Fig. 1

Hazard ratios of the combined effect of dietary carbohydrate, whole grains, refined grains and simple sugar (< median vs. ≥ median) and weight change (triangle, weight stable (± 3%); square, > 3% weight loss; and circle, > 3% weight gain) on risk MetS after adjustment for age, sex, smoking status, physical activity, total energy intake, dietary fat, dietary protein, healthy eating index, family history of diabetes, and history of cardiovascular disease. The median (interquartile range) intakes of dietary variables were: carbohydrate 53.1% of total energy (46.0-58.6); whole grains 4.0 serving/day (2.4–6.3); refined grains 6.7 serving/day (3.9–8.9); and simple sugar 15.7% of total energy (8.0-15.9)