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Association of Dietary Patterns with Metabolic Syndrome
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Association of Dietary Patterns with Metabolic Syndrome

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 110209

Special Issue Editor

Prof. Dr. Nicola Di Daniele

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Guest Editor
UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Interests: arterial hypertension; endothelial dysfunction; aging; metabolic syndrome; diabetes mellitus; caloric restriction diet
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Metabolic syndrome (MetS) is a growing global public health problem. MetS also represents a risk factor for the onset of chronic non-communicable degenerative diseases (NCDDs), including cardiovascular disease, type 2 diabetes mellitus, chronic kidney disease, and some types of cancer.

This Special Issue, titled "Association of Dietary Patterns with Metabolic Syndrome", aims to highlight the current scientific knowledge and possible new applications in the different dietary patterns for MetS prevention and treatment. In fact, a balanced diet associated with a healthy lifestyle is known to play a key role in the prevention of MetS. For this reason, the identification of different dietary patterns, in terms of quantity, quality, variety, or combination of different foods and drinks, is of fundamental relevance to its prevention. In addition to the classic concept of "dietary patterns", it is currently necessary to take into consideration the ability of an organism to process dietary nutrients. From this perspective, the composition of the gut microbiota is of great interest, and it appears to be related to the onset and degree of NCDDs. Currently, the Mediterranean diet seems to play a key role in the prevention and treatment of MetS. Additional dietetic-nutritional strategies (such as the DASH Diet, ketogenic diet, vegan diet, etc.) should be examined in order to evaluate their potential benefits in the prevention and treatment of MetS.

Prof. Dr. Nicola Di Daniele
Guest Editor

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Keywords

  • Mediterranean diet
  • Gut microbiota and metabolic syndrome
  • Vegan diet
  • DASH diet
  • Metabolic syndrome in the elderly

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Published Papers (9 papers)

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Editorial

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3 pages, 171 KiB  
Editorial
Association of Dietary Patterns with Metabolic Syndrome
by Nicola Di Daniele
Nutrients 2020, 12(9), 2840; https://doi.org/10.3390/nu12092840 - 17 Sep 2020
Cited by 5 | Viewed by 2889
Abstract
Metabolic syndrome (MetS), as originally defined by Jean Vague in 1940, was identified as a cluster of chronic, inflammatory pathologies, such as arterial hypertension, abdominal obesity, high glucose levels, high triglyceride levels and low HDL levels in the blood [...] Full article
(This article belongs to the Special Issue Association of Dietary Patterns with Metabolic Syndrome)

Research

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18 pages, 5345 KiB  
Article
A Korean-Style Balanced Diet Has a Potential Connection with Ruminococcaceae Enterotype and Reduction of Metabolic Syndrome Incidence in Korean Adults
by Xuangao Wu, Tatsuya Unno, Suna Kang and Sunmin Park
Nutrients 2021, 13(2), 495; https://doi.org/10.3390/nu13020495 - 3 Feb 2021
Cited by 38 | Viewed by 5439
Abstract
Metabolic syndrome is associated with usual dietary patterns that may be involved in enterotypes. We aimed to understand the potential relationship of enterotypes and dietary patterns to influence metabolic syndrome in the Koreans. Using the Korea National Health and Nutrition Examination Survey (KNHANES)-VI [...] Read more.
Metabolic syndrome is associated with usual dietary patterns that may be involved in enterotypes. We aimed to understand the potential relationship of enterotypes and dietary patterns to influence metabolic syndrome in the Koreans. Using the Korea National Health and Nutrition Examination Survey (KNHANES)-VI in 2014, metabolic parameters were also analyzed among the dietary patterns classified by principal component analysis in Korean adults. The fecal microbiota data of 1199 Korean adults collected in 2014 were obtained from the Korea Centers for Disease Control and Prevention. Enterotypes were classified based on Dirichlet multinomial mixtures (DMM) by Mothur v.1.36. The functional abundance of fecal bacteria was analyzed using the PICRUSt2 pipeline. Korean adults were clustered into three dietary patterns including Korean-style balanced diets (KBD, 20.4%), rice-based diets (RBD, 17.2%), and Western-style diets (WSD, 62.4%) in KNHANES. The incidence of metabolic syndrome was lowered in the order of RBD, WSD, and KBD. The participants having a KBD had lower serum C-reactive protein and triglyceride concentrations than those with RBD and WSD (p < 0.05). Three types of fecal bacteria were classified as Ruminococcaceae type (ET-R, 28.7%), Prevotella type (ET-P, 52.2%), and Bacteroides type (ET-B, 42.1%; p < 0.05). ET-P had a higher abundance of Prevotella copri, while ET-R contained a higher abundance of Alistipes, Akkermansia muciniphila, Bifidobacterium adolescentis, and Faecalibacterium prausnitzii. ET-B had a higher abundance of the order Bilophila (p < 0.05). Metabolism of propanoate, starch, and sucrose in fecal microbiome was higher in ET-P and ET-R, whereas fatty acid metabolism was enhanced in ET-B. Fecal microbiota in ET-P and ET-B had higher lipopolysaccharide biosynthesis activity than that in ET-R. The metabolic results of KBD and RBD were consistent with ET-R and ET-P’s gut microbiota metabolism, respectively. In conclusion, Korean enterotypes of ET-P, ET-B, and ET-R were associated with RBD, WSD, and KBD, respectively. This study suggests a potential link between dietary patterns, metabolic syndrome, and enterotypes among Korean adults. Full article
(This article belongs to the Special Issue Association of Dietary Patterns with Metabolic Syndrome)
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19 pages, 1346 KiB  
Article
Effects of a 3-Week In-Hospital Body Weight Reduction Program on Cardiovascular Risk Factors, Muscle Performance, and Fatigue: A Retrospective Study in a Population of Obese Adults with or without Metabolic Syndrome
by Antonello E. Rigamonti, Sabrina Cicolini, Diana Caroli, Alessandra De Col, Massimo Scacchi, Silvano G. Cella and Alessandro Sartorio
Nutrients 2020, 12(5), 1495; https://doi.org/10.3390/nu12051495 - 21 May 2020
Cited by 15 | Viewed by 3589
Abstract
Background. In clinical practice, there is the diffuse conviction that obese subjects with metabolic syndrome may be more difficult to treat. Objectives and Methods. The aim of the present study was that to investigate the effectiveness of a 3-week in-hospital body weight reduction [...] Read more.
Background. In clinical practice, there is the diffuse conviction that obese subjects with metabolic syndrome may be more difficult to treat. Objectives and Methods. The aim of the present study was that to investigate the effectiveness of a 3-week in-hospital body weight reduction program (BWRP) in a large population of obese subjects with and without metabolic syndrome (n = 1922; 222 men and 1700 women, age range 18–83 yr). Outcomes such as body mass index (BMI), total (TOT) and HDL cholesterol, systolic and diastolic blood pressures (SBP and DBP, respectively), coronary heart disease (CHD) score, fatigue severity score (FSS), and stair climbing test (SCT) time were evaluated before and after the intervention (Δ). A sex-, BMI-, and age-related stratification of the obese population with or without metabolic syndrome was applied. Results. When compared to obese subjects without metabolic syndrome, at the basal conditions, obese subjects had a poorer cardiometabolic profile, as demonstrated by higher triglycerides, TOT-cholesterol, DBP, SBP, and CHD score, and a more compromised muscle performance (evaluated by SCT), associated with more perception of fatigue (measured by FSS). Nevertheless, obese subjects with metabolic syndrome obtained more benefits from BWRP than those without metabolic syndrome for some outcomes (i.e., ΔTOT-cholesterol, ΔSBP, and ΔCHD score). Despite these differences, the BWRP-induced weight loss was similar between the two groups (i.e., ΔBMI) as well as the gain of muscle performance (i.e., ΔSCT) and the reduction of fatigue (i.e., ΔFSS). Interestingly, the potentially deleterious fall in HDL-cholesterol levels after BWRP was less evident in obese subjects with metabolic syndrome than those without metabolic syndrome. When pooling all data, the ΔCHD score was associated with age, sex, and metabolic syndrome. The remaining outcomes, such as ΔBMI, ΔFSS, and ΔSCT time, were associated with sex and age but not with metabolic syndrome. Finally, ΔBMI was positively correlated with ΔCHD score, ΔFSS, and ΔSCT time in both obese subjects without metabolic syndrome and obese subjects with metabolic syndrome. Conclusions. When comparing obese subjects undergoing a BWRP, metabolic syndrome is not a negative predictive factor affecting the effectiveness of this intervention in terms of weight loss, muscle performance, and psychological well-being. Full article
(This article belongs to the Special Issue Association of Dietary Patterns with Metabolic Syndrome)
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Review

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19 pages, 1126 KiB  
Review
Dietary Strategies for Management of Metabolic Syndrome: Role of Gut Microbiota Metabolites
by Sonia Croci, Lina Ilaras D’Apolito, Valeria Gasperi, Maria Valeria Catani and Isabella Savini
Nutrients 2021, 13(5), 1389; https://doi.org/10.3390/nu13051389 - 21 Apr 2021
Cited by 61 | Viewed by 10338
Abstract
Metabolic syndrome (MetS) is a complex pathophysiological state with incidence similar to that of a global epidemic and represents a risk factor for the onset of chronic non-communicable degenerative diseases (NCDDs), including cardiovascular disease (CVD), type 2 diabetes mellitus, chronic kidney disease, and [...] Read more.
Metabolic syndrome (MetS) is a complex pathophysiological state with incidence similar to that of a global epidemic and represents a risk factor for the onset of chronic non-communicable degenerative diseases (NCDDs), including cardiovascular disease (CVD), type 2 diabetes mellitus, chronic kidney disease, and some types of cancer. A plethora of literature data suggest the potential role of gut microbiota in interfering with the host metabolism, thus influencing several MetS risk factors. Perturbation of the gut microbiota’s composition and activity, a condition known as dysbiosis, is involved in the etiopathogenesis of multiple chronic diseases. Recent studies have shown that some micro-organism-derived metabolites (including trimethylamine N-oxide (TMAO), lipopolysaccharide (LPS) of Gram-negative bacteria, indoxyl sulfate and p-cresol sulfate) induce subclinical inflammatory processes involved in MetS. Gut microbiota’s taxonomic species or abundance are modified by many factors, including diet, lifestyle and medications. The main purpose of this review is to highlight the correlation between different dietary strategies and changes in gut microbiota metabolites. We mainly focus on the validity/inadequacy of specific dietary patterns to reduce inflammatory processes, including leaky gut and subsequent endotoxemia. We also describe the chance of probiotic supplementation to interact with the immune system and limit negative consequences associated with MetS. Full article
(This article belongs to the Special Issue Association of Dietary Patterns with Metabolic Syndrome)
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17 pages, 996 KiB  
Review
Gut Dysbiosis and Western Diet in the Pathogenesis of Essential Arterial Hypertension: A Narrative Review
by Maria Paola Canale, Annalisa Noce, Manuela Di Lauro, Giulia Marrone, Maria Cantelmo, Carmine Cardillo, Massimo Federici, Nicola Di Daniele and Manfredi Tesauro
Nutrients 2021, 13(4), 1162; https://doi.org/10.3390/nu13041162 - 1 Apr 2021
Cited by 24 | Viewed by 6211
Abstract
Metabolic syndrome is a cluster of the most dangerous cardiovascular (CV) risk factors including visceral obesity, insulin resistance, hyperglycemia, alterations in lipid metabolism and arterial hypertension (AH). In particular, AH plays a key role in the complications associated with metabolic syndrome. High salt [...] Read more.
Metabolic syndrome is a cluster of the most dangerous cardiovascular (CV) risk factors including visceral obesity, insulin resistance, hyperglycemia, alterations in lipid metabolism and arterial hypertension (AH). In particular, AH plays a key role in the complications associated with metabolic syndrome. High salt intake is a well-known risk factor for AH and CV diseases. Vasoconstriction, impaired vasodilation, extracellular volume expansion, inflammation, and an increased sympathetic nervous system (SNS) activity are the mechanisms involved in the pathogenesis of AH, induced by Western diet. Gut dysbiosis in AH is associated with reduction of short chain fatty acid-producing bacteria: acetate, butyrate and propionate, which activate different pathways, causing vasoconstriction, impaired vasodilation, salt and water retention and a consequent high blood pressure. Moreover, increased trimethylamine N-oxide and lipopolysaccharides trigger chronic inflammation, which contributes to endothelial dysfunction and target organs damage. Additionally, a high salt-intake diet impacts negatively on gut microbiota composition. A bidirectional neuronal pathway determines the “brain–gut” axis, which, in turn, influences blood pressure levels. Then, we discuss the possible adjuvant novel treatments related to gut microbiota modulation for AH control. Full article
(This article belongs to the Special Issue Association of Dietary Patterns with Metabolic Syndrome)
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24 pages, 2459 KiB  
Review
Vegan Diet Health Benefits in Metabolic Syndrome
by Giulia Marrone, Cristina Guerriero, Daniela Palazzetti, Paolo Lido, Alessandro Marolla, Francesca Di Daniele and Annalisa Noce
Nutrients 2021, 13(3), 817; https://doi.org/10.3390/nu13030817 - 2 Mar 2021
Cited by 84 | Viewed by 42590
Abstract
Plant-based diets (PBDs) are increasingly consumed by the Italian population and around the world. In particular, among PBDs, the vegan diet is a food pattern characterized by the exclusion of all animal-origin foods. What drives people to adopt this model are mainly ethical, [...] Read more.
Plant-based diets (PBDs) are increasingly consumed by the Italian population and around the world. In particular, among PBDs, the vegan diet is a food pattern characterized by the exclusion of all animal-origin foods. What drives people to adopt this model are mainly ethical, health and environmental reasons. A vegan diet, if well-balanced and varied, can help in achieving and maintaining an optimal state of health. However, this nutritional approach, if not well-balanced, can cause deficiencies in proteins, ω-3 fatty acids, iron, vitamin D and calcium, zinc, iodine and, above all, vitamin B12. Oral food supplements especially fortified foods are recommended in these cases to restore the nutritional deficiencies. A vegan diet generally reduces the risk of developing chronic non-communicable degenerative diseases, such as metabolic syndrome (MetS) and, in addition, requires fewer natural resources for food production than an omnivorous diet. The aim of this review is to analyze the possible impact of the vegan diet on MetS onset and its treatment. Full article
(This article belongs to the Special Issue Association of Dietary Patterns with Metabolic Syndrome)
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Graphical abstract

33 pages, 1544 KiB  
Review
Natural Bioactive Compounds Useful in Clinical Management of Metabolic Syndrome
by Annalisa Noce, Manuela Di Lauro, Francesca Di Daniele, Anna Pietroboni Zaitseva, Giulia Marrone, Patrizia Borboni and Nicola Di Daniele
Nutrients 2021, 13(2), 630; https://doi.org/10.3390/nu13020630 - 16 Feb 2021
Cited by 65 | Viewed by 13230
Abstract
Metabolic syndrome (MetS) is a clinical manifestation characterized by a plethora of comorbidities, including hyperglycemia, abdominal obesity, arterial hypertension, and dyslipidemia. All MetS comorbidities participate to induce a low-grade inflammation state and oxidative stress, typical of this syndrome. MetS is related to an [...] Read more.
Metabolic syndrome (MetS) is a clinical manifestation characterized by a plethora of comorbidities, including hyperglycemia, abdominal obesity, arterial hypertension, and dyslipidemia. All MetS comorbidities participate to induce a low-grade inflammation state and oxidative stress, typical of this syndrome. MetS is related to an increased risk of cardiovascular diseases and early death, with an important impact on health-care costs. For its clinic management a poly-pharmaceutical therapy is often required, but this can cause side effects and reduce the patient’s compliance. For this reason, finding a valid and alternative therapeutic strategy, natural and free of side effects, could represent a useful tool in the fight the MetS. In this context, the use of functional foods, and the assumption of natural bioactive compounds (NBCs), could exert beneficial effects on body weight, blood pressure and glucose metabolism control, on endothelial damage, on the improvement of lipid profile, on the inflammatory state, and on oxidative stress. This review focuses on the possible beneficial role of NBCs in the prevention and in the clinical management of MetS and its comorbidities. Full article
(This article belongs to the Special Issue Association of Dietary Patterns with Metabolic Syndrome)
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Graphical abstract

32 pages, 2027 KiB  
Review
Association of Gut Hormones and Microbiota with Vascular Dysfunction in Obesity
by Valentina Rovella, Giuseppe Rodia, Francesca Di Daniele, Carmine Cardillo, Umberto Campia, Annalisa Noce, Eleonora Candi, David Della-Morte and Manfredi Tesauro
Nutrients 2021, 13(2), 613; https://doi.org/10.3390/nu13020613 - 13 Feb 2021
Cited by 22 | Viewed by 5608
Abstract
In the past few decades, obesity has reached pandemic proportions. Obesity is among the main risk factors for cardiovascular diseases, since chronic fat accumulation leads to dysfunction in vascular endothelium and to a precocious arterial stiffness. So far, not all the mechanisms linking [...] Read more.
In the past few decades, obesity has reached pandemic proportions. Obesity is among the main risk factors for cardiovascular diseases, since chronic fat accumulation leads to dysfunction in vascular endothelium and to a precocious arterial stiffness. So far, not all the mechanisms linking adipose tissue and vascular reactivity have been explained. Recently, novel findings reported interesting pathological link between endothelial dysfunction with gut hormones and gut microbiota and energy homeostasis. These findings suggest an active role of gut secretome in regulating the mediators of vascular function, such as nitric oxide (NO) and endothelin-1 (ET-1) that need to be further investigated. Moreover, a central role of brain has been suggested as a main player in the regulation of the different factors and hormones beyond these complex mechanisms. The aim of the present review is to discuss the state of the art in this field, by focusing on the processes leading to endothelial dysfunction mediated by obesity and metabolic diseases, such as insulin resistance. The role of perivascular adipose tissue (PVAT), gut hormones, gut microbiota dysbiosis, and the CNS function in controlling satiety have been considered. Further understanding the crosstalk between these complex mechanisms will allow us to better design novel strategies for the prevention of obesity and its complications. Full article
(This article belongs to the Special Issue Association of Dietary Patterns with Metabolic Syndrome)
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21 pages, 710 KiB  
Review
The Effect of the Mediterranean Diet on Metabolic Health: A Systematic Review and Meta-Analysis of Controlled Trials in Adults
by Angeliki Papadaki, Eric Nolen-Doerr and Christos S. Mantzoros
Nutrients 2020, 12(11), 3342; https://doi.org/10.3390/nu12113342 - 30 Oct 2020
Cited by 139 | Viewed by 18704
Abstract
The Mediterranean diet (MD) may provide metabolic benefits but no systematic review to date has examined its effect on a multitude of outcomes related to metabolic health. This systematic review with meta-analysis (International Prospective Register of Systematic Reviews, PROSPERO; number CRD42019141459) aimed to [...] Read more.
The Mediterranean diet (MD) may provide metabolic benefits but no systematic review to date has examined its effect on a multitude of outcomes related to metabolic health. This systematic review with meta-analysis (International Prospective Register of Systematic Reviews, PROSPERO; number CRD42019141459) aimed to examine the MD’s effect on metabolic syndrome (MetSyn) incidence, components and risk factors (primary outcomes), and incidence and/or mortality from MetSyn-related comorbidities and receipt of pharmacologic treatment for MetSyn components and comorbidities (secondary outcomes). We searched Pubmed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science for controlled trials published until June 2019, comparing the MD with no treatment, usual care, or different diets in adults. Studies not published in English and not promoting the whole MD were excluded. Two authors independently extracted data and assessed risk of bias using the Cochrane Collaboration’s and Risk of Bias in non-randomised studies (ROBINS-I) tools. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random-effects meta-analyses, subgroup analyses and meta-regressions were performed, and heterogeneity was quantified using the I2 statistic. We identified 2654 reports and included 84 articles reporting 57 trials (n = 36,983). In random effects meta-analyses, the MD resulted in greater beneficial changes in 18 of 28 MetSyn components and risk factors (body weight, body mass index, waist circumference, systolic and diastolic blood pressure, glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR) index, total-, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, triglycerides, alanine transaminase, hepatic fat mass, C-reactive protein, interleukin-6, tumour necrosis factor-a, and flow-mediated dilatation) and lower risk of cardiovascular disease incidence (risk ratio (RR) = 0.61, 95% confidence intervals (CI) 0.42–0.80; I2 = 0%), and stroke (RR = 0.67, 95% CI 0.35–0.98; I2 = 0%). Only six studies reported effects on pharmacotherapy use, and pooled analysis indicated no differences between diet groups. Lack of consistency in comparator groups and other study characteristics across studies resulted in high heterogeneity for some outcomes, which could not be considerably explained by meta-regressions. However, a consistent direction of beneficial effect of the MD was observed for the vast majority of outcomes examined. Findings support MD’s beneficial effect on all components and most risk factors of the MetSyn, in addition to cardiovascular disease and stroke incidence. More studies are needed to establish effects on other clinical outcomes and use of pharmacotherapy for MetSyn components and comorbidities. Despite the high levels of heterogeneity for some outcomes, this meta-analysis enabled the comparison of findings across studies and the examination of consistency of effects. The consistent direction of effect, suggesting the MD’s benefits on metabolic health, supports the need to promote this dietary pattern to adult populations. Full article
(This article belongs to the Special Issue Association of Dietary Patterns with Metabolic Syndrome)
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