Dietary changes associated with improvement of metabolic syndrome components in postmenopausal women receiving two different nutrition interventions

Metabolic syndrome (MetS) is a cluster of interrelated metabolic abnormalities characterized by abdominal obesity, hypertension, high levels of triglycerides (TG), low high-density lipoprotein (HDL) cholesterol levels, impaired glucose metabolism, and a prothrombotic and proinflammatory state. The prevalence of MetS in the adult population is 20% to 30% in most countries.1 In Mexico, its prevalence has been reported to be 36.8%, with a higher prevalence in women (42.2%). In women aged 50 to 59 years, most of whom have already gone through menopause, the prevalence of obesity and abdominal obesity is highest.2 Because of hormonal and metabolic changes in these women, body weight increases and visceral fat accumulates. Insulin, total cholesterol, low-density lipoprotein (LDL) cholesterol, and HDL cholesterol concentrations are usually altered in postmenopausal women, with a 60% higher risk of having MetS.3 Even for women receiving pharmacologic treatment, lifestyle changes are not only the starting strategy but also the foundation for MetS treatment. Lifestyle management of MetS should focus not on transient modifications but on permanent changes.4 Lifestyle changes that focus on diet and physical activity can successfully modify both metabolic and cardiovascular risk factors.5,6 Promotion of healthy dietary behaviors has become the cornerstone of the prevention and treatment of obesity and MetS. A variety of individual foods and nutrients (eg, fats, meat, fruits, vegetables, fish, and dietary fiber) have been reported to be associated with MetS, but evidence is still scarce.7 A Western dietary pattern has been associated with increased risk of MetS. On the other hand, a diet characterized by higher intakes of fruits/vegetables, whole grains, fish, low-fat milk, and dairy have shown favorable effects on metabolic abnormalities.4,8-12 Mediterranean and Dietary Approaches to Stop Hypertension dietary patterns have been associated with benefits for some MetS components.4,13-15 The effects of changes in specific dietary behaviors on MetS components within a clinical intervention have not been studied in depth. In a recent clinical trial, Perichart-Perera et al16 compared a structured hypocaloric diet with a behavioral therapy (BT) intervention in Mexican postmenopausal women with MetS. An important and significant decrease in MetS prevalence was observed in each group after 6 months, and significant improvements in weight and waist circumference were found in both groups. Differences in metabolic outcomes were observed between groups. The remaining question is whether achievement of specific target dietary behaviors within a nutrition intervention results in positive metabolic outcomes. This article presents the results of a dietary analysis within a clinical trial to evaluate the association between positive dietary changes and improvement of individual MetS components in postmenopausal women.