Evaluating the incidence of complications among people with diabetes according to age of onset: Findings from the UK Biobank.

AIMS: To examine the impact of current age, age at diagnosis, and duration of diabetes on the incidence rate of complications among people with type 2 diabetes. METHODS: Baseline data from 19,327 individuals with type 2 diabetes in the UK Biobank were analysed. Poisson regression was used to model incidence rates by current age, age at diagnosis, and duration of diabetes for the following outcomes: myocardial infarction (MI), heart failure (HF), stroke, end-stage kidney diseases (ESKD), chronic kidney diseases (CKD), liver diseases, depression, and anxiety. RESULTS: The mean age at baseline was 60.2 years, and median follow-up was 13.9 years. Diabetes duration was significantly longer among those with younger-onset type 2 diabetes (diagnosed at <40 years) compared to later-onset type 2 diabetes (diagnosed at ≥40 years), 16.2 and 5.3 years, respectively. Incidence rates of MI, HF, stroke, and CKD had strong positive associations with age and duration of diabetes, whereas incidence rates of ESKD liver diseases, and anxiety mainly depended on duration of diabetes. The incidence rates of depression showed minor variation by age and duration of diabetes and were highest among those diagnosed at earlier ages. No clear evidence of an effect of age of onset of diabetes on risk of complications was apparent after accounting for current age and duration of diabetes. CONCLUSIONS: Our study indicates age at diagnosis of diabetes does not significantly impact the incidence of complications, independently of the duration of diabetes. Instead, complications are primarily influenced by current age and diabetes duration.

The healthy/unhealthy dietary pattern is associated with resting metabolic rate status among women with overweight/obesity.

BACKGROUND: Although various dietary patterns have been indicated to be associated with the resting metabolic rate [RMR], limited data are available in this field. This study was therefore focused on the association between dietary patterns and resting metabolic rate among participants with overweight and obesity. METHODS: This cross-sectional study was conducted on 304 women with overweight or obesity (BMI ≥ 25 kg/m2), aged 18-50. Anthropometric assessments, physical activity and biochemical measurements were assessed. RMR was also measured by means of indirect calorimetry. Dietary intake of participants was evaluated by 147-item semi-quantitative food frequency questionnaire [FFQ]. RESULTS: There was a significant association between higher adherence to the healthy dietary pattern [HDP] and RMR (P = 0.05), intakes of protein (P = 0.003), minerals (P = 0.001) as well as fat free mass [FFM] (P = 0.002), bone mineral content (P = 0.001), skeletal muscle mass (P = 0.001), soft lean mass (P = 0.002) and visceral fat area (P = 0.05). Also, there was a considerable association between higher adherence to the unhealthy dietary pattern [UHDP] and fasting blood sugar [FBS] (P = 0.05). Using multinomial logistic regression has been shown that the medium adherence to the HDP was marginally significant with decreased resting metabolic rate [Dec. RMR] group in crude model (OR: 0.54; 95% CI: 0.28-1.05, P = 0.07). After controlling for various confounders such as age, FFM, physical activity, and energy intake, the association between Dec. RMR group and the lowest quartile of the HDP (OR: 0.36; 95% CI: 0.14-0.91, P = 0.03) became significant as well as the association between Dec. RMR group and medium adherence to the HDP (OR: 0.42; 95% CI: 0.18-0.97, P = 0.04). The medium adherence to the UHDP in crude model was also significant with increased resting metabolic rate [Inc. RMR] group (OR: 2.59; 95% CI: 1.01-6.65, P = 0.04). CONCLUSIONS: Our study showed that there are significant associations between dietary patterns and RMR status.

Adherence to Lifelines Diet Score (LLDS) is associated with better sleep quality in overweight and obese women.

PURPOSE: Previous studies have shown the connection between diet quality to sleep quality and weight status, although the relationship between Lifelines Diet Score (LLDS)-a fully food-based score that uses the 2015 Dutch Dietary Guidelines and underlying international literature-and sleep quality has not been evaluated in overweight and obese individuals yet. This observational study was conducted on overweight and obese adult females to assess the relationship between adherence to a LLDS pattern and sleep quality in Iran. METHODS: A cohort of 278 overweight and obese women aged above 18 years was enrolled and their dietary intake was assessed using a 147-item, semi-quantitative, validated food frequency questionnaire. Pittsburgh Sleep Quality Index (PSQI), a self-reported questionnaire including 19-items, was applied to estimate sleep quality among the target population. Diet quality indices (LLDS) were calculated using the P.C. Vinke, et al. method, based on the 2015 Dutch Dietary Guidelines and the underlying literature. RESULTS: Subjects in the highest LLDS tertile (those who had adhered closely to the food-based score) were older, compared to the lowest tertile (37.57 ± 7.77 versus 34.57 ± 9; p = 0.01). It was shown that about 25.5% of our subjects have poor quality sleep and 39% have better sleep quality which were mostly in the third tertile with greater LLDS. The parallel values in the first tertile were 29.9% and 46.8%, respectively (p = 0.02). Binary logistic regression was applied to evaluate the association between adherence of LLDS and sleep quality. The result has shown that the LLDS were correlated with lower risk poor sleep quality, wherein those who were in higher tertile (higher adherence to LLDS) had better sleep quality (odds ratio [OR]:0.586, 95% confidence interval [CI] (0.285-1.207), p = 0.009) and the result was not affected by adjusting for potential cofounders including age, education levels, and economic levels, sleep quality remained significantly associated with [OR]: 0.531, 95% confidence interval [CI] (0.248-1.138, p = 0.014). CONCLUSIONS: From this observational study, the higher LLDS can be related with better sleep quality in overweight and obese women. LEVEL OF EVIDENCE: Level IV, evidence obtained from multiple time series with or without the intervention, such as case studies.

Vitamin D Status and Resting Metabolic Rate May Modify through Expression of Vitamin D Receptor and Peroxisome Proliferator-Activated Receptor Gamma Coactivator-1 Alpha Gene in Overweight and Obese Adults.

BACKGROUND: Resting metabolic rate (RMR) used to prognosticate and measure the amount of energy required. Vitamin D is known as a new predictor of RMR. The aim of this study is to investigate the relationship between vitamin D effects on RMR in connection with the vitamin D receptor (VDR) and peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α) gene expression. METHODS: We enrolled 298 overweight and obese adults in this cross-sectional study. Body mass index (BMI), fat mass, fat-free mass, insulin level, visceral fat, and vitamin D status were assessed. RMR was measured by means of indirect calorimetry. The real-time polymerase chain reaction using specific primer pairs for VDR and PGC-1α was performed. RESULTS: There were significant differences in terms of fat free mass, fat percentage, insulin levels, RMR/kg body weight, and RMR/BMI, VDR, and PGC-1α among participants were categorized based on the vitamin D status. But after using general linear model for adjusting, all significant results missed their effectiveness except RMR/kg body weight and VDR. Linear regression analysis used to show the mediatory role of VDR and PGC-1α on the RMR/kg body weight and vitamin D status relationship. Our results showed that VDR had a mediatory effect on the relationship between RMR/kg body weight and vitamin D status (ß = 0.38, 95% CI -0.48 to 1.60; ß = -1.24, 95% CI -5.36 to 1.70). However, PGC-1α did not affect the relationship between RMR/kg body weight and vitamin D status (ß = 0.50, 95% CI = -0.02 to 3.42; ß = 0.59, 95% CI 0.14-3.90). CONCLUSION: Our study showed the mediatory effect of VDR gene expression in the association of 25(OH)2D plasma levels and resting metabolic rate among obese individuals.

Association of major dietary patterns with socioeconomic status, obesity, and contracting COVID-19 among Iranian adults.

Background: The coronavirus disease 2019 (COVID-19) pandemic clearly affected the lifestyle and dietary habits of millions of people worldwide. The purpose of this study was to evaluate the association of major dietary patterns with socioeconomic status, obesity, and contracting COVID-19. Methods: We conducted a cross-sectional study using an online survey for data collection with a total of 1,187 participants (over the age of 18 years) who reported their sociodemographic details, anthropometric index (weight and height), and dietary intake. Multivariable logistic regression models were applied to assess the association between major dietary patterns and study outcomes. Results: A total of 1,106 adults were included in the current analysis. We identified three major dietary patterns (plant-based, meat, and Western dietary patterns). The mean age of participants was significantly higher in the upper tertile of plant-based dietary patterns (DPs) compared to the first tertile, while it was lower in the top tertile of meat and Western DPs. The percentage of participants who lived in urban areas was significantly higher in the third tertile of meat DP than in the first tertile (p < 0.001). Moderate adherence to Western DP was significantly associated with increased odds of obesity (OR: 1.79; 95% CI: 1.17, 2.74). In addition, high adherence to Western DP was significantly related to increased odds of obesity after controlling for confounders. Subjects in the second tertile of the Western DP had higher odds (95% Cl: 1.04, 1.92) for COVID-19 infection than the first tertile. Conclusion: This study showed that moderate and high adherence to a Western dietary pattern was associated with a higher risk of obesity and COVID-19 infection during the pandemic. Future studies are needed to confirm these findings.

Algorithms to define diabetes type using data from administrative databases: A systematic review of the evidence.

AIMS: To find the best-performing algorithms to distinguish type 1 and type 2 diabetes in administrative data. METHODS: Embase and MEDLINE databases were searched from January 2000 until January 2023. Papers evaluating the performance of algorithms to define type 1 and type 2 diabetes by reporting diagnostic metrics against a range of reference standards were selected. Study quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies. RESULTS: Of the 24 studies meeting the eligibility criteria, 19 demonstrated a low risk of bias and low concerns about the applicability of the study population across all domains. Algorithms considering multiple diabetes diagnostic codes alone were sensitive and specific approaches to classify diabetes type (both metrics >92.1% for type 1 diabetes; >86.9% for type 2 diabetes). Among the top 10-performing algorithms to detect type 1 and type 2 diabetes, 70% and 100% featured multiple criteria, respectively. Information on insulin use was more sensitive and specific for detecting diabetes type than were criteria based on use of oral hypoglycaemic agents. CONCLUSIONS: Algorithms based on multiple diabetes diagnostic codes and insulin use are the most accurate approaches to distinguish type 1 from type 2 diabetes using administrative data. Approaches with more than one criterion may also increase sensitivity in distinguishing diabetes type.

Changes in dietary habits and weight status during the COVID-19 pandemic and its association with socioeconomic status among Iranians adults.

Background: COVID-19 pandemic has impacted human health through sudden lifestyle changes, including isolation at home, and social distancing. Therefore, the current study aimed to investigate the effect of the COVID-19 pandemic on eating habits, weight status, and their associations with socioeconomic status. Methods: This cross-sectional study was conducted using an online structured questionnaire that inquired demographic, anthropometric (reported weight and height); dietary habits (weekly intake of certain foods); and dietary supplement intake information. Results: A total of 1,187 participants completed the questionnaire, and after validation of the data, 1,106 respondents were included in the study, with a mean age of 34.5 ± 9.4 years. Our findings showed that the body mass index (BMI) of the participants significantly increased during COVID-19 (P < 0.001). Also, there were significant changes in the intake of a variety of food and beverage during the COVID-19, including less consumption of milk, yogurt, red meat, fish, canned fish, homemade fast foods, take out fast foods, carbonated drinks, and more consumption of whole bread, legumes (chickpeas, lentil, peas, kidney beans, black beans, pinto beans, and navy beans), soy bean, nuts, seeds, high vitamin C vegetables, high vitamin C fruits, green-yellow fruits and vegetables, onion/garlic, dried fruits, natural fruit juices, and water (P < 0.001; for all). It is informed that individuals consumed more vitamin and mineral supplements (P < 0.001). Also, before and during COVID-19 pandemic weekly intakes of dairy, red meat, poultry, high vitamin C fruits, and whole bread were positively associated with socioeconomic status (P < 0.001). Conclusion: Overall, this study indicates changes in body weight, dietary habits and supplement intake during the pandemic. Therefore, the findings of this study are valuable for, health professionals and politicians to better public health practice and policy making.

Improvement in Anthropometric Measurements of Malnourished Children by Means of Complementary Food and Nutritional Education in Fars Province, Iran: A Community-Based Intervention.

Background: Childhood malnutrition could have adverse impacts on the growth of child and eventually on fertility and general economic growth, and still, this issue remains a worldwide priority and a concern. This study aimed to evaluate the effectiveness of the national nutritional interventions program on the improvement and nutritional status of malnourished children children aged 6-59 months. Methods: This community-based intervention study was conducted with 1288 acute and moderately malnourished children aged 6-59 months referred to health centers. Children received combined nutritional education and counseling with the provision of affordable complementary food for 10 months. Anthropometric measurements were assessed monthly according to the standard protocols. Results: Our results showed the reduction in the risk of malnutrition among children after nutritional interventions for weight-for-height (WHZ) (P < 0.001), height-for-age (HAZ) (P < 0.001), and weight-for-age (WAZ) (P = 0.008). Total malnourished children indicated improvement in HAZ (<-3 SD: OR = 1.10, P = 0.026), WAZ (<-2SD: OR = 1.21, P < 0.001; <-3SD: OR = 1.60, P < 0.001), and WHZ (<-3SD: OR = 1.10, P = 0.030). Controlling potential confounders (socioeconomic status, childrens' birth supine length, and weight) showed a significant amelioration in HAZ (<-2 SD: OR = 6.20, P = 0.020; <-3 SD: OR = 9, P = 0.003) and WAZ (<-2 SD: OR = 5.85, P = 0.010; <-3 SD: OR = 7.50, P = 0.004). In urban areas, significant amelioration was observed in HAZ (<-3 SD: OR = 1.22, P = 0.010) and WAZ (<-2 SD: OR = 1.24, P = 0.003; <-3 SD: OR = 1.64, P < 0.001). In rural, considerable amelioration was observed in WAZ (<-2 SD: OR = 1.20, P = 0.010; <-3 SD: OR = 1.50, P < 0.001) and WHZ (<-3 SD: OR = 1.20, P = 0.020). Conclusion: Nutritional training and counseling as well as complementary food intervention among the malnourished children significantly improved the nutritional status of children. So community-based intervention is recommended to reduce the malnutrition among children.

The Association Between Low Carbohydrate Diet and Resting Metabolic Rate in Overweight and Obese Women: A Cross-Sectional Study.

Resting metabolic rate (RMR) accounts for most daily energy expenditure. The low carbohydrate diet (LCD) attenuates decreases in RMR. This study aims to investigate the relationship between an LCD and RMR status among overweight and obese women. We enrolled 291 overweight and obese women in this cross-sectional study. Body mass index (BMI), fat mass, fat-free mass, visceral fat, and insulin level were assessed. RMR was measured using indirect calorimetry. LCD score (LCDS) was measured using a validated semi-quantitative food frequency questionnaire. Analysis of variance, independent sample t-test, and Multinomial logistic regression tests were used. Results showed no relationship between LCDS and deviation of normal RMR (DNR) even after adjust for confounders (increased [Inc.] RMR: odds ratio [OR], 0.97; 95% confidence interval [CI], 0.92-1.01; p = 0.20; decreased [Dec.] RMR: OR, 0.97; 95% CI, 0.94-1.00; p = 0.14). Some components of LCDS had no significant association with DNR, such as carbohydrate and Dec. RMR in adjusted model (OR, 1.62; 95% CI, 0.98-1.37; p = 0.08) and monounsaturated fatty acids and Dec. RMR in adjusted model (OR, 0.48; 95% CI, 0.21-1.10, p = 0.08). However, refined grains had a significant association with Inc. RMR in crude model (OR, 0.87; 95% CI, 0.77-0.99, p = 0.04). There is no association between LCDS and RMR status.

The association between deficiency of nutrient intake and resting metabolic rate in overweight and obese women: a cross-sectional study.

OBJECTIVE: The double burden of malnutrition is an emerging public health concern nowadays which a correlation with obesity. This study aimed to examine the relationship between resting metabolic rate (RMR) and dietary intake of zinc, vitamin C, and riboflavin in overweight and obese women. RESULTS: The RMR/FFM showed a significant association with riboflavin (ß = 1.59; 95% CI 1.04-23.26, P = 0.04) and zinc (ß = 0.78; 95% CI 1.04-4.61, P = 0.03) in the crude model. Moreover, differences in vitamin C and RMR/FFM was marginal significant (ß = 0.75; 95% CI 0.95-4.77, P = 0.06). After adjusting for confounders the riboflavin association change to marginal significance (ß = 1.52; 95% CI 0.91-23.04, P = 0.06). After controlling for potential confounders, the associations change between zinc and RMR/FFM (ß = 0.66; 95% CI 0.78-4.86, P = 0.15) and between RMR/FFM and vitamin C (ß = 0.48; 95% CI 0.66-3.96, P = 0.28). Our study showed a significant association between dietary intake of zinc, riboflavin, and vitamin C and change in RMR/FFM in overweight and obese women.

Does Interaction between Sleep Quality and Major Dietary Patterns Predicts Depression among Overweight and Obese Women in Iran?

BACKGROUND: Although major dietary patterns and sleep quality independently affect psychiatric disorders, their interactive association on depression is not clear. This study assesses the independent association of dietary patterns and sleep quality on depression, and also investigates their interactive associations on depression among overweight and obese women in Iran. METHODS: Cross-sectional study was conducted among 304 participants, age 18 and above in 2018 at Tehran Iran. Usual dietary intake was collected with 174-FFQ. Participants' biochemical parameters and depression were measured using standard protocol. Major dietary patterns were extracted by factor analysis and grouped into Fruits&Vegetable group (healthy dietary pattern), High Fat diary&Red Meat group (unhealthy dietary pattern) and Crackers&High Energy Drinks group (western dietary patterns). RESULTS: After adjusting for confounders poor sleep was associated with moderate and high depression; AOR (95%CI): 0.41(0.19-0.90) and 0.29(0.13-0.60) respectively. However, healthy dietary patterns (tertiles 2nd and 3rd) interact with sleep for depression; AOR (95%CI): 4.168(1.166-14.992) and 2.966(1.068-8.234) respectively. Unhealthy dietary pattern tertiles 2nd and 3rd interact with sleep for depression; AOR (95%CI): 2.925(1.055-8.113) and 4.216(1.182-15.042) respectively and Western dietary pattern tertile 3rd interacts with sleep for depression; AOR (95%CI): 4.264(1.494-12.169). CONCLUSION: Sleep deprivation could be associated with depression. However, sleep quality could interacts with dietary patterns to be associate with depression among overweight and obese people.

Principal component analysis of adipocytokines and insulin associate with risk factors of cardiovascular diseases.

OBJECTIVES: Obesity plays an important role in the development of chronic diseases like cardiovascular diseases and diabetes. The possible underlying mechanism for this connection is that adipose tissue secretes an array of chemical messenger adipokines proinflammatory cytokines (tumor necrosis factor-alpha, interleukin-6, and interleukin-1-beta). This study aimed to investigate the linkage between adipocytokines and insulin with the cardiovascular disease risk, with particular reference to the adipokines galectin-3, plasminogen activator inhibitor-1, and interleukin-1-beta, C-reactive protein, and monocyte chemoattractant protein. RESULT: Two patterns were identified. The first pattern was galectin-3, plasminogen activator inhibitor-1 and interleukin-1-beta and the second one was C-reactive protein, insulin and monocyte chemoattractant protein-1. The second pattern was strongly associated with the higher scores for resting metabolic rate, diastolic blood pressure, homeostasis model insulin resistance index, lipid profile (except low density lipoprotein, total cholesterol), and body composition parameters (except fat free mass index and waist hip ratio), while negatively associated with age and high density lipoprotein level (all p < 0.05). The first pattern was, however, significantly associated with body fat mass, obesity degree percentage, waist circumference, fat mass index, and waist hip ratio (p < 0.05 for all). This is a retrospective study. Ethics approval (IR.TUMS.VCR.REC.1395.1597).

Associations of dietary inflammatory index, serum levels of MCP-1 and body composition in Iranian overweight and obese women: a cross-sectional study.

OBJECTIVE: Although, several studies have illustrated that there is a relation between dietary inflammatory index (DII) with obesity-related parameters, and inflammation, their results were controversial. This study aimed to investigate this relationship among Iranian women. RESULTS: Multivariable linear regression showed that fat mass was 0.14 kg lower in the anti-inflammatory diet group, with respect to the pro-inflammatory group, after adjusting covariates such as age, physical activity, economic and job status (ß = - 0.142, 95% CI - 4.44, - 1.71, P = 0.03). Fat-free mass (FFM) was 1.5 kg more in the anti-inflammatory diet group, compared to the pro-inflammatory diet group, after adjusting for potentials cofounders (ß = 1.50, 95% CI 0, 3.01, p = 0.05). Furthermore, after adjusting for potentials cofounders, it was revealed that the subjects with lower DII had lower monocyte chemoattractant protein-1 (MCP-1) levels in serum (ß = - 18.81, 95% CI - 35.84, - 1.79, p = 0.03). These findings suggest an inverse and significant relationship between DII and FFM and also DII is directly related to Fat mass and the level of MCP-1. This finding can be used for developing interventions that aim to promote healthy eating to prevent inflammation and non-communicable disease development among obese females.

The association of glycemic index and glycemic load with elevated blood pressure in Iranian women.

Introduction: Dietary intake is a risk factor related to elevated blood pressure (EBP). Few studies have investigated an association of dietary glycemic index (GI) and glycemic load (GL) with the EBP. The aim of the current study was to examine the association of dietary GI and GL with the EBP among a group of healthy women. Methods: This population-based cross-sectional study was conducted on 306 healthy women. Dietary GI and GL were measured using a validated semi-quantitative food frequency questionnaire (FFQ). Blood pressure (BP) was measured twice by a mercury sphygmomanometer from the right arm. Anthropometric measurements were also assessed according to the standard protocols. Results: Before controlling for potential confounders, no significant association was seen between dietary GI/GL and SBP/DBP. Also after controlling for potential confounders, the associations did not change between dietary GI and SBP (odds ratio [OR]: 0.96; 95% CI: 0.42-2.17, P = 0.87), between GI and DBP (OR: 0.72; 95% CI: 0.35-1.45, P = 0.37), as well as between GL and SBP (OR: 1.04; 95% CI: 0.43-2.49, P = 1.00) and between GL and DBP (OR: 1.20; 95% CI: 0.56-2.00, P = 0.61). In a stratified analysis by obesity and overweight, differences between tertiles of GI were not significant (OR: 0.75; 95% CI: 0.42-1.31, P = 0.31), even after adjustment for the potential confounders (OR: 1.54; 95% CI: 0.70-3.40, P = 0.26). Conclusion: This study did not show a significant association between dietary GI/GL and the risk of high SBP/DBP. In addition, no significant association was found between dietary GI/GL and odds of overweight or obesity in adult women.

The association between total antioxidant capacity and resting metabolic rate (RMR) / respiratory quotient (RQ) in overweight and obese woman.

OBJECTIVE: The effect of total antioxidant capacity on resting metabolic rate (RMR) and respiratory quotient (RQ) of overweight and obese woman has been debated globally. Total Antioxidant Capacity may have an independent effect on resting metabolic rate and respiratory quotient. METHODS AND MATERIALS: A study population of 263 aged 18-50 years participated in this cross-sectional study from the communities of Tehran based on cluster sampling. Dietary intake assessed by using a semi quantitative food frequency questionnaire (FFQ) Demographic questions. Anthropometrics measurements for each participant were done. Dietary total antioxidant capacity (DTAC) was calculated by the 147-item food frequency questionnaire (FFQ) and FRAP assay. Resting metabolic rate and respiratory quotient was measured by Indirect calorimetry. RESULTS: The mean DTAC of the study participants was 1251.8 (SD 893.60). There was a statistically significant relationship between dietary total antioxidant capacity (DTAC) and respiratory quotient (P > 0.013). People with high dietary total antioxidant capacity have tended to show a lower RQ than those with a lower one. There was a significant correlation between DTAC and RQ for both the adjusted model for age, total energy intake, BMI, physical activity, higher DTAC diet and the crude model which were (ß = 0.011; SE = 0.005; CI = -0.021_0) and (ß = -3.143E-6; SE = 0; CI = 0), respectively. However, we found no correlation between the DTAC and RMR/FFM-RES (P < 0.49). Also, a significantly higher relationship was demonstrated between dietary total antioxidant capacity and intake vegetables (P ≤ 0.006), fruits (P ≤ 0.009), white meet (P ≤ 0.03) and dairy products (P ≤ 0.005). CONCLUSION: RQ is correlated with total antioxidant capacity. Increased intake of high DTAC foods may result in weight loss maintenance. This result may suggest a beneficial role of higher-DTAC diets in the prevention of obesity.

Relations of major dietary patterns and metabolically unhealthy overweight/obesity phenotypes among Iranian women.

OBJECTIVE: No studies have examined the contribution of major dietary patterns to MUH phenotypes in obese and overweight people based on Karelis criteria. This study was conducted to evaluate the association of major dietary patterns with MUHOW/O and MHOW/O phenotypes. METHODS: This cross-sectional study was conducted on 290 overweight and obese women aged 18-50 (BMI≥25 kg/m2). Anthropometric measurements were assessed in all participants. The MH phenotype was defined according to the Karelis criteria. Major dietary patterns were determined using factor analysis of 21 foods groups using a valid and reliable FFQ containing 147 items. Participants' body composition was assessed by BIA. Serum HDL, LDL, TG, insulin, and hs-CRP levels were quantified by ELISA. RESULTS: By the use of factor analysis, 3 major dietary patterns were extracted: healthy dietary pattern (HDP), western dietary pattern (WDP) and unhealthy dietary pattern (UNHDP). Binary logistic analysis showed that participants in the in the upper category of WDP had greater odds of MUH phenotype (OR = 2.33, 95%CI = 1.11-4.91, P = 0.02), after confounder factor control. Individuals with high adherence to the UNHDP score had high odds of MUH phenotype (OR = 1.75, 95%CI = 0.98-3.10, P = 0.05), after adjustment for BMI, age, and total EI, compared to those with low adherence. A positive relation was observed between WDP and levels of hs-CRP, HOMA-IR (OR = 1.94, 95%CI = 0.91-4.10, P = 0.05 and OR = 2.53, 95%CI = 1.26-5.11, P = 0.009) as well as a positive association between UHDP and plasma level of LDL (OR = 1.90, 95%CI = 1.04-3.47, P = 0.03), but an inverse association between HDP and hs-CRP level (OR = 0.56, 95%CI = 0.29-0.92, P = 0.03). CONCLUSIONS: The present evidence indicates various significant associations among major dietary patterns and MUHOW/O phenotypes.