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Tirani SA, Lotfi K, Shahdadian F, Hajhashemy Z, Rouhani P, Saneei P. Dietary Phytochemical Index in Relation to Metabolic Health Status, Serum Adropin, and Brain-Derived Neurotrophic Factor Levels in Adults. Curr Dev Nutr 2024; 8:102103. [PMID: 38440363 PMCID: PMC10909649 DOI: 10.1016/j.cdnut.2024.102103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/19/2024] [Accepted: 02/09/2024] [Indexed: 03/06/2024] Open
Abstract
Background Little is known about the relationship between dietary intake of phytochemicals with metabolic health status and underlying mechanisms. Objectives Little is known about the relationship between dietary intake of phytochemicals with metabolic health status and underlying mechanisms. We hypothesized that dietary phytochemical index (DPI) improves metabolic health status by ameliorating serum concentrations of brain-derived neurotrophic factor (BDNF) and adropin. Methods A cross-sectional study was performed in 527 adults (286 males and 241 females). The dietary intakes of participants were collected by a 168-item food frequency questionnaire, and DPI was estimated as a percentage of energy intake derived from phytochemical-rich foods. Anthropometric variables, blood pressure, glycemic and lipid profiles, and biochemical variables were assessed. The metabolically unhealthy (MU) phenotype was determined based on the definition presented by Wildman et al. Results The MU phenotype was identified in 51.4% of male and 32.0% of female participants. Participants in the third tertile of DPI had 59% lower odds of MU than those in the first tertile (OR: 0.41; 95% CI: 0.19, 0.87) after considering potential confounders. Stratified analysis by sex and body mass index indicated that DPI was inversely related to MU phenotype in females (OR: 0.28; 95% CI: 0.08, 0.97) and normal-weight individuals (OR: 0.11; 95% CI: 0.02, 0.62). DPI was also inversely associated with hyperglycemia, hypertriglyceridemia, and chronic inflammation. Nonsignificant reduced odds of low BDNF (OR: 0.87; 95% CI: 0.42, 1.84) and adropin (OR: 0.75; 95% CI: 0.31, 1.79) were observed in individuals in the top tertile of DPI compared with those in the bottom tertile. Conclusions This study showed that individuals with higher dietary intake of phytochemicals had lower odds of MU, particularly females and normal-weight individuals. No significant relationship was observed between serum BDNF and adropin with phytochemical intake.
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Affiliation(s)
- Shahnaz Amani Tirani
- Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, Nutrition and Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Keyhan Lotfi
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Shahdadian
- Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, Nutrition and Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, Nutrition and Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Rouhani
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Parvane Saneei
- Department of Community Nutrition, Nutrition and Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Tirani SA, Lotfi K, Mirzaei S, Asadi A, Akhlaghi M, Saneei P. The relation between dietary phytochemical index and metabolic health status in overweight and obese adolescents. Sci Rep 2023; 13:12059. [PMID: 37491451 PMCID: PMC10368731 DOI: 10.1038/s41598-023-39314-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/23/2023] [Indexed: 07/27/2023] Open
Abstract
Previous studies have rarely investigated dietary phytochemicals consumption in relation to metabolic health of adolescents. The current study was performed to investigate dietary phytochemical index (DPI) in relation to metabolic health status in overweight and obese adolescents. This cross-sectional study was conducted among 203 adolescents with overweight or obesity. Dietary intakes of participants were obtained through a validated 147-item food frequency questionnaire. DPI was calculated [(dietary energy derived from phytochemical-rich foods (kcal)/total daily energy intake (kcal)) ⨯100]. Glycemic and lipid profiles, blood pressure, and anthropometric indices were also measured. A metabolically unhealthy overweight/obesity (MUO) profile was determined based on the International Diabetes Federation (IDF) and IDF/Homeostasis Model Assessment Insulin Resistance (HOMA-IR) definitions. Study subjects had a mean age of 13.98 years and 50.2% of them were girls. According to IDF and IDF/HOMA-IR criteria, 38.9% (37 boys, and 42 girls) and 33% (35 boys, and 32 girls) of the study participants were respectively MUO. According to IDF and IDF/HOMA-IR definitions, adolescents in the third DPI tertile had respectively 61% (maximally-adjusted OR = 0.39, 95%CI 0.16-0.91) and 67% (maximally-adjusted OR = 0.33, 95%CI 0.13-0.83) lower odds of being MUO, compared to the first tertile. Stratified analysis by sex indicated that DPI was inversely related to MUO phenotype based on IDF criteria in girls (maximally-adjusted OR = 0.25, 95%CI 0.06-0.98), but not in boys. The current study found that adolescents with a higher dietary intake of phytochemicals have lower odds of being MUO, particularly among girls. However, further large-scale prospective cohort studies are required to confirm this finding.
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Affiliation(s)
- Shahnaz Amani Tirani
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Students' Research Committee, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeideh Mirzaei
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Asadi
- Department of Exercise Physiology, School of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran.
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Bentyaghoob S, Dehghani F, Alimohammadi A, Shateri Z, Kahrizsangi MA, Nejad ET, Nouri M, Rashidkhani B. Oxidative balance score and dietary phytochemical index can reduce the risk of colorectal cancer in Iranian population. BMC Gastroenterol 2023; 23:183. [PMID: 37231404 DOI: 10.1186/s12876-023-02826-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND No previous study has assessed the association between oxidative balance score (OBS) and dietary phytochemical index (DPI) with colorectal cancer (CRC) simultaneously. Therefore, this study investigated the association between OBS and DPI with the odds of CRC among the Iranian population. METHODS This hospital-based age and sex-matched case-control study was conducted between September 2008 and January 2010 (142 controls and 71 cases were entered for analysis). New diagnosed CRC cases were selected from the Cancer Institute, Imam Khomeini Hospital of Tehran. Dietary intakes were determined by a semi-quantitative food frequency questionnaire (FFQ). Then, dietary indices were calculated by food items and nutrient intake. Logistic regression was utilized for assessing the tertiles of OBS and DPI. RESULTS In multivariate analysis, OBS was associated with a 77% reduction in CRC odds in the last tertile than the first tertile (odds ratio (OR) = 0.23, confidence interval (CI): 0.07-0.72, Ptrend = 0.017). Also, we found a 64% reduction in CRC odds in the last tertile of DPI compared to the first tertile (OR = 0.36, CI: 0.15-0.86, Ptrend = 0.015). CONCLUSIONS A diet rich in phytochemicals and anti-oxidants, including fruits and vegetables (citrus fruits, colored berries, and dark-green leafy vegetables) and whole grains, may reduce the CRC odds.
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Affiliation(s)
- Shahrooz Bentyaghoob
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fereshteh Dehghani
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Arezoo Alimohammadi
- Department of Food Hygiene and Quality Control, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zainab Shateri
- Department of Nutrition and Biochemistry, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Masoud Amini Kahrizsangi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Tavassoli Nejad
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Bahram Rashidkhani
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Hamedi-Shahraki S, Jowshan MR, Zolghadrpour MA, Amirkhizi F, Asghari S. Dietary phytochemical index is favorably associated with oxidative stress status and cardiovascular risk factors in adults with obesity. Sci Rep 2023; 13:7035. [PMID: 37120685 PMCID: PMC10148862 DOI: 10.1038/s41598-023-34064-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/24/2023] [Indexed: 05/01/2023] Open
Abstract
Phytochemicals are bioactive compounds found in plant-based foods. Consumption of phytochemical-rich foods has been associated with cardiovascular and metabolic diseases prevention in various populations. To quantify the phytochemical content of the diet, dietary phytochemical index (DPI) was established which is defined as the proportion of daily energy intake derived from foods rich in phytochemicals. The purpose of this study was to evaluate the association between the DPI and oxidative stress markers and cardiovascular risk factors in obese adults. In this cross-sectional study, a total of 140 adults aged 20-60 years and body mass index (BMI) of ≥ 30 kg/m2 were included. A validated food frequency questionnaire (FFQ) was used to collect information on dietary intakes. The DPI was calculated based on the following formula: DPI = [daily energy obtained from foods rich in phytochemicals (kcal)/total daily energy intake (kcal) × 100]. There was an inverse association between DPI and serum concentrations of Malondialdehyde (MDA) (P = 0.004), triglyceride (TG) (P-trend = 0.003), high-sensitive C-reactive protein (hs-CRP) (P = 0.017), and erythrocyte superoxide dismutase (SOD) activity (P = 0.024). Total antioxidant capacity (TAC) was positively associated with DPI score (P = 0.045). No significant relationship was found between the DPI score and fasting blood sugar (FBS), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total oxidant status (TOS), glutathione peroxidase (GPx), catalase (CAT), and anthropometric parameters as well as systolic and diastolic blood pressure. The current study found that there was a significant inverse association between DPI and oxidative stress, inflammation, and hypertriglyceridemia as cardiovascular disease (CVD) risk factors in obese population. However, further research is needed to confirm these findings.
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Affiliation(s)
- Soudabeh Hamedi-Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Mohammad-Reza Jowshan
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojjatdoust St., Naderi St.,, No#44, Keshavarz Blvd, 141556117, Tehran, Iran
| | | | - Farshad Amirkhizi
- Department of Nutrition, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Somayyeh Asghari
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojjatdoust St., Naderi St.,, No#44, Keshavarz Blvd, 141556117, Tehran, Iran.
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Yoo H, Park K. Association between Phytochemical Index and Osteoporosis in Women: A Prospective Cohort Study in Korea. Nutrients 2023; 15:nu15071605. [PMID: 37049447 PMCID: PMC10097207 DOI: 10.3390/nu15071605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Osteoporosis is a prevalent issue among postmenopausal women, who have a higher incidence of the condition than men. This study aimed to examine the relationship between phytochemical-rich food intake and osteoporosis incidence in premenopausal and postmenopausal women. The data analyzed included 4600 women aged 40–69 who were free of osteoporosis at baseline, with dietary intake evaluated through a semi-quantitative food frequency questionnaire and osteoporosis prevalence determined using interviewer-administered questionnaires and bone mineral density tests. The phytochemical index (PI) was calculated to reflect the intake levels of phytochemical-rich foods. Postmenopausal women in the highest PI quartile had a 16% lower risk of osteoporosis (95% confidence interval (CI): 0.71 to 0.99, p for trend = 0.02) than those in the lowest quartile, while no significant association was observed among premenopausal women (hazard ratio: 0.98, 95% CI: 0.78 to 1.24, p for trend = 0.8). These findings suggest that consuming phytochemical-rich foods may have a protective effect against osteoporosis in postmenopausal women, offering valuable scientific insights. However, additional research is needed to validate these findings using biochemical data. Overall, this study highlights the potential of dietary interventions to reduce the risk of osteoporosis in postmenopausal women.
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Acikgoz Pinar A, Yildiz E, Altundag K. Dietary Phytochemical Index and the Risk of Breast Cancer: A Case-Control Study. Nutr Cancer 2023; 75:482-487. [PMID: 36104945 DOI: 10.1080/01635581.2022.2122518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
High intakes of phytochemical-rich foods might have beneficial effects on reducing breast cancer risk. In this study, we assessed the association between the dietary phytochemical index (PI) and breast cancer risk in a sample of premenopausal Turkish women. This case-control study was conducted on 70 newly diagnosed breast cancer cases and matched 70 healthy controls. Dietary intake was assessed using a validated food frequency questionnaire and dietary phytochemical indexes were calculated with two different methods. The mean PI score of participants was 19.9 ± 9.52 and 23.0 ± 8.95 in cases and controls, respectively (p = 0.046). After adjusting for energy intake, the risk of breast cancer significantly increased by 29.5% in the third quartile as compared to the fourth quartile of dietary PI (OR = 0.295, 95%CI = 0.106-0.822). Higher dietary PI was negatively associated with breast cancer risk; therefore, dietary PI may be suggested as an important contributor to dietary intake for breast cancer.
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Affiliation(s)
| | - Emine Yildiz
- Department of Nutrition and Dietetics, Eastern Mediterranean University, Famagusta, North Cyprus
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Mirzababaei A, Taheri A, Rasaei N, Mehranfar S, Jamili S, Clark CCT, Mirzaei K. The relationship between dietary phytochemical index and resting metabolic rate mediated by inflammatory factors in overweight and obese women: a cross-sectional study. BMC Womens Health 2022; 22:313. [PMID: 35879706 PMCID: PMC9317090 DOI: 10.1186/s12905-022-01894-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Unhealthy dietary patterns are the most important modifiable risk factors for obesity and overweight. This study aimed to examine the relationship between Dietary Phytochemical Index (DPI) and resting metabolic rate (RMR), mediated by inflammatory factors, in overweight and obese women.
Methods
A total of 404 women, aged 18–48 years, were included in the cross-sectional study. DPI was calculated using the 147-item food frequency questionnaire (FFQ). Anthropometric measurements, RMR, and blood biomarkers were assessed using standard protocols.
Results
There was marginally significant association between adherence to DPI and RMR status in the crude model (OR = 1.41, 95% CI 0.94–2.11, P = 0.09). After adjusting for potential confounders, a significant association was seen between the DPI and increase RMR.per.kg (OR = 2.77, 95% CI 0.98–7.82, P = 0.05). Our results indicated that plasminogen activator inhibitor-1 (PAI-1), transforming growth factor (TGF-β), and monocyte chemoattractant protein-1 (MCP-1) had a mediatory effect on the association between RMR and DPI (P > 0.05). Indeed, it was shown that, PAI-1, TGF-β, and MCP-1 destroyed the significance of this association and could be considered as mediating markers. However, no mediating effect was observed for high-sensitivity C reactive protein (hs-CRP).
Conclusions
Adherence to DPI can improve the RMR by reducing levels of inflammatory markers, and may be considered as a treatment for obesity. However, more long-term studies are recommended.
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Amirkhizi F, Ghoreishy SM, Hamedi-Shahraki S, Asghari S. Higher dietary phytochemical index is associated with lower odds of knee osteoarthritis. Sci Rep 2022; 12:9059. [PMID: 35641816 PMCID: PMC9156685 DOI: 10.1038/s41598-022-13019-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 05/19/2022] [Indexed: 11/09/2022] Open
Abstract
Previous studies have shown that adherence to dietary patterns rich in plant-based foods may reduce the odds of osteoarthritis; however, limited data are available on the association of consumption of diets rich in phytochemicals and odds of knee osteoarthritis (KOA). In this case–control study conducted in Iran, we aimed to investigate whether a higher dietary phytochemical index (DPI) is associated with decreased odds of having KOA. A total of 124 cases aged 20–60 years diagnosed with bilateral primary KOA according to the American College of Rheumatology criteria and 124 controls frequency-matched on age, sex, and body mass index (BMI) were included in the study. A validated food frequency questionnaire (FFQ) was used to collect information on dietary intakes. To calculate DPI scores, the dietary energy derived from foods rich in phytochemicals (kcal) was divided by the participant’s total daily energy intake (kcal). Patients with KOA had lower intakes of dietary fiber (P = 0.004), vitamin A (P = 0.007), vitamin C (P = 0.001), and folate (P = 0.021) compared to controls. In the crude model, individuals in the third tertile of DPI had 65% lower odds of having KOA compared to those in the first tertile (OR 0.35, 95% CI 0.19 to 0.67, P-trend = 0.001). After adjustment for potential confounders, including age, sex, physical activity, smoking, and supplement use, this inverse association remained significant (OR 0.37, 95% CI 0.19 to 0.73, P-trend = 0.004). After further adjustment for BMI, this inverse association between DPI and odds of KOA also remained significant (OR 0.35, 95% CI 0.18 to 0.69, P-trend = 0.003). These findings suggest that adherence to a phytochemical-rich diet, as indicated by the increasing DPI score, is associated with lower odds of KOA.
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Affiliation(s)
- Farshad Amirkhizi
- Department of Nutrition, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Seyed Mojtaba Ghoreishy
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No#44, Hojjatdoust St., Naderi St., Keshavarz Blvd, Tehran, 141556117, Iran
| | - Soudabeh Hamedi-Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Somayyeh Asghari
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No#44, Hojjatdoust St., Naderi St., Keshavarz Blvd, Tehran, 141556117, Iran.
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Sangouni AA, Vasmehjani AA, Ghayour-Mobarhan M, Ferns GA, Khayyatzadeh SS. The association between dietary phytochemical index with depression and quality of life in iranian adolescent girls. Biopsychosoc Med 2022; 16:5. [PMID: 35109893 PMCID: PMC8811992 DOI: 10.1186/s13030-022-00234-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is increasing evidence that the dietary intake of phytochemicals is inversely associated with severity of depression and positively associated with quality of life (QoL). The present study investigated the relationship between dietary phytochemical index (DPI) with depression and QoL scores in Iranian adolescent girls. METHODS A total of 733 adolescent girls from Mashhad and Sabzevar cities in northeastern Iran were entered into this cross-sectional study. Assessment of depression and QoL was performed utilizing the Beck Depression Inventory (BDI) and SF-12v2 questionnaire, respectively. Assessment of dietary intake was undertaken by a qualified dietitian, using a validated food-frequency questionnaire (FFQ) containing 168 food items. To explore the association between DPI with QoL and depression, logistic regression was used in crude and adjusted models. RESULTS The participants in the fourth quartile of DPI compared with the first quartile had a 50% lower odds of depression (OR: 0.50; 95% CI: 0.30-0.84, P = 0.009) This relation remained significant in all adjusted models. The adolescents in highest quartile of DPI compared with the first quartile had 38% lower odds of poor QoL (OR: 0.62; 95% CI: 0.41-0.94, P = 0.02). This association remained significant in adjusted models I and II, but not after adjusting for all confounding variables (OR: 0.67; 95% CI: 0.43-1.02, P = 0.06) (Model III). CONCLUSIONS DPI was inversely associated with risk of depression. The association between DPI score and QoL remained unclear. Further prospective and interventional studies are required.
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Affiliation(s)
- Abbas Ali Sangouni
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, 8914715645, Yazd, Iran
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Azam Ahmadi Vasmehjani
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, 8914715645, Yazd, Iran
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, BN1 9PH, Falmer, Brighton, Sussex, UK
| | - Sayyed Saeid Khayyatzadeh
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, 8914715645, Yazd, Iran.
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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