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Title:Dietary associations that may reduce metabolic syndrome risk in Mexican young adults
Author(s):Mosley, Michelle
Advisor(s):Teran-Garcia, Margarita D.
Department / Program:Food Science & Human Nutrition
Discipline:Food Science & Human Nutrition
Degree Granting Institution:University of Illinois at Urbana-Champaign
Subject(s):Dietary trends
Metabolic syndrome
Young adults
Mexican population
Fruit and vegetable intake
Papaya fruit intake
Abstract:The obesity epidemic has spread globally from the United States to other industrialized nations, one of which is Mexico. As of 2006, 72% of Mexican adults aged 20 years and older were overweight or obese (Barquera, Campos-Nonato et al., 2009), a statistic that surpasses the prevalence of these conditions in the United States. The Mexican young adult population (20-29 years of age) is also affected, with 55.8% of individuals who are overweight or obese – the equivalent of about 5.9 million people (Barquera, Campos-Nonato et al., 2009). Obesity is related to the development of other conditions, including, but not limited to: abdominal obesity, dyslipidemia, elevated blood pressure, and type 2 diabetes (T2D). These conditions collectively form a disease known as metabolic syndrome (MetS) (Reaven, 1988). Results from a national survey in Mexico conducted in 2006 indicated that 36% of Mexican individuals aged 20 to 39 years had MetS (Rojas et al., 2010). The high occurrence of this cluster of diseases in such a relatively young population indicates a need for effective prevention and intervention strategies. In order to do this, researchers must investigate the root cause of the environmental, social, and genetic risk factors of obesity and obesity-related diseases, particularly in the Mexican population. One risk factor of great importance is the diet. Viewing the development of Mexico from a historical standpoint, one can begin to examine the evolution of the traditional Mexican diet. Various pre-Columbian indigenous groups – the Olmec, Toltec, Aztec, Maya, Zapotec, and Mixtec – provided the foundation for Mexico and the Mexican diet (Ruiz, 1993). Agriculture allowed them to cultivate corn, beans, and squash. After Hernán Cortés and his fellow conquistadors arrived in Mexico and brought many varieties of fruits, grains, vegetables, and meat, the two eating styles merged to create traditional Mexican cuisine. Dietary pattern analyses show a Westernized dietary pattern characterized by high refined cereal, pastry, corn tortilla, and soda intake and low whole grain cereal, seafood, and dairy consumption emerging from the traditional dietary pattern (Denova-Gutierrez et al., 2011; Flores et al., 2010). This Westernized dietary pattern is associated with greater risk for obesity and metabolic syndrome (MetS). The transition from the traditional dietary pattern to the Westernized dietary pattern resulted in: (1) a reduction in dairy consumption; (2) an increase in refined sugar intake; (3) a decrease in fruit and vegetable intake; and (4) an increase in saturated fatty food consumption. The aims of the two studies presented in this thesis address the decreased dairy/increased refined sugar consumption trend and an ancient medical claim related to fruit and vegetable consumption. The rise in the prevalence of MetS has been observed in conjunction with a decrease in dairy intake and an increase in sugar-sweetened beverage consumption (SSB) (Barquera et al., 2008). For the first cross-sectional study presented here, we hypothesized that individuals who were not meeting daily dairy recommendations would be at greater risk for MetS. The study participants (n = 339 Mexicans aged18 to 25 years) in this study were selected from a larger cohort study and had complete data on a validated Willett food frequency questionnaire adapted for the Mexican population, as well as the most complete data from the health clinic assessment that is required for admission to the university. MetS was diagnosed according to the International Diabetes Federation/American Heart Association harmonized criteria (Alberti et al, 2009). We included milk-based dairy products (whole milk, various cheeses, yogurt, and ice cream) only in addition to various SSB. Overall prevalence of MetS was 10.6%. We also determined that 77% of individuals were not meeting the recommended three daily servings of dairy per day. When controlling for age, sex, family history of cardiovascular disease (CVD) and T2D, and physical activity, we observed that individuals who failed to meet dairy recommendations may be at 2.9 times greater risk for MetS (95% CI 1.0-8.3, p = 0.05), but this must be further investigated. Our results did not indicate that SSB were displacing dairy in the diet and perhaps the study design was not ideal for detecting this relationship; however, our results support the importance of meeting daily dairy recommendations for the prevention of MetS in Mexican young adults. When we assessed components of MetS in our subset of individuals, we determined that the prevalence of low high-density lipoprotein cholesterol (HDL-C) was 51.6%, which is about 10% lower than the prevalence previously reported in Mexican young adults aged 20 to 29 years. Nevertheless, it is important to investigate potential prevention and intervention strategies to raise HDL-C levels because this condition occurs in more than half of the population. For this second cross-sectional study, we used the same subset of 339 individuals and similar dietary and data analysis methodology to investigate the claim that consumption of papaya fruit can lower risk for dyslipidemias. Hypertriglyceridemia, low HDL-C, high low density lipoprotein cholesterol (LDL-C) and hypercholesterolemia were diagnosed based upon International Diabetes Federation and the National Cholesterol Education Program Adult Treatment Panel III criteria. We observed no differences in blood lipid profiles between the two groups; however, females who consumed < 3 servings of papaya per week may be at 1.5 times greater risk (95% CI 0.99-2.32, p = 0.05) of having low HDL-C after adjustment for age and family history of CVD and T2D compared to those who consumed fewer than 3 servings; however, because 1.0 is included in the confidence interval, we cannot make a definite conclusion. These findings were not observed in males and we did not observe risk for other at-risk blood lipid measures. However, prevalence of low HDL-C, hypertriglyceridemia, high LDL-C, and hypercholesterolemia was higher in those consuming < 3 weekly servings of papaya compared to those who consumed less. Our preliminary results suggest that consumption of at least 3 servings of papaya per week may help prevent dyslipidemias in Mexican college age individuals and that higher papaya intake may be a marker for an overall healthier dietary pattern, but further analyses must be done to confirm our initial observations. Overall, these two studies conclude that meeting daily dairy recommendations may reduce individual risk for MetS and that a higher fruit and vegetable intake, indicated by more frequent papaya consumption, may reduce risk for certain dyslipidemias. Further research needs to be conducted so that these findings can be appropriately incorporated into prevention and intervention strategies for Mexican young adults.
Issue Date:2012-09-18
Rights Information:Copyright 2012 Michelle Mosley
Date Available in IDEALS:2012-09-18
Date Deposited:2012-08

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