title: Brazilian dietary patterns and the dietary approaches to stop hypertension (DASH) diet-relationship with metabolic syndrome and newly diagnosed diabetes in the ELSA-Brasil study.
abstract: BACKGROUND
  Studies evaluating dietary patterns, including the DASH diet, and their relationship with the metabolic syndrome and diabetes may help to understand the role of dairy products (low fat or full fat) in these conditions. Our aim is to identify dietary patterns in Brazilian adults and compare them with the (DASH) diet quality score in terms of their associations with metabolic syndrome and newly diagnosed diabetes in the Brazilian Longitudinal Study of Adult Health-the ELSA-Brasil study.
  
  
  METHODS
  The ELSA-Brasil is a multicenter cohort study comprising 15,105 civil servants, aged 35-74 years at baseline (2008-2010). Standardized interviews and exams were carried out, including an OGTT. We analyzed baseline data for 10,010 subjects. Dietary patterns were derived by principal component analysis. Multivariable logistic regression investigated associations of dietary patterns with metabolic syndrome and newly diagnosed diabetes and multivariable linear regression with components of metabolic syndrome.
  
  
  RESULTS
  After controlling for potential confounders, we observed that greater adherence to the Common Brazilian meal pattern (white rice, beans, beer, processed and fresh meats), was associated with higher frequencies of newly diagnosed diabetes, metabolic syndrome and all of its components, except HDL-C. Participants with greater intake of a Common Brazilian fast foods/full fat dairy/milk based desserts pattern presented less newly diagnosed diabetes. An inverse association was also seen between the DASH Diet pattern and the metabolic syndrome, blood pressure and waist circumference. Diet, light foods and beverages/low fat dairy pattern was associated with more prevalence of both outcomes, and higher fasting glucose, HDL-C, waist circumference (among men) and lower blood pressure. Vegetables/fruit dietary pattern did not protect against metabolic syndrome and newly diagnosed diabetes but was associated with lower waist circumference.
  
  
  CONCLUSIONS
  The inverse associations found for the dietary pattern characterizing Brazilian fast foods and desserts, typically containing dairy products, with newly diagnosed diabetes, and for the DASH diet with metabolic syndrome, support previously demonstrated beneficial effects of dairy products in metabolism. The positive association with metabolic syndrome and newly diagnosed diabetes found for the pattern characterizing a typical Brazilian meal deserves further investigation, particularly since it is frequently accompanied by processed meat.Trial registrationNCT02320461. Registered 18 December 2014.
authors.affiliation: Department of Nutrition, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 4o andar, Porto Alegre, RS Brazil.|Postgraduate Program in Epidemiology and Hospital de Clínicas de Porto Alegre, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2600, sala 419, Porto Alegre, RS Brazil.
authors.forename: Michele
authors.initials: M
authors.lastname: Drehmer
authors.affiliation: Department of Epidemiology, School of Medicine, University of California, Irvine, USA.
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Odegaard
authors.affiliation: Postgraduate Program in Epidemiology and Hospital de Clínicas de Porto Alegre, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2600, sala 419, Porto Alegre, RS Brazil.|Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600, sala 419, Porto Alegre, RS Brazil.
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Schmidt
authors.affiliation: Postgraduate Program in Epidemiology and Hospital de Clínicas de Porto Alegre, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2600, sala 419, Porto Alegre, RS Brazil.|Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600, sala 419, Porto Alegre, RS Brazil.
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Duncan
authors.affiliation: National School of Public Health Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: Letícia de Oliveira
authors.initials: LO
authors.lastname: Cardoso
authors.affiliation: Institute of Collective Health, Federal University of Bahia, 513 Araújo Pinho Ave., Salvador, Brazil.
authors.forename: Sheila M Alvim
authors.initials: SMA
authors.lastname: Matos
authors.affiliation: Health Science Center, Federal University of Espírito Santo, Vitória, Brazil.
authors.forename: Maria Del Carmen B
authors.initials: MDCB
authors.lastname: Molina
authors.affiliation: Research Group on Epidemiology on Chronic and Occupational Diseases (GERMINAL), School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais 30130-100 Brazil.
authors.forename: Sandhi M
authors.initials: SM
authors.lastname: Barreto
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Pereira
keywords: Cohort study; Diabetes; Dietary patterns; Metabolic syndrome