University of Virginia Health System

Typical Western Diet Fuels Metabolic Syndrome

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 in the journal Circulation.

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 care.

"This is a red-alert wake-up call," says Dr. Suzanne Steinbaum of Lenox Hill Hospital, 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.

Western = Red Meat, Fried Foods and More

According to U.S. government data collected between 1988 and 1994, 24 percent of adult Americans (47 million people) had metabolic syndrome. That number is probably higher now, say the study authors.

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 filled out by almost 10,000 people participating in the government-sponsored Atherosclerosis Risk in Communities study.

The questionnaire included 66 items about 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.

People with the highest scores in the "Western-pattern" diet had an 18 percent increased risk of developing metabolic syndrome, compared with people with the lowest scores in this group.

Individuals with the highest meat consumption 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 products 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 - such as soda and fruit drinks - as well as coffee and nuts were not.

Meat Twice a Week, Veggies Every Day

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., of 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 Steffen.

Angela Taylor, M.D., Assistant Professor of Medicine at the University of Virginia Health System, isn't completely surprised by the association between diet soda and metabolic syndrome.

"People who consume diet sodas are likely to also consume more processed and ‘fast' foods," she says. "One should, however, be aware that diet sodas are high in salt, which can certainly contribute to increased blood pressure."

"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."

UVA's Taylor says it's also key to reduce your intake of fat, sugar and processed carbohydrates.

Taylor's recommendations for reducing your risk of metabolic syndrome include:

• A diet rich in fruits, vegetables and nuts. Several studies have shown this diet reduces your risk of metabolic syndrome.
• Thirty minutes of daily exercise. If you're not able to do 30 minutes of exercise at first, she says, start with a shorter workout and build up to 30 minutes a day - she says that will still improve your health.
• Talk with your doctor about your metabolic syndrome risk factors. Some people may require medication to help you control their risk factors.

To learn more about healthy eating and other health topics, visit www.uvahealth.com.

Always consult your physician for more information.