Empirically identified dietary patterns and metabolic syndrome risk in a prospective cohort study: The Cardiovascular Disease Association Study

Background & aims: Dietary pattern is a comprehensive assessment of diet that may reflect the interrelationships between foods. Analysis on actual dietary pattern and metabolic syndrome (MetS) risk are insufficient. This study examined the prospective association between empirically identified dietary patterns and MetS risk in adults aged 40 years or older. Methods: A total of 11,305 participants (58,318 person-years) without MetS were followed. Predefined 37 food/food groups from the 106-item food frequency questionnaire were used in factor analysis to identify dietary patterns. Subsequently, we conducted a hierarchical clustering analysis of group participants based on their dietary pattern scores. Incidence rate ratios and 95% confidence intervals were estimated using a modified Poisson regression model with a robust error estimator. Results: We identified three similar, but not identical, dietary patterns in men and women separately. The “vegetables/seaweeds” and “meat/poultry/seafood” patterns and MetS risk were associated differently between men and women; in men, the association with MetS risk was inverse for “vegetables/seaweeds” but U-shaped in the “meat/poultry/seafood” pattern, whereas it was positive and inverse in women, respectively. The “non-traditional/non-staple foods” pattern was inversely associated in both men and women. Three and four clusters of the three dietary patterns were observed in men and women, respectively. A cluster in women with a high “vegetables/seaweeds” score (cluster 2) showed higher incidence rate ratios of MetS compared with all other clusters. Conclusions: In the present study, the “non-traditional/non-staple foods” dietary pattern is possibly beneficial in the development of MetS in both men and women, while the “vegetables/seaweeds” pattern, if their sodium amount is not controlled, may be harmful in the development of MetS among women.