Korean J Pediatr Gastroenterol Nutr.  2011 Dec;14(4):350-358. 10.5223/kjpgn.2011.14.4.350.

Clinical Nutrition Therapy of Metabolic Syndrome in Adolescents

• Yom HW

• KMID: 2277706
• DOI: http://doi.org/10.5223/kjpgn.2011.14.4.350

Abstract

Metabolic syndrome (MetS) is characterized by the clustering of obesity, impaired glucose metabolism, hypertension, and dyslipidemia, and is predictive for development of cardiovascular disease and type 2 diabetes. The high prevalence of MetS is a serious health problem, especially among obese adolescents. Because insulin resistance and obesity play a central role in MetS, treatment of MetS should be primarily focused on improving insulin sensitivity and weight reduction. Nutritional therapy of MetS aims to reduce the intakes of saturated fat and free fructose, and increasing the intakes of dietary fiber, unsaturated fat, and antioxidant nutrients may also be beneficial.

Keyword

Metabolic Syndrome; Nutrition; Adolescents; Insulin resistance; Obesity

MeSH Terms

Adolescent
Cardiovascular Diseases
Dietary Fiber
Dyslipidemias
Fructose
Glucose
Humans
Hypertension
Insulin Resistance
Nutrition Therapy
Obesity
Prevalence
Weight Loss
Fructose
Glucose

Reference

1. Huang TT, Ball GD, Franks PW. Metabolic syndrome in youth: current issues and challenges. Appl Physiol Nutr Metab. 2007. 32:13–22.

2. Huh K, Park MJ. Preliminary analysis of metabolic syndrome components in Korean adolescents by using Korean national health and nutrition examination survey pooling data (1998, 2001, and 2005). Korean J Pediatr. 2008. 51:1300–1309.

3. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med. 2003. 157:821–827.

4. Goodman E, Daniels SR, Meigs JB, Dolan LM. Instability in the diagnosis of metabolic syndrome in adolescents. Circulation. 2007. 115:2316–2322.

5. Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, et al. International Diabetes Federation Task Force on Epidemiology and Prevention of Diabetes. The metabolic syndrome in children and adolescents. Lancet. 2007. 369:2059–2061.

6. Steinberger J, Daniels SR, Eckel RH, Hayman L, Lustig RH, McCrindle B, et al. Progress and challenges in metabolic syndrome in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2009. 119:628–647.

7. Hong YM. Metabolic syndrome in children and adolescents. Korean J Pediatr. 2009. 52:737–744.

8. Taittonen L, Uhari M, Nuutinen M, Turtinen J, Pokka T, Akerblom HK. Insulin and blood pressure among healthy children. Cardiovascular risk in young Finns. Am J Hypertens. 1996. 9:194–199.

9. Lee CG, Moon JS, Choi JM, Nam CM, Lee SY, Oh K, et al. Normative blood pressure references for Korean children and adolescents. Korean J Pediatr. 2008. 51:33–41.

10. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002. 106:3143–3421.

11. Lewis GF, Carpentier A, Adeli K, Giacca A. Disordered fat storage and mobilization in the pathogenesis of insulin resistance and type 2 diabetes. Endocr Rev. 2002. 23:201–229.

12. Esmaillzadeh A, Mirmiran P, Azizi F. Clustering of metabolic abnormalities in adolescents with the hypertriglyceridemic waist phenotype. Am J Clin Nutr. 2006. 83:36–46.

13. Weiss R, Taksali SE, Tamborlane WV, Burgert TS, Savoye M, Caprio S. Predictors of changes in glucose tolerance status in obese youth. Diabetes Care. 2005. 28:902–909.

14. Yom HW, Shin JS, Lee HJ, Park SE, Jo SJ, Seo JW. The metabolic syndrome in obese children. Korean J Pediatr Gastroenterol Nutr. 2004. 7:228–238.

15. Bhopal RS, Rafnsson SB. Could mitochondrial efficiency explain the susceptibility to adiposity, metabolic syndrome, diabetes and cardiovascular diseases in South Asian populations? Int J Epidemiol. 2009. 38:1072–1081.

16. Meas T. Fetal origins of insulin resistance and the metabolic syndrome: a key role for adipose tissue? Diabetes Metab. 2010. 36:11–20.

17. Seo JW. Obesity in children and adolescents. Korean J Pediatr. 2009. 52:1311–1320.

18. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001. 344:3–10.

19. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004. 114:555–576.

20. Giugliano D, Esposito K. Mediterranean diet and metabolic diseases. Curr Opin Lipidol. 2008. 19:63–68.

21. Hession M, Rolland C, Kulkarni U, Wise A, Broom J. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obes Rev. 2009. 10:36–50.

22. Yu-Poth S, Zhao G, Etherton T, Naglak M, Jonnalagadda S, Kris-Etherton PM. Effects of the National Cholesterol Education Program's Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis. Am J Clin Nutr. 1999. 69:632–646.

23. Committee on Nutrition Korean Pediatric Society. Manual of pediatric nutrition. 2002. Seoul: The Korean Pediatric Society.

24. Keys A, Aravanis C, Blackburn HW, Van Buchem FS, Buzina R, Djordjević BD, et al. Epidemiological studies related to coronary heart disease: characteristics of men aged 40-59 in seven countries. Acta Med Scand Suppl. 1966. 460:1–392.

25. Hu FB, Stampfer MJ, Manson JE, Rimm E, Colditz GA, Rosner BA, et al. Dietary fat intake and the risk of coronary heart disease in women. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med. 1997. 337:1491–1499.

26. Molendi-Coste O, Legry V, Leclercq IA. Why and How Meet n-3 PUFA Dietary Recommendations? Gastroenterol Res Pract. 2011. 2011:364040.

27. Ferrucci L, Cherubini A, Bandinelli S, Bartali B, Corsi A, Lauretani F, et al. Relationship of plasma polyunsaturated fatty acids to circulating inflammatory markers. J Clin Endocrinol Metab. 2006. 91:439–446.

28. GISSI-Prevenzione trial. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamine E after myocardial infartion: results of the GISSI-Prevenzione trial. Lancet. 1999. 354:447–455.

29. Mattar M, Obeid O. Fish oil and the management of hypertriglyceridemia. Nutr Health. 2009. 20:41–49.

30. Anderson BM, Ma DW. Are all n-3 polyunsaturated fatty acids created equal? Lipids Health Dis. 2009. 8:33.

31. Harris WS, Park Y, Isley WL. Cardiovascular disease and long-chain omega-3 fatty acids. Curr Opin Lipidol. 2003. 14:9–14.

32. Al-Sarraj T, Saadi H, Calle MC, Volek JS, Fernandez ML. Carbohydrate restriction, as a first-line dietary intervention, effectively reduces biomarkers of metabolic syndrome in Emirati adults. J Nutr. 2009. 139:1667–1676.

33. Volek JS, Feinman RD. Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate carbohydrate restriction. Nutr Metab (Lond). 2005. 2:31.

34. Samaha FF, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med. 2003. 348:2074–2081.

35. Angelopoulos TJ, Lowndes J, Zukley L, Melanson KJ, Nguyen V, Huffman A, et al. The effect of high-fructose corn syrup consumption on triglycerides and uric acid. J Nutr. 2009. 139:1242S–1245S.

36. Liu S, Manson JE, Stampfer MJ, Hu FB, Giovannucci E, Colditz GA, et al. A prospective study of whole-grain intake and risk of type 2 diabetes mellitus in US women. Am J Public Health. 2000. 90:1409–1415.

37. Fung TT, Hu FB, Pereira MA, Liu S, Stampfer MJ, Colditz GA, et al. Whole-grain intake and the risk of type 2 diabetes: a prospective study in men. Am J Clin Nutr. 2002. 76:535–540.

38. Priebe MG, van Binsbergen JJ, de Vos R, Vonk RJ. Whole grain foods for the prevention of type 2 diabetes mellitus. Cochrane Database Syst Rev. 2008. (1):CD006061.

39. Steffen LM, Jacobs DR Jr, Murtaugh MA, Moran A, Steinberger J, Hong CP, et al. Whole grain intake is associated with lower body mass and greater insulin sensitivity among adolescents. Am J Epidemiol. 2003. 158:243–250.

40. McKeown NM, Meigs JB, Liu S, Wilson PW, Jacques PF. Whole-grain intake is favorably associated with metabolic risk factors for type 2 diabetes and cardiovascular disease in the Framingham Offspring Study. Am J Clin Nutr. 2002. 76:390–398.

41. Veldhuis L, Koppes LL, Driessen MT, Samoocha D, Twisk JW. Effects of dietary fibre intake during adolescence on the components of the metabolic syndrome at the age of 36 years: the Amsterdam Growth and Health Longitudinal Study. J Hum Nutr Diet. 2010. 23:601–608.

42. Ventura E, Davis J, Byrd-Williams C, Alexander K, McClain A, Lane CJ, et al. Reduction in risk factors for type 2 diabetes mellitus in response to a low-sugar, high-fiber dietary intervention in overweight Latino adolescents. Arch Pediatr Adolesc Med. 2009. 163:320–327.

43. McKeown NM, Meigs JB, Liu S, Saltzman E, Wilson PW, Jacques PF. Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care. 2004. 27:538–546.

44. Liu S, Willett WC, Stampfer MJ, Hu FB, Franz M, Sampson L, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr. 2000. 71:1455–1461.

45. Steffen LM, Jacobs DR Jr, Stevens J, Shahar E, Carithers T, Folsom AR. Associations of whole-grain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Clin Nutr. 2003. 78:383–390.

46. Eisenmann JC. Physical activity and cardiovascular disease risk factors in children and adolescents: an overview. Can J Cardiol. 2004. 20:295–301.

47. Kim Y, Lee S. Physical activity and abdominal obesity in youth. Appl Physiol Nutr Metab. 2009. 34:571–581.

48. Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, et al. Evidence based physical activity for school-age youth. J Pediatr. 2005. 146:732–737.

49. Durstine JL, Haskell WL. Effects of exercise training on plasma lipids and lipoproteins. Exerc Sport Sci Rev. 1994. 22:477–521.

50. Tran ZV, Weltman A. Differential effects of exercise on serum lipid and lipoprotein levels seen with changes in body weight. A meta-analysis. JAMA. 1985. 254:919–924.