The association between dietary inflammatory index, muscle strength, muscle endurance, and body composition in Iranian adults.

PURPOSE: Dietary factors may modulate inflammation status which contributed to the various chronic diseases like sarcopenia. Therefore, we aimed to examine the association of dietary inflammatory index (DII) and muscle strength (MS), muscle endurance (ME), and body composition. METHODS: This cross-sectional study was conducted in 270 adults living in Tehran, Iran. The DII was calculated using a validated food frequency questionnaire. Body composition (fat-free mass (FFM), fat mass (FM), percent body fat (PBF), skeletal muscle mass (SMM)) was measured using body composition analyzer. Anthropometric measures (weight, body mass index (BMI), waist circumference (WC)), were done. MS was measured by a digital handgrip dynamometer in both right (MSR) and left (MSL) hand. Mean of MSR and MSL was considered as MS. RESULTS: A significant decrease was found for MS (p < 0.01) and MSR (p < 0.01) across tertiles of DII. Participants who had greater scores of DII also had lower MER (p < 0.01), even after adjustment for confounding factors (age, sex, education status, income, smoking, physical activity, body mass index and energy intake) (p < 0.02). Adherence to DII was significantly related to MSL (p < 0.01), ME (p < 0.01), and ME of the MEL (p = 0.02) in the crude model, which was disappeared after controlling for covariates. Those in the third compared to the lowest tertile of DII, had no significant difference in mean of FFM (p < 0.001), SMM (p < 0.001), and WC (p < 0.001). CONCLUSIONS: Higher DII scores were associated with less muscle strength and endurance among Iranian adults. Further studies are needed to confirm the veracity of our results. LEVEL OF EVIDENCE: Descriptive cross-sectional study, Level V.

Interaction between major dietary patterns and cardiorespiratory fitness on metabolic syndrome in Iranian adults: a cross-sectional study.

BACKGROUND: Several researches have been conducted on the associations between diet and cardiorespiratory fitness (CRF) and major cardiovascular risk factors. However, there is no report about the interaction between major dietary patterns and CRF on metabolic syndrome (MetS) and its components. To investigate the combined association of major dietary patterns and CRF on MetS and its components. METHODS: This cross-sectional study was conducted on 270 apparently healthy adults living in Tehran, Iran. Dietary intake was evaluated using a validated food frequency questionnaire (FFQ). CRF was assessed using a graded exercise treadmill test. Socio-economic status, anthropometric measures, biochemical parameters, and blood pressure were evaluated according to standard methods. Major dietary patterns were identified by factor analysis. RESULTS: Three major identified dietary patterns were (healthy, mixed, and western). Significant positive association was found between mixed dietary pattern and metabolic syndrome (OR = 2.68, 95% CI (1.92,7.78), P = 0.04). There were not relations between tertiles of identified dietary patterns and remained outcomes. Those who had higher adherence to mixed pattern with also higher CRF showed a significant decrease for diastolic blood pressure (P < 0.01). Also we found that there was no significant interaction between any of dietary patterns and CRF on odds of MetS. CONCLUSIONS: Overall, adherence to mixed dietary pattern in this population was associated with increasing odds of MetS. However, nor CRF neither the combination of dietary patterns and CRF was related to the odds of MetS among Iranian adults. More studies are needed to clarify these associations and to consider interpersonal determinants.

The lack of association between dietary antioxidant quality score with handgrip strength and handgrip endurance amongst Tehranian adults: A cross-sectional study from a Middle East country.

OBJECTIVE: The association between dietary antioxidant quality score (DAQS) and handgrip strength (HS) and handgrip endurance (HE) is still unclear. We aimed to investigate whether adherence to dietary antioxidant quality score (DAQS) is associated with handgrip strength (HS) and handgrip endurance (HE) amongst adults in Tehran. METHODS: This cross-sectional study was conducted on 270 (43.7% males, mean age 37 years and 56.3% females, mean age 35 years) apparently healthy adult subjects (53.2% were married) selected from different parts of Tehran, Iran. Dietary intake was assessed using a 168-item validated food frequency questionnaire. DAQS was calculated using antioxidant-nutrient intake. Body composition was measured using a body composition analyser. Handgrip strength and endurance were measured by a digital handgrip dynamometer. Relative muscle strength was expressed as the ratio of handgrip strength by body mass index (BMI). RESULTS: The results showed that DAQs had no significant association with HS (P = .67, adjusted R2  = .60) and HE (P = .19, adjusted R2  = .08) after adjusting for potential confounders. However, a significant positive association was found between selenium intake and HE even after adjusting for potential confounders (P = .01, adjusted R2  = .10). After controlling for potential confounders no differences in the mean of HS (P = .29) and also HE (P = .61) amongst tertiles of DAQS was found. Positive linear association was found between vitamin C (P = .02, adjusted R2  = .53) and vitamin E (P = .03, adjusted R2  = .55) intake with relative muscle strength. CONCLUSION: Our results revealed that no significant association between DAQS and HE and HS. It was found that more intake of selenium was positively linked to HE. Dietary intake of vitamin C and vitamin E are associated with higher relative muscle strength. It is evident that more prospective studies are needed to confirm the veracity of our results.

Major dietary patterns and predicted cardiovascular disease risk in an Iranian adult population.

BACKGROUND: Limited data are available on the association of major dietary patterns and predicted risk of cardiovascular disease (CVD) using the Framingham Risk Score (FRS). AIM: To investigate the association between major dietary patterns and the predicted 10-year CVD risk in an Iranian population. METHODS: This cross-sectional study was conducted on 522 apparently healthy adults referred to health centers in Tehran. Usual dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. The association between dietary patterns and the predicted risk of development of CVD was evaluated using linear multiple regression. Principal component analysis was used to identify major dietary patterns. RESULTS: In total, 41% of the men (n = 95) and 46% of women (n = 134) were in the low risk (<10%) and 6% of men (n = 14) and 1% of women (n = 3) were in the high risk (> 20%) category of the FRS. A significant decrease was found for body mass index (p < 0.001), systolic blood pressure (SBP) (p = 0.003), diastolic blood pressure (p = 0.005), and triglyceride (p = 0.02) in the higher tertile of healthy dietary pattern. Adherence to an unhealthy dietary pattern was associated with a significant increase in body weight (p = 0.03) and a significant decrease in high-density lipoprotein cholesterol (p < 0.001). The healthy dietary pattern score was negatively associated with SBP (p = 0.04) and FRS (p < 0.001). CONCLUSION: Although we observed improvements in CVD risk factors with greater adherence to healthy dietary patterns, there was no association between identified dietary patterns and the predicted risk of 10-year CVD.

The combined association of dietary inflammatory index and resting metabolic rate on cardiorespiratory fitness in adults.

BACKGROUND: No study has examined the combined association of dietary inflammatory index (DII) of the diet and resting metabolic rate (RMR) on cardiorespiratory fitness (CRF). Therefore, we investigated the combined association between DII and RMR on CRF. METHODS: This cross-sectional study was conducted on 270 adult subjects. The DII was calculated using a validated semi-quantified food frequency questionnaire. RMR was measured using an indirect calorimetric method. Socioeconomic status, anthropometric measures, body composition and blood pressure were documented by a trained interviewer. CRF was assessed by using Bruce protocol. Binary logistic regression was performed to find the association of CRF with DII/RMR categories in various models. RESULTS: The participants categorized into four groups including: (1) low DII/high RMR, (2) low DII/low RMR, (3) high DII/low RMR, (4) high DII/high RMR. The mean of VO2Max (mL/kg/min), VO2max (L/min) and VO2max relative to lean body mass (LBM) was lower in participants that were classified as high DII/low RMR compared to those in low DII/high RMR. After controlling for age, sex, education status, smoking status, and physical activity those who were in the high DII/low RMR group, compared to the low DII/high RMR group were 28% less likely to have higher VO2max (ml/kg/min) (OR 0.72; 95% CI 0.18, 0.82, p = 0.04). Moreover, had 25% lower odds of VO2max (L/min) which was significant (OR 0.75, 95% CI 0.11, 0.89, p = 0.03). In addition, were 21% less likely to have higher VO2max (LBM) (OR 0.79; 95% CI 0.30, 0.92, p = 0.02). CONCLUSIONS: Overall, consumption of a pro-inflammatory diet in combination with low RMR status is associated with lower odds of CRF compared to those who had anti-inflammatory diet in combination with high RMR status among Iranian healthy adults. This study suggests that researchers should focus on combined relationships rather than single pair-wise associations for having a better judgment.

Interaction of dietary acid load and general and central obesity with muscle strength and skeletal muscle mass.

BACKGROUND: We aimed to examine the combined association of dietary acid load and obesity with muscle strength. METHODS: This cross-sectional study was conducted on 270 adults (118 men and 152 women), aged 18-70 y. Dietary data were collected using a validated 168-item semi-quantitative food frequency questionnaire. Potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL) were calculated. General obesity was defined as a body mass index (BMI) ≥30 kg/m2 and abdominal obesity was defined as a waist circumference (WC) ≥102 cm for men and ≥88 cm for women. Muscle strength was measured by a digital handgrip dynamometer. RESULTS: The mean of muscle strength was higher in participants classified as high-PRAL/BMI≥30 (P = 0.01), high-PRAL/WC < 102 (men) or 88 (women) (P = 0.002), high-NEAP/BMI≥30 (P = 0.002), high-NEAP/WC < 102 (men) or 88 (women) (P < 0.001) and also high-DAL/BMI≥30 (P = 0.01) and high-DAL/WC < 102 (men) or 88 (women) (P = 0.001) compare to other classifications in the crude model. Both for obese and non-obese people PRAL, NEAP, and DAL were associated with higher muscle strength, which is opposite to the acid hypothesis. These associations were not significant after adjustment for confounders. Also, the mean of skeletal muscle mass was higher in participants that were classified as high-PRAL/BMI≥30 and high-PRAL/WC < 102 (men)-or-88 (women), high-NEAP/BMI≥30, and high-NEAP/WC < 102 (men)-or-88 (women), high-DAL/BMI≥30 and high-DAL/WC < 102 (men)-or-88 (women) (Ptrend<0.001 for all). These significant associations remained significant after controlling for confounders. CONCLUSIONS: We found that the interaction of dietary acid load and general and central obesity could be associated with skeletal muscle mass but not muscle strength. All findings of association indicated higher muscle strength and skeletal muscle mass with higher acid diet measures, contrary to the acid hypothesis.

The association between dietary antioxidant quality score with metabolic syndrome and its components in Iranian adults: A cross-sectional study.

We aimed to investigate whether adherence to dietary antioxidant quality score (DAQS) is associated with metabolic syndrome (MetS) among the Tehranian population. This cross-sectional study was conducted on 270 apparently healthy adults aged between 18 and 45 years old who lived in Tehran, Iran, between February 2017 and December 2018. Participants were categorized based on tertile cut-off points of DAQs. To examine the association between DAQS and MetS and its components, we used multivariable logistic regression analysis in different models. Adherence to DAQS was associated with a significant increase for intake of vitamin B6 (P-value = 0.02), riboflavin (P-value < 0.001), folate (P-value = 0.03), selenium (P-value = 0.03), vitamin D (P-value < 0.001), and calcium (P-value < 0.001). Adherence to DAQS showed a significant decrease for odds of systolic blood pressure (SBP) (OR: 0.17, 95% CI: 0.04, 0.65, P-value = 0.03). We also found that the overall adherence to DAQS was not significantly related to MetS and its other components. In conclusion, although we observed an improvement in SBP with a greater adherence to dietary antioxidant quality score, there was no association between DAQS and metabolic syndrome and its other components.

Higher health literacy score is associated with better healthy eating index in Iranian adults.

OBJECTIVE: Although there is some evidence for the importance of health literacy (HL), many health complications and nutrition knowledges such as portion size assessment, knowing the food labels, and choosing the nutrition sources affecting diet quality, data about HL and healthy eating index (HEI) are limited and controversial. The aim of this study was to evaluate the associations between HL and HEI in adults. METHODS: This cross-sectional study included 261 adults 18 to 65 y of age from five districts of Tehran, Iran. HL was estimated using the Health Literacy for Iranian Adult (HELIA) questionnaire. Dietary intake, sociodemographic data, physical activity, and anthropometric measurements were collected using validated questionnaires. Diet quality was assessed based on HEI-2015 scores using data from a food frequency questionnaire. RESULTS: Despite components of HEI-2015, the association between HEI-2015 and HL tertiles was significant (P of crude model = 0.007) even after adjustment for possible confounders. Multivariate regression showed a positive relationship between HL and HEI-2015 that was significant before (ß = 0.12, P = 0.04) and after controlling for the confounding effect in model 1 (ß = 0.14, P = 0.03). Additionally, a positive association between physical activity and HL was shown (ß = 0.12, P = 0.03) and finally among the HEI components, only saturated fats were significantly related to HL (ß = -0.11, P = 0.01). CONCLUSION: Findings from the present study confirmed a considerable association between HL and HEI and shows HL levels have an important role in adherence to the Iranian Dietary Guidelines.

Association of Nutrient Patterns and Their Relation with Obesity in Iranian Adults: a Population Based Study.

In the present research, we have evaluated the association between patterns of nutrient intake and obesity. The present cross-sectional study recruited 850 adults aged between 20-59 years old. Dietary intakes were assessed with three 24-hour recalls. As well, data on anthropometric measures were collected. General obesity was specified as body mass index ≥ 30 kg/m2. Factor analysis was conducted, and followed by a varimax rotation, was performed to extract major nutrient patterns. Our analysis identified three major nutrient patterns: The first nutrient pattern was characterized by the high consumption of saturated fatty acids (SFAs), protein, vitamins B1, B2, B6, B5, B3, B12, Zinc, and iron. The second nutrient pattern was rich in total fat, polyunsaturated fatty acids, monounsaturated fatty acids, SFAs, oleic acid, linolenic acid, zinc, vitamin E, α-tocopherol, and ß-carotene. The third one was greatly loaded with protein, carbohydrate, potassium, magnesium, phosphorus, calcium, vitamin C, and folate. Women in the third quintile of the first pattern were less likely to be generally obese in the fully adjusted model (odds ratio, 0.44; 95% confidence interval, 0.25-0.75). None of the other nutrient patterns had a significant association with obesity, even after adjusting for confounders. Adherence to a nutrient pattern rich in water-soluble vitamins was significantly associated with a greater chance of general obesity among women. Further studies in other populations, along with future prospective studies, are required to confirm these findings.

The effects of hesperidin supplementation or orange juice consumption on anthropometric measures in adults: A meta-analysis of randomized controlled clinical trials.

BACKGROUND: The current evidence-base regarding the effect of hesperidin (a flavanone found in citrus fruits) on body composition is equivocal. OBJECTIVE: We conducted a meta-analysis on the effect of orange juice and/or hesperidin supplementation on anthropometric measures in randomized controlled trials (RCTs). MATERIALS AND METHODS: A systematic search of PubMed and Scopus was performed up to February 2020. The overall estimates and their 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS: Eleven eligible RCTs, with 512 individuals, were included in this study. The meta-analysis showed that orange juice and/or hesperidin had no significant effect on body weight [weighted mean difference (WMD) = -0.31 kg; 95% CI, -1.44 to 0.82, P = 0.592], body mass index [WMD = 0.11 kg/m2; 95% CI, -0.33 to 0.56, P = 0.617], fat mass [WMD = 0.14 kg; 95% CI, -0.95 to 1.22, P = 0.807], percentage body fat [WMD = -0.70%; 95% CI, -2.58 to 1.18, P = 0.463] and waist circumference [WMD = 0.07 cm; 95% CI, -1.16 to 1.30, P = 0.588]. CONCLUSION: The present study revealed that there is no significant beneficial effect of orange juice and/or hesperidin supplementation on anthropometric measures. The authors advocate that more high-quality clinical trials are needed to better discern the potential efficacy of orange juice and/or hesperidin.

Administration of dietary antioxidants for patients with inflammatory bowel disease: A systematic review and meta-analysis of randomized controlled clinical trials.

OBJECTIVE: Accumulating evidence has been reported regarding the effect of dietary antioxidants on clinical variables in IBD patients, however, findings are controversial. This systematic review and meta-analysis aimed to investigate effect of dietary antioxidants on clinical variables in patients with IBD or its subtypes. METHODS: We searched PubMed, Scopus, and ISI Web of Science from inception to January 2021 using relevant keywords. Data were pooled by using the random-effect model. All statistical analyses were done using STATA version 14. RESULTS: Our meta-analysis was exclusively done on studies about the effect of curcumin on IBD patients, because limited studies were done on other antioxidants. Curcumin administration resulted in significant increment of clinical remission in patients with IBD (SMD: 0.86%, 95% CI: 0.16, 1.56, p = 0.016), significant remission in clinical symptoms (SMD: -0.96 score, 95% CI: -1.34, -0.57, p < 0.001), and significant increment in endoscopic remission in IBD patients (SMD: 0.51%, 95% CI: 0.16, 0.85, p = 0.004), comparing to control group. Curcumin supplementation also made better clinical response than control group (SMD: 0.74%, 95% CI: 0.22, 1.26, p = 0.005) and also resulted in significant improvement in quality of life of patients with IBD, as compared to control group (SMD: 1.23 score, 95% CI: 0.72, 1.74, p < 0.001). CONCLUSIONS: Our meta-analysis showed that curcumin significantly improved clinical and endoscopic remissions in IBD patients. This supplementation also caused significant reduction in clinical symptoms of IBD patients along with better clinical response and the increased quality of life. Further researches with larger sample size and longer period of intervention are required to evaluate efficacy of dietary antioxidants on clinical variables in patients with IBD.

The association of plant-based dietary patterns with visceral adiposity, lipid accumulation product, and triglyceride-glucose index in Iranian adults.

BACKGROUND: We sought to investigate whether adherence to a more plant-based, and less animal-based, diet is associated with visceral adiposity, lipid accumulation product (LAP), and triglyceride-glucose index (TyG) in Iranian adults. METHODS: This cross-sectional study was conducted on 270 adults aged between 18-75 years old. We created three plant-based diets. including an overall plant-based diet index (PDI), hPDI, and uPDI based on tertiles regarding the intake of animal- or plant-based food items obtained from a semi quantitative food-frequency questionnaire. RESULTS: Higher hPDI was significantly associated with lower body mass index (BMI) (P-value = 0.01), lower waist circumference (P-value<0.001), and lower waist-hip ratio (P-value<0.001). A significant increase was found for high density lipoproteins (HDL) (P-trend <0.001) with a significant decrease for LAP (P-value = 0.03) in those with higher adherence to hPDI. Moreover, greater adherence to PDI was associated with a significant increase in diastolic blood pressure (DBP) (p-value = 0.01) and fat free mass (FFM) (p-value = 0.01). There were no significant associations between PDIs and TyG and VFA. CONCLUSION: We found that a higher hPDI score was significantly associated with better anthropometric measurements. A significant increase was found for HDL and a significant decrease was found for LAP on hPDI. However, a higher PDI score was significantly associated with higher DBP and higher FFM.

The Association between Dietary Antioxidant Quality Score and Cardiorespiratory Fitness in Iranian Adults: a Cross-Sectional Study.

The association between dietary antioxidant quality score (DAQS) and cardiovascular risk factors such as low cardiovascular fitness (CRF) and elevated blood pressure (BP) has rarely been investigated. To investigate the association between DAQS, CRF, and BP. This cross-sectional study was conducted on 270 adult subjects living in Tehran, Iran. Dietary intake was evaluated using a validated food frequency questionnaire. The DAQS was calculated using antioxidant-nutrient intake. Socio-economic status, anthropometric measures, and BP were recorded by a trained interviewer, using standard methods. A significant increase was found in maximal oxygen uptake (p value = 0.01) across tertiles of DAQS. After adjusting for confounders, the association remained unchanged (p value = 0.02). Participants in the highest tertile of DAQS had higher systolic BP (SBP) (p value = 0.01) and diastolic BP (DBP) (p value = 0.03), although adjustment for confounding factors attenuated the results (p value = 0.3 for DBP and p value = 0.6 for SBP). Our results revealed that higher DAQS is associated with better CRF in Iranian adults. Further studies are needed to establish the veracity of our results.