A healthy dietary pattern consisting of a variety of food choices is inversely associated with the development of metabolic syndrome

There are limited data on healthy dietary patterns protective against metabolic syndrome (MetSyn) development. We identified dietarypatternsamong middle-aged and older adults and investigated the associations with the incidence of MetSyn. A population-based prospective cohort studyincluded 5,251 male and female Koreans aged 40-69 years. At baseline, all individuals were free of MetSyn, other major metabolic diseases, andknown cardiovascular disease or cancer. Cases of MetSyn were ascertained over a 6-year of follow-up. Dietary patterns and theirfactor scoreswere generated by factor analysis using the data of a food frequency questionnaire. We performed pooled logistic regression analysis to estimatemultivariable-adjusted relative risk (RR) and 95% confidence interval (CI) for associations between factor scores and MetSyn risk. Two dietarypatterns were identified; (1) a healthy dietary pattern, which included a variety of foods such as fish, seafood, vegetables, seaweed, protein foods,fruits, dairy products, and grains; and (2) an unhealthy dietary pattern, which included a limited number of food items. Aftercontrolling for confoundingfactors, factor scores for the healthy dietary pattern were inversely associated with MetSyn risk (P-value for trend < 0.05) while those for the unhealthydietary pattern had no association. Individuals in the top quintile of the healthy diet scores showed a multivariable-adjustedRR [95% CI] of 0.76[0.60-0.97] for MetSyn risk compared with those in the bottom quintile. The beneficial effects were derived from inverse associations with abdominalobesity, low HDL-cholesterol levels, and high fasting glucose levels. Our findings suggest that a variety of healthy food choices is recommendedto prevent MetSyn.