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Consequences of a Burger, Fries, and A Diet Soda

Middle-age adults who regularly eat a double burger, fries, and a diet soda

for lunch or dinner increase their risk of incident metabolic syndrome by

25%

compared with those who limit red meat to two servings a week.

But eating healthy doesn't reduce the odds of developing metabolic syndrome,

said Lyn M. Steffen, Ph.D., M.P.H., R.D., of the University of Minnesota,

who

studied the eating habits of more than 9,514 middle-age Americans.

Dr. Steffen reported that, after nine years of follow-up, 3,782 of the

participants in the Atherosclerosis Risk in Communities study had three or

more of

the risk factors that are used to define metabolic syndrome.

Unlike other studies that have investigated relationships between nutrients

and cardiovascular risk, " we specifically studied food intake, since when we

start to think about making recommendations it is easier to do so using the

framework of real foods, eaten by real people, " Dr. Steffen said.

The researchers assessed food intake using a 66-item food frequency

questionnaire administered at three-year intervals. From the responses to

those questions,

they were able to categorize people into a Western-pattern diet or a

prudent-pattern diet.

A Western diet contained high amounts of refined grains, processed meat,

fried foods, red meat, eggs, and soda with little consumption of low-fat

dairy

products, fruits, and vegetables. Prudent eating patterns, by contrast,

favored cruciferous vegetables, carotinoid vegetables, fruit, fish and

seafood,

poultry, and whole grains, along with low-fat dairy products. At baseline

from 1987 through 1989, the study participants were between 45 and 64 years

old,

a population at risk for weight gain, which is associated with metabolic

syndrome.

" After adjusting for demographic factors, smoking, physical activity, and

energy intake, consumption of a Western dietary pattern (Ptrend≤0.03) was

adversely

associated with incident [metabolic syndrome], " the researchers found.

When they analyzed the results by specific foods, they found that meat ,

fried foods, and diet soda were all significantly associated with increased

risk

of metabolic syndrome, but consumption of dairy products -- especially

yogurt and low-fat milk -- was beneficial.

Regular soda, which Dr. Steffen said was expected to increase risk of

metabolic syndrome, was not associated with increased risk.

Dr. Steffen said the soda findings might reflect poorer glycemic control,

which has been reported in other studies of diet sodas. Moreover, she said a

study

in rats suggested that the consumption of artificial sweeteners " impairs the

body's ability to predict the caloric content of foods, and may lead to

increased

intake and body weight. "

Dr. Steffen said the association between a Western-type diet and metabolic

syndrome, although expected, was nonetheless striking for some individual

foods.

" For example, we looked specifically at french fries and found that eating

one serving a day increased the risk of developing incident metabolic

syndrome

by 10%. "

An unexpected finding was that consuming a prudent diet (i.e. one that had a

high concentration of fruits, vegetables, whole grains) and low-fat dairy

products

did not reduce the risk of metabolic syndrome. " We had expected to see a

benefit because we have seen a beneficial relationship in other studies, "

she

said.

The researchers noted that their study was limited by its use of a

questionnaire to calculate food intake, which may have allowed for reporting

bias as

well as misclassification of some foods. For example, the questionnaire was

" not designed to differentiate whole grain from refined grain items in the

food list, " they wrote.

Practice pearl: Explain to interested patients that this study suggests that

red meats, fried foods, and sweetened diet drinks may increase the risk of

developing metabolic syndrome Lutsey PL, et al " Dietary intake and the

development of the metabolic syndrome: the ARIC study " Circulation 2008;

DOI: 10.1161/CIRCULATIONAHA.107.716159.

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