Identification of nutrition factors in the metabolic syndrome and its progression over time in older adults: analysis of the TUDA cohort

Oonagh Lyons, Maeve Kerr, Mary Flynn, L. Hoey, Catherine Hughes, Aoife Caffrey, Eamon Laird, Katie Moore, Kirsty Porter, Conal Cunningham, Kevin McCarroll, Anne M. Molloy, Fergal Tracey, Maurice OKane, JJ Strain, M Ward, H McNulty

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BACKGROUND: Nutrition is recognized as playing an important role in the metabolic syndrome (MetS), but the dietary components involved are unclear. We aimed to investigate nutrition factors in relation to MetS and its progression in older adults over a follow-up period of 5.4 years.

METHODS: Community-dwelling adults (≥ 60y) from the Trinity-Ulster-Department-of-Agriculture study, sampled at baseline (2008-12) and follow-up (2014-18; n 953), were classified as 'with MetS' by having three or more of: waist circumference (≥ 102 cm, males; ≥ 88 cm, females); HDL-cholesterol (< 1.0 mmol/L, males; < 1.3 mmol/L, females); triglycerides (≥ 1.7 mmol/L); blood pressure (systolic ≥ 130 and/or diastolic ≥ 85 mmHg); and hemoglobin A1c (≥ 39 mmol/mol).

RESULTS: MetS was identified in 67% of participants, increasing to 74% at follow-up. Predictors at baseline for the development of metabolic syndrome (MetS) at follow-up were higher waist circumference (odds ratio [95%CI]; 1.06 [1.01-1.11]), but not BMI, and increased triglyceride concentrations (2.01 [1.29-3.16]). In dietary analysis (at follow-up), higher protein (g/kg bodyweight/day) and monounsaturated fatty acid (g/day) intakes were each associated with lower risk of MetS (0.06 [0.02-0.20] and 0.88 [0.78-1.00], respectively), whilst higher protein was also associated with lower abdominal obesity (0.10 [0.02-0.51]) and hypertension (0.22 [0.00-0.80]). Furthermore, participants with, compared to without, MetS consumed less high-quality protein foods (P = 0.006) and more low-quality protein foods (P < 0.001), as defined by the protein digestibility-corrected amino acid score.

CONCLUSIONS: Dietary interventions targeting protein quantity and quality may have specific benefits in preventing or delaying the progression of MetS in at-risk older people, but this requires investigation in the form of randomized trials.

Original languageEnglish
Article number125
Pages (from-to)1-18
Number of pages18
JournalDiabetology & Metabolic Syndrome
Early online date8 Jun 2024
Publication statusPublished online - 8 Jun 2024

Bibliographical note

© 2024. The Author(s).

Data Access Statement

Data described in the manuscript, code book, and analytic code will be made
available upon request, subject to formal application and approval by the
TUDA study consortium.


  • Metabolic syndrome
  • Older adults
  • Nutrition-related factors
  • Protein quality


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