ABC | Volume 110, Nº5, May 2018

Original Article Navarro et al Metabolic Syndrome in Vegetarian and Omnivorous Men Arq Bras Cardiol. 2018; 110(5):430-437 Table 2 – Pattern of energy and nutrient ingestion of apparently healthy vegetarian and omnivorous men. Energy and nutrient ingestion Vegetarian (n = 44) Omnivorous (n = 44) p Energy (kcal) 2,177 ± 559 2,348 ± 736 0.11 Protein (% of energy) 17.1 ± 7.8 19.5 ± 4.5 0.04 Carbohydrates (% of energy) 63.2 ± 11.6 51.9 ± 9.7 < 0.001 Total Fat (% of energy) 24.8 ± 8.3 29.1 ± 7.2 0.006 Saturated fat (% of energy) 4.4 ± 3.2 6.9 ± 2.9 < 0.001 Mono-unsaturated fat (% of energy) 4.5 ± 2.4 6.8 ± 2.8 < 0.001 Polyunsaturated fat (% of energy) 4.0 ± 2.7 2.7 ± 1.6 0.004 Cholesterol (mg) 69.3 ± 224 258.1 ± 169 < 0.001 Fiber (g) 28.2 ± 15.9 17.9 ± 13.6 < 0.001 Data are means ± SD. Significant values for p < 0.05. Unpaired Student's t-test. The OMN diet was associated with a prevalence of MSyn (OR: 6.28, 95%CI 2.11-18.71) and alterations in most MSyn components [WC (OR: 7.54, 95%CI 2.55‑22.29), SBP (OR: 3.06, 95%CI 1.06-8.82), DBP (OR: 4.08, 95%CI 1.27‑13.07), and FSG (OR: 5.38, 95%CI 1.95-14.88)] in the multiple regression, independently of caloric intake, age, level of physical activity, and alcohol consumption (Table 4). Discussion This study brought the scientific evidence that in apparently healthy men a VEG diet was associated with a lower percentage of individuals with MSyn compared to an OMN diet. This difference remained after the adjustment of other lifestyle characteristics, such as smoking, alcohol intake, and physical activity. In addition, FRS and other cardiovascular risk factors (CRF) were also lower in VEG subjects. Our study is considered a pioneer for being the first to prove the association between the VEG diet and the development of MSyn in a population of Brazilian men, although an association has been reported between red meat consumption and an increase in the risk of developing MSyn after adjusting for confounders, in a cohort of Japanese-Brazilians. 28 In the present study, VEG had significantly lower values for BMI, WC, SBP, DBP, TC, LDL-c, Apo b, TG, TC/HDL-c ratio, FSG, and HbA1c, which is in accordance with other studies around the world. The Lima Study, conducted in Peru, with 45 OMN, 105 VEG, and 34 semi-vegetarians, has reported lower TC and LDL-c values in VEG compared to OMN. 1 In a cross‑sectional analysis of 773 subjects from the Adventist Health Study 2, in the United States, a VEG dietary pattern was associated with a more favorable profile for BMI, WC, SBP, DBP, TG, and FSG. 8,29 Studies in the Brazilian population have found similar results to these of the present study. A study with OMN, VEG, and semi-vegetarians from the Adventist Church of São Paulo has found lower values for SBP, DBP, TC, and LDL-c in the VEG group. 5 In another study comparing 56 VEG and 40 OMN in São Paulo, the VEG group had lower BMI and WC, but the levels of TG, TC, and LDL-c were equal between the groups, and VEG had higher HDL-c, 30 in contrast to our study, in which HDL was similar between groups. In addition, a few studies in the literature have evaluated the association of the VEG diet with FRS, 5,6 which is an algorithm for assessing risk for CHD in the short term. 7 In a study conducted with 67 VEG and 134 OMN, the MONICA Project, in the state of Espírito Santo, Brazil, blood pressure, FSG, TC, LDL-c, TG, and FRS were lower among VEG. 6 Table 3 – Distribution of individuals with metabolic syndrome and inadequacy of its components in apparently healthy vegetarian and omnivorous men Vegetarian (n = 44) % (n) Omnivorous (n = 44) % (n) p MSyn 15.9 (7) 52.3 (23) < 0.001 WC (≥ 90 cm) 20.5 (9) 63.6 (28) < 0.001 SBP (≥ 130 mm Hg) 22.7 (10) 45.5 (20) 0.025 DBP (≥ 85 mm Hg) 13.6 (6) 40.9 (18) 0.004 TG (≥ 150 mg/dL) 25.0 (11) 45.5 (20) 0.045 HDL-c (< 40 mg/dL) 22.7 (10) 36.4 (16) 0.16 FSG (≥ 100 mg/dL) 27.3 (12) 63.6 (28) 0.001 Data are means ± SD. Significant values for p < 0.05. Chi-square test. MSyn: metabolic syndrome; WC: waist circumference; SBP: systolic blood pressure; DBP: diastolic blood pressure; TG: triglycerides; HDL-c: high-density lipoprotein; FSG: fasting serum glucose. 433