Inverse association of improved adherence to dietary guidelines with metabolic syndrome: the Seoul Metabolic Syndrome Management program

Dongwoo Ham; YoungYun Cho; Mi-Suk Park; Yun-Sug Park; Sun-Young Kim; Hye-Min Seol; Yoo Mi Park; Sunok Woo; Hyojee Joung; Do-Sun Lim

doi:10.4162/nrp.2020.14.6.621

Inverse association of improved adherence to dietary guidelines with metabolic syndrome: the Seoul Metabolic Syndrome Management program

Nutr Res Pract. 2020 Dec;14(6):621-636. doi: 10.4162/nrp.2020.14.6.621. Epub 2020 Apr 27.

Authors

Dongwoo Ham¹, YoungYun Cho^{2

3}, Mi-Suk Park⁴, Yun-Sug Park⁴, Sun-Young Kim⁴, Hye-Min Seol⁴, Yoo Mi Park⁵, Sunok Woo⁵, Hyojee Joung^{1

2}, Do-Sun Lim^{4

6}

Affiliations

¹ Institute of Health and Environment, Seoul National University, Seoul 08826, Korea.
² Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea.
³ The Korean Dietetic Association, Seoul 07345, Korea.
⁴ Metabolic Syndrome Management Center of Seoul Metropolitan Government, Seoul 02751, Korea.
⁵ Health Care Policy Division, Citizen's Health Bureau, Seoul Metropolitan Government, Seoul 04524, Korea.
⁶ Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul 02841, Korea.

Abstract

Background/objectives: The Seoul Metabolic Syndrome Management (SMESY) program is a 1-yr lifestyle modification program targeting metabolic syndrome (MetS) in Seoul residents. This study investigated the associations between adherence to dietary guidelines and MetS among the SMESY program participants.

Subjects/methods: Data of 54,385 participants aged 20-64 yrs who completed the SMESY program in 2015, had information on adherence to dietary guidelines, and were not medicated for diabetes, hypertension, or dyslipidemia were analyzed. Participants underwent MetS screening and completed a lifestyle questionnaire including adherence to 10 dietary guidelines before and after participation. Participants were classified according to the number of MetS risk factors at baseline (MetS group, ≥ 3; risk group, 1-2; healthy group, none). Adherence to dietary guidelines was determined from the number of "yes" responses regarding the fulfillment of each guideline on ≥ 5 days/week. Multiple logistic regression was used to evaluate associations between newly diagnosed MetS and changes in adherence to dietary guidelines.

Results: In the MetS group, MetS prevalence decreased after the SMESY program (men, -41.9%p; women, -48.7%p), and all risk factors were significantly improved (P < 0.0001). All groups exhibited improved adherence to all dietary guidelines after participation (P < 0.0001). In the MetS group with positively changed adherence scores, the MetS prevalence decreased by -44.1%p for men and -49.5%p for women, whereas the prevalence in those with negative changes decreased by -38.1%p for men and -48.6%p for women. In the risk group, those with positively changed adherence scores had significantly decreased odds ratios (ORs) for newly diagnosed MetS compared with those with negative changes (OR, 0.70; 95% confidence interval [CI], 0.61-0.80 for men; OR, 0.88; 95% CI, 0.79-0.99 for women).

Conclusions: The SMESY program may effectively reduce the risk of MetS among adults with risk factors by improving adherence to dietary guidelines.

Keywords: dietary guidelines; guideline adherence; metabolic syndrome.