The Association Between Overall Dietary Index Revised and Metabolic Syndrome

• Main Authors: Feng-Yu Yang, 楊鳳玉
• Other Authors: Meei-shyuan Lee
• Format: Others
• Language: zh-TW
• Published: 2004
• Online Access: http://ndltd.ncl.edu.tw/handle/92843772501143933976

碩士 === 國防醫學院 === 公共衛生學研究所 === 92 === Abstract Background: ODI is a dietary index which was revised from HEI and DQI-R, and in which the dietary goal and food guides in Taiwan were taken into account. However, ODI did not show a consistent association with chronic diseases. In addition, the metabolic syndrome is a condition characterized by a constellation of obesity-related and CV disorders. Objective: The purpose of the present study was to revise ODI to the Overall Dietary Index Revised (ODI-R) in order to better reflect the quality of diet than ODI. Furtherly, we investigated the association between ODI-R and the metabolic syndrome. Methods: The data were collected from four health-screening centers around Taiwan from 1998 to 2002. Totally 46,238 (22,587 males and 23,651 females) and 8,821 (4,340 males and 4,481 females) participants were eligible for the cross-sectional analysis and prospective analysis, respectively. The study subjects were aged 19-84 years and had complete biochemical, dietary intake and lifestyle characteristics (cigarette smoking, alcohol consumption, and physical activity) information. The metabolic syndrome was defined by the combined criteria of NCEP and DOH. Result: The mean ODI-R score was lower than the mean ODI score in those who attended 1998’s check-up. Increased ODI-R was associated with higher dietary fiber, calcium, magnesium, vitamin A, vitamin E, vitamin C and polyunsaturated fatty acids intakes and lower saturated fatty acids, monounsaturated fatty acids, cholesterol and alcohol intakes. Those who with higher ODI-R were more likely to be healthier in lifestyle. The prevalence of the metabolic syndrome was 17.3% in men and 12.8% in women. After simultaneously controlling for age, education, BMI, cigarette smoking, alcohol drinking, and physical activity, the odds ratio for the fifth quintile versus the first quintile of ODI-R was 0.79 (95%CI: 0.68-0.90) in men and 0.80 (95%CI: 0.68-0.93) in women. Excluding BMI from the multivariable model, the odds ratio for the highest quintile compared to the lowest quintile of ODI-R was 0.58 (95%CI: 0.51-0.65) in men and 0.58 (95%CI: 0.50-0.66) in women. A significant dose-response relationship between ODI-R and risk of metabolic syndrome was evident. (test for trend, p<0.0001 for men, p<0.0001 for women). Compare to ODI, the magnitude of the inverse association between ODI-R and the metabolic syndrome was stronger. During a 4-year follow-up, incident metabolic syndrome cases were identified in 535 men and 259 women. ODI-R was associated with a lower risk of metabolic syndrome in women aged 65-84 (HR=0.24, 95%CI:0.06-0.91, p for trend=0.04) only. In the prospective cohort, we found a negative association between ODI-R and the risk of occurrence of the metabolic syndrome, though the association was not statistical significant. Conclusions: The ODI-R may be a useful tool describing the overall diet quality and represents a promising new tool for nutritional epidemiology.