Public Health Nutrition: 14(9), 1650–1657 doi:10.1017/S1368980010003265 High prevalence of metabolic syndrome in an elderly Croatian population – a multicentre study Daria Pas ˇalic ´ 1 , Slavica Dodig 2 , Naima C ˇ orovic ´ 3 , Alica Pizent 3 , Jasna Jurasovic ´ 3 and Mladen Pavlovic ´ 3, * 1 Department of Chemistry and Biochemistry, School of Medicine, University of Zagreb, Zagreb, Croatia: 2 Reference Centre for Clinical Paediatric Allergy of the Ministry of Health and Social Welfare, Srebrnjak Children’s Hospital, Zagreb, Croatia: 3 Institute for Medical Research and Occupational Health, Ksaverska c. 2, HR-10000 Zagreb, Croatia Submitted 18 December 2009: Accepted 21 October 2010: First published online 8 December 2010 Abstract Objective: To investigate the prevalence and characteristics of metabolic syndrome (MetS) in a healthy elderly Croatian population. Design: Cross-sectional study consisting of a health check including anthropo- metric measures and food questionnaires as well as analysis of biochemical parameters related to MetS. The diagnostic criteria of the International Diabetes Federation (IDF) were used for diagnosis of MetS. Setting: Four centres in continental (Virovitica and Zagreb) and Adriatic coast (Split and Omis ˇ) regions of Croatia. Subjects: Free-living elderly persons aged 70–90 years (n 320). Results: Significantly lower MetS prevalence was found among participants from small urban centres compared with those from large urban centres (59?1% v. 69?6 %; P 5 0?051). Participants without MetS consumed wine more frequently (P 5 0?05) than those with MetS. Compared with their peers with HDL cholesterol (HDL-C) ,1?03 mmol/l, more male participants with HDL-C $1?03 mmol/l con- sumed wine (P 5 0?04) or pelagic fish (P 5 0?03). The prevalence of participants with TAG $1?7 mmol/l was higher in wine non-consumers (P 5 0?05) than in wine consumers. Multivariate analysis with age and gender as covariates showed a significant inverse association of wine consumption with total cholesterol (P , 0?001), a positive association with HDL-C (P , 0?001) and a marginally inverse association with TAG (P 5 0?06). In the male population, alkaline phos- phatase and g-glutamyl transferase activities were higher in participants with MetS (P , 0?05). Conclusions: High MetS prevalence was observed in an elderly Croatian popu- lation. Data showed that moderate consumption of wine and/or pelagic fish has a protective role against MetS in the population studied. Keywords Metabolic syndrome Elderly Nutrition habits Biochemical markers Metabolic syndrome (MetS) is a common metabolic dis- order resulting from a cluster of interrelated abnormalities: obesity, hypertension, hyperglycaemia and dyslipidae- mia (1–3) . There are currently several definitions for MetS provided by various expert groups and organizations including WHO, the European Group for the Study of Insulin Resistance, the National Cholesterol Education Program – Third Adult Treatment Panel and the Inter- national Diabetes Federation (IDF) (4) . The aetiology of MetS includes obesity, which has been found to be responsible for the excess release of NEFA, cytokines and other pro-inflammatory factors, the development of insulin resistance and the development of hypertension and hyperlipidaemia (4) . The number of persons with MetS has been increasing intensively over the past two decades. The consequence of such an increase is a global epidemic of obesity and diabetes (5) . There is also a high risk of CVD, highlighting an urgent need for a strategy of prevention and treatment (6) . Differences in lifestyle, nutrition and environmental conditions have an impact on health status, as well as on obesity, body fat distribution and predisposition for MetS. Obesity and higher body weight are strongly associated with sedentary lifestyle and lack of physical activity in the adult population of the European Union (7) . Comparison of published MetS prevalences in different populations is difficult because such estimates have been obtained using varying diagnostic criteria (8) . Despite differences in the *Corresponding author: Email mpavlov@imi.hr r The Authors 2010