Interactions Between Diet and Exposure to Secondhand Smoke on Metabolic Syndrome Among Children: NHANES 2007-2010.
BACKGROUND
Metabolic syndrome is likely influenced by a complex interaction between exposure to secondhand smoke (SHS) and diet, but no studies have evaluated this relationship.


OBJECTIVE
This study aimed to investigate the interaction between diet and exposure to SHS on metabolic syndrome among 12-19 year olds.


METHODS
We used weighted logistic regression, adjusting for potential confounders, to examine interaction of these risk factors on the prevalence of metabolic syndrome among 12-19 year olds participating in the National Health and Nutrition Examination Survey (2007-2010). Interaction was assessed by introducing product terms between SHS (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, cotinine, and self-report) and the individual nutrients (dietary fiber, eicosapentaenoic acid, docosahexaenoic acid, vitamin C, and vitamin E) and nutrient patterns in separate models; the relative excess risk due to interaction was used to evaluate interaction on the additive scale.


RESULTS
The joint effect between high exposure to SHS and low levels of certain nutrients (vitamin E and omega-3 polyunsaturated fatty acids) on metabolic syndrome risk was greater than would be expected from the effects of the individual exposures alone (for example, relative excess risk due to interaction for SHS and vitamin E = 7.5; 95% confidence interval, 2.5-17.8).


CONCLUSIONS
Prevention strategies for metabolic syndrome aimed at reducing SHS exposures and improving diet quality may exceed the expected benefits based on targeting these risk factors separately.
Department of Environmental and Radiological Health Sciences (B.F.M., M.L.C., A.B., S.J.R., J.L.P.), and Department of Health and Exercise Science (T.L.N.), Colorado State University, Ft Collins, Colorado 80523.
Brianna F
BF
Moore
Department of Environmental and Radiological Health Sciences (B.F.M., M.L.C., A.B., S.J.R., J.L.P.), and Department of Health and Exercise Science (T.L.N.), Colorado State University, Ft Collins, Colorado 80523.
Maggie L
ML
Clark
Department of Environmental and Radiological Health Sciences (B.F.M., M.L.C., A.B., S.J.R., J.L.P.), and Department of Health and Exercise Science (T.L.N.), Colorado State University, Ft Collins, Colorado 80523.
Annette
A
Bachand
Department of Environmental and Radiological Health Sciences (B.F.M., M.L.C., A.B., S.J.R., J.L.P.), and Department of Health and Exercise Science (T.L.N.), Colorado State University, Ft Collins, Colorado 80523.
Stephen J
SJ
Reynolds
Department of Environmental and Radiological Health Sciences (B.F.M., M.L.C., A.B., S.J.R., J.L.P.), and Department of Health and Exercise Science (T.L.N.), Colorado State University, Ft Collins, Colorado 80523.
Tracy L
TL
Nelson
Department of Environmental and Radiological Health Sciences (B.F.M., M.L.C., A.B., S.J.R., J.L.P.), and Department of Health and Exercise Science (T.L.N.), Colorado State University, Ft Collins, Colorado 80523.
Jennifer L
JL
Peel
D000293:Adolescent; D001835:Body Weight; D002648:Child; D003367:Cotinine / Q000097:blood; D003404:Creatinine / Q000097:blood; D004032:Diet; D015525:Fatty Acids, Omega-3 / Q000097:blood; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology*; D009043:Motor Activity; D009602:Nitrosamines / Q000097:blood; D015995:Prevalence; D011725:Pyridines / Q000097:blood; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014810:Vitamin E / Q000097:blood; D055815:Young Adult
D015525:Fatty Acids, Omega-3; D009602:Nitrosamines; D011725:Pyridines; D014028:Tobacco Smoke Pollution; D014810:Vitamin E; D003404:Creatinine; C099565:4-(methylnitrosamino)-1-(3-pyridyl)-1-butan-1-ol; D003367:Cotinine