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Diet and metabolic syndrome: a narrative review

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Abstract

Metabolic syndrome (MetS) is a highly prevalent condition defined by the presence of at least three out of five risk factors including central obesity, increased fasting glucose, high blood pressure, and dyslipidaemia. Metabolic syndrome is associated with a 2-fold increase in cardiovascular outcomes and a 1.5-fold increase in all-cause mortality. Excess energy intake and Western dietary pattern may influence the development of metabolic syndrome. By contrast, both Mediterranean diet (Med-diet) and Dietary Approaches to Stop Hypertension (DASH) diet, with or without calorie restriction, have positive effects. For the prevention and management of MetS, it is recommended to increase the daily intake of fiber-rich and low-glycaemic-index foods and the consumption of fish and dairy products, especially yogurt and nuts. Moreover, it is advisable to consume a large variety of unprocessed cereals, legumes, and fruit. Finally, it is suggested to replace saturated fatty acids with monounsaturated and polyunsaturated fatty acids and to limit the consumption of free sugars to less than 10% of the total energy intake. The aim of this narrative review is to analyze current evidence on the different dietary patterns and nutrients that may affect prevention and treatment of MetS and to discuss the underlying pathophysiological mechanisms.

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Abbreviations

MetS:

Metabolic syndrome

Med-diet:

Mediterranean diet

DASH:

Dietary Approaches to Stop Hypertension

EDCs:

Endocrine disrupting chemicals

HFCS:

High fructose corn syrup

VLDL:

Very-low-density lipoprotein

HDL:

High-density lipoprotein

SFA:

Saturated fatty acid

MFA:

Monounsaturated fatty acid

PUFA:

Polyunsaturated fatty acid

HOMA-IR:

Homeostasis model assessment insulin resistance

TAG:

Triacylglycerols

hsCRP:

High sensitivity C-reactive protein

IL:

Interleukin

VEGF:

Vascular endothelial growth factor

CETP:

Cholesterol ester transfer protein

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  1. Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, I Clinica Medica, Sapienza University of Rome, Policlinico Umberto 1, 00161, Rome, Italy

    Francesco Angelico, Francesco Baratta, Mattia Coronati, Domenico Ferro & Maria Del Ben

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  1. Francesco Angelico
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  3. Mattia Coronati
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  5. Maria Del Ben
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Correspondence to Francesco Baratta.

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Angelico, F., Baratta, F., Coronati, M. et al. Diet and metabolic syndrome: a narrative review. Intern Emerg Med 18, 1007–1017 (2023). https://doi.org/10.1007/s11739-023-03226-7

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