Association of dietary patterns with continuous metabolic syndrome in children and adolescents; a nationwide propensity score-matched analysis: the CASPIAN-V study

Abstract

Objective: This study aims to determine the association of dietary patterns with metabolic syndrome (MetS) and its components in children and adolescents. Methods: This nationwide study was conducted in 2015 among 4200 students aged 7-18 years, who lived in 30 provinces in Iran. The analysis was conducted based on the propensity score using a matched case-control study design. Three dietary patterns were obtained conducting a principal component analysis with a varimax rotation on 16 dietary groups. Continuous MetS score was computed by standardizing the residuals (z-scores) of MetS components by regressing them according to age and sex. The gold standard diagnosis of MetS was considered based on the International Diabetes Federation criteria. Moreover, for the purpose of data analysis, matched logistics analysis was used. Results: The study participants consisted of 3843 children and adolescents (response rate 91.5) with mean (SD) age of 12.45 (3.04) years. Totally 49.4 of students were girls and 71.4 lived in urban areas. Three dietary patterns were obtained: Healthy, Western, and Sweet. Prevalence of MetS was 5 (boy 5.5 and girl 4.5). Results of multivariate analysis show that students with Sweet dietary patterns were at higher risk for abdominal obesity (OR 1.29; 95 CI 1.01-1.66), elevated blood pressure (OR 1.35; 95 CI 1.01-1.81) and MetS (OR 1.33; 95 CI 1.02-1.74). The two other dietary patterns were not associated with MetS and its components. Conclusion: Sweet dietary pattern increase the risk of MetS and some its components in Iranian children and adolescents. This finding provides valuable information for effective preventive strategies of MetS based on diet rather than medication to maintain healthy lifestyle habits.