjusted for potential confounders (age, sex, education, employment status, physical activity, smoking status, family history of diabetes and stroke, use of medication, alcohol intake, and total daily energy intake).
Results Prevalence of MetS was high in the Czech Republic (45.8%), Russia (29.1%), and Poland (27.8%). The risk of having MetS increased with age in all three countries (p < 0.001). Higher HDI score was associated with lower risk of MetS in the Czech Republic (OR of Mets per 10 unit increase in HDI=0.91, 95% CI: 0.83–1.00) and Russia (0.92, 0.85–0.99) but not Poland (1.01, 0.94–1.11).
Conclusion In the Czech Republic and Russia (but not Poland), higher adherence to HDI was associated with lower risk of MetS. Findings provide some support for the beneficial role of diet quality in lowering MetS prevalence. Future longitudinal studies should examine whether higher adherence to HDI reduces the risk of MetS and CVD.
- metabolic syndrome
- dietary patterns
- cardiovascular disease
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