Current evidence suggests that individuals with metabolic syndrome are at an increased risk of type 2 diabetes and cardiovascular disease. The metabolic syndrome is defined as a pattern of metabolic disturbances that include central obesity, insulin resistance, hyperglycemia, dyslipidemia, and hypertension. Although the precise prevalence of this syndrome is unknown, existing data suggest that the incidence is rising at an alarming rate. In Tehran, Iran, it has been estimated to occur in > 3% of adults, a prevalence that is significantly higher than in most developed countries. While there is no globally accepted definition of the metabolic syndrome, most investigators assume that insulin resistance is the fundamental metabolic defect underlying metabolic syndrome. Insulin resistance in association with increased serum apolipoproteins B concentrations and high concentrations of small, dense LDL cholesterol in the serum have been called a metabolic triad that could be identified by an inexpensive screening tool called the hypertriglyceridemic waist (HW) phenotype.
Subjects with HW were nearly four times as likely to have angiographically defined coronary artery disease compared to subjects who did not have HW phenotype. Previous studies showed that the HW phenotype is widespread in the urban population of Tehran, with an estimated prevalence of 19% in men and 32% in women. Most published reports on the diet-disease relation have researched on the role of nutrients in chronic diseases, and comparatively little emphasis was placed on the specific contribution of foods, especially whole-grain foods. Whole grains contain higher amounts of fiber, vitamin E, magnesium, antioxidants, and phytoestrogens than do non-whole-grain foods. Little research has been conducted on the physiologic effects of a diet high in whole grains. A recent study was conducted to assess the association between whole-grain consumption and HW phenotype in an urban population of Tehranian adults.
The study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS), a prospective study performed in a representative sample of residents of Tehran. A total of 827 subjects (357 men and 470 women) aged 18 yr to 74 yr were utilized for the current analysis. Usual dietary intake was assessed using a 168-item semiquantitative food-frequency questionnaire (FFQ). Investigators used a procedure developed by Jacobs et al for classifying foods as whole or refined grains. The subjects' height and weight were measured and their body mass index (BMI) was calculated. Waist-to-hip ratio was calculated as waist circumference (WC) divided by hip circumference. Blood samples were drained and assessed for lipids. HW phenotype was defined as serum triacylglycerol concentrations of > 150 mg/dL and concurrent WC of > 80 cm (men) and > 79 cm (women).
Mean ([+ or -] standard deviation consumption of whole and refined grains was 93 [+ or -] 29 and 201 [+ or -] 57 gm/day, respectively. Subjects in the highest quartile of whole-grain intake had a significantly lower prevalence of HW (29%) than did those in the lowest quartile (44%; P <0.05). Conversely, those in the highest quartile of refined-grain intake had a significantly higher prevalence of HW (45%) than did those in the lowest quartile (27%; P<0.05). After control for potential confounding factors, a significantly decreasing trend was observed for the risk of HW phenotype across quartiles of whole-grain intake (odds ratios among quartiles: 1.00, 0.95, 0.90, and 0.78 respectively; P for trend = 0.02). Higher consumption of refined grains was associated with better odds of HW phenotype (by quartile: 1.00, 1.38, 1.65, and 2.1; P for trend = 0.01).
Whole-grain intake appears to be inversely associated with and refined-grain intake positively associated with the risk of HW.
A. Esmaillzadeh, P. Mirmiran, F. Azizi. Whole-grain intake and the prevalence of hypertriglyceridemic waist phenotype in Tehranian adults. Am J Clin Nutr; 81:55-63 (January, 2005). (Correspondence: F. Azizi, Endocrine Research Center, Shaheed Beheshti University of Medical Sciences, PO Box 19395-4763, Tehran, IR Iran. E-mail: azizi@erc.ac.ir).
COPYRIGHT 2005 Frost & Sullivan
COPYRIGHT 2005 Gale Group