Dietary Goals for Metabolic Syndrome

Jonathan Frazier, PharmD Candidate 2015 Mercer University College of Pharmacy

Metabolic syndrome is a group of metabolic risk factors that increases the risk of developing cardiovascular disease and type 2 diabetes. The etiology of metabolic syndrome still remains unclear, but what is known is that it seems to be a complex interaction between genetic, metabolic, and environmental factors.1 According to the American Heart Association (AHA), around 34% of United States adults are affected by metabolic syndrome. The AHA also states that metabolic syndrome is a serious heart condition, and patients who present with multiple metabolic risk factors have greater chances for future cardiovascular problems than those presenting only one factor.2

Currently, AHA’s position on dietary goals focuses on three main risk factors associated with heart disease – high cholesterol, high blood pressure, and excess body weight. The AHA recommends the same basic guidelines for diet and healthy eating as the United States Department of Agriculture (USDA); however, the AHA has added some minor changes such as limiting cholesterol intake to <300mg/d, avoiding trans fats, limiting saturated fatty acid intake <10% of total calories, and eating fish twice a week.3

Title: Single-Component Versus Multicomponent Dietary Goals for the Metabolic Syndrome
Design Randomized control trial; 240 participants
Objective To evaluate a diet focused on increased fiber consumption versus the multicomponent American Heart Association (AHA) dietary guidelines
Study groups AHA diet group (N=119)
High-fiber diet group (N= 121)
Methods Patients were randomized into two diet groups, a high-fiber diet or the AHA diet, in which they compared single goal dietary recommendations to increase fiber intake to >30g/d with the multicomponent AHA dietary guidelines for persons with metabolic syndrome.
Duration June 2009 to January 2014
Primary Outcome Measure Weight change at 12 months
Baseline Characteristics High-fiber diet: mean age 52 years (+10.3), female 88 (72.7%), white 102 (85%)mean BMI 35.0 kg/m2 (+2.8)
AHA diet: mean age 52.5 years (+9.9), female 85 (71.4%), white 106 (89.8%) mean BMI 34.9 kg/m2 (+3.1)
Results Mean weight change at 12 months:
High-fiber diet group: -2.1 kg (95% CI, -2.9 to -1.3 kg)
AHA diet group: -2.7 kg (95% CI, -3.5% to -2.0 kg)
Mean between group difference of 0.6kg (CI, -0.5 to 1.7 kg)
Adverse Events Common Adverse Events:None
Serious Adverse Events:None
Percentage that Discontinued due to Adverse Evens:None
Study Author Conclusions Based on the results of this study, the authors concluded that there was no clear between-group differences suggesting that even though the more complex AHA diet may result in up to 1.7 kg more weight loss, a diet focusing on a targeted fiber goal may be able to achieve clinically meaningful weight loss similar to the widely applied, but more intense, AHA guidelines.

With metabolic syndrome increasing the risk for cardiovascular events and developing diabetes, dietary intake is an important way that patients can take control and impact their own healthcare. Based on this study and reviews of others, there does not seem to one superior diet option at this time for patients suffering from metabolic syndrome. What is evident though is that the best diet option for patients is one that suits their most current needs at the time such as a diabetic diet or a heart healthy diet.

References
1. Feldeisen SE, Tucker KL. Nutritional strategies in the prevention and treatment of metabolic syndrome. Appl Physiol Nutr Metab. 2007;32(1):46-60.
2. http://www.heart.org. Metabolic syndrome. 2015. Available at: http://www.heart.org/HEARTORG/Conditions/More/MetabolicSyndrome/About-Metabolic-Syndrome_UCM_301920_Article.jsp. Accessed March 6, 2015.
3. Zivkovic AM, German JB, Sanyal AJ. Comparative review of diets for the metabolic syndrome: implications for nonalcoholic fatty liver disease. Am J Clin Nutr. 2007;86(2):285-300.

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