Sex-specific dietary patterns and their association with metabolic syndrome: Insights from a cross-sectional analysis

This study aims to identify a posteriori dietary patterns with a sex approach and to evaluate their association with metabolic syndrome criteria. Cross-sectional study conducted in 6821 men and women between 55 and 75 years of age. Forty-two food groups were analyzed from dietary information collected with food frequency questionnaires, using principal component analysis and cluster analysis and then information from both statistical methods was compared. Prevalences were calculated foreach cluster group, based on the number and types of metabolic syndrome criteria they met. Following principal component analysis, two dietary patterns labeled “healthy” and “unhealthy” were identified in both men and women, due to the presence of foods that are considered more or less healthy. These same dietary patterns were found in cluster analysis plus an “intermediate” cluster consisting of both healthy and unhealthy foods. The presence of metabolic syndrome is related to the “healthy” dietary pattern in women and to the “unhealthy” dietary pattern in men. Comparison of the two statistical approaches showed a high level of correlation between them (weighted Kappa = 0.703 in women and weighted Kappa = 0.691 in men). Adherence to both healthy and unhealthy dietary pattern appears to be related to the development of MS. The differences found by sex make it necessary to develop interventions with a sex-specific approach. •It is necessary to approach sex as men and women followed different dietary patterns.•Cluster analysis and principal component analysis revealed similar patterns, being more coherent when sex was considered.•An intermediate pattern was found where healthy and unhealthy foods were consumed in similar proportions.