Nutritional Strategies in the Prevention and Treatment of Metabolic Syndrome

Authors: FELDEISEN, SABRINA - TUFTS/HNRCA; Tucker, Katherine

Submitted to: Canadian Journal of Applied Physiology
Publication Type: Review Article
Publication Acceptance Date: 9/7/2006
Publication Date: 1/29/2007
Citation: Feldeisen, S.E., Tucker, K. 2007. Nutritional Strategies in the Prevention and Treatment of Metabolic Syndrome. Applied Physiology, Nutrition, and Metabolism. 32(1):46-60.

Interpretive Summary:

Technical Abstract: The metabolic syndrome is a clustering of metabolic abnormalities that increase the risk of developing atherosclerotic cardiovascular disease and type 2 diabetes. The exact etiology remains unclear, but it is known to be a complex interaction between genetic, metabolic and environmental factors. Among environmental factors, dietary habits are of central importance in the prevention and treatment of this condition. However, there is currently no firm consensus on the most appropriate dietary recommendations. General recommendations include decreasing obesity, increasing physical activity and consuming an anti-atherogenic diet, and have traditionally focused on low total fat intake. A major problem with the focus on low fat is that high carbohydrate diets can contribute to increasing triglyceride and decreasing HDL concentrations. Low-carbohydrate diets have been popular in recent years. However, such diets are typically higher in saturated fat and lower in fruit, vegetables and whole grains than national dietary recommendations. More recently the quality of carbohydrate has been studied in relation to metabolic syndrome, including a focus on dietary fiber and glycemic index. Similarly there has been a move from limiting total fat, to a focus on the quality of the fat, with evidence of beneficial effects of replacing some carbohydrate with monounsaturated fat. Other nutrients examined for possible importance include calcium, vitamin D and magnesium. Together, the evidence suggests that the components of diet currently recommended as “healthy” are likely to also be protective against metabolic syndrome, including low saturated and trans fat (rather than low total fat) and balanced carbohydrate intake rich in dietary fiber, as well as high fruit, and vegetable intake (rather than low total carbohydrate); and the inclusion of low-fat dairy foods. Accelerating research on gene-diet interactions is likely to contribute interesting information that may lead to further individualized dietary guidance in the future.