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Background <p>Concerning rare evidence on the relationship of dietary nitrate (NO<sub>3</sub>)/nitrite (NO<sub>2</sub>) from plant or animal food groups with metabolic syndrome (MetS) in children and adolescents, this study investigates the longitudinal association of total, plant- or animal-sourced dietary NO<sub>2</sub>/NO<sub>3</sub> intake in children and adolescents with the incidence of MetS and its risk factors.</p> Methods <p>In this secondary analysis, 1144 children and adolescents (46.2% male) aged 6–19 years were selected from the Tehran Lipid and Glucose Study participants. Dietary data were gathered by a valid and reliable semi-quantitative food frequency questionnaire. A validated national database was used to estimate dietary NO<sub>2</sub>/NO<sub>3</sub> intakes. MetS was defined according to Cook’s criteria and the Iranian-modified National Cholesterol Education Program.</p> Results <p>The mean ± SD ages of males and females at baseline were 13.1 ± 3.76 and 14.0 ± 3.77, respectively. The risk of MetS increased with consuming total nitrite and total nitrate exceeding acceptable dietary intake (ADI); however, this association disappears after adjusting for dietary variables. There were positive significant associations between total NO<sub>2</sub> intake and the incidence of high fasting blood glucose (FBG) in follow-ups [HR (CI) Q4: 1.42(1.13–1.77), P-trend = 0.001]. Also, the HR of high FBG increased across quartiles of animal-based dietary NO<sub>3</sub> and plant-sourced dietary NO<sub>2</sub>. The risk of high blood pressure (BP) increased about 5% with consuming every 100&#xa0;mg of total nitrate exceeding ADI. Exposure to nitrate from animal and plant food groups were positively associated with high BP incidence, while higher intake of plant originated nitrite increased the risk of high BP incidence. Participants with the highest animal-sourced nitrate intake had a 19% higher risk of high triglyceride (TG), compared to the lowest intake.</p> Conclusion <p>Our findings provide evidence that dietary NO<sub>2</sub>/NO<sub>3</sub> intake in children and adolescents whether from the plant or animal food sources were not associated with MetS incidence. High dietary intake of total NO<sub>2</sub> increased the incidence of some MetS risk factors; while high intake of NO<sub>3</sub> in spite of their sources increased the incidence of high BP. Exposure to animal-sourced nitrate intake had increased the risk of high TG.</p>

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Prospective association between dietary source-determined nitrate/nitrite and the risk of metabolic syndrome among children and adolescents: Tehran lipid and glucose study

  • 期刊论文

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  • 发表日期：

    2025年11月24日

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  • Firoozeh Hosseini-Esfahani,
  • Maryam Rafiei,
  • Zahra Bahadoran,
  • Mitra Hasheminia,
  • Parvin Mirmiran,
  • Fereidoun Azizi

摘要

Background

Concerning rare evidence on the relationship of dietary nitrate (NO3)/nitrite (NO2) from plant or animal food groups with metabolic syndrome (MetS) in children and adolescents, this study investigates the longitudinal association of total, plant- or animal-sourced dietary NO2/NO3 intake in children and adolescents with the incidence of MetS and its risk factors.

Methods

In this secondary analysis, 1144 children and adolescents (46.2% male) aged 6–19 years were selected from the Tehran Lipid and Glucose Study participants. Dietary data were gathered by a valid and reliable semi-quantitative food frequency questionnaire. A validated national database was used to estimate dietary NO2/NO3 intakes. MetS was defined according to Cook’s criteria and the Iranian-modified National Cholesterol Education Program.

Results

The mean ± SD ages of males and females at baseline were 13.1 ± 3.76 and 14.0 ± 3.77, respectively. The risk of MetS increased with consuming total nitrite and total nitrate exceeding acceptable dietary intake (ADI); however, this association disappears after adjusting for dietary variables. There were positive significant associations between total NO2 intake and the incidence of high fasting blood glucose (FBG) in follow-ups [HR (CI) Q4: 1.42(1.13–1.77), P-trend = 0.001]. Also, the HR of high FBG increased across quartiles of animal-based dietary NO3 and plant-sourced dietary NO2. The risk of high blood pressure (BP) increased about 5% with consuming every 100 mg of total nitrate exceeding ADI. Exposure to nitrate from animal and plant food groups were positively associated with high BP incidence, while higher intake of plant originated nitrite increased the risk of high BP incidence. Participants with the highest animal-sourced nitrate intake had a 19% higher risk of high triglyceride (TG), compared to the lowest intake.

Conclusion

Our findings provide evidence that dietary NO2/NO3 intake in children and adolescents whether from the plant or animal food sources were not associated with MetS incidence. High dietary intake of total NO2 increased the incidence of some MetS risk factors; while high intake of NO3 in spite of their sources increased the incidence of high BP. Exposure to animal-sourced nitrate intake had increased the risk of high TG.