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Topal GG, Sevim S, Gumus D, Balaban HY, Karçaaltıncaba M, Kizil M. Are dietary factors associated with cardiometabolic risk factors in patients with non-alcoholic fatty liver disease? PeerJ 2024; 12:e17810. [PMID: 39099651 PMCID: PMC11296304 DOI: 10.7717/peerj.17810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/03/2024] [Indexed: 08/06/2024] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is intricately linked with dietary patterns and metabolic homeostasis. Therefore, the present study focused to investigate the relation between dietary patterns and cardiometabolic risk factors related to fatty liver in NAFLD patients. Methods This cross-sectional study included 117 individuals whose body mass index (BMI) threshold of 25 or above diagnosed with NAFLD by magnetic resonance imaging. The hospital database was used to review the patients' medical records such as lipid parameters, and fasting blood sugar. Anthropometric measurements and body composition were measured by researchers. Likewise, data from 24-h dietary recalls of individuals were collected to analyze their energy and nutrient intakes besides calculating dietary insulin index (DII), dietary insulin load (DIL), dietary glycemic index (DGI), and dietary glycemic load (DGL). Results Participants consuming diets with distinct levels of DII, DIL, DGI, and DGL exhibited variations in dietary energy and nutrient intake. Specifically, differences were noted in carbohydrate intake across quartiles of DII, DIL, DGI, and DGL, while fructose consumption showed variability in DGL quartiles (p ≤ 0.05). Moreover, sucrose intake demonstrated distinctions in both DII and DGL quartiles (p ≤ 0.05). No statistical difference was found in biochemical parameters and the fatty liver index among different levels of DII, DIL, DGI, and DGL (p > 0.05). After adjusting for potential confounders, participants with a higher DGI had four times greater odds of developing metabolic syndrome compared to those in the bottom quartile (OR, 4.32; 95% CI [1.42-13.11]). Conclusion This study provides initial evidence of the intricate association between dietary factors and NAFLD, emphasizing the necessity for further research including prospective designs with larger sample sizes, to garner additional insights.
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Affiliation(s)
- Gulsum Gizem Topal
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Antalya, Turkey
| | - Sumeyra Sevim
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara Medipol University, Ankara, Turkey
| | - Damla Gumus
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Hatice Yasemin Balaban
- Department of Gastroenterology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Mevlude Kizil
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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Rajaie SH, Khayyatzadeh SS, Faghih S, Mansoori Y, Naghizadeh MM, Farjam M, Homayounfar R, Mozaffari-Khosravi H. The High-Dietary Insulin Load Score Is Associated With Elevated Level of Fasting Blood Sugar in Iranian Adult Men: Results From Fasa PERSIAN Cohort Study. BIOMED RESEARCH INTERNATIONAL 2024; 2024:6991072. [PMID: 39045408 PMCID: PMC11265942 DOI: 10.1155/2024/6991072] [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: 06/04/2022] [Revised: 09/13/2023] [Accepted: 04/23/2024] [Indexed: 07/25/2024]
Abstract
Aim: The potential of different foods to induce postprandial hyperinsulinemia may be involved in the development of metabolic syndrome (MetS). We aimed to evaluate the association between dietary insulin indices and MetS in a large population of adults in Iran. Methods: A total of 6356 adults aged 35-70 years were included in the present cross-sectional study. A validated block-format 125-item semiquantitative food frequency questionnaire (FFQ) was used to obtain usual food intakes, and MetS was defined according to the International Diabetes Federation (IDF) and American Heart Association (AHA)/National Heart, Lung, and Blood Institute (NHLBI) criteria. Results: MetS was prevalent in 13.8% of participants. Mean age of the study participants was 46.58 ± 8.82 years, and mean body mass index (BMI) was 25.02 ± 4.60 kg/m2. Mean dietary insulin index (DII) and dietary insulin load (DIL) were 63.15 ± 7.57 and 168.253 ± 52.09, respectively. In the crude model, men in the highest DIL quartile were more likely to have hyperglycemia than those in the lowest quartile (OR: 1.75, 95% CI: 1.12-2.73, p trend = 0.04). This association remained significant and was even stronger after adjusting for potential confounders in model I (OR: 3.64, 95% CI: 1.57-8.47, p trend = 0.005) and further adjustment for BMI in model II (OR: 3.61, 95% CI: 1.55-8.44, p trend = 0.006). Conclusions: In healthy men, adherence to a high-DIL diet may be associated with a greater likelihood of having hyperglycemia. No statistically significant association was observed between insulin indices and the odds of having MetS.
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Affiliation(s)
- Seyede Hamide Rajaie
- Nutrition and Food Security Research CenterShahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of NutritionSchool of Public HealthShahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sayyed Saeid Khayyatzadeh
- Nutrition and Food Security Research CenterShahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of NutritionSchool of Public HealthShahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shiva Faghih
- Department of Community Nutrition Research CenterSchool of Nutrition and Food SciencesShiraz University of Medical Science, Shiraz, Iran
| | - Yaser Mansoori
- Noncommunicable Diseases Research CenterDiseases Research CenterFasa University of Medical Sciences, Fasa, Iran
| | - Mohammad Mehdi Naghizadeh
- Noncommunicable Diseases Research CenterDiseases Research CenterFasa University of Medical Sciences, Fasa, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research CenterDiseases Research CenterFasa University of Medical Sciences, Fasa, Iran
| | - Reza Homayounfar
- National Nutrition and Food Technology Research InstituteFaculty of Nutrition Sciences and Food TechnologyShahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Mozaffari-Khosravi
- Nutrition and Food Security Research CenterShahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of NutritionSchool of Public HealthShahid Sadoughi University of Medical Sciences, Yazd, Iran
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Solgi S, Zayeri F, Abbasi B. Association between dietary insulin index and postmenopausal osteoporosis in Iranian women: a case-control study. BMC Womens Health 2024; 24:401. [PMID: 39004741 PMCID: PMC11247899 DOI: 10.1186/s12905-024-03248-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 07/08/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND The relationship between the dietary insulin index (DII) and the disease's risk is unknown, despite the fact that hyperinsulinemia is presumed to contribute to osteoporosis. The insulin response of various diets determines the DII. This study aimed to investigate the connection between postmenopausal Iranian women's adherence to a diet with a higher insulinemic potential and osteoporosis. METHODS A total of 380 postmenopausal women were included in the current case-control study. A 168-item food frequency questionnaire (FFQ) with established validity and reliability was used to evaluate individuals' daily calorie intake. The standard formula was employed to determine the dietary insulin load of each product. Subsequently, the calculation of DII was performed by dividing the dietary insulin load by the total energy consumed for each individual. In order to investigate the relationship between osteoporosis and DII, logistic regression was implemented. RESULTS The results of the current study demonstrated a substantial inverse relationship between osteoporosis and the DII, even after accounting for confounding variables (OR = 0.927; 95% CI = 0.888-0.967). The mean scores of DII (P < 0.001) was significantly higher in control group (36.82 ± 8.98) compared to the case group (33.53 ± 6.28). CONCLUSIONS Our findings suggest that keeping a diet high in insulin index and low in foods that are insulinogenic may improve bone mass density. Consequently, it may be essential for postmenopausal women to consume nutrients that stimulate insulin production in order to prevent osteoporosis.
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Affiliation(s)
- Shakiba Solgi
- Department of Nutrition, Electronic Health and Statistics Surveillance Research center, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Farid Zayeri
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behnood Abbasi
- Department of Nutrition, Electronic Health and Statistics Surveillance Research center, Science and Research Branch, Islamic Azad University, Hesarak Blvd, Daneshgah Square, Sattari Expressway, Tehran, Iran.
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Bahrami A, Parastouei K, Taghdir M, Ghadyani M. Dietary insulin indices and low-carbohydrate diet and the odds of colorectal cancer: a case-control study. Eur J Cancer Prev 2024; 33:363-367. [PMID: 38190110 DOI: 10.1097/cej.0000000000000867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
BACKGROUND Regarding the role of insulin and insulin-inducing dietary factors in some cancers' etiology, we hypothesized that the risk of colorectal cancer may be lessened by following a lower carbohydrate and insulinogenic diet. Therefore, we performed this study to explore the association between a low-carbohydrate diet and insulin indices and the odds of colorectal cancer. METHOD This hospital-based case-control study was conducted on 150 newly diagnosed colorectal cancer patients and 300 healthy age- and sex-matched hospitalized controls. A valid and reliable food frequency questionnaire was used to calculate the insulin indices and low-carbohydrate diet score. Multivariate logistic regression was used to estimate the association between insulin indices and low-carbohydrate diet and the odds of colorectal cancer. RESULT After adjusting for potential confounders, individuals in the highest tertile of insulin indices had a higher risk of colorectal cancer (OR insulin index = 3.46; 95% CI, 2.00-5.96; OR insulin load = 2; 95% CI, 1.17-3.41). No association was found between a low-carbohydrate diet and colorectal cancer (OR = 1.55; 95% CI, 0.85-2.84). CONCLUSION Current results demonstrated that a high insulinemic diet was associated with a higher risk of colorectal cancer.
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Affiliation(s)
- Alireza Bahrami
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Karim Parastouei
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Maryam Taghdir
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Nutrition and Food Hygiene, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mojtaba Ghadyani
- Department of Oncology, Gastroenterology and Liver Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hendricks SA, Paul MJ, Subramaniam Y, Vijayam B. A collectanea of food insulinaemic index: 2023. Clin Nutr ESPEN 2024; 63:92-104. [PMID: 38941186 DOI: 10.1016/j.clnesp.2024.06.017] [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: 02/12/2024] [Revised: 04/28/2024] [Accepted: 06/11/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND AND AIMS To systematically update and publish the lnsulinaemic Index (II) value compilation of food/beverages. METHODS A literature search identified around 400 scholarly articles published between inception and December 2023. II values were pooled according to the selection criteria of at least 10 healthy, non-diabetic subjects with normal BMI. In addition, the II reported should have been derived from incremental area under the curve (iAUC) calculation of the insulin concentration over time. The reference food used from the pooled articles were either glucose or bread. RESULTS The II of 629 food/beverage items were found from 80 distinct articles. This is almost a five-fold increase in the number of entries from a previous compilation in 2011. Furthermore, these articles originated from 32 different countries, and were cleaved into 25 food categories. The II values ranged from 1 to 209. The highest overall recorded II was for a soy milk-based infant formula while the lowest was for both acacia fibre and gin. Upon clustering to single food, the infant formula retained the highest II while both acacia fibre and gin maintained the lowest recording. As for mixed meal, a potato dish served with a beverage recorded the highest II while a type of taco served with a sweetener, vegetable and fruit had the lowest II. Our minimum and maximum II data values replace the entries reported by previous compilations. CONCLUSION Acknowledging some limitations, these data would facilitate clinical usage of II for various applications in research, clinical nutrition, clinical medicine, diabetology and precision medicine. Future studies concerning II should investigate standardisation of reference food, including glucose and the test food portion. Although this collectanea adds up new food/beverages II values, priority should be given to populate this database.
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Affiliation(s)
| | | | - Yuganeswary Subramaniam
- Surgical Department, Hospital Besar Pulau Pinang, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
| | - Bhuwaneswaran Vijayam
- Newcastle University Medicine Malaysia (NUMed), Iskandar Puteri, 79200 Johor, Malaysia; Regenerative Medicine Working Group, Newcastle University Medicine Malaysia (NUMed), 79200 Iskandar Puteri, Johor, Malaysia.
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Strydom H, Delport E, Muchiri J, White Z. The Application of the Food Insulin Index in the Prevention and Management of Insulin Resistance and Diabetes: A Scoping Review. Nutrients 2024; 16:584. [PMID: 38474713 DOI: 10.3390/nu16050584] [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: 11/17/2023] [Revised: 02/08/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
The food insulin index (FII) is a novel algorithm used to determine insulin responses of carbohydrates, proteins, and fats. This scoping review aimed to provide an overview of all scientifically relevant information presented on the application of the FII in the prevention and management of insulin resistance and diabetes. The Arksey and O'Malley framework and the PRISMA Extension for Scoping Reviews 22-item checklist were used to ensure that all areas were covered in the scoping review. Our search identified 394 articles, of which 25 articles were included. Three main themes emerged from the included articles: 1. the association of FII with the development of metabolic syndrome, insulin resistance, and diabetes, 2. the comparison of FII with carbohydrate counting (CC) for the prediction of postprandial insulin response, and 3. the effect of metabolic status on the FII. Studies indicated that the FII can predict postprandial insulin response more accurately than CC, and that a high DII and DIL diet is associated with the development of metabolic syndrome, insulin resistance, and diabetes. The FII could be a valuable tool to use in the prevention and management of T1DM, insulin resistance, and T2DM, but more research is needed in this field.
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Affiliation(s)
- Hildegard Strydom
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa
| | - Elizabeth Delport
- GI Foundation of South Africa, Nelspruit, Mbombela 1201, South Africa
| | - Jane Muchiri
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa
| | - Zelda White
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa
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Amiri Khosroshahi R, Mirzababaei A, Setayesh L, Bagheri R, Heidari Seyedmahalleh M, Wong A, Suzuki K, Mirzaei K. Dietary Insulin Index (DII) and Dietary Insulin load (DIL) and Caveolin gene variant interaction on cardiometabolic risk factors among overweight and obese women: a cross-sectional study. Eur J Med Res 2024; 29:74. [PMID: 38268038 PMCID: PMC10807169 DOI: 10.1186/s40001-024-01638-5] [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: 03/25/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Studies have shown that Caveolin gene polymorphisms (CAV-1) are involved in chronic diseases, such as metabolic syndrome. Moreover, the dietary insulin index (DII) and dietary insulin load (DIL) have been shown to potentially elicit favorable effects on cardiovascular disease (CVD) risk. Therefore, this study sought to investigate the effect of DII DIL and CAV-1 interaction on CVD risk factors. METHODS This cross-sectional study consisted of 333 overweight and obese women aged 18-48 years. Dietary intakes, DII, and DIL were evaluated using the 147-item food frequency questionnaire (FFQ). Serum profiles were measured by standard protocols. The CAV-1 rs 3,807,992 and anthropometric data were measured by the PCR-RFLP method and bioelectrical impedance analysis (BIA), respectively. Participants were also divided into three groups based on DII, DIL score, and rs3807992 genotype. RESULTS This comparative cross-sectional study was conducted on 333 women classified as overweight or obese. Participants with A allele for the caveolin genotype and higher DII score showed significant interactions with high-density lipoprotein (HDL) (P for AA = 0.006 and P for AG = 0.019) and CRI-I (P for AA < 0.001 and P for AG = 0.024). In participants with AA genotype and greater DII score, interactions were observed in weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, CRI-II, fat-free mass (FFM), and skeletal muscle mass (SMM) (P < 0.079). Those with higher DIL scores and AA genotype had higher weight (P = 0.033), FFM (P = 0.022), and SMM (P = 0.024). In addition, DIL interactions for waist/hip ratio (WHR), waist circumference (WC), triglyceride (TG), CRI-I, and body fat mass (BFM) among individuals with AA genotype, while an HDL interaction was observed in individuals with AG and AA (P < 0.066). CONCLUSION The findings of the present study indicate that people who carry the caveolin rs3807992 (A) allele and have greater DII and DIL scores are at higher risk for several cardiovascular disease and metabolic syndrome biomarkers. These results highlight that diet, gene variants, and their interaction, should be considered in the risk evaluation of developing CVD.
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Affiliation(s)
- Reza Amiri Khosroshahi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Leila Setayesh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Mohammad Heidari Seyedmahalleh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, USA
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, 359-1192, Japan.
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Elyasi L, Borazjani F, Ahmadi Angali K, Hosseini SA, Saki N. Dietary insulin index, dietary insulin load and dietary patterns and the risk of metabolic syndrome in Hoveyzeh Cohort Study. Sci Rep 2024; 14:1968. [PMID: 38263222 PMCID: PMC10806255 DOI: 10.1038/s41598-024-52263-5] [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: 08/27/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024] Open
Abstract
Postprandial insulin secretion has been associated with metabolic disorders such as hyperlipidemia and type 2 diabetes. Therefore, we aimed to explore the relationship between dietary insulin indices and dietary pattern with the risk of Metabolic Syndrome (MetS). The participants of the present cross-sectional study were included among the individuals who participated in the Hoveyzeh Cohort Study (HCS). A total of 3905 Iranian adults, aged 35-70 years, are included in the current analysis. The Food Frequency Questionnaire (FFQ) is used to calculate the dietary Insulin Index (DII), Insulin Load (DIL), and dietary pattern. Dietary pattern was derived using Reduced-Rank Regression (RRR) based on intake of protein (g/day), fiber (g/day), fat (g/day), magnesium (mg/day), and dietary insulin index were considered as response variables. The Generalized Linear Model was used to obtain the odds ratio (OR) and 95% confidence interval (CI) for MetS based on gender, while considering quartiles of DIL, DII scores, and dietary pattern, adjusted for potential confounders. The mean ± SD of age and BMI of the participants in the top quartile of DIL were 45.72 ± 8.05 years and 28.25 ± 5.02 kg/m2, respectively. The mean ± SD of DII was 40.53 ± 4.06 and the mean ± SD of DIL was 117,986.1 ± 30,714.06. A significant positive association was observed between DIL and MetS in women after adjusting for confounding factors (OR: 1.51; 95% CI 1.16; 1.96). No significant association was seen between DIL, DII, and MetS among men. A derived dietary pattern characterized by high intakes of fruits, sugar, sweet deserts, Whole Grains, and dairy was associated with an increased risk of MetS in adjusted model2 among women (OR: 1.41; 95% CI 1.13; 1.75) and men in the same model (OR: 2.09; 95% CI 1.35; 3.21).However, the final model was significant just for men (OR: 2.08; 95% CI 1.35; 3.21) and not for women (OR: 1.24; 95% CI 0.96; 1.60). Our findings showed that adherence to a diet with a high insulin load can increase the risk of MetS in women. In addition, a derived dietary pattern by RRR indicated that a diet rich in fruits, sugar, sweet deserts, whole Grains, and dairy is related to increased risk of MetS in both men and women.
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Affiliation(s)
- Leila Elyasi
- Nutrition and Metabolic Disease Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Borazjani
- Nutrition and Metabolic Disease 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.
| | - Kambiz Ahmadi Angali
- Department of Biostatistics, School of Health Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Social Determinant of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Nutrition and Metabolic Disease 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
| | - Nader Saki
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Arabshahi V, Amiri R, Ghalishourani SS, Hasaniani N, Nozarian S, Tavasolian R, Khiabani A, Rahimlou M. Association between dietary insulin index and load with cardiometabolic risk factors and risk of metabolic syndrome among the patients with type 2 diabetes: a cross-sectional study. BMC Nutr 2023; 9:141. [PMID: 38049837 PMCID: PMC10694962 DOI: 10.1186/s40795-023-00803-z] [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: 10/17/2023] [Accepted: 11/27/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND This study aims to investigate the association between dietary insulin index (DII) and load (DIL) with cardiometabolic risk factors and the risk of developing metabolic syndrome (MetS) among patients with type 2 diabetes (T2DM). METHODS A cross-sectional study was conducted among 500 T2DM patients. Dietary intake was assessed using a validated food frequency questionnaire, and DII and DIL were calculated based on insulin response and energy content. Logistic regression analyses were performed to determine the odds ratios (ORs) for MetS. RESULTS Participants in the highest quartile of DIL had significantly higher odds of MetS (OR: 2.16; 95% CI: 1.02-4.25, P = 0.039) and hyperglycemia (OR: 1.69; 95% CI: 1.08-4.96, P = 0.032). We also discovered that patients in the highest quartile of DII had higher odds of MetS (OR: 1.69; 95% CI: 1.08-4.96, P = 0.034) and hyperglycemia (OR: 1.39; 95% CI: 1.04-4.12, P = 0.019). Furthermore, participants in the highest quartile of DIL (OR: 1.64; 95% CI: 1.00-2.59, P = 0.03) and DII (OR: 1.42; 95% CI: 1.05-1.95, P = 0.026) had higher odds of high waist circumference. When it came to hypertriglyceridemia, we found a significant association between DII and DIL only in the crude model, not the fully adjusted model. However, we didn't observe any significant association between DII and DIL with hypercholesteremia, Low HDL, and high blood pressure (P > 0.05). CONCLUSION Our study provides evidence suggesting that a higher DII and DIL may be associated with an increased risk of cardiometabolic risk factors and MetS in patients with T2DM.
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Affiliation(s)
- Vajeheh Arabshahi
- Department of Nutrition, School of Public health, Iran University of Medical Sciences, Tehran, Iran
| | - Roksaneh Amiri
- Department of Nutrition, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Samira Sadat Ghalishourani
- Department of Physical education and sport science, science of research branch, Islamic Azad University, Tehran, Iran
| | - Nazila Hasaniani
- Emam Reza Hospital affiliated with Social Security Organization, Urmia, Iran
| | - Shadi Nozarian
- Department of Nutrition, Ahvaz Jondishapur University of Medical Sciences, Ahvaz, Iran
| | - Ronia Tavasolian
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Azadi Square, Zanjan, Iran
| | - Alireza Khiabani
- School of Medicine, Bam University of Medical Sciences, Bam, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Azadi Square, Zanjan, Iran.
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10
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Nematbakhsh R, Hajhashemy Z, Lotfi K, Shahdadian F, Rouhani P, Saneei P. Association between dietary insulin index and load with brain derived neurotrophic factor, adropin and metabolic health status in Iranian adults. Sci Rep 2023; 13:20540. [PMID: 37996610 PMCID: PMC10667526 DOI: 10.1038/s41598-023-48056-x] [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: 07/19/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023] Open
Abstract
The associations of high potential insulinogenic foods with metabolic health (MH) status and brain-derived neurotrophic factor (BDNF) and adropin were not investigated quite enough. We examined the relationship between dietary insulin load (DIL) and dietary insulin index (DII) with MH and serum levels of BDNF and adropin among Iranian adults. This cross-sectional investigation accomplished among 527 Iranian middle-aged adults (54.3% men). Dietary information was obtained by a validated food frequency questionnaire. Anthropometric indices and blood pressure were assessed. For measuring lipid and glycemic profile and serum levels of BDNF and adropin, blood samples were assembled after 12 h of fasting. MH was defined based on lipid and glycemic profile, high blood pressure, insulin resistance and chronic inflammation. After adjustments all confounders, participants in the highest tertile of DII compared to the lowest one had a 115% increased odds for metabolic unhealthy (MU) profile (ORT3 vs. T1 = 2.15, 95% CI 1.03-4.49). However, DIL was not related to MU. Higher DII was additionally associated with high blood pressure, in maximally-adjusted model (ORT3 vs. T1 = 3.57, 95% CI 1.61-7.92). Moreover, moderate DIL was significantly associated with hypertriglyceridemia (ORT2 vs. T1 = 2.56, 95% CI 1.01-6.45). Each tertile increase in DII or DIL was not significantly associated with serum BDNF or adropin values. Greater DII was associated with higher chance of MU and hypertension in Iranian adults; but no association was found between DIL and metabolic health. DIL or DII was not related to circulating BDNF or adropin. To confirm these findings, additional prospective investigations are required.
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Affiliation(s)
- Roxana Nematbakhsh
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Shahdadian
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Rouhani
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran.
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Vajdi M, Ardekani AM, Nikniaz Z, Hosseini B, Farhangi MA. Dietary insulin index and load and cardiometabolic risk factors among people with obesity: a cross-sectional study. BMC Endocr Disord 2023; 23:117. [PMID: 37226148 DOI: 10.1186/s12902-023-01377-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/19/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND The hypothesis of the effect of the insulinogenic effects of diet on the development of cardiometabolic disorders has been suggested, but limited data are available for adults with obesity. This study aimed to determine the association of dietary insulin index (DII) and dietary insulin load (DIL) with cardiometabolic risk factors among Iranian adults with obesity. METHODS The study was conducted with a total of 347 adults aged 20-50 years in Tabriz, Iran. Usual dietary intake was assessed through a validated 147-item food frequency questionnaire (FFQ). DIL was computed using published food insulin index (FII) data. DII was calculated by dividing DIL by the total energy intake of each participant. Multinational logistic regression analysis was performed to evaluate the association between DII and DIL and cardiometabolic risk factors. RESULTS Mean age of participants was 40.78 ± 9.23 y, and mean body mass index (BMI) was 32.62 ± 4.80 kg/m2. Mean of DII and DIL was 73.15 ± 37.60 and 196,242 ± 100,181. Participants with higher DII had higher BMI, weight, waist circumference (WC), and blood concentrations of triglyceride (TG) and Homeostasis model assessment insulin resistance index (HOMA-IR) (P < 0.05). After taking potential confounders into account, DIL was positively associated with MetS (OR: 2.58; 95% CI: 1.03-6.46), and high blood pressure (OR: 1.61; 95% CI: 1.13-6.56). Moreover, after adjustment for potential confounders, moderate DII was associated with increased odds of MetS (OR: 1.54, 95% CI: 1.36-4.21), high TG (OR, 1.25; 95% CI, 1.17-5.02), and high blood pressure (OR: 1.88; 95% CI: 1.06-7.86). CONCLUSION This population-based study revealed that adults with higher DII and DIL associated with cardiometabolic risk factors and consequently, replacement of high with low DII and DIL may have reduce the risk of cardiometabolic disorders. Further studies with longitudinal design are required to confirm these findings.
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Affiliation(s)
- Mahdi Vajdi
- Department of Community Nutrition, Student Research Committee, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, 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
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases 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
| | - Mahdieh Abbasalizad Farhangi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Attar Neyshabouri, Daneshgah Blv, Tabriz, Iran.
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Faramarzi E, Somi MH, Naghibi Irvani SS, Pourhashem N, Nourizadeh AM. Associations between Insulin Index and dietary insulin load with cardiometabolic phenotype in the AZAR cohort population in north-western Iran: a cross-sectionalstudy. BMJ Open 2023; 13:e068303. [PMID: 37130689 PMCID: PMC10163542 DOI: 10.1136/bmjopen-2022-068303] [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] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVES Hyperinsulinaemia and insulin resistance are proposed as contributors to the incidence of cardiometabolic phenotypes (CMPs) with unhealthy metabolic status. This study analysed the association between dietary insulin load (DIL) and Dietary Insulin Index (DII) with CMPs in the AZAR cohort population. DESIGN This study was a cross-sectional analysis of the AZAR Cohort Study, beginning in 2014 and continuing to this date. SETTING The AZAR cohort is a part of an Iranian screening programme named the Persian cohort and involves participants living in the Shabestar region, Iran for at least 9 months. PARTICIPANTS A total of 15 006 participants agreed to partake in the study. We excluded participants with missing data (n=15), daily energy intake lower than 800 kcal (n=7) or higher than 8000 kcal (n=17), and cancer (n=85). Finally, 14 882 individuals remained. PRIMARY AND SECONDARY OUTCOME MEASURES The gathered information included the participants' demographic, dietary, anthropometric and physical activity data. RESULTS The frequency of DIL and DII significantly decreased from the first to fourth quartiles in metabolically unhealthy participants (p≤0.001). The mean values of DIL and DII were greater in metabolically healthy participants than in unhealthy ones (p<0.001). The results of the unadjusted model showed that the risks of unhealthy phenotypes in the fourth DIL quartile decreased by 0.21 (0.14-0.32) and 0.37 (0.33-0.43), respectively, compared with the first quartile. The same model showed the same risks for DII decreased by 0.18 (0.11-0.28) and 0.39 (0.34-0.45), respectively. The results in both genders were the same as all participants combined. CONCLUSIONS DII and DIL were correlated with a decreased OR of unhealthy phenotypes. We suggest the reason may be either a lifestyle change in metabolically unhealthy participants or elevated insulin secretion not being as detrimental as previously thought. Further studies can confirm these speculations.
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Affiliation(s)
- Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)
| | - Seyed Sina Naghibi Irvani
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)
| | - Nahid Pourhashem
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)
| | - Amir Mohammad Nourizadeh
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)
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Kahrizsangi MA, Ebrahimi Z, Shateri Z, Mansouri F, Zangene A, Rajabzadeh-Dehkordi M, Nouri M, Rashidkhani B. Carbohydrate quality indices and colorectal cancer risk: a case-control study. BMC Cancer 2023; 23:347. [PMID: 37069525 PMCID: PMC10108463 DOI: 10.1186/s12885-023-10786-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/29/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the fourth and third most common cancer in Iran and the world, respectively. Carbohydrates can lead to the proliferation of cancer cells, including CRC. The current study aimed to investigate the association between glycemic load (GL), insulin load (IL), glycemic index (GI), insulin index (II), low-carbohydrate diet score (LCDS), and carbohydrate quality index (CQI) with CRC odds. METHODS The present case-control study was performed on 71 CRC cases and 142 controls in the Hospital Cancer Organization and three general hospitals in Tehran, Iran. We calculated the dietary GI, GL, IL, II, CQI, and LCDS by a validated food frequency questionnaire. RESULTS The results indicated that people who were in the highest tertile of the GI had higher odds of CRC compared to the lower tertile (in the adjusted model: odds ratio (OR) = 3.89; 95% confidence interval (CI): 1.71-8.84). On the contrary, people who were in the highest tertile of the CQI and LCDS had significantly lower odds of CRC compared to the lower tertile (in the adjusted model: tertile (T) 2-OR = 0.24; 95% CI: 0.11-0.53 and T3-OR = 0.15; 95% CI: 0.06-0.39 for CQI and T2-OR = 0.33; 95% CI: 0.13-0.79 and T3-OR = 0.28; 95% CI: 0.10-0.82 for LCDS). Also, IL was positively associated with the odds of CRC after adjusting for confounding factors (T2-OR = 2.46; CI: 1.08-5.61 and T3- OR = 2.80; 95% CI: 1.07-7.31). Regarding the GL, only individuals who were in the second tertile had significantly higher odds of CRC compared to the first tertile (OR = 2.42; CI: 1.07-5.47). CONCLUSION According to the findings, it is recommended to use a diet with high-quality carbohydrates and low GI and GL to minimize the odds of developing CRC. People should also be encouraged to have a balanced carbohydrate intake.
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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
| | - Zohreh Ebrahimi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zainab Shateri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Mansouri
- 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
| | - Ali Zangene
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Milad Rajabzadeh-Dehkordi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Nouri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Bahram Rashidkhani
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Beba M, Gholizadeh M, Sharifi M, Seifbarghi T, Djafarian K. The association of dietary insulin load and dietary insulin index with body composition among professional soccer players and referees. BMC Sports Sci Med Rehabil 2023; 15:31. [PMID: 36915133 PMCID: PMC10010033 DOI: 10.1186/s13102-023-00635-1] [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: 12/18/2022] [Accepted: 02/22/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND There has been limited research undertaken about the association of dietary insulin load (DIL) and dietary insulin index (DII) with body composition in non-athletic adults, however, to the best of our knowledge No previous study has investigated such an association in an athletic population. PURPOSE The aim of this study was to explore the association of DII and DIL with body compositions in male and female soccer players and referees. METHODS The cross-sectional study was conducted on 199 professional male and female soccer players and referees. A 147-item semi-quantitative food frequency questionnaire (FFQ) was adopted to congregate the participants' dietary data. Body composition was measured using InBody to gain a detailed understanding of fat mass, percent body fat (PBF), lean mass, percent muscle mass (PMM), and bone mineral content (BMC). Waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were obtained from all participants. Other body composition parameters include a body shape index (ABSI), abdominal volume index (AVI), body adiposity index (BAI), body roundness index (BRI), conicity index (CI), weight-adjusted waist index (WWI) and waist-to-hip-to-height ratio (WHHR) were calculated using a particular defined formula. RESULTS Results of multiple linear regression revealed that there is a significant association between DIL and BMI (P = 0.04) in < 18 male soccer players, CI (P = 0.04) and WWI (P = 0.03) in ≥ 18 female soccer players, PBF (P = 0.02), PMM (P = 0.01) and WWI (P = 0.01) in ≥ 18 female soccer players. Nevertheless, no significant associations between DIL and body composition parameters were found in the referees. Additionally, there is a significant association between DII and BMC (P = 0.02) in male soccer referees, however, no significant associations were found in young soccer players and female athletes. CONCLUSION This study demonstrates that DIL is positively associated with BMI, CI, and WWI in male soccer players and PBF, and WWI in female soccer players. Although, there was an observed negative association between DIL and PMM in females. In addition, a significant negative association between DII and BMC was observed in male soccer players.
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Affiliation(s)
- Mohammad Beba
- Department of Clinical Nutrition, school of Nutritional Sciences and Dietetics, Tehran University of Medical sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Mohammad Gholizadeh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Sharifi
- Department of Clinical Nutrition, school of Nutritional Sciences and Dietetics, Tehran University of Medical sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Tohid Seifbarghi
- Department of Sport Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, school of Nutritional Sciences and Dietetics, Tehran University of Medical sciences, P.O. Box 14155-6117, Tehran, Iran.
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Nouri M, Mahmoodi M, Shateri Z, Ghadiri M, Rajabzadeh-Dehkordi M, Vali M, Gargari BP. How do carbohydrate quality indices influence on bone mass density in postmenopausal women? A case-control study. BMC Womens Health 2023; 23:42. [PMID: 36721166 PMCID: PMC9887922 DOI: 10.1186/s12905-023-02188-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/23/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Carbohydrates are the primary energy source in Asian countries, including Iran. An emerging method can be used to measure the quality of carbohydrates, including the carbohydrate quality index (CQI), which includes a variety of components. Low-carbohydrate diet score (LCDS) has been proposed as a new method of scoring micronutrient intake that could provide a reasonable explanation for the link between diet and the risk of chronic diseases. OBJECTIVE This study aimed to investigate the relationship between CQI, LCDS, glycemic index (GI), glycemic load (GL), insulin load (IL), and insulin index (II) with bone mass density (BMD) in postmenopausal women. METHOD In this case-control study, 131 postmenopausal women with osteoporosis/osteopenia and 131 healthy postmenopausal women aged 45-65 participated. The dual-energy X-ray absorptiometry (DEXA) method measured the BMD of the lumbar vertebrae and femoral neck. A validated semi-quantitative food frequency questionnaire was used to assess dietary intake. Logistic regression were used to evaluate the relation between GI, GL, II, IL, CQI, and LCDS with BMD. RESULTS Diets with higher GI increased the risk of osteopenia and osteoporosis, but LCDS and CQI decreased the risk of osteopenia and osteoporosis. CONCLUSION These findings suggest that a higher intake of fruits and vegetables and receiving various dietary vitamins, minerals, and antioxidant compounds may be a useful way to prevent osteopenia in Iranian women.
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Affiliation(s)
- Mehran Nouri
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Mahmoodi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zainab Shateri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Ghadiri
- Student Research Committee, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Milad Rajabzadeh-Dehkordi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahram Pourghassem Gargari
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Khoshnoudi-Rad B, Hosseinpour-Niazi S, Javadi M, Mirmiran P, Azizi F. Relation of dietary insulin index and dietary insulin load to metabolic syndrome depending on the lifestyle factors: Tehran lipid and glucose study. Diabetol Metab Syndr 2022; 14:198. [PMID: 36585722 PMCID: PMC9801646 DOI: 10.1186/s13098-022-00968-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/15/2022] [Indexed: 12/31/2022] Open
Abstract
AIM The hypothesis of the effect of the insulinogenic effects of diet on the development of cardiovascular diseases has been proposed, but the findings of previous studies are very contradictory. We investigated the association between dietary insulin index (DII) and dietary insulin load (DIL), and metabolic syndrome (MetS) risk. Another objective was to examine the extent to which lifestyle (physical activity, smoking status, and weight change) and sex influence the relationship between DII, DIL, and MetS risk. MATERIALS AND METHODS We followed 1915 participants in the Tehran Lipid and Glucose Study. DIL and DII were calculated based on a validated food frequency questionnaire. Weight change was measured, and participants were categorized into > 3% weight loss, weight stable (± 3%), and > 3% weight gain. By joint classification, the association between DII and DIL (< median and ≥ median) and risk of MetS was assessed according to weight change, sex, physical activity levels, and smoking status. Cox proportional hazards models were used to estimate the HRs (95% CI), adjusting for potential confounders. RESULTS During 8.9 years of follow-up, among 1915 participants, we documented 591 new cases of MetS. DII and DIL were not associated with MetS risk in the crude and adjusted models. However, DIL and DII were associated with weight gain (≥ 3%). In the crude model, DIL and DII were associated with a higher risk of weight gain [HR: 1.74: 95% CI 1.50-2.03, and 1.70 (1.46-1.98), respectively]. These associations remained significant after further adjustment for confounders. The HRs were 1.61 (1.35-1.92) for DIL and 1.64 (1.39-1.93) for DII. Among men, women, participants with low physical activity levels, and smokers, the risk of MetS, independent of DIL and DII, only increased in a participant with weight gain. In women with weight stability, DIL and DII, higher than the median, were positively associated with MetS risk. CONCLUSION Our findings suggest that the association between MetS risk and a hyperinsulinemic diet depended on weight change.
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Affiliation(s)
- Bayyeneh Khoshnoudi-Rad
- Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Bahonar Blvd, P.O. Box: 34185-754, Qazvin, Iran
| | - Somayeh Hosseinpour-Niazi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, A'rabi St., Yeman Av., Velenjak, P.O. Box: 19395-4763, Tehran, Iran.
| | - Maryam Javadi
- Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Bahonar Blvd, P.O. Box: 34185-754, Qazvin, Iran.
| | - Parvin Mirmiran
- 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
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Karimbeiki R, Namkhah Z, Alipoor E, Yaseri M, Hosseinzadeh-Attar MJ. The relationship between low-carbohydrate diet score, dietary insulin index and load with obesity in healthy adults. Eat Weight Disord 2022; 27:3341-3350. [PMID: 35995887 DOI: 10.1007/s40519-022-01464-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/29/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Carbohydrate intake and insulinemic potential of diet are suggested to be correlated with the development of different chronic diseases. Considering the limited research on obesity, this study aimed to investigate the association of dietary insulin index (DII), dietary insulin load (DIL), and low-carbohydrate diet score (LCDS) with body weight and obesity in healthy adults. METHODS In this cross-sectional study, DII, DIL, and LCDS were calculated using relevant formulas based on dietary intakes obtained by a valid 168-item food frequency questionnaire, in 393 otherwise healthy adults of either normal-weight, overweight, or obese. RESULTS Individuals in the highest tertile of DIL and DII had respectively 73% (OR: 0.27, 95% CI 0.08-0.94, p = 0.049) and 50% (OR: 0.5, 95% CI 0.26-0.96, p = 0.038) lower odds of being overweight compared to the lowest tertile, after adjusting the effects of age, sex, and dietary energy intake. Participants in the highest tertile of DIL had 92% greater odds of being obese compared to the lowest tertile, but this association did not remain significant after adjusting the effect of energy intake. Individuals in the highest tertile of LCDS had about 2 times odds of being overweight compared with those in the lowest tertile (OR: 2.04, 95% CI 1.04-4.01, p = 0.049). There was no relationship between being obese and tertiles of LCDS. CONCLUSION Higher dietary carbohydrate intake and insulinemic potential of diet could not be considered independent dietary risk factors for overweight or obesity. LEVEL OF EVIDENCE Level III: evidence obtained from an observational study.
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Affiliation(s)
- Razieh Karimbeiki
- Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No#44, Hojjatdoust St., Naderi St., Keshavarz Blvd, Tehran, 14155-6117, Iran
| | - Zahra Namkhah
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No#44, Hojjatdoust St., Naderi St., Keshavarz Blvd, Tehran, 14155-6117, Iran
| | - Elham Alipoor
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No#44, Hojjatdoust St., Naderi St., Keshavarz Blvd, Tehran, 14155-6117, Iran.,Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Hosseinzadeh-Attar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No#44, Hojjatdoust St., Naderi St., Keshavarz Blvd, Tehran, 14155-6117, Iran. .,Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Hajhashemy Z, Lotfi K, Shahdadian F, Rouhani P, Heidari Z, Saneei P. Dietary insulin index and insulin load in relation to hypertriglyceridemic waist phenotype and low brain derived neurotrophic factor in adults. Front Nutr 2022; 9:980274. [PMID: 36185667 PMCID: PMC9520245 DOI: 10.3389/fnut.2022.980274] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/29/2022] [Indexed: 11/20/2022] Open
Abstract
Background The evidence about the relation of the insulinemic potential of food with visceral obesity and brain-derived neurotrophic factor (BDNF) was limited. We aimed to investigate the relation of dietary insulin index (DII) and dietary insulin load (DIL) with hypertriglyceridemic waist phenotype (HTGW) and serum BDNF in Iranian adults. Methods This cross-sectional study included 528 middle-aged adults (45.6% women), using a multistage cluster random-sampling method. Dietary intakes were assessed using a validated semi-quantitative 168-item food frequency questionnaire. Blood samples were collected after 12 h of fasting for assessing the serum BDNF and triglyceride concentrations. HTGW was defined as triacylglycerol ≥ 150 mg/dL plus enlarged waist circumference. The values less than the first decile of serum BDNF were considered as the low level. Results Individuals in the top tertile of DIL, in comparison to those in the bottom tertile, had higher odds of HTGW in both crude (OR = 1.96, 95% CI: 1.14–3.37) and fully adjusted model (OR = 6.10, 95% CI: 1.58–23.53). However, the relation between DII and odds of HTGW was statistically insignificant in crude (OR = 1.30, 95% CI: 0.78–2.16) and maximally adjusted model (OR = 1.25, 95% CI: 0.65–2.40). After considering confounders, participants in the top tertile of DIL had marginally higher odds of having low BDNF values (OR = 2.00, 95% CI: 0.95–4.21). Nevertheless, the association between DII and odds of low BDNF values was statistically insignificant. Conclusion This population-based study demonstrated that adults with higher DIL had significantly higher chance of HTGW phenotype and slightly higher chance for low BDNF level. DII was not associated with HTGW phenotype or BDNF values.
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Affiliation(s)
- Zahra Hajhashemy
- Department of Community Nutrition, Nutrition and Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Shahdadian
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, Nutrition and Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Rouhani
- Department of Community Nutrition, Nutrition and Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, Nutrition and Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- *Correspondence: Parvane Saneei, ,
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Hajhashemy Z, Mirzaei S, Asadi A, Akhlaghi M, Saneei P. Association of Dietary Insulin Index and Dietary Insulin Load With Metabolic Health Status in Iranian Overweight and Obese Adolescents. Front Nutr 2022; 9:821089. [PMID: 35369069 PMCID: PMC8969564 DOI: 10.3389/fnut.2022.821089] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/15/2022] [Indexed: 11/24/2022] Open
Abstract
Background Limited data are available on the association of dietary insulin load (DIL) and dietary insulin index (DII) with health status in pediatrics. We aimed to investigate the relationship of DIL and DII with metabolic health status in Iranian overweight/obese adolescents. Methods In this cross-sectional study, using a multistage cluster random-sampling method, 203 overweight/obese adolescents (aged 12 to <18 years) were included. A validated 147-item food frequency questionnaire (FFQ) was used for a dietary intake assessment. Glycemic and lipid profile, blood pressure (BP), and anthropometric indices were measured. Participants were categorized as metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO) using the two methods of the International Diabetes Federation (IDF) and a combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR). Results According to IDF and IDF/HOMA-IR strategies, 38.9% (n = 79) and 33.0% (n = 67) of participants belonged to MUO category. After adjustments for potential confounders, subjects in the highest tertile of DIL in comparison with those in the lowest tertile had the odds ratio (OR) values of 8.44 (95% CI: 2.24-31.78) and 5.86 (95% CI: 1.39-24.58) for MUO based on IDF and IDF/HOMA-IR definitions, respectively. Moreover, after considering potential confounders, adolescents in the highest tertile of DII, compared to the lowest tertile, were, respectively, 6.93 (OR: 6.93; 95% CI: 2.59-18.57) and 5.26 (OR: 5.26; 95% CI: 1.85-14.97) times more likely to be MUO, based on IDF and IDF/HOMA-IR definitions. A significant decreasing trend was observed for OR of MUO in tertiles of DIL and DII. The stratified analysis revealed that these associations were stronger in obese participants; in overweight subjects, the association was not independent of confounders. Conclusion This population-based study revealed that higher DIL and DII were strongly related to increased OR of MUO in Iranian adolescents, especially in obese participants. Further investigations, especially with a prospective design, are needed to affirm these findings.
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Affiliation(s)
- Zahra Hajhashemy
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeideh Mirzaei
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Asadi
- Department of Exercise Physiology, School of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Ghorbaninejad P, Imani H, Sheikhhossein F, Tijani Jibril A, Mohammadpour S, Shab-Bidar S. Higher dietary insulin load and index are not associated with the risk of metabolic syndrome and obesity in Iranian adults. Int J Clin Pract 2021; 75:e14229. [PMID: 33864715 DOI: 10.1111/ijcp.14229] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/12/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Data about the relation between dietary insulin load (DIL) and dietary insulin index (DII) with metabolic syndrome (MetS) and obesity are scarce. Therefore, the present study aimed to examine the association of the insulinemic potential of the diet with MetS and obesity amongst Iranian adults. METHODS This cross-sectional study was conducted amongst 850 adults aged 20-59 years. Dietary data were collected using a 168-item food frequency questionnaire. DIL was calculated using a standard formula and DII was obtained by dividing DIL by the total energy intake of each participant. The guidelines of the International Diabetes Federation were used to define MetS. General obesity was considered as body mass index ≥ 30 kg/m2 , and abdominal obesity as waist circumference ≥ 94 cm for men and ≥ 80 cm for women. RESULTS Mean DIL and DII values were 101 684 ± 54 802 and 49.4 ± 33.4, respectively. The mean age of participants was 44.9 ± 10.7 years and 36.8%, 28.5% and 48.8% of participants were suffering from MetS, general and abdominal obesity, respectively. In contrast with DIL (P = .73), participants in the last quartile of DII (P = .62) had lower odds of MetS than the first quartile. There were non-significant inverse associations between DIL (P = .91, P = .85) and DII (P = .59, P = .53) with odds of general and abdominal obesity before and after the adjustment of confounders, respectively. CONCLUSIONS We did not observe any significant association of DIL and DII with the risk of MetS and obesity amongst the Iranian population. Further prospective studies are needed to confirm the findings of this study.
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Affiliation(s)
- Parivash Ghorbaninejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hosein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliyu Tijani Jibril
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Saba Mohammadpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Sheikhhossein F, Shab-Bidar S, Amini MR, Hosseini F, Imani H. Dietary Insulin Index and Insulin Load in Relation to Breast Cancer: Findings from a Case-Control Study. Clin Breast Cancer 2021; 21:e665-e674. [PMID: 34052108 DOI: 10.1016/j.clbc.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/20/2021] [Accepted: 04/16/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND No data are available on the association between dietary insulin index (DII) and dietary insulin load (DIL) and the risk of breast cancer (BC). PATIENTS AND METHODS This hospital-based case-control study enrolled 150 newly diagnosed cases of BC and 150 age-matched controls. All cases were patients with pathologically confirmed BC, with no history of any type of other pathologically confirmed cancers. Controls were selected from visitors, relatives, and friends of non-cancer patients in other wards who had no family relationships with the cases. We assessed the dietary intakes of study participants using a validated 147-item semiquantitative food frequency questionnaire. DII and DIL were obtained from previously published data. RESULTS A significant positive association was found between DII and BC (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.02-3.25), such that after considering energy intake and age, participants in the highest tertile of DII had 1.86 times greater risk of BC than those in the lowest tertile (OR, 1.86; 95% CI, 1.03-3.35). However, this association became non-significant after controlling for further potential risk factors (OR, 3.26; 95% CI, 0.9-11.7). Furthermore, we observed a significant positive association between DIL and BC (OR, 1.9; 95% CI, 1.06-3.40). The association remained significant even after controlling for age and energy intake. Further controlling for other potential confounders resulted in the disappearance of the association (OR, 3.06; 95% CI, 0.87-10.6). CONCLUSION Adherence to a diet with high DII and DIL was not associated with odds of BC after controlling for potential confounders.
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Affiliation(s)
- Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Amini
- Department of Clinical Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hosseini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Caferoglu Z, Erdal B, Akin L, Kurtoglu S. Breakfast and dinner insulin index and insulin load in relation to overweight in children and adolescents. Eur J Nutr 2021; 60:2819-2829. [PMID: 33420527 DOI: 10.1007/s00394-020-02478-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/23/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE Hyperinsulinemia is related to the development of several chronic diseases, particularly obesity. Therefore, this study aimed to examine the association between the insulinemic potential of both total diet and meals, measured by the glycemic index (GI), glycemic load (GL), insulin index (II), and insulin load (IL), and overweight risk among children and adolescents. METHODS This cross-sectional study was conducted on 205 overweight and 146 normal-weight participants aged 6-18 years. Overweight was defined as body mass index ≥ 85th percentile of Turkish growth-reference data. Through the use of standard methodology, dietary and meal GI, GL, II, and IL were derived from dietary data collected via a 3-day dietary record. Associations were investigated using multivariable-adjusted regression analysis. RESULTS When controlling for potential covariates, a greater dietary II (OR 2.69, 95% CI 1.28, 5.68) and IL (OR 5.22, 95% CI 2.39, 11.38), as well as GL (OR 3.89, 95% CI 1.77, 8.56), was strongly associated with higher odds of overweight (both Pfor trend < 0.001). Furthermore, breakfast GL (OR 4.87, 95% CI 2.15, 11.01), II (OR 3.88, 95% CI 1.79, 8.39), IL (OR 4.93, 95% CI 2.20, 11.05) and dinner GL (OR 2.39, 95% CI 1.10, 5.20), II (OR 3.81, 95% CI 1.73, 8.41), IL (OR 3.63, 95% CI 1.67, 7.91) were found to be a significant independent predictor of overweight (all Pfor trend < 0.001) in pediatric population. CONCLUSION Our results suggest that dietary insulin demand, particularly for breakfast and dinner, was independently associated with overweight in children and adolescents. These findings may shed light on the relevance of considering meal insulin demand while developing dietary strategies in this population.
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Affiliation(s)
- Zeynep Caferoglu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Erciyes University, Melikgazi, 38039, Kayseri, Turkey.
| | - Busra Erdal
- Department of Nutrition and Dietetics, Institute of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Leyla Akin
- Department of Pediatric Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.,Department of Pediatric Endocrinology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Selim Kurtoglu
- Department of Pediatric Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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The association between food insulin index and odds of non-alcoholic fatty liver disease (NAFLD) in adults: a case-control study. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2021; 14:221-228. [PMID: 34221261 PMCID: PMC8245830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
AIM This research aimed to study the association of food insulin index and biochemical parameters with the odds of developing NAFLD in adult Iranians. BACKGROUND Hyperinsulinemia may play an important role in the development of non-alcoholic fatty liver disease (NAFLD) because of the relationship between insulin response and body fat accumulation. METHODS A case-control study of 169 NAFLD patients and 200 healthy adults aged 18-55 years was conducted. Dietary data was collected using a validated 168-item quantitative food frequency questionnaire (FFQ). Food insulin index (FII) was calculated by dividing the total insulin load by total energy intake (kcal/day). Total insulin load (ILoverall) was also calculated using a standard formula. RESULTS Mean participant age was 43.9 ± 5.9 years. Patients with NAFLD were significantly associated with higher body mass index, levels of liver enzymes, triglyceride, low density lipoprotein-cholesterol (LDL), total cholesterol, and fasting blood sugar (FBS) compared to the healthy subjects (p < 0.05). The highest tertiles of FII were associated with higher odds of NAFLD (OR=1.4, 95% CI: 0.88-2.48, p for trend <0.001) and obesity (OR=2.33, 95% CI: 0.97-5.75) compared to the lowest tertiles. Potential confounders for the association were controlled. CONCLUSION This study found that adherence to a diet with high FII was associated with greater odds of NAFLD and overweight or obesity. Additional studies are required to better understand this association.
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Dietary Insulin Index and Dietary Insulin Load in Relation to Metabolic Syndrome: The Shahedieh Cohort Study. J Acad Nutr Diet 2020; 120:1672-1686.e4. [DOI: 10.1016/j.jand.2020.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 03/10/2020] [Indexed: 12/14/2022]
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Yari Z, Behrouz V, Zand H, Pourvali K. New Insight into Diabetes Management: From Glycemic Index to Dietary Insulin Index. Curr Diabetes Rev 2020; 16:293-300. [PMID: 31203801 DOI: 10.2174/1573399815666190614122626] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/05/2019] [Accepted: 05/03/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite efforts to control hyperglycemia, diabetes management is still challenging. This may be due to focusing on reducing hyperglycemia and neglecting the importance of hyperinsulinemia; while insulin resistance and resultant hyperinsulinemia preceded diabetes onset and may contribute to disease pathogenesis. OBJECTIVE The present narrative review attempts to provide a new insight into the management of diabetes by exploring different aspects of glycemic index and dietary insulin index. RESULTS The current data available on this topic is limited and heterogeneous. Conventional diet therapy for diabetes management is based on reducing postprandial glycemia through carbohydrate counting, choosing foods with low-glycemic index and low-glycemic load. Since these indicators are only reliant on the carbohydrate content of foods and do not consider the effects of protein and fat on the stimulation of insulin secretion, they cannot provide a comprehensive approach to determine the insulin requirements. CONCLUSION Selecting foods based on carbohydrate counting, glycemic index or glycemic load are common guides to control glycemia in diabetic patients, but neglect the insulin response, thus leading to failure in diabetes management. Therefore, paying attention to insulinemic response along with glycemic response seems to be more effective in managing diabetes.
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Affiliation(s)
- Zahra Yari
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahideh Behrouz
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Zand
- Department of Cellular and Molecular Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Katayoun Pourvali
- Department of Cellular and Molecular Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Abstract
AbstractThe present study was carried out to determine whether the dietary insulin index (DII) and dietary insulin load (DIL) are related to psychological disorders in a cross-sectional study among adults. A total of 3172 Iranian adults (age range of 18–55 years) were included. Data on dietary intakes were collected using a validated dish-based 106-item semi-quantitative FFQ. DII and DIL were calculated using food insulin index values published earlier. To assess depression and anxiety, an Iranian validated version of the Hospital Anxiety and Depression Scale was used. Furthermore, psychological distress was examined using the General Health Questionnaire. Among women, a significant positive association was seen; such that women in the highest quartile of DIL had higher odds of depression than those in the lowest quartile (OR 1·84; 95 % CI 1·14, 2·96). In terms of DII, in the fully adjusted model, women in the top quartile of DII were more likely to be depressed compared with those in the bottom quartile (OR 1·65; 95 % CI 1·05, 2·58). In conclusion, we found a significant positive association between DIL and DII and odds of depression among women, but not in men. However, such findings were not seen for anxiety and psychological distress.
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Association between dietary insulin index and load with obesity in adults. Eur J Nutr 2019; 59:1563-1575. [PMID: 31147833 DOI: 10.1007/s00394-019-02012-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 05/23/2019] [Indexed: 01/16/2023]
Abstract
PURPOSE Hyperinsulinemia is linked to the development of various chronic diseases, especially obesity given to the role of insulin responses in body fat accumulation; hence, the current study aimed to examine the association of insulinemic potential of the diet with general and abdominal obesity among a large population of Iranian adults. METHODS This cross-sectional study was carried out among 8691 adult participants aged 18-55 years. Dietary data were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire. Dietary insulin index (DII) was computed through considering food insulin index values published earlier. Dietary insulin load (DIL) was also calculated using a standard formula. Assessment of anthropometric measures was conducted through a self-administered questionnaire. General obesity was defined as body mass index ≥ 25 kg/m2, and abdominal obesity as waist circumference ≥ 94 cm for men and ≥ 80 cm for women. RESULTS Mean age of study participants was 36.8 ± 8.1 years; 60.3% were women. Compared with the lowest quintile, women in the highest quintile of DIL were less likely to be abdominally obese (OR 0.73; 95% CI 0.57-0.92). Such significant association was not seen after controlling for potential confounders (OR 0.86; 95% CI 0.44-1.67). Neither in crude nor in adjusted models, we observed a significant association between DIL and general obesity among men and women. In terms of dietary insulin index, men in the top quintile of DII were more likely to be generally overweight or obese compared with those in the bottom quintile (OR 1.27; 95% CI 1.00-1.62). This association became non-significant after controlling for demographic characteristics (OR 1.14; 95% CI 0.84-1.56). Furthermore, in thefully adjusted model, women in the top quintile of DII were more likely to have general obesity compared with those in the bottom quintile (OR 1.40; 95% CI 1.07-1.84). CONCLUSIONS We found that adherence to a diet with a high DII was associated with greater odds of general obesity among women, but not in men. Although such information might help to draw conclusions on the practical relevance of the shown findings, further studies, specifically of prospective design, are warranted.
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