title: Adherence index to the American Heart Association Diet and Lifestyle Recommendation is associated with the metabolic syndrome in Japanese male workers.
abstract: BACKGROUND
  As Japanese societies rapidly undergo Westernization, the prevalence of metabolic syndrome is increasing. We investigated the association between dietary habits and the prevalence of metabolic syndrome using a new adherence index to optimal dietary habits based on the American Heart Association Diet and Lifestyle Recommendation (AHA-DLR).
  
  
  METHODS
  We conducted a cross-sectional study of 503 male workers who completed a brief food frequency questionnaire. Adherence to the AHA-DLR was assessed using a 10-component adherence index (AI-84; a total possible score of 84 points). Metabolic syndrome was defined according to the most recently published harmonized criteria by the International Diabetes Federation in conjunction with the National Heart, Lung, and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society, and International Association for the Study of Obesity.
  
  
  RESULTS
  The prevalence of metabolic syndrome was 26.6% and the AI-84 score ranged from 5 to 56 points. Subjects with metabolic syndrome had a significantly lower AI-84 score compared with those without (27.1 ± 9.1 vs. 28.9 ± 9.2, p=0.042). After adjusting for age, energy intake, smoking habit and physical activity, a higher AI-84 score was associated with a significantly lower prevalence of metabolic syndrome, with an odds ratio of 0.778 (95% CI 0.614-0.986, p=0.038) for each 10-point score increment.
  
  
  CONCLUSIONS
  A lower AI-84 score was associated with increased prevalence of metabolic syndrome. Our findings support a potential beneficial impact of nutritional assessment using adherence to the AHA-DLR for prevention of metabolic syndrome.
authors.affiliation: Department of Health and Nutrition, Faculty of Health Science, Kio University, Japan.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Kuroki
authors.forename: Kimiko
authors.initials: K
authors.lastname: Kanauchi
authors.forename: Masao
authors.initials: M
authors.lastname: Kanauchi
mesh_terms: D000328:Adult; D000572:American Heart Association; D044466:Asian People / Q000706:statistics & numerical data*; D002908:Chronic Disease; D004651:Employment / Q000706:statistics & numerical data; D005247:Feeding Behavior; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008019:Life Style / Q000208:ethnology*; D008297:Male; D024821:Metabolic Syndrome / Q000178:diet therapy* / Q000208:ethnology*; D008875:Middle Aged; D015596:Nutrition Assessment; D015995:Prevalence; D012307:Risk Factors; D057185:Sedentary Behavior / Q000208:ethnology; D011795:Surveys and Questionnaires; D014481:United States