A low-fat dietary pattern and risk of metabolic syndrome in postmenopausal women: the Women's Health Initiative.
OBJECTIVE
Nutrition plays an important role in metabolic syndrome etiology. We examined whether the Women's Health Initiative (WHI) Dietary Modification Trial influenced metabolic syndrome risk.


METHODS
48,835 postmenopausal women aged 50-79 years were randomized to a low-fat (20% energy from fat) diet (intervention) or usual diet (comparison) for a mean of 8.1 years. Blood pressure, waist circumference and fasting blood measures of glucose, HDL-cholesterol and triglycerides were measured on a subsample (n=2816) at baseline and years 1, 3 and 6 post-randomization. Logistic regression estimated associations of the intervention with metabolic syndrome risk and use of cholesterol-lowering and hypertension medications. Multivariate linear regression tested associations between the intervention and metabolic syndrome components.


RESULTS
At year 3, but not years 1 or 6, women in the intervention group (vs. comparison) had a non-statistically significant lower risk of metabolic syndrome (OR=0.83, 95%CI 0.59-1.18). Linear regression models simultaneously modeling the five metabolic syndrome components revealed significant associations of the intervention with metabolic syndrome at year 1 (p<0.0001), but not years 3 (p=0.19) and 6 (p=0.17). Analyses restricted to intervention-adherent participants strengthened associations at years 3 (p=0.05) and 6 (p=0.06). Cholesterol-lowering and hypertension medication use was 19% lower at year 1 for intervention vs. comparison group women (OR=0.81, 95% CI 0.60-1.09).Over the entire trial, fewer intervention vs. comparison participants used these medications (26.0% vs. 29.9%), although results were not statistically significant (p=0.89).


CONCLUSIONS
The WHI low-fat diet may influence metabolic syndrome risk and decrease use of hypertension and cholesterol-lowering medications. Findings have potential for meaningful clinical translation.
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA. mneuhous@fhcrc.org
Marian L
ML
Neuhouser
Barbara
B
Howard
Jingmin
J
Lu
Lesley F
LF
Tinker
Linda
L
Van Horn
Bette
B
Caan
Thomas
T
Rohan
Marcia L
ML
Stefanick
Cynthia A
CA
Thomson
D000368:Aged; D004041:Dietary Fats / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D017698:Postmenopause; D012307:Risk Factors; D016387:Women's Health
D004041:Dietary Fats