Metabolic syndrome in adolescents and its association with diet quality
Keywords:
Adolescents, Food consumption, Metabolic syndromeAbstract
Objective
Analyzing the prevalence of metabolic syndrome and its association with adolescent diet quality.
Methods
Cross-sectional research with 327 adolescents from public and private high schools of Teresina, Piauí. Socioeconomic, anthropometric, and food consumption data were analyzed to obtain the Brazilian Healthy Eating Index-Revised. Moreover, data related to metabolic syndrome (blood glucose, blood pressure, waist circumference, triglycerides, and high-density lipoprotein cholesterol) were also analyzed. Continuous variables were described by means, standard deviations, and 95% confi dence intervals. To verify the association between dependent and explanatory variables, we calculated the adjusted odds ratio. The level of signifi cance was set at p<0.05.
Results
The prevalence of metabolic syndrome was 3.3%, with low high-density lipoprotein cholesterol concentration being the most frequent alteration (50.5%). The mean score on the Brazilian Healthy Eating Index-Revised was 55.4 points. The worst scores were obtained in whole cereals, dark-green and orange vegetables, oils, milk and dairy products, and whole fruits. In contrast, total cereals, meat, eggs, and legumes had scores close to the maximum stipulated. The lowest tertile of dark-green, orange, and leguminous vegetables showed risk for low high-density lipoprotein cholesterol, and the second tertile was protective against high blood glucose levels. As for the milk group, its lower intake increased the chances for high triglyceride and blood pressure levels.
Conclusion
Despite the low prevalence of metabolic syndrome, there were significant alterations in its components, associated with less consumption of important Brazilian Healthy Eating Index-Revised items.
References
Barbalho SM, Oshiiwab M, Fontanac LCS, Finallic EFR, Filhoc MEP, Spadac APM. Metabolic syndrome and atherogenic indices in school children: A worrying panorama in Brazil. Diab Met Syndr: Clin Res Rev. 2017;11(Suppl. 1):397-401. http://dx.doi.org/10.1016/j.dsx.2017.03.024
Bhalavi V, Deshmukh PR, Goswami K, Garg N. Prevalence and correlates of metabolic syndrome in the adolescents of rural wardha. Indian J Community Med. 2015;40(1):43-8. http://dx.doi.org/10.4103/0970-0218.149270
Kaur I. A comprehensive review on metabolic syndrome. Cardiol Res Pract. 2014; 2014:1-22. http://dx.doi.org/10.1155/2014/943162
Sherling DH, Perumareddi P, Hennekens CH. Metabolic syndrome: clinical and policy implications of the new silent killer. J Cardiovasc Pharmacol Ther. 2017; 22(4):365-7. http://dx.doi.org/10.1177/1074248416686187journals.sagepub.com/home/cpt
Midei AJ, Matthews KA. Positive attributes protect adolescents from risk for the metabolic syndrome. J Adolesc Health. 2014;55(1):678-83. http://dx.doi.org/10.1016/j.jadohealth.2014.05.018
Mbowe O, Diaz A, Wallace J, Mazariegos M, Jolly P. Prevalence of metabolic syndrome and associated cardiovascular risk factors in guatemalan school children. Matern Child Health J. 2014;18(1):1619-27. http://dx.doi.org/ 10.1007/s10995-013-1402-y
Kuschnir MCC, Bloch KV, Szklo M, Klein CH, Barufaldi LA, Abreu GA, et al. ERICA: prevalência de síndrome metabólica em adolescentes brasileiros. Rev Saúde Pública. 2016;50(Supl. 1):1-13. http://dx.doi.org/10.1590/S01518-8787.2016050006701
Ramic E, Prasko S, Mujanovic OB, Gavran L. Metabolic syndrome-theory and practice. Mater Sociomed. 2016; 28(1):71-3. http://dx.doi.org/10.5455/msm.2016.28.71-73
Sabaté J, Wien M. A perspective on vegetarian dietary patterns and risk of metabolic syndrome. Br J Nutr. 2015;113(Suppl. 1):136-43. http://dx.doi.org/10.1017/S0007114514004139
Previdelli AN, Andrade SC, Fisberg RM, Marchioni DM. Using two different approaches to assess dietary patterns: hypothesis-driven and data-driven analysis. Nutrients. 2016;8(10):1-15. http://dx.doi.org/10.3390/nu8100593
Tavares LF, Castro IRR, Levy RB, Cardoso LO, Claro RM. Padrões alimentares de adolescentes brasileiros: resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE). Cad Saúde Pública. 2014;30(12):1-13. http://dx.doi.org/10.1590/0102-311X0001681412. Monteiro LS, Rodrigues PRM, Veiga GV, Marchioni DML, Pereira RA. Diet quality among adolescents has deteriorated:a panel study in Niterói, Rio de Janeiro State, Brazil, 2003-2008. Cad Saúde Pública.
;32(12):1-10. http://dx.doi.org/10.1590/0102-311x0012471513. Silva DFO, Lyra CO, Lima SCVC. Padrões alimentares de adolescentes e associação com fatores de risco cardiovascular: uma revisão sistemática. Ciênc Saúde Coletiva. 2016;21(4):1181-95. http://dx.doi.org/10.1590/1413-81232015214.08742015.
Instituto Nacional de Estudos e Pesquisas Educacionais (Brasil). Educação básica: censo escolar 2014. Brasília: Inep; 2014 [citado 2015 jun 14]. Disponível em: http://www.dataescolabrasil.inep.gov.br/dataEscolaBrasil/home.seam
Bloch KV, Klein CH, Szklo M, Kuschnir MCC, Abreu GA, Barufaldi LA, et al. ERICA: prevalência de hipertensão e obesidade em adolescentes brasileiros. Rev Saúde Pública. 2016;50(Supl. 1):9s. http://dx.doi.org/10.1590/S01518-8787.2016050006685
Luiz RR, Torres TG, Magnanini MMF. Planejamento amostral. In: Luiz RR, Costa AJL, Nadanovsky P, organizadores. Epidemiologia e bioestatística na pesquisa odontológica. São Paulo: Atheneu; 2005.
Armitage P. Statistical method in medical research. New York: John Wiley and Sons; 1981.
Cameron N. Anthropometric measurements. In: Cameron N, editor. The measurement of human growth. London: Croom Helm; 1984. p.56-99.
Jelliffe DB, Jelliffe PEF. Anthropometry: Major measurements. In: Jelliffe DB, Jelliffe PEF. Community nutritional assessment. Oxford: Oxford University Press; 1989. p.68-105.
World Health Organization. Multicentre Growth Reference Study Group. WHO child growth standards: Length/height-forage, weight-for-age, weight-for-length, weight-for height and body mass index-for-age: Methods and development. Geneva: World Health Organization; 2007.
Callaway CW, Chumlea WC, Bouchard C, Himes JH, Lohman TG, Martin AD, et al. Circunferences. In: Lohman TG, Roche AF, Martorell R, editors. Anthropometric standardization reference manual. Champaign: Human Kinetics; 1988. p.39-54.
Malachias MVB, Souza WKSB, Plavnik FL, Rodrigues CIS, Brandão AA, Neves MFT, et al. 7ª Diretriz Brasileira de Hipertensão Arterial Sistêmica. Arq Bras Cardiol. 2016:107(3);1-82. http://dx.doi.org/10.5935/abc.20160151
Brandão-Souza C, Dourado CS, Quinte GC, Justo GF, Molina MCB. Determinantes da pressão arterial elevada em crianças: um estudo caso-controle em área rural do Espírito Santo. Rev Fund Care. 2018;10(1):190-5. http://dx.doi.org/10.9789/2175-5361.2018.v10i1.190-195
Christofaro DGD, Ritti-Dias RM, Fernandes RA, Polito MD, Andrade SM, Cardoso JR, et al. Detecção de hipertensão arterial em adolescentes através de marcadores gerais e adiposidade abdominal. Arq Bras Cardiol. 2011;96(6):465-70. http://dx.doi.org/10.1590/S0066-82X2011005000050
Zimmet P, Alberti KGMM, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents: An IDF consensus report. Pediatr Diabetes. 2007;8(5):299-306. http://dx.doi.org/10.1111/j.1399-5448.2007.00271.x
Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome: A new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diab Mellitus. 2006;23(5):469-80. http://dx.doi.org/10.1111/j.1464-5491.2006.01858.x
Moshfegh AJ, Rhodes DG, Baer DJ, Murayi T, Clemens JC, Rumpler WV. The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr. 2008;88(2):324-32.
Verly-Júnior E, Castro MA, Fisberg RM, Marchioni DML. Precision of usual food intake estimates according to the percentage of individuals with a second dietary measurement. J Acad Nutr Diet. 2012;122(7):1015-20. http://dx.doi.org/10.1016/j.jand.2012.03.028
Universidade Estadual de Campinas. Tabela brasileira de composição de alimentos-TACO. 4. ed. Campinas: Unicamp; 2011 [citado 2017 fev 10]. Disponível em: http://www.unicamp.br/nepa/taco/tabela.php?ativo= tabela
German Institute of Human Nutrition Potsdam-Rehbrücke [site].The Multiple Source Method (MSM). Nuthetal: Dife; 2017 [cited 2017 Jan 20]. Available from: https://msm.dife.de
Previdelli AN, Andrade SC, Pires MM, Ferreira SRG, Fisberg RM, Marchioni DM. Índice de Qualidade da Dieta Revisado para população brasileira. Rev Saúde Pública. 2011;45(4):794-8. http://dx.doi.org/10.1590/S0034-89102011005000035
Andrade SC, Previdelli NA, Marchioni DM, Fisberg RM. Avaliação da confiabilidade e validade do Índice de Qualidade da Dieta Revisado. Rev Saúde Pública. 2013;47(4):675-86. http://dx.doi.org/10.1590/S0034-8910.2013047004267
Reuter CP, Burgos MS, Barbian CD, Renner JDP, Franke SIR, Mello ED. Comparison between different criteria for metabolic syndrome in schoolchildren from southern Brazil. Eur J Pediatr. 2018;177(10):1471-7. http://dx.doi.org/ 10.1007/s00431-018-3202-2
Ricarte KMP, Costa NF, Lima TS, Silva ARV, Oliveira EAR, Lima LHO. Relação entre estado nutricional e síndrome metabólica em adolescentes do semiárido piauiense. Ciênc Cuid Saúde. 2017;16(2):1-8. http://dx.doi.org/10.4025/cienccuidsaude.v16i2.29703
Cirino IP, Silva LLA, Oliveira KM, Júnior EBM, Oliveira EAR, Lima LHO. Comparing the diagnostic criteria of metabolic syndrome in schoolchildren: cross-sectional study. Int Arch Med. 2017;10(224):1-8. http://dx.doi.org/10.3823/2494
Li P, Jiang R, Li L, Liu C, Yang F, Qiu Y. Prevalence and risk factors of metabolic syndrome in school adolescents of northeast China. J Pediatr Endocrinol Metab. 2014;27(5-6):525-32. http://dx.doi.org/10.1515/jpem-2013-0336
Faria ER, Faria FR, Franceschini SCC, Peluzio MCG, Sant’Ana LFR, Novaes JF, et al. Resistência à insulina e componentes da síndrome metabólica, análise por sexo e por fase da adolescência. Arq Bras Endocrinol Metab. 2014;58(6):610-8. http://dx.doi.org/10.1590/0004-2730000002613
Santos MC, Castro Coutinho APC, Dantas MS, Yabunaka LAM, Guedes DP, Oesterreich SA. Correlates of metabolic syndrome among young Brazilian adolescents population. Nutr J. 2018;17(66):1-8. http://dx.doi.org/ 10.1186/s12937-018-0371-9
Nogay NH. Assessment of the correlation between the atherogenic index of plasma and cardiometabolic risk factors in children and adolescents: might it be superior to the TG/HDL-C ratio? J Pediatr Endocrinol Metab. 2017;30(9):947-55. http://dx.doi.org/10.1515/jpem-2016-0479
Rae-Ellen W, Kavey, MD. Combined dyslipidemia in childhood. J Clin Lipidol. 2015; 9(5 Suppl.):S41-56. http://dx.doi.org/10.1016/j.jacl.2015.06.008
Instituto Brasileiro de Geografia e Estatística. Pesquisa de Orçamentos Familiares 2008-2009-POF. Rio de Janeiro: IBGE; 2010.
Altman M, Wilfley DE. Evidence update on the treatment of overweight and obesity in children and adolescents. J Clin Child Adolesc Psycol. 2015.44(4):521-37. http://dx.doi.org/10.1080/15374416.2014.9638544
Wendap LL, Ferreira MG, Rodrigues PRM, Pereira RA, Loureiro AS, Gonçalves-Silva RMV. Qualidade da dieta de adolescentes e fatores associados. Cad Saúde Pública. 2014;30(1):97-106. http://dx.doi.org/10.1590/0102-31 1X00082412
Sardinha NA, Canella DS, Martins APB, Claro RM, Levy RB. Dietary sources of fiber intake in Brazil. Appetite. 2014;79(1):134-8. https://dx.doi.org/10.1016/j.appet.2014.04.018
Barufaldi LA, Abreu GA, Oliveira JS, Santos DF, Fujimori E, Vasconcelos SML, et al. ERICA: prevalência de comportamentos alimentares saudáveis em adolescentes brasileiros. Rev. Saúde Pública. 2016;50(Supl.1):1s-9s. http://dx.doi.org/10.1590/s01518-8787.2016050006678
Assumpção D, Domene SMA, Fisberg RM, Barros MBA. Social and demographic inequalities in diet quality in a population-based study. Rev Nutr. 2016;29(2):151-62. http://dx.doi.org/10.1590/1678-986520160002 00001
Fontanelli MM, Sales CH, Carioca AAF, Marchioni DM, Firsberg FM. The relationship between carbohydrate quality and the prevalence of metabolic syndrome: challenges of glycemic index and glycemic load. Eur J Nutr. 2018;57(3):1197-205. http://dx.doi.org/10.1007/s00394-017-1402-6
Calton EK, James AP, Pannu PK, Soares MJ. Certain dietary patterns are beneficial for the metabolic syndrome: reviewing the evidence. Nutr Res. 2014; 34(7):559-68. http://dx.doi.org/10.1016/j.nutres.2014.06.012
Salas-Salvadó J, Guasch-Ferré M, Lee CH, Estruch R, Clish CB, Ros E. Protective effects of the Mediterranean Diet on type 2 diabetes and metabolic syndrome. J Nutr. 2016;146(4):920S-7S. http://dx.doi:org/ 10.3945/jn.115.218487
Fiorelli SKA, Vianna LM, Oliveira CAB, Fiorelli RKA, Barros BCS, Almeida CR. Efeitos da suplementação suprafisiológica de b-caroteno em ratos espontaneamente hipertensos (SHR e SHR-sp). Rev Col Bras Cir. 2014;41(5): 351-6. http://dx.doi.org/10.1590/0100-69912014005010
Nascimento LM, Gomes KRO, Mascarenhas MDM, Miranda CES, Araújo TME, Frota KMG. Association between the consumption of antioxidant nutrients with lipid alterations and cardiometabolic risk in adolescents. Rev Nutr. 2018;31(2):183-97. http://dx.doi.org/10.1590/1678-98652018000200005
Ministério da Saúde (Brasil). Guia alimentar para a População Brasileira: Promovendo a alimentação saudável. Brasília: Ministério da Saúde; 2008.
Ministério da Saúde (Brasil). Guia alimentar para a população brasileira. 2a. ed. Brasília: Ministério da Saúde; 2014.
Dugan CE, Fernandez ML. Effects of dairy on metabolic syndrome parameters: a review. Yale J Biol Med. 2014;87(2):135-47.
Drehmer M, Odegaard AO, Schmidt MI, Duncan BB, Cardoso LO, Matos SMA, et al. Brazilian dietary patterns and the dietary approaches to stop hypertension (DASH) diet-relationship with metabolic syndrome and newly diagnosed diabetes in the ELSA-Brasil study. Diabetol Metab Syndr. 2017;9(13):1-12. http://dx.doi.org/10.1186/s13098-017-0211-7
Asghari G, Yuzbashian E, Mirmiran P, Hooshmand F, Najafi R, Azizi F. Dietary Approaches to Stop Hypertension (DASH) dietary pattern is associated with reduced incidence of metabolic syndrome in children and adolescents. J Pediatr. 2016;174:178-84. http://dx.doi.org/10.1016/j.jpeds.2016.03.077
Santos MC, Coutinho APCC, Dantas MS, Yabunaka LAM, Guedes DP, Oesterreich SA. Correlates of metabolic syndrome among young Brazilian adolescents population. Nutr J. 2018;17(1):1-8. http://dx.doi.org/10.1186/s12937-018-0371-9
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Copyright (c) 2023 Larissa Carvalho Ribeiro de Sá LUSTOSA, Larisse Monteles NASCIMENTO, Layanne Cristina de Carvalho LAVÔR, Keila Rejane Oliveira GOMES, Márcio Dênis Medeiros MASCARENHAS, Karoline de Macêdo Gonçalves FROTA
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