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Moradi L, Hashemi SJ, Zaman F, Alipour M, Farhangiyan Z, Sharifzadeh M. Comparison of metabolic risk factors, lipid indices, healthy eating index, and physical activity among premenopausal, menopausal, and postmenopausal women. ROMANIAN JOURNAL OF INTERNAL MEDICINE = REVUE ROUMAINE DE MEDECINE INTERNE 2024; 62:260-271. [PMID: 38536781 DOI: 10.2478/rjim-2024-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Indexed: 08/29/2024]
Abstract
INTRODUCTION In this study, we aimed to compare metabolic risk factors, lipid indices, healthy eating index, and physical activity among premenopausal, menopausal, and postmenopausal women. METHODS In this cross-sectional study, a total of 4,732 women participating in the Hoveyzeh Cohort Study were placed into three groups of premenopausal (n=736), menopausal (n=396), and postmenopausal (n=917) women, according to the inclusion and exclusion criteria . RESULTS The prevalence of metabolic syndrome was 43.3%, 55.6%, and 62.8% in premenopausal, menopausal, and postmenopausal women, respectively. After menopause, the prevalence of hypertension (50.2%), dyslipidemia (61.2%), diabetes (37.7%), and abdominal obesity according to the Iranian guidelines (75.9%) was higher than before menopause. Based on the results, cardiovascular disease had the highest prevalence after menopause (23%). The weight-adjusted waist index (WWI) had the highest odds ratio (OR) among indices, with values of 2.94 and 1.93 in menopausal and postmenopausal women, respectively (P<0.001). According to the Healthy Eating Index-2015 (HEI-2015), the total consumption of fruits, vegetables, seafood, and protein was higher in premenopausal women than in postmenopausal women, and the consumption of foods containing sugar was higher in menopausal women than in premenopausal women. The results showed that the level of physical activity was the highest and the lowest in premenopausal and postmenopausal women, respectively (P<0.001). CONCLUSION Menopause leads to an increase in the prevalence of metabolic syndrome. The Atherogenic Index of Plasma (AIP), Triglyceride Glucose (TyG) index, WWI, and physical activity index increased in postmenopausal women compared to premenopausal women. The TyG index, WWI, and HEI-2015 did not show significant differences between the groups, based on the multiple regression analysis.
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Affiliation(s)
- Leila Moradi
- 1Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sayed Jalal Hashemi
- 2Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ferdos Zaman
- 1Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Meysam Alipour
- 3Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Zahra Farhangiyan
- 1Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Sharifzadeh
- 1Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Hemami RM, Farhangi MA, Rouzi MD, Abdi F. Dietary fatty acid pattern and its association with metabolic profile among overweight and obese adults. BMC Endocr Disord 2024; 24:141. [PMID: 39103858 DOI: 10.1186/s12902-024-01662-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 07/22/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Numerous studies have revealed the role of dietary fatty acids in human health. However, few studies have evaluated dietary fatty acid patterns and their association with metabolic parameters. The current study aimed to explore the association between dietary fatty acid patterns and risk factors for metabolic syndrome (MetS) among overweight and obese adults. METHODS This cross-sectional study involved 340 participants who were overweight or obese. The study included assessments of body composition and anthropometric measurements. Dietary fatty acid consumption was evaluated using a validated Food Frequency Questionnaire (FFQ) containing 168 items. Additionally, biochemical parameters, including serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting serum glucose (FSG), and insulin levels, were measured using enzymatic methods. Fatty acid patterns were determined by principal component analysis (PCA), and the association between these dietary FA patterns and risk factors related to MetS components was assessed using logistic regression. RESULTS Factor analysis conducted in this study explored three dietary fatty acid patterns: saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), and long-chain combined fatty acids (LC-CFA). Those at the highest tertile of the SFA pattern had lower diastolic blood pressure (DBP) (P = 0.03). Low-density lipoprotein cholesterol (LDL) was lower in the second and third tertiles (P ≤ 0.05). Also, higher fasting blood glucose (FBS) was observed in the second and third tertiles (P < 0.05), and the homeostatic model assessment of insulin resistance (HOMA-IR) was higher in the third tertile (P = 0.049). In the PUFA pattern, FBS was lower in the third tertile (P = 0.03). In the LC-CFA pattern, lower TC was achieved in higher tertiles (P = 0.04). CONCLUSION Our findings demonstrated that consuming high and moderate SFA patterns is associated with higher FBS and HOMA-IR. Also, increased consumption of SCFAs is related to lower DPB and LDL. Individuals who consumed more PUFA, especially linoleic acid, had lower FBS. These outcomes might be beneficial in managing MetS and leading to a new field of research.
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Affiliation(s)
- Reyhaneh Mokhtari Hemami
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Attar Neyshabouri street, Daneshgah Blv, Tabriz, Iran.
| | | | - Fatemeh Abdi
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Attar Neyshabouri street, Daneshgah Blv, Tabriz, Iran
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Ning L, He C, Lu C, Huang W, Zeng T, Su Q. Association between basal metabolic rate and cardio-metabolic risk factors: Evidence from a Mendelian Randomization study. Heliyon 2024; 10:e28154. [PMID: 38590845 PMCID: PMC10999873 DOI: 10.1016/j.heliyon.2024.e28154] [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: 11/21/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/10/2024] Open
Abstract
Background Cardio-metabolic risk factors play a crucial role in the development of cardiovascular and metabolic diseases. Basal metabolic rate (BMR) is a fundamental physiological parameter that affects energy expenditure and might contribute to variations in these risk factors. However, the exact relationship between BMR and cardio-metabolic risk factors has remained unclear. Methods We employed Mendelian Randomization (MR) analysis to explore the association between BMR (N: 534,045) and various cardio-metabolic risk factors, including body mass index (BMI, N: 681,275), fasting glucose (N: 200,622), high-density lipoprotein (HDL) cholesterol (N = 403,943), low-density lipoprotein (LDL) cholesterol (N = 431,167), total cholesterol (N: 344,278), and triglycerides (N: 441,016), C-reactive protein (N: 436,939), waist circumference (N: 232,101), systolic blood pressure (N: 810,865), diastolic blood pressure (N: 810,865), glycated haemoglobin (N: 389,889), and N-terminal prohormone brain natriuretic peptide (N: 21,758). We leveraged genetic variants strongly associated with BMR as instrumental variables to investigate potential causal relationships, with the primary analysis using the Inverse Variance Weighted (IVW) method. Results Our MR analysis revealed compelling evidence of a causal link between BMR and specific cardio-metabolic risk factors. Specifically, genetically determined higher BMR was associated with an increased BMI (β = 0.7538, 95% confidence interval [CI]: 0.6418 to 0.8659, p < 0.001), lower levels of HDL cholesterol (β = -0.3293, 95% CI: 0.4474 to -0.2111, p < 0.001), higher levels of triglycerides (β = 0.1472, 95% CI: 0.0370 to 0.2574, p = 0.0088), waist circumference (β = 0.4416, 95% CI: 0.2949 to 0.5883, p < 0.001), and glycated haemoglobin (β = 0.1037, 95% CI: 0.0080 to 0.1995, p = 0.0377). However, we did not observe any significant association between BMR and fasting glucose, LDL cholesterol, total cholesterol, C-reactive protein, systolic blood pressure, diastolic blood pressure, or N-terminal prohormone brain natriuretic peptide (all p-values>0.05). Conclusion This MR study provides valuable insights into the relationship between BMR and cardio-metabolic risk factors. Understanding the causal links between BMR and these factors could have important implications for the development of targeted interventions and therapies.
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Affiliation(s)
- Limeng Ning
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi, 530021, China
| | - Changjing He
- Pediatric surgery, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Baise, China
- Health Management Service Center, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No.85 Hedi Road, Nanning, Guangxi, 530021, China
- Guangxi Clinical Medical Research Center for Hepatobiliary Diseases, China
- Guangxi Zhuang Autonomous Region Engineering Research Center for Biomaterials in Bone and Joint Degenerative Diseases, China
- Guangxi Key Laboratory for Preclinica1 and Translational Research on Bone and Joint Degenerative Diseases, China
- Guangxi Key Laboratory of Molecular Pathology in Hepatobiliary Diseases, China
- Guangxi Key Laboratory of Clinical Cohort Research on Bone and Joint Degenerative Disease, China
- Guangxi Key Laboratory of Medical Research Basic Guarantee for Immune-Related Disease Research, China
- Guangxi Key Laboratory for Biomedical Material Research, China
- Key Laboratory of Research on Prevention and Control of High Incidence Diseases in Western Guangxi, China
- Key Laboratory of Molecular Pathology in Tumors of Guangxi, China
- Key Laboratory of Research on Clinical Molecular Diagnosis for High Incidence Diseases in Western Guangxi, China
- Baise Key Laboratory of Mo1ecular Pathology in Tumors, China
- Baise Key Laboratory for Metabolic Diseases, China
- Baise Key Laboratory for Research and Deve1opment on Clinical Mo1ecular Diagnosis for High-Incidence Diseases, China
- Key Laboratory of the Bone and Joint Degenerative Diseases, China
- Laboratory of the Atherosclerosis and Ischemic Cardiovascular Diseases, China
- Life Science and C1inical Medicine Research Center, China
- Key Laboratory of Clinical Diagnosis and Treatment Research of High Incidence Diseases in Guangxi, China
| | - Chunliu Lu
- Health Management Service Center, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No.85 Hedi Road, Nanning, Guangxi, 530021, China
| | - Wanzhong Huang
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi, 530021, China
| | - Ting Zeng
- Health Management Service Center, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi, 530021, China
| | - Qiang Su
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi, 530021, China
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Zhu Y, Wang Z. Association between joint physical activity and healthy dietary patterns and hypertension in US adults: cross-sectional NHANES study. BMC Public Health 2024; 24:855. [PMID: 38504199 PMCID: PMC10953194 DOI: 10.1186/s12889-024-18346-8] [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: 11/02/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Lack of physical activity (PA), poor dietary habits, or other unhealthy lifestyle behaviors are potential modifiable risk factors for hypertension. It has been sufficiently demonstrated in previous studies that physical activity or healthy dietary patterns can reduce the risk of hypertension. However, no research focused on the joint effects of PA and healthy dietary patterns on hypertension in a representative sample of adults. METHODS We used data collected from the 2007-2018 National Health and Nutrition Examination Survey. Healthy dietary patterns were assessed with the Healthy Eating Index 2015 (HEI-2015), and PA was measured using the metabolic equivalent minutes per week reported in questionnaires. We created four lifestyle categories based on the HEI-2015 and PA: (1) unhealthy diet and physically inactive (less than recommended PA), (2) healthy diet but physically inactive, (3) unhealthy diet but physically active (recommended PA), (4) healthy diet and physically active. Logistic regression was used to evaluate the association between joint PA and HEI-2015 and hypertension. RESULTS A total of 24,453 participants were enrolled in the study. Compared with unhealthy diet and physically inactive individuals, only healthy diet and physically active participants (adjusted odds ratio [AOR]: 0.77, 95% CI 0.65-0.9) were negatively associated with hypertension, while healthy diet but physically inactive participants (AOR: 0.89, 95% CI 0.76-1.03) and unhealthy diet but physically active participants (AOR: 0.9, 95% CI 0.76-1.06) were not associated with hypertension. CONCLUSION In a representative sample of US adults, our findings suggest that individuals with recommended PA and healthy dietary patterns have a lower risk of hypertension than those with an unhealthy diet or less than recommended PA. Healthy eating habits and regular PA are potential preventive precautions against hypertension.
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Affiliation(s)
- Yanzhou Zhu
- Department of Geriatrics, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, 355000, China
| | - Zhigang Wang
- Department of Geriatrics, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, 355000, China.
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Abdi F, Mohammadzadeh M, Abbasalizad-Farhangi M. Dietary amino acid patterns and cardiometabolic risk factors among subjects with obesity; a cross-sectional study. BMC Endocr Disord 2024; 24:21. [PMID: 38355488 PMCID: PMC10865612 DOI: 10.1186/s12902-024-01549-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The prevalence of obesity is a growing global public health concern. Certain dietary amino acids have been shown to have a potential therapeutic role in improving metabolic syndrome parameters and body composition in individuals with obesity. However, some amino acids have been linked to an increased risk of cardiometabolic disorders. This cross-sectional study aims to investigate the association between dietary amino acid patterns and cardiometabolic risk factors in individuals with obesity. METHODS This cross-sectional study included 335 participants with obesity (57.9% males and 41.5% females) from Tabriz and Tehran, Iran. The participants were between the ages of 20-50, with a body mass index (BMI) of 30 kg/m2 or higher, and free from certain medical conditions. The study examined participants' general characteristics, conducted anthropometric assessments, dietary assessments, and biochemical assessments. The study also used principal component analysis to identify amino acid intake patterns and determined the association between these patterns and cardiometabolic risk factors in individuals with obesity. RESULTS Upon adjusting for potential confounders, the study found that individuals in the third tertiles of pattern 1 and 2 were more likely to have lower LDL levels (OR = 0.99 and 95% CI (0.98-0.99)) for both. Additionally, a significant decrease in total cholesterol was observed in the third tertiles of pattern 2 in model II (OR = 0.99, 95% CI (0.98-0.99)). These findings suggest a potential cardioprotective effect of these amino acid patterns in managing cardiometabolic risk factors in individuals with obesity. CONCLUSIONS This study found that two identified amino acid patterns were associated with lower serum LDL and total cholesterol levels, while a third pattern was associated with higher serum triglycerides. The specific amino acids contributing to these patterns highlight the importance of targeted dietary interventions in managing cardiometabolic risk factors in individuals with obesity.
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Affiliation(s)
- Fatemeh Abdi
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Attar Neyshabouri, Daneshgah Blv, Tabriz, Iran
| | - Milad Mohammadzadeh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdieh Abbasalizad-Farhangi
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Attar Neyshabouri, Daneshgah Blv, Tabriz, Iran.
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Faraji H, Jamshidi S, Ferrie S, Azar PS. The Relationship between Healthy Eating Index and Lipid Profile in Healthy Individuals: A Systematic Review. Int J Prev Med 2024; 15:6. [PMID: 38487701 PMCID: PMC10935573 DOI: 10.4103/ijpvm.ijpvm_404_22] [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: 12/23/2022] [Accepted: 05/17/2023] [Indexed: 03/17/2024] Open
Abstract
Background The Healthy Eating Index (HEI) and Alternate Healthy Eating Index (AHEI) are instruments developed by competing American research teams, aiming to assess the level of adherence to a dietary pattern, claimed to prevent chronic illness conditions such as dyslipidemia. This systematic review evaluated cross-sectional studies examining the association between HEI/AHEI score and the lipid profile in healthy participants. Methods The systematic review was Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) compliant, and a search process was conducted through Scopus, Web of Knowledge, Google Scholar, Cochrane, PubMed, and ScienceDirect up to November 2022. Studies assessing the relationship between HEI/AHEI and lipid profile (low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG)) were eligible for inclusion. The statistical differences in outcomes, anthropometric indices, and demographic data were extracted from the selected studies. Also, the quality assessment of studies was performed using the Newcastle-Ottawa scale. Results The systematic search presented 17 cross-sectional studies. Most of the studies revealed a significant correlation between HEI score and lipid profile (LDL-C, HDL-C, TG, and TC) (P < 0.05), while a few of them indicated a significant relationship between AHEI score and these factors. Overall, the elevation of HEI/AHEI score was associated with the improvement in lipid profile (P < 0.05), though this association was more obvious for HEI compared with AHEI. Conclusions Overall, the results of the study indicated that an improved lipid profile in healthy individuals is associated with a higher score in either HEI or AHEI. Further research in the future is required to confirm the claim.
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Affiliation(s)
- Hossein Faraji
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sanaz Jamshidi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Suzie Ferrie
- Critical Care Dietitian, Royal Prince Alfred Hospital and Department of Nutrition and Dietetics, School of Life and Environmental Sciences, University of Sydney, Australia
| | - Pouria Sefidmooye Azar
- Department of Nutrition, School of Applied Sciences, The University of Mississippi, Oxford, MS, United States
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Hojati A, Farhangi MA. The Association Between Food Quality Score (FQS) and Metabolic Syndrome Risk Factors in Overweight and Obese Individuals: A Cross-Sectional Study. Clin Nutr Res 2024; 13:51-60. [PMID: 38362134 PMCID: PMC10866677 DOI: 10.7762/cnr.2024.13.1.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/17/2024] Open
Abstract
Obesity and overweight pose a significant public health problem, as they are associated with an elevated risk of metabolic syndrome (MetS). Several studies have shown that diet quality is associated with the development of MetS risk factors. Analyzing dietary patterns may be more helpful in determining the relationship between eating habits and chronic diseases compared to focusing on single foods or nutrients. In this study, our objective was to evaluate the association of food quality score (FQS) with risk factors for MetS in individuals with obesity and overweight. The participants in this cross-sectional study were 340 adults with overweight and obesity. Participants' food intake was measured using a Food Frequency Questionnaire, then the FQS was calculated. A fasting blood sample assessed serum glucose, triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol, and serum insulin levels. Fat-free mass, height, basal metabolic rate, socio-economic score, and waist-to-hip ratio significantly differed among FQS tertiles. TC, systolic and diastolic blood pressure, and fasting blood glucose were significantly lower in the highest tertile of FQS. After multivariable adjustment, our results showed that individuals in the third tertile of FQS had reduced risk of higher levels of TC (odds ratio [OR], 0.982; 95% confidence interval [CI], 0.970-0.984) and higher levels of low-density lipoprotein cholesterol (OR, 0.974; 95% CI, 0.974-0.999). Our findings demonstrate an inverse relationship between diet quality, as measured by FQS, and MetS risk factors. However, further experimental and longitudinal investigations are warranted to elucidate the causal nature of this association.
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Affiliation(s)
- Ali Hojati
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz 51666-14711, Iran
| | - Mahdieh Abbasalizad Farhangi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz 51666-14711, Iran
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Thakur J, Goswami M, Roy S. Pathways that determine the fertility of sedente and migrant Oraon populations of Eastern India: a structural equation modelling approach. HUM FERTIL 2023; 26:1202-1218. [PMID: 36715214 DOI: 10.1080/14647273.2022.2156302] [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: 02/07/2022] [Accepted: 09/02/2022] [Indexed: 01/31/2023]
Abstract
Within local socio-ecological context, the fertility determinants of a population are mediated through complex interrelated physiological and behavioural pathways. We aimed to find out the direct and indirect determinants of fertility of sedente and migrant Oraon populations using Structural Equation Model (SEM). Bivariate analysis showed significant (p ≤ 0.05) sedente-migrant differences in socio-demographic, reproductive, contraceptive, and reproductive and sexual decision-making variables. Results of SEM showed migration status, age at first conception, contraceptive preference and reproductive and sexual decision making have direct but negative association (p ≤ 0.05), and age of the participants, under-five mortality and preference for male child have direct but positive association with fertility (p ≤ 0.05). These variables are also associated with fertility through certain mediated pathways (p ≤ 0.05) like ages at first conception with contraceptive preferences, reproductive and sexual decision-making ability (positive), under-five mortality and desired family size (negative). Educational status of the spouses showed indirect association (p ≤ 0.05) with fertility through four pathways: (i) contraceptive preferences; (ii) reproductive and sexual decision-making ability; (iii) ages at first conception (positive); and (iv) desired family size (negative). Hence, sedente and migrant participants reflected a sharp difference in the determinants of fertility owing to differential local socio-ecological attributes.
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Affiliation(s)
- Joyeeta Thakur
- Department of Anthropology, University of Calcutta, Kolkata, India
| | - Monali Goswami
- Department of Anthropology, University of Calcutta, Kolkata, India
| | - Subho Roy
- Department of Anthropology, University of Calcutta, Kolkata, India
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Hu K, Button AM, Tate CM, Kracht CL, Champagne CM, Staiano AE. Adolescent Diet Quality, Cardiometabolic Risk, and Adiposity: A Prospective Cohort. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:851-860. [PMID: 37897452 PMCID: PMC10842960 DOI: 10.1016/j.jneb.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/27/2023] [Accepted: 10/03/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE Examine the prospective association among diet with adolescent cardiometabolic risk (CMR) and anthropometrics. METHODS Secondary analysis of an observational study of adolescents aged 10-16 years. Twenty-four-hour food recalls were used to calculate Healthy Eating Index-2015 (HEI-2015) scores. Anthropometrics were assessed using magnetic resonance imaging, dual-energy x-ray absorptiometry, and height/weight measurements. CMR included mean arterial pressure, homeostatic model assessment for insulin resistance, high-density lipoprotein cholesterol, and triglycerides. Associations between HEI-2015 score at baseline with follow-up adiposity and CMR were examined using regression models. RESULTS A total of 192 adolescents were included. Baseline HEI-2015 scores were inversely associated with follow-up total CMR z-score (P = 0.01), homeostatic model assessment for insulin resistance (P < 0.01), waist circumference z-score (P = 0.02), body mass index percentile (P = 0.01), fat mass (P = 0.04), lean mass (P = 0.02), and visceral adipose tissue mass (P = 0.01). CONCLUSIONS AND IMPLICATIONS Adolescents with lower adherence to dietary guidelines and greater CMR and anthropometry measurements at baseline continued this trajectory across the observation.
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Affiliation(s)
- Kathy Hu
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA; Episcopal School of Baton Rouge, Baton Rouge, LA
| | - Alyssa M Button
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Claire M Tate
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Chelsea L Kracht
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | | | - Amanda E Staiano
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA.
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Bishehsari F, Drees M, Adnan D, Sharma D, Green S, Koshy J, Giron LB, Goldman A, Abdel-Mohsen M, Rasmussen HE, Miller GE, Keshavarzian A. Multi-omics approach to socioeconomic disparity in metabolic syndrome reveals roles of diet and microbiome. Proteomics 2023; 23:e2300023. [PMID: 37525324 DOI: 10.1002/pmic.202300023] [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: 01/18/2023] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 08/02/2023]
Abstract
The epidemy of metabolic syndrome (MetS) is typically preceded by adoption of a "risky" lifestyle (e.g., dietary habit) among populations. Evidence shows that those with low socioeconomic status (SES) are at an increased risk for MetS. To investigate this, we recruited 123 obese subjects (body mass index [BMI] ≥ 30) from Chicago. Multi-omic data were collected to interrogate fecal microbiota, systemic markers of inflammation and immune activation, plasma metabolites, and plasma glycans. Intestinal permeability was measured using the sugar permeability testing. Our results suggest a heterogenous metabolic dysregulation among obese populations who are at risk of MetS. Systemic inflammation, linked to poor diet, intestinal microbiome dysbiosis, and gut barrier dysfunction may explain the development of MetS in these individuals. Our analysis revealed 37 key features associated with increased numbers of MetS features. These features were used to construct a composite metabolic-inflammatory (MI) score that was able to predict progression of MetS among at-risk individuals. The MI score was correlated with several markers of poor diet quality as well as lower levels of gut microbial diversity and abnormalities in several species of bacteria. This study reveals novel targets to reduce the burden of MetS and suggests access to healthy food options as a practical intervention.
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Affiliation(s)
- Faraz Bishehsari
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
| | - Michael Drees
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
| | - Darbaz Adnan
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
| | - Deepak Sharma
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
| | - Stefan Green
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
| | - Jane Koshy
- The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Leila B Giron
- The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Aaron Goldman
- The Wistar Institute, Philadelphia, Pennsylvania, USA
| | | | | | - Gregory E Miller
- Institute for Policy Research and Dept of Psychology, Northwestern Univ, Evanston, Illinois, USA
| | - Ali Keshavarzian
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA
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Hemami RM, Shakarami A, Ardekani AM, Aghaii S, Makarem D, Nikrad N, Farhangi MA, Pour Abbasi MS. Investigation of the association between habitual dietary FODMAP intake, metabolic parameters, glycemic status, and anthropometric features among apparently healthy overweight and obese individuals. BMC Endocr Disord 2023; 23:206. [PMID: 37752490 PMCID: PMC10521509 DOI: 10.1186/s12902-023-01458-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The predisposition of humans to metabolic syndrome is affected by many factors, including diet and lifestyle. Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are a set of carbohydrates that are fermented by gut microbiota. In animal studies, supplementation with FODMAP-rich diets as prebiotics can alter body composition and gut microbiota. This study evaluates any relationship between FODMAP and metabolic syndrome risk factors among adults with metabolic syndrome in Iran. METHODS This cross-sectional study is based on sociodemographic information from 347 overweight and obese participants selected from outpatient clinics through public declaration. Participants body composition and anthropometric measures were also determined. A validated Food Frequency Questionnaire (FFQ) with 168 questions was used to collect dietary data. Biochemical parameters, including serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), fasting serum glucose (FSG), and insulin levels, were determined by enzymatic methods. In addition, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated. RESULTS In moderate FODMAP and low FODMAP groups, lower waist-to-hip ratio (WHR) and higher fat-free mass (FFM) were achieved in higher tertiles. In high FODMAP groups, higher systolic blood pressure (SBP) was shown in the higher tertile (P < 0.05). Higher insulin, HOMA-IR, and lower QUICKI in the second tertile of the high FODMAP group were also observed. CONCLUSION Findings of this study highlight the potential role of FODMAP in managing metabolic syndrome and open a new field of research.
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Affiliation(s)
- Reyhaneh Mokhtari Hemami
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Shakarami
- Department of Cardiovascular Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sara Aghaii
- Faculty of Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Dorna Makarem
- Escuela Tecnica Superior de Ingenieros de Telecomunicacion Politecnica de Madrid, Madrid, Spain
| | - Negin Nikrad
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mohammad Sadegh Pour Abbasi
- Department of Cardiovascular Surgery, Kashan University of Medical Sciences and Health Services, Kashan, Iran.
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Soleimani E, Rashnoo F, Farhangi MA, Hosseini B, Jafarzadeh F, Shakarami A, Sadabadi Y. Dietary branched-chain amino acids intake, glycemic markers, metabolic profile, and anthropometric features in a community-based sample of overweight and obese adults. BMC Endocr Disord 2023; 23:205. [PMID: 37749544 PMCID: PMC10518913 DOI: 10.1186/s12902-023-01459-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/14/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Existing research provides conflicting evidence regarding the relationship between estimated branched-chain amino acid (BCAA) intake and metabolic, glycemic markers, and anthropometric characteristics. This research seeks to examine the association between estimated dietary BCAA consumption and glycemic, and metabolic markers, as well as anthropometric parameters in adults classified as overweight or obese. METHODS In this cross-sectional analysis, we gathered data from 465 overweight and obese individuals aged between 18 and 37 years. To evaluate dietary data, we employed the food frequency questionnaire, and the BCAA content in foods was determined via the United States Department of Agriculture website. We utilized ELISA kits to measure fasting blood glucose (FBS) and lipid profile markers, and additionally calculated low-density lipoprotein (LDL) and insulin sensitivity markers. We assessed sociodemographic status, physical activity (PA), and anthropometric attributes through a method recognized as both valid and reliable. For statistical analysis, we conducted analyses of covariance (ANCOVA), making adjustments for variables including sex, PA, age, energy, and body mass index (BMI). RESULTS Upon adjusting for confounders, those in the highest tertiles of BCAA intake exhibited an increase in weight, BMI, waist circumference (WC), waist-to-hip ratio (WHR), and fat-free mass (FFM). Conversely, they demonstrated reduced fat mass (FM) (%) and FM (kg) compared to their counterparts in the lowest tertiles (P < 0.05). Additionally, there was a noted association between greater estimated BCAA intake and reduced LDL levels. Nonetheless, our findings did not reveal a significant relationship between dietary BCAA and glycemic indices. CONCLUSIONS From our findings, an increased estimated intake of BCAA seems to correlate with diminished serum LDL concentrations. To gain a more comprehensive understanding of this association, it is imperative that further experimental and longitudinal studies be conducted.
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Affiliation(s)
- Ensiye Soleimani
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariborz Rashnoo
- Department of General and Minimally Invasive surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Babak Hosseini
- Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Faria Jafarzadeh
- Assistant Professor of Endocrinology & Metabolism, Department of Internal Medicine, School of Medicine, North Khorasan University of Medical Sciences, Bojnourd, Iran.
| | - Amir Shakarami
- Department of Cardiovascular Medicine, Assistant Professor of Cardiology, Lorestan University of Medical Sciences, Khorramabad, Iran
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Firouzabadi FD, Mirzababaei A, Shiraseb F, Tangestani H, Mirzaei K. The interaction between CRY1 Polymorphism and Alternative Healthy Eating Index (AHEI) on cardiovascular risk factors in overweight women and women with obesity: a cross-sectional study. BMC Endocr Disord 2023; 23:172. [PMID: 37580741 PMCID: PMC10424458 DOI: 10.1186/s12902-023-01429-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 08/01/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND According to some studies, diet can be interaction with CRY1 polymorphism and may be related to obesity and the risk of cardiovascular diseases (CVD). So, this study examined the interaction between CRY1 polymorphism and AHEI on cardiovascular risk factors in overweight women and women with obesity. METHODS This cross-sectional study was performed on 377 Iranian women with overweight and obesity aged 18-48(BMI ≥ 25 kg/m2). Dietary intake was evaluated by the use of a food frequency questionnaire (FFQ) with 147 items. The AHEI was calculated based on previous studies. Anthropometric and biochemical measurements were assessed and the bioelectrical impedance analysis method was used for body analysis. The rs2287161 was genotyped by the restriction fragment length polymorphism (PCR-RFLP) method. Objects were divided into three groups based on rs2287161 genotypes. RESULTS Our findings determined that the prevalence of the C allele was 51.9% and the G allele was 48.0%. The mean age and BMI were 36.6 ± 9.1years and 31 ± 4 kg/m2 respectively. After controlling for confounders (BMI, age, total energy intake, and physical activity), this study demonstrated that there was a significant interaction between CC genotype and adherence to AHEI on odds of hyper LDL (OR = 1.94, 95% CI = 1.24-3.05, P for interaction = 0.004), hypertension (OR = 1.80, 95% CI = 1.11-2.93, P for interaction = 0.01) and hyperglycemia (OR = 1.56, 95% CI = 0.98-2.47, P for interaction = 0.05). CONCLUSIONS This study indicated that adherence to AHEI can reduce the odds of hyper LDL, hypertension, and hyperglycemia in the CC genotype of rs2287161.
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Affiliation(s)
- Fatemeh Dehghani Firouzabadi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Hadith Tangestani
- Department of Nutrition, Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran.
- Department of Nutrition, Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
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Nikrad N, Hosseini B, Pakmehr A, Tousi AZ, Ardekani AM, Farhangi MA, Akhavan-Sigari R. Dietary carbohydrate quality index (CQI), cardio-metabolic risk factors and insulin resistance among adults with obesity. BMC Endocr Disord 2023; 23:171. [PMID: 37568117 PMCID: PMC10416415 DOI: 10.1186/s12902-023-01420-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS), as a cluster of cardiometabolic risk factors, is a global public health concern due to its increasing prevalence. Considering the previous evidence of the association between carbohydrate quality and cardiometabolic risk factors, our study was aimed to evaluate any possible association between carbohydrate quality index (CQI) and cardiometabolic risk factors among obese adults. METHODS In this cross-sectional study, 336 apparently healthy individuals with obesity were participated. Dietary intake was assessed by a semi-quantitative Food Frequency Questionnaire (FFQ), including 168 food items validated for the Iranian population. CQI was calculated with three components of solid carbohydrates to total carbohydrates ratio, dietary fiber intake, and dietary glycemic index (GI). Body composition was determined by bioelectrical impedance analysis (BIA). Blood pressure was measured by sphygmomanometer and enzymatic methods were used to evaluate serum lipid, glucose, and insulin concentrations. RESULTS Subjects in the third quartile of CQI had significantly lower systolic blood pressure (SBP) (P = 0.03) and diastolic blood pressure (DBP) (P = 0.01). Participants in the higher quartiles of CQI had more intake of energy, carbohydrates, fat, saturated fatty acid (SFA), and mono-saturated fatty acid (MUFA) (P < 0.05). Moreover, the homeostasis model assessment of insulin resistance (HOMA-IR) was decreased in the second quartile of CQI [odds ratio (OR) = 0.146, P = 0.01) after adjustment for age, body mass index (BMI), sex, physical activity, socioeconomic status (SES) and energy intake. CONCLUSION According to our findings, a higher quality of dietary carbohydrates, determined by CQI, could be associated with a lower risk of hypertension.
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Affiliation(s)
- Negin Nikrad
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Hosseini
- Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azin Pakmehr
- Tehran University of Medical Sciences, Tehran, Iran
| | - Ayda Zahiri Tousi
- Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
| | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | | | - Reza Akhavan-Sigari
- Department of Neurosurgery, University Medical Center Tuebingen, Tuebingen, Germany
- Department of Health Care Management and Clinical Research, Collegium Humanum Warsaw Management University, Warsaw, Poland
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Amini Kahrizsangi M, Jafari F, Najam W, Safarpour AR, Fattahi MR, Nouri M, Ghalandari H, Askarpour M, Hamidian Shirazi M, Amini MR, Akbarzadeh M. Adherence to a healthy diet and odds of metabolic syndrome: A cross-sectional study. Clin Nutr ESPEN 2023; 56:180-186. [PMID: 37344071 DOI: 10.1016/j.clnesp.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 05/12/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023]
Abstract
INTRODUCTION Metabolic syndrome (MetS) is a major health concern around the world. Dietary factors, including diet quality, play a significant role in its pathophysiology. Healthy Eating Index (HEI) is a tool used as a valid measurement of the individual's diet quality. We aimed at investigating the relationship between diet quality as assessed by HEI-2015 and the risk of MetS and its components in a cross-sectional sample of suburban individuals from PERSIAN Kavar cohort study (PKCS), Fars province, Iran. METHODS 2225 individuals meeting the eligibility criteria participated in the study. The relevant data were obtained from the baseline phase of PKCS. MetS was defined according to cut-offs presented by the National Cholesterol Education Program Adult Treatment Panel III (ATP III). HEI-2015 was calculated for the included individuals. Odds ratios were estimated. P-values <0.05 were considered as significant. RESULTS The overall prevalence of MetS was 27.3%. Individuals with lower HEI-2015 scores had higher odds for MetS and its components. We observed that those who were categorized as the top HEI-2015 tertile had 42% (OR: 0.58; 95% CI: 0.38-0.90) lower odds of high blood pressure in the overall population. Also, the odds of high serum triacylglycerol was lower (OR: 0.72; 95% CI: 0.57-0.90) in those with the highest HEI-2015 scores. CONCLUSION We found that higher dietary quality measured by HEI will decrease the risk of developing MetS, hypertension, and hypertriglyceridemia among Iranian adults. However, future interventional studies are required to further elucidate the issue.
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Affiliation(s)
- Masoud Amini Kahrizsangi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Jafari
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX, United States
| | - Wasiuddin Najam
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX, United States
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, 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
| | - Hamid Ghalandari
- 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
| | - Moein Askarpour
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Hamidian Shirazi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Amini
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Akbarzadeh
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Nikrad N, Shakarami A, Tousi AZ, Farhangi MA, Ardekani AM, Jafarzadeh F. Dietary Antioxidant Quality Score (DAQS), serum lipids, markers of glucose homeostasis, blood pressure and anthropometric features among apparently metabolically healthy obese adults in two metropolises of Iran (Tabriz and Tehran): a cross-sectional study. BMC Endocr Disord 2023; 23:157. [PMID: 37479979 PMCID: PMC10360357 DOI: 10.1186/s12902-023-01392-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/27/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Oxidative stress (OS) is associated with a variety of non-communicable diseases, including MetS, diabetes mellitus, metabolic syndrome, and cardiovascular disease through increased production of reactive oxygen species (ROS) and impairment of antioxidant defense mechanisms. Antioxidants can protect cells against free radical damage, so it seems important to determine the relationship between the quality of dietary antioxidants intake and chronic diseases. The Dietary Antioxidant Quality Score (DAQS) is obtained by adding the daily intake of known dietary vitamins and minerals, including selenium, zinc, vitamin A, vitamin C, and vitamin E, compared to the recommended daily intake (RDI). Therefore, this study aims to determine the relationship between DAQS, serum lipids, markers of glucose homeostasis, blood pressure and anthropometric features among obese adults. METHODS In the present cross-sectional study, 338 individuals who were obese (BMI ≥ 30 kg/m2) aged 20-50 years were recruited from Tabriz and Tehran, Iran. A validated semi-quantitative Food Frequency Questionnaire (FFQ) with 168 food items was used to quantify dietary consumption; accordingly, DAQS was computed. Blood biomarkers were measured using enzyme-linked immunosorbent assay (ELISA) kits. A standard mercury sphygmomanometer was used to assess blood pressure, and bioelectrical impedance analysis (BIA) was performed to determine body composition. The association between the DAQS tertiles and biochemical variables was investigated using multinomial logistic regression. RESULTS Participants in the highest tertile of DAQS have a lower diastolic blood pressure (DBP) values in all of the adjusted models [odds ratio (OR) = 0.920; confidence interval (CI)= 0.852-0.993, P-value = 0.03] in the analysis of co-variance (ANCOVA) model. Similarly, subjects at the second tertile of DAQS had lower DBP compared with the first tertile in age and sex-adjusted model [OR= 0.937; CI= 0.882-0.997]. There was no statistically significant difference for other metabolic parameters in different DAQS tertiles. CONCLUSION According to our findings, higher DAQS was associated with lower DBP among obese adults with obesity in two major cities of Iran (Tehran and Tabriz). Other studies with interventional design are needed to better elucidate these associations and underlying mechanisms.
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Affiliation(s)
- Negin Nikrad
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Shakarami
- Department of Cardiovascular Medicine, Assistant Professor of Cardiology, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ayda Zahiri Tousi
- Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
| | - Mahdieh Abbasalizad Farhangi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Nutrition in Community, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Faria Jafarzadeh
- Assistant Professor of Endocrinology & Metabolism, Department of Internal Medicine, School of Medicine, North Khorasan University of Medical Sciences, Bojnourd, Iran.
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Nikrad N, Shakarami A, Rahimi Z, Janghorbanian-Poodeh R, Farhangi MA, Hosseini B, Jafarzadeh F. Dietary pro-oxidant score (POS) and cardio-metabolic panel among obese individuals: a cross-sectional study. BMC Endocr Disord 2023; 23:144. [PMID: 37430312 PMCID: PMC10332071 DOI: 10.1186/s12902-023-01395-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/29/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Oxidative stress is a disturbance in the natural balance between oxidative and anti-oxidative processes, which is the major effective factor in cardiovascular disorders and metabolic syndrome (MetS), due to the role of pro-oxidants in inducing oxidative stress, and as a result, the occurrence and exacerbation of components of metabolic syndrome and cardiovascular risk factors, this cross-sectional study was conducted with the aim of investigating the relationship between the status of dietary pro-oxidants score (POS) and metabolic parameters including serum lipids, glycemic markers and blood pressure among obese adults. METHODS 338 individuals with obesity (BMI ≥ 30 kg/m 2), aged between 20 and 50 years were recruited in the present cross-sectional study. A validated food frequency questionnaire (FFQ) was used to determine the dietary pro-oxidant score (POS). Analysis of variance (ANOVA) with Tukey's post-hoc comparisons after adjustment for confounders and multivariable logistic regression analysis were performed to determine the association of cardiometabolic risk factors among the tertiles of POS. RESULTS Participants with higher POS had lower levels of body mass index (BMI), weight and waist circumference (WC). There were no significant associations between metabolic parameters including glycemic markers and lipid profile in one-way ANOVA and multivariate multinomial logistic regression models. CONCLUSIONS The findings of this study revealed that greater dietary pro-oxidant intake might be associated with lower BMI, body weight, and WC in Iranian obese individuals. Further studies with interventional or longitudinal approaches will help to better elucidate the causality of the observed associations.
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Affiliation(s)
- Negin Nikrad
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Shakarami
- Department of Cardiovascular Medicine, Assistant Professor of Cardiology, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Zahra Rahimi
- Teaching Experimental Sciences Group, Teachers Training Center, Pardis Bahonar Faculty of Farhangian University, Isfahan, Iran
| | - Raheleh Janghorbanian-Poodeh
- Coronary Angiography Group, Heart Department of Chamran Sub-Speciality Heart Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdieh Abbasalizad Farhangi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Hosseini
- Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Faria Jafarzadeh
- Department of Internal Medicine, School of Medicine, North Khorasan University of Medical Sciences, Bojnourd, Iran.
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Jahanbazi L, Abbasalizad Farhangi M, Tousi AZ, Nikrad N. The Association Between Healthy Beverage Index (HBI) With Metabolic Risk Factors Among Apparently Metabolically Healthy Overweight and Obese Individuals. Clin Nutr Res 2023; 12:218-228. [PMID: 37593211 PMCID: PMC10432163 DOI: 10.7762/cnr.2023.12.3.218] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 05/02/2023] [Accepted: 05/17/2023] [Indexed: 08/19/2023] Open
Abstract
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.
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Affiliation(s)
- Leila Jahanbazi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz 5165665811, Iran
| | - Mahdieh Abbasalizad Farhangi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz 5165990001, Iran
| | - Ayda Zahiri Tousi
- Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad 9189865456, Iran
| | - Negin Nikrad
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz 5166614711, Iran
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Vajdi M, Karimi A, Tousi AZ, Hosseini B, Nikniaz Z, Farhangi MA. Association between plant-based diets and metabolic syndrome in obese adults from Iran: a cross-sectional study. BMC Endocr Disord 2023; 23:109. [PMID: 37193979 DOI: 10.1186/s12902-023-01358-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a common chronic disease with several complications. Given that, studies on the association of plant-based diet indices (PDIs) with risk of MetS among adults with obesity, are limited, we aimed to examine the association between PDIs (including overall PDI, healthy PDI (hPDI), unhealthy PDI (uPDI)) and MetS in Iranian adults with obesity. METHODS In Tabriz, Iran, a total of 347 adults between the ages of 20 and 50 participated in this cross-sectional research study. We created an overall PDI, hPDI, and uPDI from validated semi-quantitative food-frequency questionnaire (FFQ) data. To investigate the association between hPDI, overall PDI, uPDI, and MetS and its components, a binary logistic regression analysis was performed. RESULTS The average age was 40.78 ± 9.23 years, and the average body mass index was 32.62 ± 4.80 kg/m2. There was no significant association between overall PDI (OR: 0.87; 95% CI: 0.54-1.47), hPDI (OR: 0.82; 95% CI: 0.48-1.40), and uPDI (OR: 0.83; 95% CI: 0.87-2.46) with MetS, even after adjustment for confounders. Moreover, our findings showed that participants with the highest adherence to uPDI had a higher chance of hyperglycemia (OR: 2.50; 95% CI: 1.13-5.52). Also, this association was significant in the first (OR: 2.51; 95% CI: 1.04-6.04) and second (OR: 2.58; 95% CI: 1.05-6.33) models, after controlling for covariates. However, in both adjusted and crude models, we did not find a significant association between hPDI and PDI scores and MetS components such as high triglyceride, high waist circumference, low High-density lipoprotein cholesterol, raised blood pressure, and hyperglycemia. Moreover, those in the top tertile of uPDI had higher fasting blood sugar and insulin levels when compared with those in the first tertile, and subjects in the last tertile of hPDI compared with participants in the first tertile had lower weight, waist-to-hip ratio, and fat-free mass. CONCLUSION We found a direct significant association between uPDI and odds of hyperglycemia in the whole population of study. Future large-scale, prospective studies on PDIs and the MetS are necessary to confirm these findings.
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Affiliation(s)
- Mahdi Vajdi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Karimi
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ayda Zahiri Tousi
- Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
| | - Babak Hosseini
- Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Attar Neyshabouri, Daneshgah Blv, Tabriz, Iran.
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Abbasi MSP, Tousi AZ, Yazdani Y, Vahdat S, Gharebakhshi F, Nikrad N, Manzouri A, Ardekani AM, Jafarzadeh F. Dietary choline and betaine intake, cardio-metabolic risk factors and prevalence of metabolic syndrome among overweight and obese adults. BMC Endocr Disord 2023; 23:67. [PMID: 36973700 PMCID: PMC10041695 DOI: 10.1186/s12902-023-01323-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Choline is an important metabolite involved in phospholipids synthesis, including serum lipids, and is the immediate precursor of betaine. There are numerous studies with inconsistent results that evaluated the association between dietary choline intakes with cardiovascular risk factors. In addition, the association between dietary betaine and choline intakes with cardio-metabolic risk factors is not well studied. In the current study, our aim was to evaluate dietary choline and betaine intakes in the usual diet of obese individuals and to assess its association with serum lipids, blood pressure and glycemic markers among obese individuals. METHODS We recruited a total number of 359 obese people aged between 20 and 50 years in the present study. A semi-quantitative food frequency questionnaire (FFQ) was used for dietary assessment; dietary choline and betaine intakes were calculated using the United States Department of Agriculture (USDA) database. National cholesterol education program adult treatment panel (NCEP-ATP)-III criteria was used metabolic syndrome (MetS) definition. Enzymatic methods were used to assess biochemical variables. Body composition was measured with the bioelectrical impedance analysis (BIA) method. RESULTS Higher body mass index (BMI), waist to hip ratio (WHR), fat-free mass (FFM) and basal metabolic rate (BMR) were observed in higher tertiles of dietary choline intake (P < 0.01). There was no significant difference in terms of biochemical parameters among different tertiles of dietary choline intake, while systolic blood pressure (SBP) and diastolic blood pressure (DBP) were reduced in higher betaine tertiles (P < 0.05). For total dietary choline and betaine intakes, there was a reduction in DBP and low density lipoprotein (LDL) concentrations (P < 0.05). Also, a non-significant reduction in serum total cholesterol (TC), triglyceride (TG) and MetS prevalence was observed in higher tertiles of dietary choline and betaine intakes. After classification of the study population according to MetS status, there was no significant difference in biochemical variables in subjects with MetS (P > 0.05), while in the non-MetS group, SBP, DBP, TG and insulin levels reduced in higher tertiles of dietary betaine and choline (P > 0.05). CONCLUSION According to our findings, higher dietary intakes of choline and betaine were associated with lower levels of blood pressure and LDL concentrations among obese individuals. Further studies are warranted to confirm the results of the current study.
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Affiliation(s)
| | - Ayda Zahiri Tousi
- Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
| | - Yalda Yazdani
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahar Vahdat
- Isfahan Kidney Disease Research Center, School of Medicine, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farshad Gharebakhshi
- Department of Radiology, School of Medicne, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negin Nikrad
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Manzouri
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Faria Jafarzadeh
- Department of Internal Medicine, School of Medicine, North Khorasan University of Medical Sciences, Bojnourd, Iran
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Siri G, Nikrad N, Keshavari S, Jamshidi S, Fayyazishishavan E, Ardekani AM, Farhangi MA, Jafarzadeh F. A high Diabetes Risk Reduction Score (DRRS) is associated with a better cardio-metabolic profile among obese individuals. BMC Endocr Disord 2023; 23:31. [PMID: 36737726 PMCID: PMC9896813 DOI: 10.1186/s12902-023-01279-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dietary indices and scores are valuable predictive markers against chronic diseases. Several previous studies have revealed the beneficial effects of diabetes risk reduction score (DRRS) against diabetes and cancer incidence. However, its association with metabolic abnormalities among obese individuals have not been revealed before. In the current study, we aimed to investigate the association between DRRS and metabolic risk factors among obese individuals. METHODS In the current cross-sectional study, 342 obese individuals [Body mass index (BMI) ≥ 30 kg/m2] aged 20-50 years were included. Dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) of 168 food items and DRRS was calculated. Metabolic syndrome (MetS) was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Enzymatic methods were used to assess serum lipids, glucose, and insulin concentrations. Blood pressure was measured by a sphygmomanometer and body composition with bioelectrical impedance analysis (BIA). RESULTS Those with a higher adherence to DRRS had a significantly higher intake of energy, fiber, and lower protein compared with those in the lower quartiles. Moreover, lower intakes of trans fats, meat, sugar sweetened beverages (SSB), and glycemic index (GI) with higher intakes of fruits, cereal fiber, polyunsaturated fatty acids/ saturated fatty acids (PUFA/ SFA) ratio, coffee, and nuts were observed in the highest versus lowest DRRS categories. Lower systolic blood pressure, diastolic blood pressure, triglyceride and, higher high-density lipoprotein values were observed in higher DRRS categories. Logistic regression analysis showed that hypertension was significantly associated with adherence to DRRS among obese individuals, the odds ratio (OR) was 0.686 (95% confidence interval [CI], 0.26-0.84) after adjustment for potential confounders. But the risk of other components of MetS was not significantly associated with higher quartiles of adherence to DRRS. Also, a non-significantly lower prevalence of MetS was observed in the higher quartile of DRRS. CONCLUSIONS According to the results of the current study, higher DRRS was associated with lower blood pressure, modified serum lipids, and lower Mets prevalence. Further studies in different populations are warranted for better generalization of the obtained findings.
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Affiliation(s)
- Goli Siri
- Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Nikrad
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sheida Keshavari
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saideh Jamshidi
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ehsan Fayyazishishavan
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX77030 USA
| | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahdieh Abbasalizad Farhangi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Attar Neyshabouri, Daneshgah Blv, Tabriz, Iran
| | - Faria Jafarzadeh
- Department of Internal Medicine, School of Medicine, North Khorasan University of Medical Sciences, Bojnourd, Iran
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Ardekani AM, Vahdat S, Hojati A, Moradi H, Tousi AZ, Ebrahimzadeh F, Farhangi MA. Evaluating the association between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, mental health, and cardio-metabolic risk factors among individuals with obesity. BMC Endocr Disord 2023; 23:29. [PMID: 36726099 PMCID: PMC9893576 DOI: 10.1186/s12902-023-01284-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/30/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Several previous investigations have examined the brain-protective role of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. However, more knowledge is needed about the MIND diet's other favorable impacts. The purpose of this study was to examine the relationship between the MIND diet, mental health, and metabolic markers in individuals with obesity. METHODS In this cross-sectional study, we included 339 individuals with obesity (BMI ≥ 30 kg/m2) aged 20-50 years. We utilized a semi-quantitative Food Frequency Questionnaire (FFQ), we assessed dietary intake, including 168 food items, and calculated the value of MIND. Metabolic syndrome (MetS) was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) guidelines. We assessed biochemical parameters using Enzymatic methods. Blood pressure and body composition were also determined. RESULTS Higher tertiles of the MIND diet score were associated with significantly higher energy intake, macronutrients, and brain-healthy food intakes (P < 0.001). Among the brain-unhealthy foods, only the intake of sweets and pastries was significantly lower in the highest versus lowest MIND tertiles. We also observed lower odds of stress (P < 0.05) and higher insulin sensitivity (P < 0.05) in the highest versus lowest MIND diet tertiles. We witnessed no significant changes in other parameters. CONCLUSION Lower stress levels and higher insulin sensitivity independent of some confounders like age, BMI, sex, and physical activity were associated with the highest tertile of MIND diet score.
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Affiliation(s)
- Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sahar Vahdat
- Isfahan Kidney Disease Research Center, Khorshid Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Hojati
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Moradi
- Faculty of Medicine, Belarusian State Medical University (BSMU), Minsk, Belarus
| | - Ayda Zahiri Tousi
- Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
| | - Farnoosh Ebrahimzadeh
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mahdieh Abbasalizad Farhangi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Attar Neyshabouri St., Daneshgah Blvd., Tabriz, Iran.
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Vajdi M, Karimi A, Farhangi MA, Ardekani AM. The association between healthy lifestyle score and risk of metabolic syndrome in Iranian adults: a cross-sectional study. BMC Endocr Disord 2023; 23:16. [PMID: 36647030 PMCID: PMC9843981 DOI: 10.1186/s12902-023-01270-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Lifestyle risk factors, such as obesity, physical inactivity, smoking, and having an unhealthy diet are significantly associated to the risk of developing metabolic diseases such as type 2 diabetes, insulin resistance, and metabolic syndrome (MetS). Consequently, it is important to examine multiple lifestyle risk factors instead of single ones. Moreover, the combined effects of these factors on risk of MetS are not fully investigated. This study investigated the relationship between HLS and MetS and its components among apparently healthy adults living in Tabriz-Iran. METHODS This cross-sectional study includes 347 apparently healthy adults aged 20-50. To assess healthy lifestyle, four habits were used to examine HLS: physical activity (PA), smoking, healthy eating index-2015 (HEI-2015), and body mass index (BMI). Smoking status, PA, and dietary intakes (147-item) of study participants were evaluated using valid questionnaires. The lifestyle score ranged from zero (non-healthy) to four (most healthy) points. Binary logistic regression with adjusted models was used to examine the association of HLS and MetS, and its components. P < 0.05 was considered statistically significant. RESULTS In the current study, the average age and BMI of study participants were 40.78 ± 9.23 years old and 29.23 ± 5.97 kg/m2, respectively. Participants in the highest quartile of HLS had significantly lower waist circumference (WC), BMI, weight, and had less fasting blood sugar (FBS), and triglyceride (TG) compared to the lowest quartile of HLS. Individuals in the second quartile of HLS had 24% greater odds for having MetS compared with those in the first quartile (adjusted OR: 1.24; 95% CI: 1.05-2.66). A significant reduction in hyperglycemia (adjusted OR: 0.85, 95% CI: 0.55-0.96) and high TG (adjusted OR: 0.83; 95% CI: 0.55-0.93) risk was also observed in the highest category of HLS compared to the lowest category. Moreover, after taking potential confounders into account, low score of HLS was associated with increased odds of MetS in women (adjusted OR: 1.32; 95% CI: 1.03-2.91). CONCLUSION The results showed that the lowest adherence to HLS was associated with higher odds MetS in women, after adjusting for all covariates. Moreover, adherence to a healthy lifestyle was related to lower odds of hyperglycemia and high TG in Iranian adults. To confirm these results, prospective studies are required.
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Affiliation(s)
- Mahdi Vajdi
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arash Karimi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
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Pour-Abbasi MS, Nikrad N, Farhangi MA, Vahdat S, Jafarzadeh F. Dietary energy density, metabolic parameters, and blood pressure in a sample of adults with obesity. BMC Endocr Disord 2023; 23:3. [PMID: 36600237 PMCID: PMC9814455 DOI: 10.1186/s12902-022-01243-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Several previous studies revealed the role of dietary energy density (DED) in developing obesity and related disorders. However, the possible role of DED in triggering cardiometabolic risk factors of individuals with obesity has not been studied yet. This study aimed to evaluate the association between DED and anthropometric parameters, blood pressure, and components of metabolic syndrome (MetS) (such as glycemic markers, lipid profile, and blood pressure) among individuals with obesity. METHODS In this cross-sectional study, we included 335 adults with obesity (BMI ≥ 30 kg/m2) aged 20-50 years in Tabriz and Tehran, Iran. Dietary intake was assessed by a validated semi-quantitative Food Frequency Questionnaire (FFQ), including 168 food items; then, DED was calculated. MetS was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Enzymatic methods were used to assess serum lipids, glucose, and insulin concentrations. Blood pressure was measured by sphygmomanometer and body composition by bioelectrical impedance analysis (BIA). RESULTS Participants in the higher tertiles of DED had more intake of carbohydrate, dietary fat, saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), and meat, fish, poultry (MFP). Increasing the DED in both methods had no association with systolic blood pressure (SBP), fasting blood sugar (FBS), low-density lipoprotein cholesterol (LDL-C), insulin, triglyceride (TG), and homeostatic model assessment of insulin resistance (HOMA-IR) even after adjustment for confounders. However, diastolic blood pressure (DBP) decreased in second tertile of DED I (β = 0.921, P = 0.004). The quantitative insulin-sensitivity check index (QUICKI) in second tertile of both DED methods had significant positive association with DED. In the second tertile of DED II, while total cholesterol (TC) significantly decreased (P crude = 0.036, P adjusted = 0.024), high-density lipoprotein cholesterol (HDL-C) increased (β = 1.096, p = 0.03). There was no significant changes in biochemical parameters in third tertile of DED I and II even after adjustment for covariates. Also, higher tertiles of DED was associated with reduced prevalence of MetS. CONCLUSION High DED was associated with lower levels of blood pressure and TC but elevated levels of HDL and QUICKI independent of such confounders as age, BMI, sex, and physical activity. Further longitudinal studies are warranted to better elucidate casual associations.
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Affiliation(s)
| | - Negin Nikrad
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Attar Neyshabouri St, Tabriz, Iran.
| | - Sahar Vahdat
- Isfahan Kidney Disease Research Center, Khorshid Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Faria Jafarzadeh
- Department of Internal Medicine, School of Medicine, North Khorasan University of Medical Sciences, Bojnourd, Iran.
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Khodarahmi M, Siri G, Erahimzadeh F, Farhangi MA, Shanehbandi D. Dietary glycemic index and glycemic load mediate the effect of CARTPT rs2239670 gene polymorphism on metabolic syndrome and metabolic risk factors among adults with obesity. BMC Endocr Disord 2022; 22:288. [PMID: 36404325 PMCID: PMC9677654 DOI: 10.1186/s12902-022-01188-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The importance of genetic and dietary factors in occurrence and progression of chronic diseases such as metabolic syndrome (MetS) has been established. However, complex interrelationships, including direct and indirect effects of these variables are yet to be clarified. So, our aim was to investigate the mediating role of glycemic indices in the relationship between CARTPT rs2239670 polymorphism, socio-demographic and psychological factors and metabolic risk factors and the presence of MetS in adults with obesity. METHODS In a cross-sectional study of 288 apparently healthy adults with obesity aged 20-50 years, dietary glycemic index (GI) and glycemic load (GL) were measured using a validated semi-quantitative food frequency questionnaire (FFQ). Biochemical parameters, blood pressure and anthropometric indicators were assayed by standard methods. Genotyping was carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Structural equation modeling (SEM) was used in the statistical analysis. RESULTS CARTPT rs2239670 had a positive direct effect on MetS (B = 0.037 ± 0.022; P = 0.043) and, on the other hand, this variant was found to be indirectly associated with MetS presence through mediation of GI (B = 0.039 ± 0.017; P = 0.009). CARTPT was a significant predictor of both dietary GI and GL (B = 1.647 ± 0.080 and B = 3.339 ± 0.242, respectively). Additionally, glycemic indicators appeared to mediate the association of age and gender with LDL-C (B = 0.917 ± 0.332; P = 0.006) and HDL (B = 1.047 ± 0.484; P = 0.031), respectively. GI showed a positive relationship with LDL-C (P = 0.024) in men and similar relationships were found between GL and LDL-C (P = 0.050) and cholesterol (P = 0.022) levels in women. CONCLUSION The SEM findings suggest a hypothesis of the mediating effect of glycemic indices in the relationship between genetic susceptibility to obesity and MetS presence. Our findings need to be confirmed with large prospective studies.
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Affiliation(s)
- Mahdieh Khodarahmi
- Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Goli Siri
- Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Erahimzadeh
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Dariush Shanehbandi
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Akhavanfar R, Hojati A, Kahrizi MS, Farhangi MA, Ardekani AM. Adherence to lifelines diet score and risk factors of metabolic syndrome among overweight and obese adults: A cross-sectional study. Front Nutr 2022; 9:961468. [PMID: 36466413 PMCID: PMC9713010 DOI: 10.3389/fnut.2022.961468] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 11/02/2022] [Indexed: 09/28/2023] Open
Abstract
Background Metabolic syndrome (MetS) is one of the most significant public health issues worldwide, and diet quality is an important controllable environmental factor influencing the incidence of MetS. Numerous dietary scores have been established to assess compliance with dietary recommendations or eating patterns, many of which are not entirely food-based. Hence, Lifelines Diet Score (LLDS) was developed in response to the shortcomings of existing tools. This study aimed to assess any possible links between total food quality and cardiometabolic risk factors among overweight and obese adults. Methods This cross-sectional study included 338 overweight and obese individuals [body mass index (BMI) > 25 kg/m2] aged 20-50 years in Tabriz, Iran. To collect dietary data, we used a validated semi-quantitative Food Frequency Questionnaire (FFQ) for Iranian population. Enzymatic-colorimetric methods were used to assess serum glucose and lipids, and enzyme-linked immunosorbent assay (ELISA) kits were used to measure insulin levels. In addition, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated. Results BMI and hip circumference (HC) were significantly different (P < 0.05) amongst LLDS tertiles. Adherence to the highest tertile of LLDS was associated with lower SBP, and the subjects in higher LLDS tertiles significantly had lower systolic blood pressure (SBP) (P = 0.04). Triglyceride (TG) levels were also lower in the third tertile of LLDS with a near-significant P-value (P = 0.05). Conclusion According to our results, a higher diet quality score, determined by LLDS, can be associated with a lower risk of MetS. Further experimental and longitudinal studies are needed to better understand this relationship.
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Affiliation(s)
- Roozbeh Akhavanfar
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Hojati
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Abnoos Mokhtari Ardekani
- Endocrinoligy and Metabolism Research Center, Institute of Basic and Clinical Physiology Science and Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
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The Role of Dietary Glycemic Index and Glycemic Load in Mediating Genetic Susceptibility via MC4R s17782313 Genotypes to Affect Cardiometabolic Risk Factors among Apparently Healthy Obese Individuals. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3044545. [PMID: 36440355 PMCID: PMC9683967 DOI: 10.1155/2022/3044545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 10/11/2022] [Accepted: 10/29/2022] [Indexed: 11/18/2022]
Abstract
Background The association of genetic and dietary factors with occurrence and progression of chronic diseases such as metabolic syndrome (MetS) has long been addressed but there is a lack of evidence for complex interrelationships, including direct and indirect effects of these variables. Hence, this study is aimed at evaluating the mediating role of glycemic indices in the association of melanocortin-4 receptor (MC4R) rs17782313 polymorphism, sociodemographic, and psychological factors with the risk of MetS in obese adults using structural equation modeling. Methods We performed a cross-sectional analysis of data from 287 apparently healthy adults. Dietary glycemic index (GI) and glycemic load (GL) were calculated from a validated 147-item food frequency questionnaire (FFQ). MC4R s17782313 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Structural equation modeling was used to explore direct and indirect effects of genetic and nongenetic factors on MetS. Results MC4R gene variant was directly associated with the risk of MetS (B = 0.010; P = 0.023). On the other hand, this variant was found to be indirectly and positively associated with LDL-C (B = 6.589; P = 0.042) through mediatory effects of GI and GL. Moreover, GI and GL also mediated indirect positive effects of sex and age on LDL-C (B = 3.970; P ≤ 0.01; B = 0.878; P ≤ 0.01, respectively) and HDL (B = 2.203; P ≤ 0.01; B = 0.129; P ≤ 0.01, respectively). MC4R rs17782313 polymorphism had positive effects on GI (B = 1.577; P ≤ 0.01) and GL (B = 1.235; P ≤ 0.01). Conclusion Our data may state a hypothesis of the mediating effect of quantity and quality of carbohydrates consumed in relationship between genetic susceptibility to obesity and cardiometabolic risk factors. Further analyses should be carried out in high-quality cohort studies in order to confirm the findings.
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Siri G, Mahmoudinezhad M, Alesaeidi S, Farhangi MA, Ardekani AM. The association between dietary glycemic index and cardio-metabolic risk factors in obese individuals. BMC Nutr 2022; 8:114. [PMID: 36253802 PMCID: PMC9575192 DOI: 10.1186/s40795-022-00608-6] [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: 04/09/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/26/2022] Open
Abstract
Background: The dietary glycemic index (GI) has been introduced as a novel index to elucidate the potential of foods to increase postprandial glucose. According to the limited available data about the association of GI with cardio-metabolic risk factors such as lipid profile, blood glucose markers, and blood pressure in developing countries, the current study was conducted to investigate this association in apparently obese individuals. Method and material: Three hundred forty-seven obese adults were recruited in the present cross-sectional study. A validated 147-food item semi-quantitative food frequency questionnaire (FFQ) was used to evaluate the usual dietary intake of study participants. Dietary GI was calculated using the international GI database. Fatty acid desaturase (FADs)2 gene variants were determined according to polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). ANOVA was used to compare study variables across different tertile of GI. Results: We found significant differences in terms of anthropometric parameters [weight (P = 0.038), waist circumference (WC) (P = 0.023), weight to hip ratio (WHR) (P = 0.007), and fat-free mass (FFM) (P < 0.001)] between different tertiles of GI. Similarly, energy and macronutrient intakes had a significant difference across dietary GI, and subjects with a higher dietary intake of energy and macronutrients (carbohydrate, protein, and total fat) were assigned to the third tertile of dietary GI (P < 0.001). While there was no significant difference in terms of cardio-metabolic risk factors in different dietary GI tertiles. Moreover, the total GI score was non-significantly higher in the TT genotype of FADS2 gene polymorphism compared with other genotypes. While no significant difference was observed between FADS2 genotype frequencies in different GI tertiles. Conclusion: Calculated dietary GI was associated with several cardio-metabolic risk factors in obese individuals. However, further prospective studies and clinical trials are needed to confirm our findings.
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Affiliation(s)
- Goli Siri
- Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Mahmoudinezhad
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samira Alesaeidi
- Department of Internal Medicine and Rheumatology, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
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Konikowska K, Bombała W, Szuba A, Różańska D, Regulska-Ilow B. Metabolic Syndrome Is Associated with Low Diet Quality Assessed by the Healthy Eating Index-2015 (HEI-2015) and Low Concentrations of High-Density Lipoprotein Cholesterol. Biomedicines 2022; 10:biomedicines10102487. [PMID: 36289749 PMCID: PMC9599166 DOI: 10.3390/biomedicines10102487] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Presenting diet quality of patients with metabolic syndrome (MetS), using a holistic approach is more useful than investigating dietary individual components, but there is still a small amount of research in this area. The aim of this study assessed the diet quality, as measured by the HEI-2015, of MetS patients compared to healthy individuals. The study and control group consisted of 215 patients with MetS and 320 people without MetS, respectively. A nutritional analysis using a semi-quantitative food frequency questionnaire was used to evaluate the nutritional habits in the study and control group. Total HEI-2015 scores were significantly lower in MetS subjects than in those in the control group (65.04 ± 9.71 vs. 66.75 ± 8.88) and the quality of women’s diets was better than the quality of men’s diet (66.83 ± 8.99 vs. 64.75 ± 9.57). We also observed that low HDL-c concentration increased the risk of MetS in the general population the most. Across the population, there was a weak positive correlation between HDL-c concentrations and total HEI-2015 scores and a weak negative correlation between mean waist circumference values and total HEI-2015 scores. HDL-c concentrations may be a key factor in the prevention of MetS and appropriate therapeutic management to increase HDL-c levels may be of key importance in patients diagnosed with MetS.
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Affiliation(s)
- Klaudia Konikowska
- Department of Dietetics, Wroclaw Medical University, Borowska Street 211, 50-556 Wroclaw, Poland
- Correspondence:
| | - Wojciech Bombała
- Statistical Analysis Center, Wroclaw Medical University, Marcinkowski Street 2-6, 50-368 Wroclaw, Poland
| | - Andrzej Szuba
- Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Dorota Różańska
- Department of Dietetics, Wroclaw Medical University, Borowska Street 211, 50-556 Wroclaw, Poland
| | - Bożena Regulska-Ilow
- Department of Dietetics, Wroclaw Medical University, Borowska Street 211, 50-556 Wroclaw, Poland
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Nutrient patterns are associated with discordant apoB and LDL: a population-based analysis. Br J Nutr 2022; 128:712-720. [PMID: 34523396 PMCID: PMC9346615 DOI: 10.1017/s000711452100369x] [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] [Indexed: 12/24/2022]
Abstract
Individuals with discordantly high apoB to LDL-cholesterol levels carry a higher risk of atherosclerotic CVD compared with those with average or discordantly low apoB to LDL-cholesterol. We aimed to determine associations between apoB and LDL-cholesterol discordance in relation to nutrient patterns (NP) using National Health and Nutrition Examination Survey data. Participants were grouped by established LDL-cholesterol and apoB cut-offs (Group 1: low apoB/low LDL-cholesterol, Group 2: low apoB/high LDL-cholesterol, Group 3: high apoB/low LDL-cholesterol, Group 4: high apoB/high LDL-cholesterol). Principle component analysis was used to define NP. Machine learning (ML) and structural equation models were applied to assess associations of nutrient intake with apoB/LDL-cholesterol discordance using the combined effects of apoB and LDL-cholesterol. Three NP explained 63·2 % of variance in nutrient consumption. These consisted of NP1 rich in SFA, carbohydrate and vitamins, NP2 high in fibre, minerals, vitamins and PUFA and NP3 rich in dietary cholesterol, protein and Na. The discordantly high apoB to LDL-cholesterol group had the highest consumption of the NP1 and the lowest consumption of the NP2. ML showed nutrients that had the greatest unfavourable dietary contribution to individuals with discordantly high apoB to LDL-cholesterol were total fat, SFA and thiamine and the greatest favourable contributions were MUFA, folate, fibre and Se. Individuals with discordantly high apoB in relation to LDL-cholesterol had greater adherence to NP1, whereas those with lower levels of apoB, irrespective of LDL-cholesterol, were more likely to consume NP3.
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Khodarahmi M, Sobhrakhshan Khah A, Farhangi MA, Siri G, Kahroba H. Dietary total antioxidant capacity interacts with a variant of chromosome 5q13-14 locus to influence cardio-metabolic risk factors among obese adults. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022; 23:117. [PMID: 37521830 PMCID: PMC9362403 DOI: 10.1186/s43042-022-00328-3] [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: 08/31/2021] [Accepted: 07/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background The association between cocaine- and amphetamine-regulated transcript prepropeptide gene (CARTPT) and obesity-related outcomes has shown in the epidemiological studies. Nevertheless, there is lack of data regarding the CARTPT gene-diet interactions in terms of antioxidant potential of diet. So, this study aimed to test CARTPT gene-dietary non-enzymatic antioxidant capacity (NEAC) interactions on cardio-metabolic risk factors in obese individuals. Methods and material The present cross-sectional study was carried out among 288 apparently healthy obese adults within age range of 20-50 years. Antioxidant capacity of diet was estimated by calculating the oxygen radical absorbance capacity (ORAC), ferric reducing antioxidant power (FRAP), total radical-trapping antioxidant parameter (TRAP) and Trolox equivalent antioxidant capacity (TEAC) using a semiquantitative food frequency questionnaire (FFQ). Genotyping for CARTPT rs2239670 polymorphism was conducted by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results A significant interaction was revealed between CARTPT rs2239670 and dietary ORAC on BMI (PInteraction = 0.048) and fat mass percent (FM%) (PInteraction = 0.008); in A allele carriers, higher adherence to the dietary ORAC was related to lower level of BMI and FM%. And, the significant interactions were observed between FRAP index and rs2239670 in relation to HOMA (PInteraction = 0.049) and QUICKI (PInteraction = 0.048). Moreover, there were significant interactions of rs2239670 with TRAP (PInteraction = 0.029) and TEAC (PInteraction = 0.034) on the serum glucose level; individuals with AG genotype were more respondent to higher intake of TRAP. Conclusion The present study indicated that the relationships between CARTPT rs2239670 and obesity and its-related metabolic parameters depend on adherence to the dietary NEAC. Large prospective studies are needed to confirm our findings.
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Affiliation(s)
- Mahdieh Khodarahmi
- Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Sobhrakhshan Khah
- Sepehr Heart Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Abbasalizad Farhangi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Attar-neishabouri Ave, Golgasht St, Tabriz, 5165665931 Iran
| | - Goli Siri
- Department of Internal Medicine, Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Houman Kahroba
- Department of Toxicogenomics, GROW School of Oncology and Development Biology, Maastricht University, Maastricht, The Netherlands
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
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Pour Abbasi MS, Shojaei N, Farhangi MA. Low-carbohydrate diet score is associated with improved blood pressure and cardio-metabolic risk factors among obese adults. Physiol Rep 2022; 10:e15375. [PMID: 35822420 PMCID: PMC9277405 DOI: 10.14814/phy2.15375] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/11/2022] [Accepted: 06/17/2022] [Indexed: 05/29/2023] Open
Abstract
Obesity is associated with numerous co-morbidities and diet, is one of the modifiable risk factors for prevention against these obesity-related metabolic disorders. In the current study, we aimed to evaluate the association between adherence to low carbohydrate diet (LCD) score and serum lipids, glycemic markers, blood pressure, and anthropometric parameters among obese individuals. The current cross-sectional study is a combination of two projects with total participants of 359 obese individuals (body mass index [BMI] ≥ 30 kg/m2 ) aged 20-50 years were included. Dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) of 132 food items. Low carbohydrate diet score was estimated by deciles of dietary intakes. Metabolic syndrome (MetS) was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Enzymatic methods were used to assess serum lipids, glucose, and insulin concentrations. Blood pressure was measured by sphygmomanometer and body composition with bioelectrical impedance analysis (BIA). Higher adherence to LCD score was associated with significantly lower DBP and triglyceride (TG) concentrations and increased high density lipoprotein (HDL)-C levels after adjustment for the confounders (p < 0.05). A non-significant reduction in systolic blood pressure (SBP) and total cholesterol (TC) values were also observed. Also, high adherence to LCD score was associated with reduced prevalence of metabolic syndrome (p < 0.05). Higher BMI, fat mass, and lower fat-free mass were also accompanied with higher adherence to LCD score. According to our study, low carbohydrate diet score was associated with more favorable cardio-metabolic risk factors independent of some confounders like age, BMI, sex, and physical activity level. Further studies in different communities will help for generalization of our findings.
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Affiliation(s)
| | - Niloofar Shojaei
- School of MedicineZanjan University of Medical SciencesZanjanIran
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Khodarahmi M, Javidzade P, Farhangi MA, Hashemzehi A, Kahroba H. Interplay between fatty acid desaturase2 (FADS2) rs174583 genetic variant and dietary antioxidant capacity: cardio-metabolic risk factors in obese individuals. BMC Endocr Disord 2022; 22:167. [PMID: 35773659 PMCID: PMC9245241 DOI: 10.1186/s12902-022-01075-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Polymorphisms of the fatty acid desaturase (FADS) gene cluster have been associated with obesity and its-related consequences. This cross-sectional study aimed to investigate whether the adherence to dietary non-enzymatic antioxidant capacity (NEAC), reflecting the antioxidant potential of the whole diet, modifies the association of FADS2 rs174583 polymorphism with cardio-metabolic risk factors in obese adults. METHODS The present study included 347 healthy obese adults (aged 20-50 years). Dietary NEAC was assessed by a validated food frequency questionnaire with 147 items and estimated through total radical-trapping antioxidant parameters (TRAP), oxygen radical absorbance capacity (ORAC), and ferric reducing ability of plasma (FRAP) with the use of published databases. FADS2 rs174583 polymorphism was characterized using PCR-RFLP. ANCOVA multivariate interaction model was used to analyze gene-diet interactions. RESULTS after adjustment for the confounding variables (age, physical activity, SES and WC), this study showed significant interactions between rs174583 polymorphism and adherence to dietary ORAC on the serum cholesterol (P Interaction = 0.029), LDL-C (P Interaction = 0.025) and HDL-C levels (P Interaction = 0.049) among the male group; minor allele carriers who had the highest adherence to the NEAC (ORAC) showed a better metabolic profile (lower TG and LDL-C and higher HDL-C) (P < 0.05). Among women, the dietary ORAC-rs174583 interactions were statistically significant for the serum insulin concentration (P Interaction = 0.020), QUICKI (P Interaction = 0.023) and HOMA-IR (P Interaction = 0.017); the highest QUICKI and the lowest HOMA-IR and serum insulin levels were observed in the CC homozygote carriers with the moderate compliance with the dietary ORAC (P < 0.05). In addition, the dietary TRAP modified the association between FADS2 variant and change in LDL-C levels (P Interaction = 0.037); the homozygous wild-type (CC) women who placed in the top tertile of TRAP had significantly the lowest LDL-C levels than those in the second tertile (P < 0.05). CONCLUSION These data indicate that the FADS2 rs174583 polymorphism interacts with the dietary NEAC to influence cardio-metabolic risk factors in obese subjects. Replication in prospective cohort studies among other populations is required to confirm the results of our study.
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Affiliation(s)
- Mahdieh Khodarahmi
- Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Javidzade
- Department of Genetics, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Attar-Neishabouri Ave, Golgasht St, Tabriz, 5165665931, Iran.
| | - Ahmad Hashemzehi
- Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Houman Kahroba
- Department of Toxicogenomics, GROW School of Oncology and Development Biology, Maastricht University, Maastricht, the Netherlands
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
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Giorgi D, Bastiani L, Morales MA, Pascali MA, Colantonio S, Coppini G. Cardio-metabolic risk modeling and assessment through sensor-based measurements. Int J Med Inform 2022; 165:104823. [PMID: 35763936 DOI: 10.1016/j.ijmedinf.2022.104823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/13/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Cardio-metabolic risk assessment in the general population is of paramount importance to reduce diseases burdened by high morbility and mortality. The present paper defines a strategy for out-of-hospital cardio-metabolic risk assessment, based on data acquired from contact-less sensors. METHODS We employ Structural Equation Modeling to identify latent clinical variables of cardio-metabolic risk, related to anthropometric, glycolipidic and vascular function factors. Then, we define a set of sensor-based measurements that correlate with the clinical latent variables. RESULTS Our measurements identify subjects with one or more risk factors in a population of 68 healthy volunteers from the EU-funded SEMEOTICONS project with accuracy 82.4%, sensitivity 82.5%, and specificity 82.1%. CONCLUSIONS Our preliminary results strengthen the role of self-monitoring systems for cardio-metabolic risk prevention.
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Affiliation(s)
- Daniela Giorgi
- CNR Institute of Information Science and Technologies, Via G. Moruzzi 1, Pisa 56124, Italy.
| | - Luca Bastiani
- CNR Institute of Clinical Physiology, Via G. Moruzzi 1, Pisa 56124, Italy.
| | | | | | - Sara Colantonio
- CNR Institute of Information Science and Technologies, Via G. Moruzzi 1, Pisa 56124, Italy.
| | - Giuseppe Coppini
- CNR Institute of Information Science and Technologies, Via G. Moruzzi 1, Pisa 56124, Italy.
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Fujiwara A, Omura Y, Oono F, Sugimoto M, Sasaki S, Takimoto H. A Scoping Review of Epidemiological Studies on Intake of Sugars in Geographically Dispersed Asian Countries: Comparison of Dietary Assessment Methodology. Adv Nutr 2022; 13:1947-1973. [PMID: 35641021 PMCID: PMC9526866 DOI: 10.1093/advances/nmac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/10/2022] [Accepted: 05/26/2022] [Indexed: 01/28/2023] Open
Abstract
Previous systematic reviews, which focused on sugar intake and its relation with health issues, were mainly conducted in Western countries, not Asian countries characterized by differences in dietary habits and disease prevalence. The scarcity of Asian studies may be attributed to the lack of assessment tools for estimating sugar intake. To provide an overview of the epidemiological studies on sugar intake in Asian countries, with a primary focus on dietary assessment methodology for estimating sugar intake, we conducted a scoping review of the epidemiological studies estimating sugar intake in Asian countries (the United Nations' definition) and Taiwan using PubMed and Web of Science. Study quality was evaluated based on its assessment of sugar intake in the whole diet, dietary assessment methods, and data sources used for estimating sugar content. We identified 143 studies from 136 publications from Eastern (n = 63), Southern (n = 30), South-Eastern (n = 26), and Western (n = 24) Asia. Total sugars were investigated in 95 studies, while 23-30 studies investigated sucrose, fructose, added sugars, and free sugars. The main aim of the selected studies was assessment of diet-disease relations (n = 85) and estimation of dietary intake (n = 40), and 62 studies assessed sugars as the primary exposure/outcome. A total of 120 studies assessed sugar intake in the whole diet, and 62 studies used validated FFQs or multiple-day dietary assessment methods. Only 41 studies used country-specific comprehensive food-composition databases or directly measured sugar content. Only 17 studies reported high-quality data. This review elucidated a sufficient number of epidemiological studies estimating sugar intake across Asian countries; however, most studies reported low-quality data. The results from our review showed that both feasible and validated dietary assessment methods, as well as comprehensive country-specific sugar-composition databases, are essential for producing high-quality studies with accurate sugar intake to examine its association with health outcomes.
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Affiliation(s)
- Aya Fujiwara
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan,Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Yuka Omura
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Fumi Oono
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Minami Sugimoto
- Institute for Future Initiatives, University of Tokyo, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
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ApoA2-256T > C polymorphism interacts with Healthy Eating Index, Dietary Quality Index-International and Dietary Phytochemical Index to affect biochemical markers among type 2 diabetic patients. Br J Nutr 2022; 127:1343-1351. [PMID: 34167597 DOI: 10.1017/s0007114521002348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Several investigations revealed the association between ApoA2 concentration and lipid profile, inflammation and oxidative stress markers. Dietary habits also play a major role in the health status of individuals with type 2 diabetes mellitus (T2DM). This study aimed to investigate the interaction of ApoA2-256T > C with dietary indexes on ghrelin and leptin hormones together with biochemical markers among individuals with T2DM. A cross-sectional study was conducted on 726 randomly selected individuals with T2DM. A validated FFQ was used to evaluate Healthy Eating Index, Dietary Quality Index-International (DQI-I) and Dietary Phytochemical Index (DPI). ApoA2-256T > C genotypes were detected by real-time-PCR. Ghrelin, leptin and biochemical markers were also assessed. ANCOVA was used for the interaction between the polymorphism and dietary indexes. A significant interaction was observed between ApoA2-256T > C and DQI-I on high-sensitivity C-reactive protein (hs-CRP) level and superoxide dismutase (SOD) activity. Besides, the interaction of the SNP and DPI significantly affected hs-CRP and 8-isoprostane F2α (PGF2α) levels. CC in the second tertile of DPI had the lowest hs-CRP level, and it was elevated due to adhering to DQI-I (Pinteraction = 0·01 and 0·04, respectively). Moreover, T-allele (protective allele) carriers with the highest level of PGF2α and SOD activity were those in the second tertile of DPI and DQI-I, respectively (Pinteraction = 0·03 and 0·007, respectively). SOD activity, hs-CRP and PGF2α concentration may be modified in T-allele carriers and CC by the adherence to DPI and DQI-I, though additional studies are required to confirm these findings.
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Ertuglu LA, Demiray A, Afsar B, Ortiz A, Kanbay M. The Use of Healthy Eating Index 2015 and Healthy Beverage Index for Predicting and Modifying Cardiovascular and Renal Outcomes. Curr Nutr Rep 2022; 11:526-535. [PMID: 35476188 DOI: 10.1007/s13668-022-00415-2] [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] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW With the wide recognition of the importance of dietary patterns rather than isolated nutrient groups on health outcomes, numerous diet quality indices have been designed to evaluate the overall food intake quality in the last two decades. RECENT FINDINGS The newest version of the Healthy Eating Index (HEI), HEI-2015, is a diet quality index that measures adherence to the recommendations of the 2015-2020 Dietary Guidelines for Americans. While the key nutrient groups are included in most diet quality indices, differences in other components and the scoring system differentiate HEI. The Healthy Beverage Index (HBI) was recently introduced. Previous literature has confirmed the association of the older versions of HEI with metabolic syndrome, inflammatory markers, and negative health outcomes including cardiovascular disease, type 2 diabetes mellitus, chronic kidney disease, and all-cause mortality. This review presents the existing evidence on the association of HEI-2015 and HBI with health markers and long-term outcome, provides guidance on their use, and identifies persisting challenges such as the development of simple, unified, and objective tools to characterize healthy diets in routine clinical practice.
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Affiliation(s)
- Lale A Ertuglu
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Atalay Demiray
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Baris Afsar
- Division of Nephrology, Department of Internal Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Alberto Ortiz
- Department of Medicine, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, 34010, Istanbul, Turkey.
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Healthy eating index 2015 and major dietary patterns in relation to incident hypertension; a prospective cohort study. BMC Public Health 2022; 22:734. [PMID: 35418042 PMCID: PMC9006467 DOI: 10.1186/s12889-022-13166-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/05/2022] [Indexed: 01/11/2023] Open
Abstract
Background Since hypertension (HTN) is responsible for more than half of all deaths from cardiovascular disease, it is vital to understand the nutritional factors that reduce its risk. Little information, however, is known about it in the Kurdish population. This study was aimed to evaluate the healthy eating index (HEI) 2015 and major dietary patterns concerning incident HTN. Methods This case-cohort study was designed using Ravansar non-communicable diseases (RaNCD) cohort study data (294 participants with incident HTN and 1295 participants as representative random sub-cohort). HEI 2015 and major dietary patterns were extracted using data from their dietary intake, and three major dietary patterns were identified, including plant-based, high protein, and unhealthy dietary patterns. To analyses the association between HEI 2015 and major dietary patterns with incident HTN Cox proportional hazards regression models were applied. Results There was a significant positive correlation between HEI 2015 and plant-based diet (r = 0.492). The participants in the highest quartile of HEI-2015 had a 39% and 30% lower risk of incident HTN, compared to participants in the first quartile in both crude and adjusted model (HR: 0.61; 95% CI: 0.46–0.82) and (HR: 0.70; 95% CI: 0.51–0.97), respectively. Furthermore, participants with the highest tertile of the plant-based dietary pattern were at lower risk of incident HTN in both crude and adjusted models (HR: 0.69; 95% CI: 0.54–0.9) and (HR: 0.70; 95% CI: 0.53–0.94), respectively. However, the other two identified dietary patterns showed no significant association with incident HTN. Conclusions We found evidence indicating higher adherence to HEI 2015 and plant- based diet had protective effects on incident HTN. The HEI 2015 emphasizes limited sodium intake and adequate intake of vegetables and fruits.
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Teixeira JE, Bragada JA, Bragada JP, Coelho JP, Pinto IG, Reis LP, Fernandes PO, Morais JE, Magalhães PM. Structural Equation Modelling for Predicting the Relative Contribution of Each Component in the Metabolic Syndrome Status Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063384. [PMID: 35329071 PMCID: PMC8992136 DOI: 10.3390/ijerph19063384] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 02/04/2023]
Abstract
Understanding the factor weighting in the development of metabolic syndrome (MetS) may help to predict the progression for cardiovascular and metabolic diseases. Thus, the aim of this study was to develop a confirmatory model to describe and explain the direct and indirect effect of each component in MetS status change. A total of 3581 individuals diagnosed with MetS, aged 18−102 years, were selected between January 2019 and December 2020 from a community-representative sample of Portuguese adults in a north-eastern Portuguese region to test the model’s goodness of fit. A structural equation modelling (SEM) approach and a two-way ANOVA (age × body composition) were performed to compare the relative contribution of each MetS component using joint interim statement (JIS). Waist circumference (β = 0.189−0.373, p < 0.001), fasting glucose (β = 0.168−0.199, p < 0.001) and systolic blood pressure (β = 0.140−0.162, p < 0.001) had the highest direct effect on the change in MetS status in the overall population and concerning both sexes. Moreover, diastolic blood pressure (DBP), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-c) had a low or non-significant effect. Additionally, an indirect effect was reported for age and body composition involving the change in MetS status. The findings may suggest that other components with higher specificity and sensitivity should be considered to empirically validate the harmonised definition of MetS. Current research provides the first multivariate model for predicting the relative contribution of each component in the MetS status change, specifically in Portuguese adults.
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Affiliation(s)
- José E. Teixeira
- Research Centre in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal; (J.A.B.); (J.E.M.)
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal;
- Correspondence:
| | - José A. Bragada
- Research Centre in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal; (J.A.B.); (J.E.M.)
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal;
| | - João P. Bragada
- North East Local Health Unit (ULSNE)—Health Care Unit of Santa Maria, 5301-852 Bragança, Portugal; (J.P.B.); (J.P.C.); (I.G.P.); (L.P.R.)
| | - Joana P. Coelho
- North East Local Health Unit (ULSNE)—Health Care Unit of Santa Maria, 5301-852 Bragança, Portugal; (J.P.B.); (J.P.C.); (I.G.P.); (L.P.R.)
| | - Isabel G. Pinto
- North East Local Health Unit (ULSNE)—Health Care Unit of Santa Maria, 5301-852 Bragança, Portugal; (J.P.B.); (J.P.C.); (I.G.P.); (L.P.R.)
| | - Luís P. Reis
- North East Local Health Unit (ULSNE)—Health Care Unit of Santa Maria, 5301-852 Bragança, Portugal; (J.P.B.); (J.P.C.); (I.G.P.); (L.P.R.)
| | - Paula O. Fernandes
- Applied Management Research Unit (UNIAG), Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal;
| | - Jorge E. Morais
- Research Centre in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal; (J.A.B.); (J.E.M.)
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal;
| | - Pedro M. Magalhães
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal;
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Cheraghian B, Karandish M, Hashemi SJ, Zendehdel M, Rahimi Z, Mousavi R. Dietary diversity score is associated with cardiometabolic risk factors in patients with hypertension (Hoveyzeh cohort study). MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-210556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND: Dietary diversity score (DDS) is recognized as an essential factor of a high-quality diet. OBJECTIVE: To evaluate the relationship between DDS and cardiometabolic risk factors in hypertensive patients. METHODS: In this cross-sectional study, 972 hypertensive patients (322 males and 650 females) aged 35–70y participated were recruited. Dietary intake was evaluated using a semi-quantitative food frequency questionnaire and DDS was calculated. Metabolic syndrome was defined according to the IDF/AHA criteria. The anthropometric parameters, fasting blood sugar, lipid profile, and liver enzymes were measured. RESULTS: Male subjects who assigned to the top DDS tertile had 51% lower risk of having low serum HDL-C (OR: 0.49; 95% CI: 0.24–0.96) in the crude model. A similar association was observed for men in the second tertile of DDS after adjusting for covariates (OR: 0.47; 95% CI: 0.23–0.97). A significant inverse association was found between vegetable diversity score and odds of hyperglycemia in the male group in the adjusted model (OR: 0.44; 95% CI: 0.22–0.91). The vegetable diversity score was inversely associated with 67% decreased metabolic syndrome risk in the adjusted model (OR: 0.33; 95% CI: 0.15–0.70). CONCLUSION: These findings clarify the possible preventive role of higher DDS against metabolic syndrome.
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Affiliation(s)
- Bahman Cheraghian
- Hearing Research Center, Clinical Sciences Research Institute, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid Karandish
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Jalal Hashemi
- Alimentary Tract Research Center, Clinical Sciences Research Institute, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohadeseh Zendehdel
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Rahimi
- Hearing Research Center, Clinical Sciences Research Institute, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reihaneh Mousavi
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Webb RJ, Mazidi M, Lip GYH, Kengne AP, Banach M, Davies IG. The role of adiposity, diet and inflammation on the discordance between LDL-C and apolipoprotein B. Nutr Metab Cardiovasc Dis 2022; 32:605-615. [PMID: 35123856 DOI: 10.1016/j.numecd.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/21/2021] [Accepted: 12/03/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS While low-density lipoprotein cholesterol (LDL-C) is a good predictor of atherosclerotic cardiovascular disease, apolipoprotein B (ApoB) is superior when the two markers are discordant. We aimed to determine the impact of adiposity, diet and inflammation upon ApoB and LDL-C discordance. METHODS AND RESULTS Machine learning (ML) and structural equation models (SEMs) were applied to the National Health and Nutrition Examination Survey to investigate cardiometabolic and dietary factors when LDL-C and ApoB are concordant/discordant. Mendelian randomisation (MR) determined whether adiposity and inflammation exposures were causal of elevated/decreased LDL-C and/or ApoB. ML showed body mass index (BMI), dietary saturated fatty acids (SFA), dietary fibre, serum C-reactive protein (CRP) and uric acid were the most strongly associated variables (R2 = 0.70) in those with low LDL-C and high ApoB. SEMs revealed that fibre (b = -0.42, p = 0.001) and SFA (b = 0.28, p = 0.014) had a significant association with our outcome (joined effect of ApoB and LDL-C). BMI (b = 0.65, p = 0.001), fibre (b = -0.24, p = 0.014) and SFA (b = 0.26, p = 0.032) had significant associations with CRP. MR analysis showed genetically higher body fat percentage had a significant causal effect on ApoB (Inverse variance weighted (IVW) = Beta: 0.172, p = 0.0001) but not LDL-C (IVW = Beta: 0.006, p = 0.845). CONCLUSION Our data show increased discordance between ApoB and LDL-C is associated with cardiometabolic, clinical and dietary abnormalities and that body fat percentage is causal of elevated ApoB.
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Affiliation(s)
- Richard J Webb
- School of Health Sciences, Faculty of Science, Liverpool Hope University, Hope Park Campus, Taggart Avenue, Liverpool, L16 9JD, United Kingdom.
| | - Mohsen Mazidi
- Nuffield Department of Population Health, Richard Doll Building, Old Road Campus, University of Oxford, Oxford, OX3 7LF, United Kingdom; Department of Twin Research & Genetic Epidemiology, King's College London, 4th Floor, South Wing, St Thomas', London, SE1 7EH, United Kingdom.
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, DK-9100 Aalborg, Denmark.
| | - Andre P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, 7505, Cape Town, South Africa.
| | - Maciej Banach
- Cardiovascular Research Centre, University of Zielona Gora, 65-046, Zielona Gora, Poland; Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), 93-338, Lodz, Poland.
| | - Ian G Davies
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, L3 3AF, United Kingdom.
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Khodarahmi M, Niknam M, Farhangi MA. Personalized gene-diet study of rs2239670 gene variants and dietary patterns among obese adults. Clin Nutr ESPEN 2022; 47:358-366. [DOI: 10.1016/j.clnesp.2021.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/31/2021] [Accepted: 11/08/2021] [Indexed: 12/29/2022]
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Khodarahmi M, Nikniaz L, Abbasalizad Farhangi M. The Interaction Between Fatty Acid Desaturase-2 (FADS2) rs174583 Genetic Variant and Dietary Quality Indices (DASH and MDS) Constructs Different Metabolic Phenotypes Among Obese Individuals. Front Nutr 2021; 8:669207. [PMID: 34164423 PMCID: PMC8215104 DOI: 10.3389/fnut.2021.669207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/22/2021] [Indexed: 01/02/2023] Open
Abstract
Background and Aim: Genetic variation in fatty acid desaturases (FADS) has previously been linked to several diet-related diseases. We aimed to determine whether the FADS2 rs174583 variant interacts with the Dietary Approach to Stop Hypertension (DASH) score and Mediterranean dietary score (MDS) to influence cardio-metabolic risk factors among obese adults. Methods: This cross-sectional study was performed among 347 apparently healthy obese adults (aged 20-50 years). Dietary quality indicator scores (DASH and MDS) were generated using a validated 147-item Food Frequency Questionnaire (FFQ). The FADS2 rs174583 variant was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The gene-diet interaction was analyzed by the ANCOVA multivariate interaction model. Results: A significant interaction was observed between rs174583 and adherence to the DASH score in relation to serum triglyceride (TG) concentration among the female group (P Interaction = 0.046); CT-genotype carriers who were assigned to the second tertile of DASH compared with those in the first tertile had a lower TG level (P < 0.05). Another significant interaction was revealed between adherence to MDS score and rs174583 polymorphism on serum glucose levels (P Interaction = 0.044); the lowest mean of glucose level was observed in homozygous minor subjects (TT) in the third tertile of MDS, in comparison with other tertiles of this dietary index (P < 0.05). There was a similar significant interaction between DASH and rs174583 in relation to diastolic blood pressure (P Interaction = 0.038) among the male group. Additionally, a significant positive association was found between TT genotype and odds of having high TG both in the crude (OR, 3.21; 95% CI, 1.02-10.14) and adjusted (OR, 3.58; 95% CI, 1.07-11.97) models, taking into account different confounders. Conclusion: Adherence to the dietary quality indicators (DASH and MDS) modified the relationship between FADS2 rs174583 polymorphism and cardio-metabolic risk factors in obese subjects. Prospective cohort studies are needed to confirm the results of our study.
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Affiliation(s)
- Mahdieh Khodarahmi
- Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
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DeMoranville KJ, Carter WA, Pierce BJ, McWilliams SR. Flight training in a migratory bird drives metabolic gene expression in the flight muscle but not liver, and dietary fat quality influences select genes. Am J Physiol Regul Integr Comp Physiol 2020; 319:R637-R652. [PMID: 32966121 DOI: 10.1152/ajpregu.00163.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Training and diet are hypothesized to directly stimulate key molecular pathways that mediate animal performance, and flight training, dietary fats, and dietary antioxidants are likely important in modulating molecular metabolism in migratory birds. This study experimentally investigated how long-distance flight training, as well as diet composition, affected the expression of key metabolic genes in the pectoralis muscle and the liver of European starlings (Sturnus vulgaris, n = 95). Starlings were fed diets composed of either a high or low polyunsaturated fatty acid (PUFA; 18:2n-6) and supplemented with or without a water-soluble antioxidant, and one-half of these birds were flight trained in a wind-tunnel while the rest were untrained. We measured the expression of 7 (liver) or 10 (pectoralis) key metabolic genes in flight-trained and untrained birds. Fifty percent of genes involved in mitochondrial metabolism and fat utilization were upregulated by flight training in the pectoralis (P < 0.05), whereas flight training increased the expression of only one gene responsible for fatty acid hydrolysis [lipoprotein lipase (LPL)] in the liver (P = 0.04). Dietary PUFA influenced the gene expression of LPL and fat transporter fatty acid translocase (CD36) in the pectoralis and one metabolic transcription factor [peroxisome proliferator-activated receptor (PPAR)-α (PPARα)] in the liver, whereas dietary antioxidants had no effect on the metabolic genes measured in this study. Flight training initiated a simpler causal network between PPARγ coactivators, PPARs, and metabolic genes involved in mitochondrial metabolism and fat storage in the pectoralis. Molecular metabolism is modulated by flight training and dietary fat quality in a migratory songbird, indicating that these environmental factors will affect the migratory performance of birds in the wild.
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Affiliation(s)
- Kristen J DeMoranville
- Department of Natural Resources Science, University of Rhode Island, Kingston, Rhode Island
| | - Wales A Carter
- Department of Natural Resources Science, University of Rhode Island, Kingston, Rhode Island
| | - Barbara J Pierce
- Department of Biology, Sacred Heart University, Fairfield, Connecticut
| | - Scott R McWilliams
- Department of Natural Resources Science, University of Rhode Island, Kingston, Rhode Island
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Harrison S, Couture P, Lamarche B. Diet Quality, Saturated Fat and Metabolic Syndrome. Nutrients 2020; 12:nu12113232. [PMID: 33105691 PMCID: PMC7690379 DOI: 10.3390/nu12113232] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/13/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022] Open
Abstract
Indices reflecting overall diet quality are used globally in research to predict the risk of various diseases and metabolic disorders such as metabolic syndrome (MetS). Such indices are built to measure adherence to current dietary guidelines or to best assess the diet-disease relationship. Although mostly food-based, dietary guidelines often include recommendations to limit saturated fatty acid (SFA) intake in order to prevent cardiovascular diseases. However, not all diet quality indices consider SFA in their definition of diet quality. Additionally, the relationship between SFA consumption and the development of MetS remains unclear. The purpose of this short review was to explore the association between MetS and various diet quality indices and dietary patterns, with a focus on how SFA contributes to these associations.
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Affiliation(s)
- Stéphanie Harrison
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada; (S.H.); (P.C.)
- School of Nutrition, Université Laval, Québec, QC G1V 0A6, Canada
| | - Patrick Couture
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada; (S.H.); (P.C.)
- CHU Research Center, Québec, QC G1V 0A6, Canada
| | - Benoît Lamarche
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada; (S.H.); (P.C.)
- School of Nutrition, Université Laval, Québec, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +1-418-656-2131 (ext. 404355)
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Patti AM, Carruba G, Cicero AFG, Banach M, Nikolic D, Giglio RV, Terranova A, Soresi M, Giannitrapani L, Montalto G, Stoian AP, Banerjee Y, Rizvi AA, Toth PP, Rizzo M. Daily Use of Extra Virgin Olive Oil with High Oleocanthal Concentration Reduced Body Weight, Waist Circumference, Alanine Transaminase, Inflammatory Cytokines and Hepatic Steatosis in Subjects with the Metabolic Syndrome: A 2-Month Intervention Study. Metabolites 2020; 10:E392. [PMID: 33023123 PMCID: PMC7601817 DOI: 10.3390/metabo10100392] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/24/2020] [Accepted: 09/30/2020] [Indexed: 12/31/2022] Open
Abstract
Extra virgin olive oil (EVOO) intake is associated with reduced cardiovascular risk, and its phenolic compound oleocanthal (OC) has anti-oxidant and anti-inflammatory properties. The cardiometabolic effects of EVOO with a high OC concentration have not been fully elucidated. We administered EVOO with a high OC concentration daily to 23 subjects with the metabolic syndrome (MetS) and hepatic steatosis (15 men and 8 women, age: 60 ± 11 years) for 2 months. Anthropometric data, metabolic parameters, hepatic steatosis (by fatty liver index, FLI), abdominal fat distribution (by ultrasound), and pro- and anti-inflammatory cytokines were assessed before and after the intervention. EVOO supplementation was associated with a reduction in body weight, waist circumference, body mass index (BMI), alanine transaminase and FLI, as well as interleukin (IL)-6, IL-17A, tumor necrosis factor-α and IL-1B, while IL-10 increased. Maximum subcutaneous fat thickness (SFT max) also increased, with a concomitant decrease in the ratio of visceral fat layer thickness/SFT max. Correlation analysis revealed positive associations between changes in body weight and BMI and those in SFT max, along with an inverse association between changes in IL-6 and those in SFT max. In conclusion, ingestion of EVOO with a high OC concentration had beneficial effects on metabolic parameters, inflammatory cytokines and abdominal fat distribution in MetS subjects with hepatic steatosis, a category of patients at high cardiometabolic risk.
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Affiliation(s)
- Angelo M. Patti
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.M.P.); (R.V.G.); (A.T.); (M.S.); (L.G.); (G.M.); (M.R.)
| | - Giuseppe Carruba
- Division of Research and Internationalization, ARNAS-Civico Di Cristina e Benfratelli Hospital, 90127 Palermo, Italy;
| | - Arrigo F. G. Cicero
- Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy;
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, 90-419 Lodz, Poland;
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI) in Lodz, 93-338 Lodz, Poland
| | - Dragana Nikolic
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.M.P.); (R.V.G.); (A.T.); (M.S.); (L.G.); (G.M.); (M.R.)
| | - Rosaria V. Giglio
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.M.P.); (R.V.G.); (A.T.); (M.S.); (L.G.); (G.M.); (M.R.)
| | - Antonino Terranova
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.M.P.); (R.V.G.); (A.T.); (M.S.); (L.G.); (G.M.); (M.R.)
| | - Maurizio Soresi
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.M.P.); (R.V.G.); (A.T.); (M.S.); (L.G.); (G.M.); (M.R.)
| | - Lydia Giannitrapani
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.M.P.); (R.V.G.); (A.T.); (M.S.); (L.G.); (G.M.); (M.R.)
| | - Giuseppe Montalto
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.M.P.); (R.V.G.); (A.T.); (M.S.); (L.G.); (G.M.); (M.R.)
| | - Anca Pantea Stoian
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Yajnavalka Banerjee
- Mohammed Bin Rashid University of Medicine and Health Sciences, 505055 Dubai, UAE;
| | - Ali A. Rizvi
- Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, SC 29203, USA;
- Division of Endocrinology, Metabolism, and Lipids, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Peter P. Toth
- CGH Medical Center, Sterling, IL 61081, USA;
- School of Medicine, University of Illinois, Peoria, IL 60612, USA
- Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Manfredi Rizzo
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.M.P.); (R.V.G.); (A.T.); (M.S.); (L.G.); (G.M.); (M.R.)
- Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, SC 29203, USA;
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Khodarahmi M, Jafarabadi MA, Farhangi MA. Melanocortin-4 receptor (MC4R) rs17782313 polymorphism interacts with Dietary Approach to Stop Hypertension (DASH) and Mediterranean Dietary Score (MDS) to affect hypothalamic hormones and cardio-metabolic risk factors among obese individuals. GENES AND NUTRITION 2020; 15:13. [PMID: 32758123 PMCID: PMC7403790 DOI: 10.1186/s12263-020-00672-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/28/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIM The association with obesity of a common variant near the melanocortin-4 receptor (MC4R) gene (rs17782313) has been indicated in various studies. Adherence to dietary quality indices also have shown to have potential favorable effects on obesity-related health outcomes. However, no study has examined the interaction between rs17782313 and the Dietary Approach to Stop Hypertension (DASH) score and the Mediterranean Dietary Score (MDS) on cardio-metabolic risk factors and hypothalamic hormones. Therefore, the purpose of the current study was to examine whether adherence to these dietary quality indices modifies the association of the MC4R rs17782313 polymorphism with cardio-metabolic risk factors and hypothalamic hormones among obese adults. METHOD Two hundred eighty-eight healthy obese adults were recruited in this cross-sectional study. Diet quality indices, including DASH score and MDS, were calculated from a validated 147-item food frequency questionnaire (FFQ). MC4R s17782313 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). An ANCOVA multivariate interaction model was used to assess the gene-diet interaction. RESULTS Significant interactions were detected between DASH score and MC4R rs17782313 genotypes on systolic blood pressure (SBP), atherogenic index of plasma (AIP), and serum glucose and triglyceride (TG) among the female group (pInteraction < 0.05). In the male group, there were gene-DASH and gene-MDS interactions in relation to serum glucose concentration and plasma α-melanocyte stimulating hormone (MSH) levels, but these were found only in multi-adjusted interaction models (pInteraction < 0.05). In addition, there was a significant interaction between MC4R rs17782313 polymorphism and DASH score on plasma agouti-related peptide (AgRP) concentrations in the female group in a multivariate interaction model (pInteraction < 0.05). An inverse association between DASH score and chance of having the CC genotype in a multivariate-adjusted model among women was also revealed. CONCLUSION MC4R rs17782313 interacts with healthy dietary pattern (DASH score and MDS) to influence cardio-metabolic risk factors and hypothalamic hormones in obese individuals. Prospective cohort studies are needed to further assess these findings.
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Affiliation(s)
- Mahdieh Khodarahmi
- Nutrition Research Center, Department of Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Attar-neishabouri Ave, Golgasht St, Tabriz, 5165665931, Iran.
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