The association between Healthy Beverage Index and anthropometric measures among children: a cross-sectional study

Healthy beverage index is associated with metabolic syndrome: insights from the Ravansar non-communicable disease (RaNCD) cohort study

BACKGROUND

Dietary patterns play a crucial role in the development and management of metabolic syndrome (MetS). The Healthy Beverage Index (HBI) is a novel tool that assesses the quality of beverage choices in the diet and provides insights into their potential impact on metabolic health. The aim of this study was to investigate the association between the HBI and the MetS.

METHODS

This cross-sectional study was conducted using data collected at baseline from the Ravansar Noncommunicable Disease Cohort Study. A total of 9,025 participants aged 35 to 65 years were included in the analysis. HBI was calculated using food items from the Food Frequency Questionnaire (FFQ). MetS status was defined according to established criteria, and logistic regression analysis was performed to assess the association between HBI scores and MetS, adjusting for potential confounding variables.

RESULTS

In our study, 41.13% of the population was found to have MetS, with a significant association between MetS and tertiles of HBI. Furthermore, the logistic regression model showed a significant inverse association between HBI scores and the odds of developing a MetS (OR = 0.90; 95% CI: 0.86, 0.94), even after adjusting for confounding factors, emphasizing the potential protective effect of higher HBI scores.

CONCLUSION

Increased HBI scores were associated with lower risk of MetS, emphasizing the importance of choosing health-promoting beverages in controlling MetS. These findings support the association between dietary habits and metabolic health and provide practical guidance for individuals and public health initiatives aimed at improving metabolic outcomes.

The association between healthy beverage index and sarcopenia in Iranian older adults: a case-control study

BACKGROUND

Sarcopenia is a progressive disease with age-related loss of skeletal muscle mass, strength, and function. No study has investigated the association between healthy beverage index (HBI) and sarcopenia in older adults. Therefore, the present study aimed to investigate the association between HBI and sarcopenia in Iranian older adults.

METHODS

In the present case-control study, 80 sarcopenic and 80 non-sarcopenic participants matched in sex were included. Body composition was measured using bioelectrical impedance analysis. Handgrip strength (HGS), skeletal muscle mass index (SMI), and gait speed were utilized to confirm sarcopenia. Also, a food frequency questionnaire was used to evaluate food intake. HBI score was calculated based on ten sub-components of the total beverages. Moreover, logistic regression was applied to assess the association between HBI and sarcopenia.

RESULTS

In the crude model, we observed no significant association between HBI and the odds of sarcopenia. Still, after adjusting the confounders, the odds of developing sarcopenia decreased significantly in the second and last tertiles (T) (T2- odds ratio (OR) = 0.04, 95% confidence interval (CI): 0.01-0.25 and T3- OR = 0.10, 95% CI: 0.01-0.60).

CONCLUSIONS

Our findings indicated that HBI is inversely related to the chance of sarcopenia. Therefore, to reduce the odds of sarcopenia, it is recommended to consume healthy drinks such as fruit juices and milk.

Association between healthy beverage index and nonalcoholic fatty liver disease in the Ravansar noncommunicable disease cohort study

The quality of drinks affects the functioning of the liver. In recent decades, the variety of high-calorie and sweet drinks has increased. The objective of this study was to explore the association between Healthy Beverage Index (HBI) and the risk of nonalcoholic fatty liver disease (NAFLD) among adults. We included 6,276 participants aged 35 to 65 from the Ravansar Non-Communicable Disease (RaNCD) cohort study at baseline. NAFLD is defined based on the fatty liver index (FLI), calculated using anthropometric measurements and non-invasive markers. The HBI was developed using a combination of water, low-fat milk, 100% fruit juice, sugar-sweetened beverages, met fluid requirement and % energy from beverages. Logistic and linear regression models were employed to investigate the associations of the HBI and high FLI. The average FLI was significantly lower in the first tertile of HBI compared to the third tertile (47.83 vs. 45.77; P = 0.001). After adjusting for confounding variables, the odds of high FLI decreased by 28% (OR 0.72, 95% CI 0.63, 0.82) in the second tertile of HBI and by 21% in the third tertile (OR 0.79, 95% CI 0.70, 0.91). There was no correlation between gamma glutamyl transferase (GGT), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and aspartate transaminase (AST) levels with HBI. The study findings indicate an inverse association between high FLI and HBI. Therefore, it is recommended to consume healthy beverages and without added sugar. However, additional longitudinal studies are required to examine the association between beverage consumption and the development of NAFLD.

Full-Day Physical Activity and Sedentary Behaviour Levels of Typically Developing Children and Adolescents in the Middle East: A Systematic Review

Physical activity (PA) and sedentary behaviour (SB) are important components of physical behaviour associated with long-term health outcomes. Environmental and cultural factors may influence physical behaviour. To explore full day PA and SB in children and adolescents (2-18 years old) in the Middle East, a systematic literature review was performed including 183 journal articles. A wide range of PA and SB outcomes were reported, in some cases making synthesis of results difficult. As a consequence, results were generally reported narratively (MVPA time, total PA, SB time). Meta-regression of daily step count revealed females took 4600 fewer steps than males, with 3000 fewer steps on weekdays than weekends, and overweight individuals taking 2800 fewer steps/day. Steps decreased with age. Meta-regression for TV viewing time demonstrated an increase by 0.04 h per year of age. Even though environmental and cultural conditions may be different, PA and SB of children and adolescents in the Middle East were largely comparable to those of Europeans and North Americans. The wide range of data collection instruments used (both self-report questionnaire and body-worn devices) and heterogeneity of data made synthesis of reported data across studies very difficult, suggesting a need for greater standardisation of data collection methods.

Healthy beverage index could decrease odds of metabolic syndrome: A cross-sectional study

Some studies indicated that sugar-sweetened beverages (SSBs) were related to MetS risk, and others found no relationship between MetS and SSBs. Therefore, the present study aimed to investigate the relationship between healthy beverage index (HBI) and MetS in Iranian adults. This cross-sectional study was performed on baseline data FASA cohort. Out of 10,127 participants in the FASA cohort study, 8838 participants were included in this study. The National Cholesterol Education Program's Adult Treatment Panel (ATP) III was used for MetS definition. The HBI was calculated by a 125-item food frequency questionnaire with standard criteria. The association between HBI and MetS and its components was evaluated by univariate regression. Multivariate regression with the backward method was used for adjusting confounders. p < .05 was considered as statistically significant. Compared to the first quartile, it was observed that HBI in the last quartile was significantly related to lower odds of MetS in the multivariate analysis (odds ratio [OR] = 0.72; 95% confidence interval [CI]: 0.60-0.87, p < .001). Also, we observed a significant association between the last quartile of HBI with lower odds of high waist circumference (WC) (OR = 0.55; 95% CI: 0.45-0.67, p < .002). Our findings showed that the higher HBI score reduced MetS odds and WC. Therefore, to reduce the odds of MetS, a healthy pattern of beverage consumption, including drinking water, low-fat milk, unsweetened tea, and coffee, and reducing the consumption of SSB are recommended. More studies are needed to confirm the findings.

The Association Between Healthy Beverage Index (HBI) With Metabolic Risk Factors Among Apparently Metabolically Healthy Overweight and Obese Individuals

Recent studies have evaluated the association between specific beverage intake and metabolic risks in adults. However, more evidence is needed to examine the association between the Healthy Beverage Index (HBI) and metabolic factors. Therefore, this study investigated the relationship between HBI and metabolic factors in adults. In this cross-sectional study, 338 overweight and obese individuals living in Tabriz, Iran were selected. Data on beverage consumption, demographics, physical activity, and anthropometric characteristics were evaluated using validated standard protocols. The predefined HBI was calculated based on previous studies. The mean value of HBI index among all of the participants was 59.76 ± 6.51. Those at the higher HBI scores had significantly lower waist circumference, waist-to-hip ratio, fat mass, and weight (p < 0.05). HBI and triglyceride scores also had a significant relationship. It has been shown that at higher HBI scores compared to lower scores, high-density lipoprotein cholesterol levels increase while homeostatic model assessment for insulin resistance, low-density lipoprotein cholesterol, total cholesterol, and blood pressure decrease. HBI scores higher among Iranian adults were associated with a better chance of losing weight and weight loss and a better lipid profile, and lower blood pressure. Therefore, HBI can be a useful and helpful tool for assessing the overall quality of beverages adults consume. However, further studies are warranted to confirm the possible health effects of healthy beverage index.

The association between glycemic index and glycemic load and quality of life among overweight and obese women: a cross-sectional study

BACKGROUND

The association between different dietary approaches and quality of life (QoL) has been well-demonstrated in previous research. However, the relationship between glycemic index (GI) and glycemic load (GL) with different dimensions of QoL has not been established. Therefore, we aimed to investigate the relationship between GI and GL with QoL in overweight and obese women.

METHODS

Two hundred seventy-six overweight and obese women (body mass index (BMI) ≥ 30 kg/m2), aged 18-64 years old, were included in this cross-sectional study. The amount of dietary intake and GI and GL indexes were established using a valid and reliable Food Frequency Questionnaire (FFQ) containing 147 items. Body composition (using bioimpedance analysis), anthropometrics, and physical activity were assessed. Insulin resistance (HOMA-IR) and hs-CRP were also measured, whilst QoL was measured using the SF-36 (short-form-36), self-administered, questionnaire.

RESULT

Analyses were performed using multivariable linear regression, considering a wide range of confounding variables, such as age, physical activity, BMI, education, job, smoking, and marriage. We found a significant negative association between glycemic load and quality of life (β = -0.07, 95%CI = -0.13_ -0.01, p = 0.01). No significant associations were observed between glycemic index and quality of life (β = -0.03, 95%CI = -0.81_ 0.75, p = 0.93).

CONCLUSION

We observed a significant negative association between QoL and GL, but not GI, among overweight and obese women in Iran. Our results need to be confirmed with further well-designed and adequately powered studies that control for clinical confounders.

The association between healthy beverage index and quality of life among overweight and obese women: a cross-sectional study

BACKGROUND

Although several studies have evaluated the association between patterns of beverage consumption with different components of quality of life separately, the findings are controversial. In addition, none have examined all components of quality of life together in relation to patterns of beverage consumption. Therefore, this study was conducted to identify the association between healthy beverage index (HBI) and quality of life among overweight and obese women.

METHODS

For this cross-sectional study, 210 obese and overweight women were recruited from health centers in Tehran, Iran. Using reliable and verified standard protocols, data on beverage intake, socio-demographic, physical activity, and anthropometric variables were assessed. Based on past studies, the predetermined HBI was estimated. Serum samples were used to determine biochemical characteristics, and quality of life was assessed using SF-36 questionnaires.

RESULTS

There was a significant association between total QoL score with T2 tertile of HBI in the adjusted model (β: 13.11, 95% CI: 1.52, 24.69, p-value = 0.027). General health had a significant negative association with T2 (β: -5.83; 95% CI: - 11.48, - 0.18; p-value = 0.043) and T3 (β: -6.20; 95% CI: - 12.37, - 0.03; p-value = 0.049). Women with greater adherence to the HBI had a higher physical functioning score, and there was a significant upward trend from the second to the third tertile (7.74 vs 0.62) (-trend = 0.036). There was a significant positive association between mental health with T3 of HBI (β: 4.26; 95% CI: 1.51, 5.98; p-value = 0.015) and a significant increasing trend was observed with increasing tertiles (P-trend = 0.045).

CONCLUSION

In conclusion, there is a significant association between total QoL score, and its components, with HBI among overweight and obese women. However, additional well-designed studies are needed to confirm these findings.

Association of healthy beverage index with circadian rhythm and quality of sleep among overweight and obese women: a cross-sectional study

PURPOSE

Circadian rhythm is a behavioral, physiological, and molecular change with a cycle length of approximately 24 h. Changes to the circadian rhythm can result in sleep difficulty. The healthy beverage index (HBI) is a holistic concept for evaluating the quality of overall beverage intake and its association with health-related outcomes in nutritional epidemiological studies. This study aimed to assess the relationship of HBI with circadian rhythm and sleep quality among overweight/obese women.

METHODS

The current study was conducted among 208 overweight and obese women between 18-48 years in Tehran, Iran. We evaluated potential HBI with a valid food frequency questionnaire. Following standard procedures, trained personnel assessed anthropometric measures, blood samples, and other baseline characteristics. The Pittsburgh Sleep Quality Index and the morning-eveningness questionnaire were applied to evaluate sleep quality and circadian rhythm respectively.

RESULTS

The mean (SD) BMI for this study was 30.8 (4.2) kg/m². We observed that subjects in the least tertile had significantly high levels of triglyceride (p = 0.04) and low-density lipoprotein (p = 0.009). High-density lipoprotein was significantly different across the tertiles (p = 0.003). After adjusting for potential covariates, subjects in the second tertile of HBI had 5.07 odds of having the worst quality of sleep as compared to those in the third tertile, p < 0.05. We also observed a significant inverse association between the HBI and the "moderately evening type" participants (OR 0.86; 95% CI 0.68-0.99; p: 0.02) after adjusting for potential confounders.

CONCLUSION

Healthy beverage consumption may have the potential of improving sleep quality among overweight and obese subjects.

LEVEL OF EVIDENCE

Level IV, evidence obtained from a descriptive study.

Healthy beverages may reduce the genetic risk of abdominal obesity and related metabolic comorbidities: a gene-diet interaction study in Iranian women

BACKGROUND & AIMS

The nutrition transition in developing countries like Iran causes the increasing rise of obesity and abdominal obesity rates. However, it is not yet well proven that environmental modifications like improving the quality of beverage intake can be effective in people who have a genetic predisposition to obesity. So, in the present study, we examine the interaction between genetic predisposition and healthy beverage index (HBI) with abdominal obesity and obesity-related metabolic risk factors in overweight and obese women.

METHOD

Based on inclusion and exclusion criteria, 202 overweight or obese females were chosen for this cross-sectional study. Body composition, anthropometric measures, physical activity, and beverage intake data were collected and analyzed using recognized and trustworthy methodologies. Biochemical tests were performed on serum samples. A genetic risk score (GRS) was calculated based on the results of genetic tests. The predetermined HBI was calculated based on previous studies. A generalized linear model was used to estimate the interactions between GRS and HBI (GLM).

RESULTS

We found significant interactions between GRS and HBI on WHR (β = - 0.39, CI: -0.07 to 0.001, P = 0.05) and WC (β = - 6.18, CI: - 13.41 to 1.05, P = 0.09). Also, there were significant gene-diet interactions for HBI and GRS on HDL (β = 7.09, CI: - 0.73 to 14.92, P = 0.07) and FBS (β = - 9.07, CI: - 18.63 to 0.47, P = 0.06).

CONCLUSIONS

These findings emphasize the HBI considering genetics appears to protect against the risks of abdominal obesity and metabolic associated obesity markers.

The association between Healthy Beverage Index and psychological disorders among overweight and obese women: a cross-sectional study

BACKGROUND AND AIMS

The Healthy Beverage Index (HBI) is a valuable technique to estimate the synergistic effects of overall beverage consumption. Several studies have evaluated the associations between HBI and beneficial changes in the health status. however, there is no study on the association between patterns of beverage consumption and mental health status. Therefore, this study sought to examine the association between HBI and psychological disorders among overweight and obese women.

METHODS

199 overweight and obese women, between the ages of 18 and 55 y, were enrolled in this cross-sectional study in Tehran, Iran. To collect beverage dietary data, a validated semi-quantitative food-frequency questionnaire (FFQ) was used. Furthermore, the DASS-21 questionnaire was used to assess psychological profile states.

RESULTS

The association of total depression anxiety stress (DASS) score with healthy beverage index (HBI) tertiles in models was marginally significant (OR =: 0.78; 95% CI 0.30-2.02; P-value = 0.074; (OR = 0.77; 95% CI 0.28-2.16; P-value = 0.062), respectively. In terms of stress, anxiety, and depression, after adjusting for confounders, participants with higher HBI in the third tertile had lower odds of depression vs. the first tertile (OR = 0.99; 95% CI 0.35-2.81; P-trend = 0.040).

CONCLUSION

We demonstrate that the total DASS score was associated with HBI tertiles. We also found that participants with higher HBI had lower odds of depression. However, additional well-designed studies are needed to confirm the veracity of these findings.