title: Sex may modify the effects of macronutrient intake on metabolic syndrome and insulin resistance in American Indians: the strong heart study.
abstract: BACKGROUND
  Diet has been related to several characteristics of metabolic syndrome (MSDR) and insulin resistance, which carry an increased risk for diabetes and heart disease.
  
  
  OBJECTIVE
  To examine the cross-sectional association between macronutrient intake, sex, and MSDR and insulin resistance in American Indians without diabetes.
  
  
  METHODS
  Dietary intake, MSDR, and insulin resistance (estimated by homeostasis model assessment) were assessed.
  
  
  METHODS
  Data were analyzed from participants with complete dietary data (n=1,516 for MSDR, n=1,458 for insulin resistance) from the second examination (1993-1995) of the Strong Heart Study, a longitudinal, population-based study of cardiovascular disease and its risk factors in American Indians.
  
  
  METHODS
  Logistic regression and analysis of covariance were used to study associations among tertiles of macronutrient intake and MSDR and homeostasis model assessment scores.
  
  
  RESULTS
  Polyunsaturated fatty acid intake was associated with less MSDR and lower homeostasis model assessment scores in women (odds ratio 0.69 and 95% confidence interval 0.50 to 0.96 for MSDR in the third tertile) but not men. Higher simple carbohydrate intake was associated with more MSDR in men (odds ratio 1.72 and 95% confidence interval 1.10 to 2.69 in the third tertile) but not women.
  
  
  CONCLUSIONS
  Polyunsaturated fatty acid and simple carbohydrates may be associated with MSDR and insulin resistance in American Indians and sex may modify the association between dietary intake and MS and insulin resistance in this population. Further studies should focus on the longitudinal association between dietary intake and incidence of MSDR and insulin resistance and the role of sex in this relationship in American Indians and other populations.
authors.affiliation: MedStar Research Institute, Hyattsville, MD, USA. eilatsi@017.net.il <eilatsi@017.net.il>
authors.forename: Sigal
authors.initials: S
authors.lastname: Eilat-Adar
authors.forename: Jiaqiong
authors.initials: J
authors.lastname: Xu
authors.forename: Uri
authors.initials: U
authors.lastname: Goldbourt
authors.forename: Ellie
authors.initials: E
authors.lastname: Zephier
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
authors.forename: Helaine E
authors.initials: HE
authors.lastname: Resnick
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D015331:Cohort Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000378:metabolism; D004041:Dietary Fats / Q000008:administration & dosage* / Q000378:metabolism; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage / Q000378:metabolism; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D014481:United States
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004042:Dietary Fats, Unsaturated; D004043:Dietary Fiber; D004044:Dietary Proteins