ABC | Volume 110, Nº5, May 2018

Original Article Prevalence of Metabolic Syndrome and Framingham Risk Score in Apparently Healthy Vegetarian and Omnivorous Men Julio Cesar Acosta Navarro, 1,2 Luiza Antoniazzi, 1 Adriana Midori Oki, 1 Maria Carlos Bonfim, 1 Valeria Hong, 1 Luiz Aparecido Bortolotto, 1 Pedro Acosta-Cardenas, 1 Valeria Sandrim, 3 Marcio Hiroshi Miname, 1 Raul Dias dos Santos Filho 1 Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo, 1 São Paulo, SP – Brazil Hospital Regional de Ferraz de Vasconcelos - Osiris Florindo, 2 São Paulo, SP – Brazil Departamento de Farmacologia do Instituto de Biociências de Botucatu - Universidade Estadual Paulista (UNESP), 3 São Paulo, SP – Brazil Mailing Address: Julio Cesar Acosta Navarro • Av. Dr. Enéas de Carvalho Aguiar, 44. Postal Code 05403-900, Cerqueira César, São Paulo, SP – Brazil E-mail: jnavarro_2@hotmail.com Manuscript received May 27, 2017, revised manuscript December 12, 2017, accepted December 12, 2017 DOI: 10.5935/abc.20180073 Introduction The number of individuals consuming a vegetarian (VEG) or plant-based diet is increasing, and there is evidence that this habit is associated with a lower prevalence of risk factors for cardiovascular diseases (CVD). 1-5 A few studies in the literature have evaluated the association between the VEG diet and the lower risk of coronary heart disease (CHD), 5,6 according to the Framingham Risk Score (FRS), an algorithm for assessing risk for CHD in the short term (< 10 years). 7 Furthermore, recent studies have shown a lower prevalence of metabolic syndrome (MSyn) in VEG 8,9 despite the inconclusive evidence from others. 10-14 The only study found in the scientific literature that evaluated the relationship in a Abstract Background: Recent studies have shown a lower prevalence of metabolic syndrome (MSyn) in vegetarians (VEG) despite the inconclusive evidence from others. Objective: To verify the association between diet and other lifestyle characteristics and the prevalence of MSyn, cardiovascular risk factors (CRF), and Framingham Risk Score (FRS) in apparently healthy VEG and omnivorous (OMN) men. Methods: In this cross-sectional study, 88 apparently healthy men ≥ 35 years, 44 VEG and 44 OMN, were assessed for anthropometric data, blood pressure, blood lipids, glucose, C-reactive protein (CRP) and FRS. To test the association between lifestyle and MSyn, Student t test, chi‑square test, and multiple logistic regression model were used. A significance level of 5% was considered in all statistical analyses. Results: Several CRF were significantly lower in VEG than in OMN: body mass index, systolic blood pressure, diastolic blood pressure, fasting serum total cholesterol, LDL-cholesterol, apolipoprotein b, glucose, and glycated hemoglobin (all p < 0.05). The FRS mean was lower in VEG than in OMN (2.98 ± 3.7 vs 4.82 ± 4.8, p = 0.029). The percentage of individuals with MSyn was higher among OMN than among VEG (52.3 vs.15.9%) (p < 0.001). The OMN diet was associated with MSyn (OR: 6.28 95%CI 2.11-18.71) and alterations in most MSyn components in the multiple regression model independently of caloric intake, age and physical activity. Conclusion: The VEG diet was associated with lower CRF, FRS and percentage of individuals with MSyn. (Arq Bras Cardiol. 2018; 110(5):430-437) Keywords: Metabolic Syndrome; Coronary Artery Disease; Vegetarians; Men; Risk Factors; Diet, Vegetarian Latin American population has demonstrated no association. 5 The importance of MSyn rests in the fact that approximately one in four adults in the United States has MSyn, which is considered a risk factor for atherosclerotic cardiovascular disease. 15 In addition, 20-25% of adults worldwide have MSyn, which doubles the risk for having a heart attack and triples the risk for stroke, 16-18 in addition to increasing the risk of death in the general population. 19 The aim of this observational study was to investigate the association between the type of diet and the prevalence of MSyn assessed in apparently healthy VEG and omnivorous (OMN) men. Our hypothesis is that VEG men have better indicators of these conditions compared to OMN men. Methods In the recently published cross-sectional Carotid Atherosclerosis and Arterial Stiffness in Vegetarians and Omnivorous Subjects (CARVOS) study, 20 745 adult volunteers initially were recruited in São Paulo through social activities and the Internet. The participants filled out questionnaires regarding past medical history, family history, dietary preferences, and personal data. Exclusion criteria 430