title: Nutritional risk and the metabolic syndrome in women: opportunities for preventive intervention from the Framingham Nutrition Study.
abstract: BACKGROUND
  Diet is recognized as a key factor in the cause and management of the metabolic syndrome (MetS). However, policies to guide preventive clinical nutrition interventions of the condition are limited.
  
  
  OBJECTIVE
  We examined the relation between dietary quality and incident MetS in adult women and identified foci for preventive nutrition interventions.
  
  
  METHODS
  This was a prospective study of 300 healthy women (aged 30-69 y) in the Framingham Offspring-Spouse study who were free of MetS risk factors at baseline. The development of individual MetS traits and overall MetS status during 12 y of follow-up were compared in women by tertile of nutritional risk, based on intake of 19 nutrients. Multivariate logistic regression models considered age, smoking, physical activity, and menopausal status.
  
  
  RESULTS
  Baseline age-adjusted mean nutrient intake and ischemic heart disease risk profiles differed by tertile of nutritional risk. Women with higher nutritional risk profiles consumed more dietary lipids (total, saturated, and monounsaturated fats) and alcohol and less fiber and micronutrients; they had higher cigarette use and waist circumferences. Compared with women with the lowest nutritional risk, those in the highest tertile had a 2- to 3-fold risk of the development of abdominal obesity and overall MetS during 12 y of follow-up [odds ratio: 2.3 (95% CI: 1.2, 4.3) and 3.0 (95% CI: 1.2, 7.6), respectively].
  
  
  CONCLUSIONS
  Higher composite nutritional risk predicts the development of abdominal obesity and MetS during long-term follow-up in healthy women, independent of lifestyle and ischemic heart disease risk factors. Preventive nutrition interventions for obesity and MetS risk reduction should focus on the overall nutritional quality of women's dietary profiles.
authors.affiliation: Department of Family Medicine and the Graduate Medical Sciences Division, Boston University School of Medicine, Boston, MA, USA. bmillen@bu.edu
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Millen
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pencina
authors.forename: Ruth W
authors.initials: RW
authors.lastname: Kimokoti
authors.forename: Lei
authors.initials: L
authors.lastname: Zhu
authors.forename: James B
authors.initials: JB
authors.lastname: Meigs
authors.forename: Jose M
authors.initials: JM
authors.lastname: Ordovas
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D016001:Confidence Intervals; D004032:Diet / Q000592:standards*; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008593:Menopause / Q000502:physiology; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000517:prevention & control*; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000453:epidemiology; D018673:Nutrition Policy; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects