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A Swedish dietary guideline index, gut microbial α-diversity and prevalence of metabolic syndrome – observations in the Swedish CArdioPulmonary bioImage Study (SCAPIS)

Ericson, Ulrika LU ; Hellstrand, Sophie LU ; Larsson, Anna LU ; Miari, Mariam LU ; Sayolsbaixeras, Sergi ; Dekkers, Koen F. ; Bergström, Göran ; Malinovschi, Andrei ; Engström, Gunnar LU and Ärnlöv, Johan , et al. (2024) In Food and Nutrition Research 68.
Abstract

Background: Metabolic syndrome (MetS) is characterized by coexisting risk factors for type 2 diabetes and cardiovascular disease. Diet is of importance in their aetiology, and gut microbiota (GM) may constitute a link between diet and metabolic health. Understanding the interplay between diet and GM could contribute novel insights for future dietary guidelines, and aid in preventive actions to motivate adherence to dietary guidelines. Objective: We intended to create a Swedish dietary guideline index (SweDGI) measuring adherence to 12 Swedish dietary guidelines and examine whether SweDGI and its components are associated with GM α-diversity (Shannon index) and prevalent MetS, and if the association between the Shannon index and MetS... (More)

Background: Metabolic syndrome (MetS) is characterized by coexisting risk factors for type 2 diabetes and cardiovascular disease. Diet is of importance in their aetiology, and gut microbiota (GM) may constitute a link between diet and metabolic health. Understanding the interplay between diet and GM could contribute novel insights for future dietary guidelines, and aid in preventive actions to motivate adherence to dietary guidelines. Objective: We intended to create a Swedish dietary guideline index (SweDGI) measuring adherence to 12 Swedish dietary guidelines and examine whether SweDGI and its components are associated with GM α-diversity (Shannon index) and prevalent MetS, and if the association between the Shannon index and MetS differs depending on SweDGI. Design: SweDGI was based on food-frequency data assessed 2014–2018 in 10,396 diabetes-free participants from the Malmö and Uppsala-sites of the Swedish CArdioPulmonary bioImage Study (SCAPIS) (50–64 y, 53% women). We estimated the Shannon index from shotgun metagenomic sequencing-data to assess microbial richness and evenness. We used a general linear model to examine cross-sectional SweDGI-Shannon associations and logistic regression for associations with MetS. Results: Most guidelines were followed by less than half of the participants. Men showed poorer adherence. Higher SweDGI was linked to higher Shannon index (P-trend across five SweDGI-groups = 1.7 × 10-12). Most guidelines contributed to this observation. Higher SweDGI and Shannon index were associated with lower MetSprevalence, where the lowest prevalence was observed among those with both high SweDGI and high Shannon index (odds ratio:0.43; 95% confidence interval:0.35, 0.52). Both the Shannon index and SweDGI were associated with MetS, independently of the level of the other factor (P-interaction = 0.82). Conclusions: We created a new index to comprehensively reflect adherence to the Swedish dietary guidelines in sub-cohorts within the large multicentre SCAPIS study. Better adherence was associated with a richer and more even GM and lower prevalence of MetS. The inverse association between the Shannon index and MetS was consistent at different levels of adherence to dietary guidelines.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
epidemiology, food patterns, gut microbiota, metabolic syndrome
in
Food and Nutrition Research
volume
68
article number
10547
publisher
Co-Action Publishing
external identifiers
  • pmid:39691688
  • scopus:85211086240
ISSN
1654-6628
DOI
10.29219/fnr.v68.10547
language
English
LU publication?
yes
id
a390d8aa-2ce9-4a8a-a4b1-5de156c24751
date added to LUP
2025-01-28 10:42:05
date last changed
2025-01-29 03:00:21
@article{a390d8aa-2ce9-4a8a-a4b1-5de156c24751,
  abstract     = {{<p>Background: Metabolic syndrome (MetS) is characterized by coexisting risk factors for type 2 diabetes and cardiovascular disease. Diet is of importance in their aetiology, and gut microbiota (GM) may constitute a link between diet and metabolic health. Understanding the interplay between diet and GM could contribute novel insights for future dietary guidelines, and aid in preventive actions to motivate adherence to dietary guidelines. Objective: We intended to create a Swedish dietary guideline index (SweDGI) measuring adherence to 12 Swedish dietary guidelines and examine whether SweDGI and its components are associated with GM α-diversity (Shannon index) and prevalent MetS, and if the association between the Shannon index and MetS differs depending on SweDGI. Design: SweDGI was based on food-frequency data assessed 2014–2018 in 10,396 diabetes-free participants from the Malmö and Uppsala-sites of the Swedish CArdioPulmonary bioImage Study (SCAPIS) (50–64 y, 53% women). We estimated the Shannon index from shotgun metagenomic sequencing-data to assess microbial richness and evenness. We used a general linear model to examine cross-sectional SweDGI-Shannon associations and logistic regression for associations with MetS. Results: Most guidelines were followed by less than half of the participants. Men showed poorer adherence. Higher SweDGI was linked to higher Shannon index (P-trend across five SweDGI-groups = 1.7 × 10<sup>-12</sup>). Most guidelines contributed to this observation. Higher SweDGI and Shannon index were associated with lower MetSprevalence, where the lowest prevalence was observed among those with both high SweDGI and high Shannon index (odds ratio:0.43; 95% confidence interval:0.35, 0.52). Both the Shannon index and SweDGI were associated with MetS, independently of the level of the other factor (P-interaction = 0.82). Conclusions: We created a new index to comprehensively reflect adherence to the Swedish dietary guidelines in sub-cohorts within the large multicentre SCAPIS study. Better adherence was associated with a richer and more even GM and lower prevalence of MetS. The inverse association between the Shannon index and MetS was consistent at different levels of adherence to dietary guidelines.</p>}},
  author       = {{Ericson, Ulrika and Hellstrand, Sophie and Larsson, Anna and Miari, Mariam and Sayolsbaixeras, Sergi and Dekkers, Koen F. and Bergström, Göran and Malinovschi, Andrei and Engström, Gunnar and Ärnlöv, Johan and Fall, Tove and Orho-Melander, Marju}},
  issn         = {{1654-6628}},
  keywords     = {{epidemiology; food patterns; gut microbiota; metabolic syndrome}},
  language     = {{eng}},
  publisher    = {{Co-Action Publishing}},
  series       = {{Food and Nutrition Research}},
  title        = {{A Swedish dietary guideline index, gut microbial α-diversity and prevalence of metabolic syndrome – observations in the Swedish CArdioPulmonary bioImage Study (SCAPIS)}},
  url          = {{http://dx.doi.org/10.29219/fnr.v68.10547}},
  doi          = {{10.29219/fnr.v68.10547}},
  volume       = {{68}},
  year         = {{2024}},
}