title: Dietary indexes, food patterns and incidence of metabolic syndrome in a Mediterranean cohort: The SUN project.
abstract: OBJECTIVE
  We prospectively assessed the association between adherence to several a priori defined healthy food patterns and risk of metabolic syndrome (MetS).
  
  
  METHODS
  We assessed 6851 participants of a Spanish dynamic prospective cohort of university graduates, initially free of any MetS-specific definition criteria, and followed-up for a median of 8.3 years. We calculated the adherence to thirteen different a priori defined food patterns or dietary indexes. MetS was classified according to the updated harmonizing criteria. We estimated multivariable-adjusted Incidence Rate Ratios (IRR) of metabolic syndrome and their 95% Confidence Intervals (95% CI), using Poisson regression models.
  
  
  RESULTS
  The cumulative incidence of MetS was 5.0%. Moderate adherence to the Pro-Vegetarian Diet (PVEG) was significantly associated with a lower risk for developing MetS (IRR = 0.75, 95% CI = 0.59-0.97). Among women, an inverse association with the PVEG was significant not only for a moderate adherence (IRR = 0.54, 95% CI = 0.36-0.82), but also for higher adherence (IRR = 0.63, 95% CI = 0.43-0.93). A higher adherence to the Dietary Approaches to Stop Hypertension (DASH) diet showed an inverse association with the MetS among participants, but only if they had low alcohol intake (RR = 0.41, 95% CI = 0.20-0.85).
  
  
  CONCLUSIONS
  Our findings support the adoption of a PVEG dietary pattern for the reduction of MetS risk. The same statement can be applied in relation to the DASH diet, insofar a limited consumption of alcoholic beverages is also maintained.
authors: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address: adrianomp@ufmg.br.
authors: Adriano M
authors: AM
authors: Pimenta
authors: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
authors: Estefanía
authors: E
authors: Toledo
authors: Human Physiology Unit, School of Medicine, University of Navarra, Pamplona, Spain.
authors: Maria C
authors: MC
authors: Rodriguez-Diez
authors: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
authors: Alfredo
authors: A
authors: Gea
authors: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain.
authors: Roberto
authors: R
authors: Lopez-Iracheta
authors: Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
authors: Nitin
authors: N
authors: Shivappa
authors: Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
authors: James R
authors: JR
authors: Hébert
authors: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
authors: Miguel A
authors: MA
authors: Martinez-Gonzalez
mesh_terms: D000328:Adult; D000434:Alcoholic Beverages; D004032:Diet; D014676:Diet, Vegetarian; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000178:diet therapy; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Alcohol drinking; Cohort studies; Diet, vegetarian; Metabolic syndrome X; Sodium restricted; Spain