TY  - THES
T1  - Factors associated with metabolic syndrome among vegetarians in Kuala Lumpur and Selangor, Malaysia
A1  - Ching, Yuan Kei
LA  - English
YR  - 2018
UL  - http://discoverylib.upm.edu.my/discovery/Record/oai:ethesis.upm.edu.my:14183
AB  - Metabolic syndrome (MetS) is characterised by a cluster of risk factors, including abdominal obesity, high blood pressure (BP), elevated fasting blood glucose (FBG), elevated triglyceride (TG) and low levels of high-density lipoprotein cholesterol (HDL-c), that is associated with the development of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Based on the Joint Interim Statement (JIS) criteria, an individual with at least three out of five of the MetS components is considered as having MetS. Several studies have reported the prevalence of MetS among vegetarians, however, the factors associated with MetS remain unknown in this population. Therefore, this cross-sectional study aimed to determine the prevalence of MetS among vegetarians in Kuala Lumpur and Selangor and its associated factors.
A total of 200 adult vegetarians (males: 34.5%, females: 65.5%), with a mean age of 48.3 ± 13.2 years, were recruited in the present study. The data on vegetarianism practices, socio-demographic characteristics and lifestyle behaviours (cigarette smoking, alcohol consumption, physical activity, psychological distress and sleep quality) were collected through a set of self-administered questionnaire. Three-day dietary recall was used to assess the dietary intake of the vegetarians. Body weight, height, body fat percentage (BF%), waist circumference (WC), BP of the vegetarians were measured by the researcher. A total of 10 ml of overnight venous fasting blood sample was drawn by a registered nurse. Allele-specific polymerase chain reaction was used to genotype the rs174547 in the fatty acid desaturase 1 (FADS1) gene from extracted deoxyribonucleic acid (DNA). Allele-specific polymerase chain reaction aimed to detect any point of mutation in human DNA through the polymerase chain reaction products in ethidium bromide-stained agarose gel.
Out of the 200 vegetarians in the present study, nearly half of the vegetarians were lacto-ovo vegetarians (48.0%), followed by lacto-vegetarians (26.0%), vegans (19.0%) and ovo-vegetarians (7.0%), with an average of 13.7±9.2 years of practising vegetarianism. Based on the JIS criteria, the prevalence of MetS was 21.0%, with a significant difference found between sexes (males: 30.4%, females: 16.0%) (p < 0.05). High BP (49.5%) was the most common MetS component among the vegetarians. The number of years of practising vegetarianism was longer among vegetarians with MetS than vegetarians without MetS (p < 0.05). In bivariate analyses, older age, males, Indians, “practising vegetarianism is environmentally friendly”, TT genotype of rs174547 in FADS1 gene, high BF%, high intake of carbohydrate and high intake of dietary fibre were significantly associated with MetS among vegetarians (p < 0.05). In addition, there were no significant associations of vegetarian categories, reasons for adopting vegetarianism (animal welfare, health concern, religious belief, family influence and other reasons), cigarette smoking, alcohol consumption, physical activity level, dietary intake [protein, total fat, cholesterol, saturated fat (SFA), monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), linoleic acid (LA) and alpha-linoleic acid (ALA)], psychological distress and sleep quality with MetS. The multiple logistic regression analysis showed that TT genotype of rs174547 in FADS1 gene (OR = 6.76, 95% CI: 1.48-30.90), high BF% (OR = 10.72, 95% CI: 3.32-34.59) and high intake of SFA (OR = 1.05, 95% CI: 1.00-1.09) were identified as significant risk factors of MetS among the vegetarians. These results indicate the importance to focus on the mechanism linking between rs174547 in FADS1 gene, BF% and SFA intake and the development of MetS among vegetarians.
In conclusion, about one-fifth (21.0%) of the vegetarians had MetS, which emphasise the need to monitor the MetS status among vegetarians in Malaysia. The present study found that vegetarians with TT genotype of rs174547 in FADS1 gene, high BF% and high SFA intake were risk factors of MetS. These findings suggest that future prospective studies are needed to affirm the associations of TT genotype of rs174547 in FADS1 gene, high BF% and high SFA intake with MetS among vegetarians. Additionally, intervention programmes to prevent MetS should be established among those vegetarians with high BF% and high SFA intake. In terms of rs174547 in FADS1 gene, nutritionists and genomic researchers are suggested to work together to establish a personalised intervention based on genetic variation make-up for MetS management, especially for those vegetarians with TT genotype of rs174547 in FADS1 gene among Malaysian vegetarians.
ER  -