The association of insulinemic potential of diet and lifestyle with the risk of insulin-related disorders: a prospective cohort study among participants of Tehran Lipid and Glucose Study

The association of dietary and lifestyle indices for insulin resistance with the risk of cardiometabolic diseases among Iranian adults

The current study aimed to examine the possible association of the dietary index for insulin resistance (DIR) and the lifestyle index for insulin resistance (LIR), determined by dietary components, body mass index, and physical activity, with the risk of cardiometabolic diseases, including insulin resistance (IR), hypertension (HTN), diabetes, and metabolic syndrome (MetS). This prospective cohort study was performed on 2717 individuals aged ≥ 19 years in the framework of the Tehran Lipid-Glucose Study. Data on nutritional intakes were assessed using a validated food frequency questionnaire. Logistic regression models were used to determine the odds ratio and 95% confidence intervals (ORs and 95% CIs) of cardiometabolic diseases across tertiles of DIR and LIR scores. During 3-years of follow-up, the incidence rate of diabetes, IR, HTN, and MetS was 3%, 13%, 13.9%, and 17%, respectively. In the multi-variables model, after controlling all potential confounders, the risk of IR(OR: 1.65, 95% CI 1.01-2.69, P-trend = 0.047), diabetes (OR: 1.95, 95% CI 1.02-3.74, P-trend = 0.058), and HTN(OR: 1.52, 95% CI 1.07-2.15, P-trend = 0.016) was increased across tertiles of DIR score. Also, the risk of IR (OR: 2.85, 95% CI 1.72-4.73, P-trend < 0.001), diabetes(OR: 2.44, 95% CI 1.24-4.78, P-trend = 0.004), HTN(OR: 1.95, 95% CI 1.35-2.81, P-trend < 0.001), and MetS (OR: 2.87, 95% CI 1.96-4.18, P-trend < 0.001) were increased across tertiles of LIR score. Our findings reported that a dietary pattern with a higher DIR score and a lifestyle with a higher LIR score might be related to increased cardiometabolic disorders, including diabetes, HTN, Mets, and IR in Iranian adults.

The association of dietary and lifestyle indices for hyperinsulinemia with odds of non-alcoholic fatty liver disease in Iranian adults: a case-control study

BACKGROUND

Evidence on the association of insulinemic effects of dietary pattern and other lifestyle factors with the odds of non-alcoholic fatty liver disease (NAFLD) are limited. In the current study, we aimed to examine the association of the empirical dietary index for hyperinsulinemia (EDIH) and empirical lifestyle index for hyperinsulinemia (ELIH) index with the NAFLD odds in the adult population.

METHODS

In the current case-control study, 120 cases of NAFLD and 240 controls aged 20-60 years were included. The ultrasonography test was used to determine NAFLD. We used a validated food frequency questionnaire to collect dietary data of individuals and determine the scores of EDIH. Also, we determined the ELIH score based on diet, body mass index, and physical activity. The odds ratio (OR) of NAFLD was calculated using logistic regression test across EDIH and ELIH tertiles.

RESULTS

The mean ± SD age of subjects (53% men) were 41.8 ± 7.5 years. In the age and sex-adjusted model, there is a significant association between a higher ELIH score and higher odds of NAFLD (OR = 2.74;95%CI:1.51-4.96,P_trend = 0.001). Also, based on the multivariable-adjusted model, after controlling for age and sex, smoking, SES, and dietary intake of energy a remarkable positive association was observed between the higher score of ELIH and the odds of NAFLD (OR = 2.70; 95%CI:1.46-5.01,P_trend = 0.002). However, there is no significant relationship between the higher score of EDIH and NAFLD odds.

CONCLUSIONS

Our results showed that the high insulinemic potential of lifestyle, determined by the ELIH score, can be related to an increased NAFLD odds. However, no significant association was found between higher EDIH score and odds of NAFLD.

High insulinemic potential of diet and lifestyle is associated with increased risk of chronic kidney disease incident in adults

BACKGROUND

The role of higher insulinemic effects of dietary pattern and lifestyle factors on the risk of chronic kidney disease (CKD) is not well-studied. In the current study, we aimed to investigate the relationship between the insulinemic potential of diet and lifestyle with the risk of CKD in adults.

METHODS

A total of 6044 individuals without CKD, aged>18 years, were recruited from among participants of the Tehran Lipid and Glucose Study (third and fourth surveys) and followed a mean of 6.03 years(follow-up rate:94.95%). The dietary intake data were collected using a food frequency questionnaire. The insulinemic potential of diet and lifestyle was determined based on four empirical indices, including the empirical dietary index for hyperinsulinemia (EDIH), the empirical dietary index for insulin resistance (EDIR), the empirical lifestyle index for hyperinsulinemia (ELIH), and the empirical lifestyle index for insulin resistance (ELIR).

RESULTS

Mean ± SD age of all study participants (54.3% women) was 37.8 ± 12.8 years. During the 6.03 years of follow-up (46,889.8 person-years), 1216(20.1%) new cases of CKD were identified. According to the multivariable-adjusted model, the risk of CKD incident is increased across quintiles of EDIR (OR = 1.29;95% CI: 1.06-1.57), ELIH (OR = 1.35; 95%CI: 1.10-1.67), and ELIR (OR = 1.24; 95%CI:1.02-1.51). However, no significant relationship was found between the EDIH score and the risk of CKD.

CONCLUSION

Results of the current study showed that dietary pattern with a high EDIR score and a lifestyle with higher ELIH and ELIR scores may be related to increasing the risk of CKD incident. However, no significant association was observed between EDIH score and CKD incident.

The dietary and lifestyle indices of insulin resistance are associated with increased risk of cardiovascular diseases: A prospective study among an Iranian adult population

BACKGROUND AND AIMS

Previous studies have introduced insulin resistance (IR) as a major risk factor for poor cardiovascular diseases (CVDs) outcomes. Diet, body weight, and physical activity are three key pillars of lifestyle that can significantly impact the IR status. We aimed to assess the possible link between the empirical dietary index for IR (EDIR) and the empirical lifestyle index for IR (ELIR) with the risk of chronic heart disease (CHD) and CVDs.

METHODS AND RESULTS

This study was conducted on 4980 participants aged ≥30 years (follow-up rate: 99.85%). Dietary intake data was collected using a validated food frequency questionnaire. Cox proportional hazard regression was used to estimate the hazard ratio and 95% confidence intervals (HRs and 95% CIs) of CVDs and CHD across tertiles of EDIR and ELIR scores. In the final model, after adjusting for all potential confounding variables, participants in the highest tertile of EDIR had a higher risk of CVD (HR:1.36, 95%CI:1.03-1.80, P-trend = 0.016) and CHD (HR:1.36, 95% CI:1.01-1.83, P-trend = 0.023) compared to the lowest tertile. Also, participants with a higher score of ELIR had a higher risk of CVD (HR: 1.64, 95%CI:1.24-2.16, P-trend=<0.001) and CHD (HR: 1.72, 95%CI:1.28-2.32, P-trend=<0.001).

CONCLUSION

A greater adherence to the lifestyle and diet with a higher EDIR and ELIR may be associated with an increased risk of CVD and CHD outcomes in the adult population.

Dietary and lifestyle indices for hyperinsulinemia with the risk of obesity phenotypes: a prospective cohort study among Iranian adult population

Background

Previous studies have cited insulin-related disorders, including hyperinsulinemia, as one of the main causes of obesity risk and metabolic disorders. We aimed to investigate the association of the Empirical Dietary Index for Hyperinsulinemia (EDIH) and Empirical Lifestyle Index for Hyperinsulinemia (ELIH) with the risk of obesity phenotypes among Iranian adults.

Methods

Present study was conducted on 2705 subjects, including 1604 metabolically healthy normal weights (MHNW) and 1101 metabolically healthy obesity (MHO) individuals. Obesity phenotypes, including MHNW, MHO, metabolically unhealthy normal weights (MUNW), and metabolic unhealthy obesity (MUO), were determined using the criteria of the Joint International statement (JIS) for metabolic syndrome. Dietary intake data from the previous year was gathered using a food frequency questionnaire. Cox proportional hazard regression was used to estimate the hazard ratio and 95% confidence intervals (HRs and 95% CIs) of obesity phenotypes incident across tertiles of EDIH and ELIH scores.

Results

The mean ± SD of age and BMI of all participants were 33.5 ± 12.2 years and 24.3 ± 3.8 kg/m², respectively. In the multivariable-adjusted model, a higher ELIH score was associated with a greater risk for incidence of MUO (HR: 3.47, 95%CI: 2.54–4.74; P_trend =  < 0.001) and MHO (HR: 3.61, 95%CI: 2.73–4.77; P_trend =  < 0.001). Also, a higher score of EDIH was related to an increased risk of MUO incidence (HR: 1.35, 95%CI: 1.02–1.79; P for trend = 0.046). However, there was no significant association between a higher score of EDIH and the risk of MHO.

Conclusion

Our findings revealed that a high insulinemic potential of diet and lifestyle, determined by EDIH and ELIH indices, may be related to an increase in the simultaneous occurrence of obesity with metabolic disorders in Iranian adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13401-8.