The impact of diet quality on Metabolic Syndrome risk among fishermen and oil palm farmers: A case-control study using  the Healthy Diet Indicator (HDI)

Background: Metabolic Syndrome (MetS) is a cluster of risk factors that increase the likelihood of developing cardiovascular disease (CVD) and diabetes mellitus (DM). In Indonesia, the prevalence of MetS is rising, with fishermen and oil palm farmers showing higher rates compared to other populations. This study aims to explore the impact of diet quality on the risk of MetS among fishermen and oil palm farmers in Aceh, Indonesia. Methods: This community-based case-control study included 240 participants aged 35 to 65 years, divided into four groups: fishermen and oil palm farmers with (cases) and without (controls) MetS. Data collection took place between April and July 2024, covering sociodemographic characteristics, anthropometric measurements, blood pressure, lipid profile, blood glucose levels, and food security. Diet quality was assessed using the Healthy Diet Indicator (HDI) based on 24-hour dietary recall. Statistical analysis was performed using SPSS version 27, employing binary logistic regression. Results: Among fishermen, diet quality (HDI score) showed a significant association with MetS risk (OR=3.296, p=0.000). Smoking status, age, and income did not exhibit significant effects. Among farmers, diet quality was also associated with MetS risk (OR=1.880, p=0.000), with income showing a significant relationship with MetS risk (p=0.018). Conclusion: Diet quality plays a critical role in the risk of metabolic syndrome among fishermen and oil palm farmers, with poor dietary patterns increasing the risk of MetS in both groups. These findings provide a basis for public health interventions to prevent metabolic syndrome in these communities.