Sex-specific dietary patterns and their association with metabolic syndrome: Insights from a cross-sectional analysis.

This study aims to identify a posteriori dietary patterns with a sex approach and to evaluate their association with metabolic syndrome criteria. Cross-sectional study conducted in 6821 men and women between 55 and 75 years of age. Forty-two food groups were analyzed from dietary information collected with food frequency questionnaires, using principal component analysis and cluster analysis and then information from both statistical methods was compared. Prevalences were calculated foreach cluster group, based on the number and types of metabolic syndrome criteria they met. Following principal component analysis, two dietary patterns labeled "healthy" and "unhealthy" were identified in both men and women, due to the presence of foods that are considered more or less healthy. These same dietary patterns were found in cluster analysis plus an "intermediate" cluster consisting of both healthy and unhealthy foods. The presence of metabolic syndrome is related to the "healthy" dietary pattern in women and to the "unhealthy" dietary pattern in men. Comparison of the two statistical approaches showed a high level of correlation between them (weighted Kappa = 0.703 in women and weighted Kappa = 0.691 in men). Adherence to both healthy and unhealthy dietary pattern appears to be related to the development of MS. The differences found by sex make it necessary to develop interventions with a sex-specific approach.

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Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Miguel Angel Martinez Gonzalez reports financial support was provided by the European Research Council. Dr. Salas-Salvado and Dr. Vidal reports financial support was provided by Instituto de Salud Carlos III, through the Fondo de Investigación para la Salud, which is cofunded by the European Regional Development Fund. Dr Salas-Salvado reports financial support was provided by the Especial Action Project titled Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant. Dr Salas-Salvado reports financial support was provided by the Recercaixa grant (2013ACUP00194). PREDIMED-Plus study reports financial support was provided by Inter-institutional Council of Science and Technology. PREDIMED-Plus study reports financial support was provided by Government of Valencia. Dr. Estruch reports financial support was provided by Generalitat de Catalunya (SGR-2019). PREDIMED-Plus study reports financial support was provided by Consejería de Salud de la Junta de Andalucía. PREDIMED-Plus study reports financial support was provided by Government of Valencia. Vicente Martin Sanchez reports financial support was provided by A SEMERGEN (Sociedad Española de Médicos de Atención Primaria) grant. PREDIMED-Plus study reports financial support was provided by EU-COST (European Cooperation in Science and Technology) Action CA16112. Research group number 35 2011 reports financial support was provided by Balearic Islands Government. PREDIMED-Plus reports financial support was provided by Grants from IDISBA (Instituto de Investigación Sanitaria Islas Baleares). PREDIMED-Plus reports financial support was provided by European Regional Development Fund. PREDIMED-Plus reports financial support was provided by The European Commission (EAT2BENI-CE_H2020_SFS2016). Jadwiga Konieczna reports financial support was provided by State Agency of Research. PREDIMED-Plus reports financial support was provided by INSA-Ma María de Maeztu Unit of Excellence. Dr Estruch reports a relationship with Cerveza y Salud, Spain, and Fundacion Dieta Mediterranea that includes: funding grants. Dr Estruch reports a relationship with Brewers of Europe, Fundacion Cerveza y Salud, Pernod Ricard, Instituto Cervantes, Instituto Cervantes, Instituto Cervantes Japan, Lilly Laboratories, and Wine and Culinary International Forum that includes: speaking and lecture fees. Dr Ros reports a relationship with the California Walnut Commission, Alexion, Sanofi Aventis, Ferrer International, Danone, Merck Sharp Dohme, Amarin that includes: funding grants, non-financial support, and speaking and lecture fees. Dr Lamuela-Raventos reports a relationship with Cerveceros de España, Adventia, Ecoveritas, that includes: consulting or advisory. Dr Salas Salvado reports a relationship with Instituto de Salud Carlos III, Ministerio de Educación y Ciencia, the European Commission, the US National Institutes of Health that includes: non-financial support. Dr Salas Salvado reports a relationship with from Eroski Foundation, Instituto Danone, Nestle, and Abbott Laboratories that includes: consulting or advisory and travel reimbursement. Dr Salas Salvado reports a relationship with Hojiblanca, Patrimonio Comunal Olivarero, the California Walnut Commission, Almond Board of California, La Morella Nuts, Pistachio Growers, and Borges that includes: non-financial support. Dr Salas Salvado reports a relationship with International Nut and Dried Foundation and the Eroski Foundation that includes: board membership and funding grants. Dr Salas Salvado reports a relationship with Instituto Danone and Board of Danone Institute International that includes: board membership and consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.