ASSESSMENT OF METABOLIC SYNDROME AMONG TEACHING AND NON TEACHING

STAFF OF UNIVERSITY OF SARGODHA

Sumaira IftikharStudent ID # MFNF13E017

M. Sc. (Hons). Food and Nutrition3rd Semester

INSTITUTE OF FOOD SCIENCE AND NUTRITIONUNIVERSITY OF SARGODHA, SARGODHA

OUTLINE

INTRODUCTION

REVIEW OF LITERATURE

RESEARCH METHODOLOGY

LITERATURE CITED

INTRODUCTIONMetabolic Syndrome

“Metabolic syndrome (MetS) is a cluster of physio-

pathological markers that include obesity, insulin resistance,

dyslipidemia and hypertension”

(NCEP, 2002)MetS Increases Risk of

Coronary heart disease Cardiovascular diseases Diabetes mellitus

(Kassi et al., 2011)

4

INTRODUCTION… MetS Components

Dyslipidemia • Elevated triglyceride

Apo lipoprotein B • Low level of high-density lipoproteins (HDL)

Elevated blood pressure (BP) Central obesity Insulin resistance

(Kassi et al., 2011)

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INTRODUCTION…Etiology of MetS

Insulin resistance Central obesity

(Bruce and Byrne, 2009) Malnutrition Genetics Physical inactivity

(Fulop et al., 2006) Aging Sedentary life style Ethnicity Smoking

(Oguz, 2008)

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INTRODUCTION…Diagnosis of MetSAny three or more of the following biomarkers Waist circumference > 102 cm in men

> 88 cm in women Triglycerides ≥ 150 mg/dL HDL cholesterol < 40 mg/dL in men

< 50 mg/dL in women BP ≥ 130/85 mmHg FBS ≥ 110 mg/dL

(US-National Cholesterol Educational Program, 2001)

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INTRODUCTION…MetS and risk of CVDs and DM Metabolic syndrome has been accepted worldwide as a

clinical marker for earlier detection of cardiovascular disease and type 2 diabetes

(Alberti, 2008)

People with metabolic syndrome are estimated to have twice the risk of developing cardiovascular diseases compared to healthy individuals and a five-fold increased risk of type 2 diabetes

(Grundy, 2008)

8

INTRODUCTION…Prevalence of MetS USA 40.1 % Europe 32.2 %

(Turner, 2013)

Pakistan (a rural area study) 35.2- 41%(Jahan et al., 2007)

Pakistan (a study in Karachi) • According to IDF 34.8% • According to NCEP (ATP-III) 49%

(Hydrie et al., 2009)

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INTRODUCTION…Foods that may Cause MetS High-salt foods contribute to the pathogenesis of

hypertension

(Commerford et al., 2000)

Consumption of high fructose corn syrup, energy drinks,

sweetened beverages cause obesity and diabetes(Tappy et al., 2010)

10

INTRODUCTION…Foods that may Reduce MetS Vegetables and fruits including a low glycemic index

foods such as beans, legumes and nuts reduce • Oxidative stress• Chronic inflammation • MetS

(Shang et al., 2011)

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INTRODUCTION…

Objectives Assessment of NHS of volunteers regarding

metabolic syndrome Correlation of nutrition of volunteers and metabolic

syndrome

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REVIEW OF LITERATUREMetS among Rural Bangladeshi Women Conducted a study to estimate prevalence and assessment of risk

factor

A total of 1535 women, aged ≥ 15 years were selected

The prevalence rate of MetS were 25.60% (NCEP ATP III),

19.80% (IDF) 11.60% have excess waist circumference, 29.12% had elevated

BP, 30.42% elevated FG, 85.47% low HDL values and 26.91% had increased TG

(Jesmin et al., 2012)

13

REVIEW OF LITERATURE…Screening of the Risk Factors in MetS Conducted a cross sectional survey to screen the risk factors

and components Result were analysed by chi square test

High prevalence in females (57.38%), age >50 years

Sedentary lifestyle (72.14%), positive family history (42.63%), omnivore diet (47.55%), stress (78.69%), insomnia (29.51%) and increased BMI (83.62%) had shown predisposition to MetS

(Kaur, 2014)

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REVIEW OF LITERATURE…Screening of the Risk Factors in MetS Protective role of an active lifestyle (36.21%), vegetarian

diet (62.07%) and adequate sleep (73.11%) was observed

A significant hypertension (98.37%),dyslipidemia (77.05%) dysglycemia (75.41%) and obesity (59.02%) was reported in MetS

Concluded that healthy dietary habits and physically active lifestyle fight against the growing epidemic of Metabolic Syndrome.

(Kaur, 2014)

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REVIEW OF LITERATURE…Screening of the Risk Factors in MetS A survey conducted among the women of North East of Iran

(20-40 years) NCEP Adult Treatment Panel-III (ATP-III) criteria used The mean HDL- cholesterol was lesser but the waist

circumferences, mean triglyceride, total cholesterol, and fasting blood glucose levels were significantly high

Metabolic syndrome prevalence rate was 20.62% Prevalence of metabolic syndrome was high in 35 to 40 years

women(Marjani et al., 2012)

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REVIEW OF LITRERATURE…Effects of Cinnamon Extract on MetS Investigated special effect on body composition and features of

metabolic syndrome They divided participant into two groups

Age, systolic blood pressure, fasting blood glucose, body mass index were randomly assigned

1st group was control group

2nd group were fed with 2 capsule of water soluble cinnamon extract for 12 week

(Ziegenfuss et al., 2006)

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REVIEW OF LITERATURE…Effects of Cinnamon Extract on MetS Substantial decrease in fasting blood glucose and systolic

blood pressure

Increases in lean mass and decrease in body fat

Cinnamon reduce FBG, SBP and improve body composition

Naturally-occurring spice can reduce risk factors associated with diabetes and cardiovascular diseases

(Ziegenfuss et al., 2006)

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REVIEW OF LITERATURE…Graphically Representation of Factors in MetS

(Adapted from: Kaur, 2014)

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REVIEW OF LITERATUREEffects of Diet on MetS Moderate replacement of carbohydrate by dietary fat improve • HDL cholesterol level• Low triglycerides (TG)• Reduce diastolic blood pressure (DBP)• Lower the prevalence of metabolic syndrome

(Rajaie et al., 2013) Freeze dried strawberry powder a concentrated source of

polyphenolic flavonoids, fiber and phytosterols• Improve lipid profile • Reduce cardiovascular diseases

(Basu et al., 2009)

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RESEARCH METHODOLOGYEthical Review of Research Proposal

The research proposal will be submitted to Departmental

Review Committee for Ethics (DRCE), Institute of Food

Science and Nutrition, University of Sargodha to check

the research work for ethical values

(Gibney, 2009)

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RESEARCH METHODOLOGY…

Study Site University of Sargodha will be selected as study site for

the research project after getting written permission from the competent authority

(Fatahalla and Mahmoud, 2004)

Target Population Teaching and non-teaching staff will be the target

population for the study

(Muhammad, 2000)

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RESEARCH METHODOLOGY…Study Design

The study design will be Cross Sectional

This type of study design is utilized for estimation of the

prevalence of a disease or disorder

This study design has highest external validity, relatively low

cost effective, efficient and have minimal ethical problems

(Gibney, 2009)

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RESEARCH METHODOLOGY…SOP for NHS Assessment Demographics Anthropometrics Energetics Vital signs observations Clinical signs and symptoms Medical and family history Indicative biomarkers Dietary history by food frequency questionnaire Potential food records

(Rico et al., 2002; Kumar et al., 2008)

(Rico et al, 2002).(Rico et al, 2002).

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RESEARCH METHODOLOGY…Selection of Volunteers 100 volunteers will be approached, the research study will

be disseminated, and informed consent will be taken from agreed ones

Volunteers will be assessed through previously mentioned instruments and tools for their• Assessment of NHS• Prevalence of metabolic syndrome

(Gibson,1990)

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RESEARCH METHODOLOGY…Dietary Intake Assessment The dietary intake assessment of volunteers will be

carried out by food frequency questionnaire (F.F.Q) FFQ will be based on Food Guide Pyramid Serving no. of each food group will be calculated The serving no. will be compared Food Guide Pyramid

(Gibson,1990)

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RESEARCH METHODOLOGY…Demographics Name Age Occupation Physical Activity Ethnicity Income Qualification Contact Information

(Jana, 2009)

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RESEARCH METHODOLOGY…Anthropometric Measurements

Height (cm)

Body Mas Index (BMI)

Ideal Body Weight (IBW)

Lean Body Weight (LBW)

Body Surface Area (BSA)

Waist Circumference

(Jana, 2009)

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RESEARCH METHODOLOGY

Anthropometric Measurements Body composition • Weight (Kg)• Body fat (%)• Body water (%)• Muscle mass (%)

These will be carried out through Bio-Electrical Impedance based scale (BG-64)

(Jana, 2009)

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RESEARCH METHODOLOGY…

Vital Signs Body temperature Blood pressure Pulse rate

 Medical and Family History Obesity Insulin Resistance Other diseases will be explored (Questionnaire)

(Gibson, 1990)

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RESEARCH METHODOLOGY…

Energetics Active metabolic rate (AMR) Basal metabolic rate (BMR)

(Jana, 2009)Investigations of Indicative Biomarkers Lipid profile FBS Complete blood count (CBC) LFT RFT

(US-National Cholesterol Educational Program, 2001)

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RESEARCH METHODOLOGY

Statistical Analysis The data will be analyzed by using an appropriate

statistical software

Descriptive analysis such as mean, frequencies and

percentage will be used for interpretation of the data(Steel et al., 1997)

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LITERATURE CITED Alberti, K. G and P. Z. Zimmet. 2008. Should we dump the

metabolic syndrome.? Bio. Med. J. 336-641.

Basu, A., M. Wilkinson, K. Penugonda1, B. Simmons, N. M. Betts and T. J. Lyons. 2009. Freeze-dried strawberry powder improves lipid profile and lipid peroxidation in women with metabolic syndrome: baseline and post intervention effects. Nutr. J. 8:43.

Bruce, K. D., C. D. Byrne. 2009. The metabolic syndrome common origins of a multifactorial discussion. Post. Med. J. 85: 614–21.

 

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LITERATURE CITED Canale, M.P., S. M. Villahermosa, G. Martino.

2013.Obesity-related metabolic syndrome: mechanisms of sympathetic overactivity. Int. J. Endoc. 865-965.

Commerford, S. R., M. J. Pagliassotti, C. L. Melby, Y. Wei, E. C. Gayles and J. O. Hill. 2002. Fat oxidation, lipolysis, and free fatty acid cycling in obesity-prone and obesity-resistant rats. Am. J. Phys. Endoc. Meta. 279: 875–85.

  Drewnowski, A., and F. Bellisle. 2007. Liquid calories,

sugar, and body weight. Am. J. Clin. Nutr. 8: 651–61.

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LITERATURE CITED National Cholesterol Education Program. 2001. Expert

Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the 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). JAMA. 285: 2486–97.

Fulop, T., D. Tessier and A. Carpentier. 2006. The metabolic syndrome. Pathol. Biol. 54: 375–86.

Grundy, S. M. 2008. Metabolic syndrome pandemic. Arterio. Thro. Vas. Biol. 28: 629-636.

35

LITERATURE CITED Hydrie, M. Z. I., A. S. Shera, A. Fawwad, A. Basit and

A. Hussain. 2009. Prevalence of Metabolic Syndrome in Urban Pakistan (Karachi): Comparison of Newly Proposed International Diabetes Federation and Modified Adult Treatment Panel III Criteria. Met. Syn. Rel. Disordes.7: 119–124.

International Diabetes Federation. 2005. The IDF consensus worldwide definition of the metabolic syndrome. [accessed on: 07 02-2015, available at: www.idf.org].

Jahan, F., R. Qureshi, T. Borhany and H. B. Hamza. 2007. Metabolic syndrome: frequency and gender differences at an Out-Patient clinic. Phys. Surg. Pak. 17: 32–35.

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LITERATURE CITED Jesmin, S., Md. R. Islam, A. M. S. Islam1., Md. S. Mia1,

S. N. Sultana., S. Zaedi, N. Yamaguchi., Y. Iwashima, M Hiroe, and T. Watanabe. 2012. Comprehensive assessment of metabolic syndrome among rural Bangladeshi women. BMC. Pub. Heal. 12: 49.

Kassi, E., P. Pervanidou, G. Kaltsas and G. Chrousos. 2011. Metabolic syndrome: definitions and Controversies. BMC. Medi. 9: 48.

Marjani, A. S. Hezarkhani and N. Shahini. 2012. Prevalence of Metabolic Syndrome among Fars Ethnic Women in North East of Iran. Worl. J. Med. Sci. 7(1): 17-22.

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LITERATURE CITED Nesto, R.W. 2003.The relation of insulin resistance

syndrome risk of cardiovascular disease. Cardio. Med. 4(6): 11-13.

Oguz, A. 2008. Metabolic syndrome. Clin. Nutr.18: 57–61. Rajaie, S., L. Azadbakht, M. Khazaei, M. Sherbafchi and

M. A. Esmaillzade. 2014. Moderate replacement of carbohydrates by dietary fats affects features of metabolic syndrome: A randomized crossover clinical trial. Nutr. 30: 61–68.

Shang, P., Z. Shu, Y. Wang, N. Li, S. F. Sun, Y. Xia and S. Zhan. 2011. Veganism does not reduce the risk of the metabolic syndrome in a Taiwanese cohort. Asia. Pac. J. Clin. Nutr. 20: 404–410.

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LITERATURE CITED Tappy, L., K. A. Le, C. Tran, N. Paquot. 2010. Fructose

and metabolic diseases: new findings, new questions. Nutr. 26: 1044–9.

Wierzbicki, A. S., S. Nishtar, P. J. Lumb, M. Lambert-Hammill, C. N. Turner, M.A. Crook, M. S. Marber and J. Gill. 2005. Metabolic syndrome and risk of coronary heart disease in a Pakistani cohort. Heart. 91:1003–1007.

Jana, A. K. 2009. Interventions for promoting the initiation of breastfeeding: RHL commentary, the World Health Organization Reproductive Health Library, Geneva: WHO.