The Association Between Food Quality Score (FQS) and Metabolic Syndrome Risk Factors in Overweight and Obese Individuals: A Cross-Sectional Study

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.

MyKid'sNutrition mobile application trial: a randomized controlled trial to promote mothers' nutritional knowledge and nutritional status of preschool children with undernutrition-a study protocol

BACKGROUND

Childhood malnutrition is a crucial public health issue in developing countries. Mothers' nutritional knowledge significantly affects children's nutritional status. It also appears that mothers with low health literacy are unable to adequately meet their children's nutritional needs because they do not clearly understand their children's nutrition and malnutrition status.

METHODS

This randomized controlled trial aims to describe the development and study protocol of the MyKid'sNutrition application, a smartphone-based intervention for mothers of preschool (2-6 years old) children. The application contains several contents on children's healthy eating, childhood underweight, children's loss of appetite, and child growth assessment. As part of the MyKid'sNutrition trial, a total of 116 participants will be randomized 1:1 either to (a) treatment as usual and MyKid'sNutrition or (b) treatment as usual alone. The results of this trial will be based on changes in growth indicators and mothers' nutritional knowledge, attitude, and practice within the groups and the differences between them.

DISCUSSION

Due to their widespread availability throughout society, smartphones can be used to deliver educational content on a large scale at a low cost. In addition, they can provide novel ways for patients to receive support. Hence, it is essential to conduct research studies on these types of interventions. MyKid'sNutrition application offers dietary solutions for such nutritional problems as underweight, loss of appetite, and malnutrition in children. Meanwhile, it provides detailed instructions on how to interact with the child.

TRIAL REGISTRATION

IRCT.ir IRCT20140907019082N11. Registered on February 19, 2022.

The association between screen use and central obesity among children and adolescents: a systematic review and meta-analysis

Currently, there is no summative study evaluating the association between central obesity and screen time. This systematic review and meta-analysis aimed to summarize the results of studies evaluating the association between screen time and central obesity among children and adolescents. To this end, we performed a systematic search in three electronic databases, including Scopus, PubMed, and Embase to retrieve the related studies up to March 2021. Nine studies were eligible to be included in the meta-analysis. There was no association between odds of central obesity and screen time [odds ratio (OR) 1.136; 95% CI 0.965-1.337; P = 0.125]; however, waist circumference (WC) was 1.23 cm higher in those with highest screen time versus those in the lowest screen time category [weighted mean difference (WMD) = 1.23; 95% 95% CI 0.342-2.112; P = 0.007; Fig. 3]. Moreover, the possible sources of heterogeneity in the included studies were continent and sample size. No evidence of publication bias was reported. For the first time, the current systematic review and meta-analysis revealed that those with the highest screen time had higher WC compared with those with the lowest screen time. Although, there was no association between odds of central obesity and screen time. Due to the observational design of the included studies, it is impossible to infer the cause-effect relationship. Therefore, further interventional and longitudinal studies are warranted to better elucidate the causality of these associations.

Evaluating the association between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, mental health, and cardio-metabolic risk factors among individuals with obesity

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.

Adherence to lifelines diet score and risk factors of metabolic syndrome among overweight and obese adults: A cross-sectional study

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.

Preoperative anxiety among Iranian adult patients undergoing elective surgeries in educational hospitals

BACKGROUND

Although surgical techniques have been improving, preoperative anxiety is still a challenge in preoperative care and is known as an expected response experienced by patients waiting to undergo surgery. The present study aimed to compare preoperative anxiety levels in three educational hospitals in Kerman.

MATERIALS AND METHODS

This cross-sectional study was conducted in three educational hospitals in Kerman, Iran, from December 2017 to May 2018. The participants were 100 patients from each hospital (300 patients in sum) who were selected through the convenience sampling method. Sampling was not restricted to sex and type of surgery. The 40-item Spielberger State-Trait Anxiety Inventory was administered to the patients to assess the level of preoperative anxiety experienced by them. Bivariate linear regression models were used to compare the preoperative state anxiety levels based on the patients' demographic information. A multivariate linear regression model was used to determine the predictors of preoperative state anxiety.

RESULTS

The participants were 149 males and 151 females with a mean age of 36.38 (12.75) years (age range: 12-79 years). Almost two-third of the patients showed upper-middle symptoms of state anxiety (n = 197, 65.7%) followed by upper-middle symptoms of trait anxiety (40% and 49.3%, respectively). There was a significant relationship between the patient's sex and state anxiety (P = 0.05) and also between trait anxiety and state anxiety (P ≤ 0.001). It was shown that train anxiety could predict state anxiety before surgery (B: 0.53, 95% confidence interval: 0.44, 0.62; P ≤ 0.001).

CONCLUSION

The results of the present study confirmed the presence of preoperative anxiety in a sample of Iranian patients. Although the anxiety scores were not very high, organizing intervention and training programs to control and reduce preoperative anxiety among patients seems essential.