Association of rs2282679 polymorphism in vitamin D binding protein gene (GC) with the risk of vitamin D deficiency in an iranian population: season-specific vitamin D status.

BACKGROUND: Genome-wide association studies in Western countries indicate a considerable impact of variations in vitamin D binding protein (GC) genes on serum concentrations of 25-hydroxyvitamin D (25(OH)D). We aimed to investigate an association between rs2282679 polymorphism in GC and vitamin D deficiency. METHODS: A cross-sectional study conducted in the framework of the Tehran Cardio-Metabolic Genetic Study (TCGS) cohort. A total of 1568 participants aged > 18 years were randomly selected, and their 25(OH) D concentration was measured. Vitamin D deficiency was assessed concerning rs2282679 by descriptive and multivariate analysis, odds ratio (OR), and 95% confidence intervals (95%CI) calculated. Since the interaction term between rs2282679 and recruitment season was significant, we performed regression analysis separately for individuals whose blood was taken in high sunny and those whose blood was drawn in the low sunny season. RESULTS: The rs2282679 polymorphism was in Hardy-Weinberg equilibrium (P > 0.05) in the studied population. The serum concentration of 25(OH) D median was 15.0 ng/mL, and the prevalence of VDD was 27.8%. The presence of the G allele in rs2282679 increases the risk of VDD in additive (OR = 1.35, 95% CI: 1.06-1.73) and dominant (OR = 1.33, 95% CI: 1.06-1.68) genetic models. After separating participants based on the recruitment season, the unfavorable association was observed in the additive and dominant only in the low sunny season. CONCLUSION: The finding of the current study indicates that the GC rs2282679 SNP is associated with vitamin D deficiency. It seems that the impact of risk allele increased in the low sunny season when UV exposure has been declined.

Dairy product consumption and risk of non-alcoholic fatty liver disease: A systematic review and meta-analysis of observational studies.

BACKGROUND AND AIMS: It is unclear whether regular consumption of dairy products is associated with the risk of developing non-alcoholic fatty liver disease (NAFLD). Thus, we conducted a systematic review followed by a meta-analysis of studies reporting on the association of dairy consumption with NAFLD risk. METHODS AND RESULTS: We comprehensively searched PubMed, Web of Science, and Scopus for observational studies that evaluated the association between dairy intake and NAFLD likelihood that were published before September 1, 2022. The reported odds ratios (ORs) of fully adjusted models and their 95% confidence intervals (CIs) were pooled using a random-effects model for the meta-analysis. Out of 1206 articles retrieved, 11 observational studies, including 43,649 participants and 11,020 cases, were included. Pooled OR indicated a significant association between dairy intake and NAFLD (OR = 0.90; 95% CI: 0.83, 0.98; I2 = 67.8%, n = 11). Pooled ORs revealed that milk (OR: 0.86; 95% CI: 0.78, 0.95; I2 = 65.7%, n = 6), yogurt (OR: 0.88; 95% CI: 0.82; I2 = 0.0%, n = 4), and high-fat dairy (OR: 0.38; 95% CI: 0.19, 0.75; I2 = 0.0%, n = 5) consumption was inversely associated with NAFLD while cheese was not linked to NAFLD risk. CONCLUSION: We observed that consumption of dairy products is linked to a reduced risk of developing NAFLD. Overall, the data in the source articles is of low to moderate quality; therefore, further observational studies are required to support the current findings (PROSPERO Reg. number: CRD42022319028).

Graduate Student Literature Review: A scoping review on the impact of consumption of dairy products on phosphatidylcholine and lysophosphatidylcholine in circulation and the liver in human studies and animal models.

Dairy consumption is inversely related to the risk of developing type 2 diabetes in epidemiological research. One proposed hypothesis is that phospholipid (PL) species associated with dairy consumption mediate this relationship. This scoping review aimed to identify the existing literature in animal and human trials investigating the impact of dairy products, including milk, yogurt, and cheese as well as dairy-derived PL supplementation on PL and its species in the circulation, summarizing the characteristics of these studies and identifying research gaps. A systematic search was conducted across 3 databases (PubMed, Scopus, and Web of Science) in March 2021. Of 2,427 identified references, 15 studies (7 humans and 8 animal studies) met the eligibility criteria and were included in the final narrative synthesis. The evidence base was heterogeneous, involving a variety of clinical and preclinical studies, metabolically healthy or obese/diabetic participants or animal models, and displayed mixed findings. Circulating postprandial concentrations of total PL were elevated acutely but unchanged after longer intervention with dairy products. The PL concentration remained stable even after a high dosage of milk supplemented with dairy-derived PL, which may be related to increased fecal excretion; however, certain phosphatidylcholine (PC) or lysophosphatidylcholine species were increased in circulation by interventions. These include several PC species with 32 to 38 total carbons in addition to the dairy biomarkers C15:0 and C17:0. The results of this scoping review demonstrate a small body of literature indicating that dairy products can influence blood concentrations of PC and lysophosphatidylcholine species in both rodents and humans without alteration of total PL and PC. There is a lack of well-designed trials in humans and animals that explore the potential differences between individual dairy foods on PL species. In addition, trials to understand the bioactive properties of PC and lysophosphatidylcholine species on cardiometabolic risk are needed.

The relation of omentin gene expression and glucose homeostasis of visceral and subcutaneous adipose tissues in non-diabetic adults.

BACKGROUND: Adipose tissue (AT) is a passive reservoir for energy storage and an active endocrine organ responsible for synthesizing bioactive molecules called adipokines. Omentin is known as an anti-inflammatory adipokine that can modulate insulin sensitivity. The present study aimed to investigate the relationship between omentin mRNA expression and glucose homeostasis of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in non-diabetic adults. METHODS: VAT and SAT adipose tissues were collected from 137 adults aged ≥ 18 years hospitalized for abdominal surgery. Before surgery, preoperative blood samples were taken from the participants to measure fasting plasma glucose, insulin, and triglyceride. BMI, HOMA-IR, HOMA-B, and QUICKI were calculated. Insulin levels were measured with Mercodia kits using enzyme-linked immunosorbent assay (ELISA). In order to obtain omentin mRNA expression, real-time PCR was performed. RESULTS: Overall, 91 (66.4%) subjects were healthy [without insulin resistance (IR)], and 46 (33.6%) participants were with IR. In healthy and IR subjects, omentin gene expression was 1.04 and 2.32, respectively in VAT, and 3.06 and 1.30, respectively, in SAT (P > 0.05). After controlling for age and BMI, linear regression analysis indicated a significant positive association of SAT omentin expression with insulin concentration (ß = 0.048; 95% CI 0.009, 0.088, P = 0.017) and HOMA-IR (ß = 0.173; 95% CI 0.023, 0.323, P = 0.014). Moreover, a negative association of SAT omentin expression with HOMA-B (ß = - 0.001; 95% CI 0.002, - 0.001, P < 0.001) was observed. CONCLUSION: This study's finding confirms a direct association between IR with omentin mRNA levels in SAT. Besides, the indicator of insulin sensitivity had an inverse association with omentin gene expression in SAT. This aspect of research suggests that omentin secretion from SAT has a strong link with insulin regulation.

Association of dairy consumption patterns with the incidence of type 2 diabetes: Findings from Alberta's Tomorrow Project.

BACKGROUND AND AIMS: We aimed to extract dairy consumption patterns of men and women from a population-based cohort and then assess the association of each consumption pattern with incident T2D risk. METHODS AND RESULTS: This prospective study was conducted within the framework of Alberta's Tomorrow Project (ATP), in which 8615 men and 15,016 women provided information on dietary intake by completing a food-frequency questionnaire at baseline, and then were followed up over time to determine the incidence of T2D via questionnaires. Principal Component Analysis (PCA) was used to extract dairy consumption patterns (DCPs). The association between each extracted pattern and T2D incidence was estimated using multivariable logistic regression models.The incidence of T2D among men and women was 3.8 and 3.2%, respectively, and the mean duration of follow-up was 5.2 years. Three major DCPs were identified. After controlling for potential confounders, the OR for risk of T2D in men in the highest compared with those in the lowest quartile of the DCP3 (whole milk, regular cheese, and non-fat milk as a beverage and in cereal) was 0.64 (95%CI: 0.47 to 0.88, P-trend=0.001), whereas it was not significant for women. DCP1 and DCP2 were not associated with incident T2D in men or women. CONCLUSION: Adherence to a DCP characterized by higher consumption of whole milk, regular cheese, and non-fat milk was associated with decreased risk of incident T2D only in men. Our results support current evidence that a combination of different dairy products, regardless of their fat content, might be favorable for health maintenance, at least in men.

Association between dietary behaviors and depression in adolescent girls.

BACKGROUND: The growing prevalence of depression has become a major public health problem. There is limited evidence regarding the relationship between dietary behaviors and depression. The present study was designed to evaluate the association between dietary behaviors and depression score. METHODS: A total of 933 Iranian adolescent girls aged 12 to 18 years were included in this cross-sectional study. Depression severity score was assessed using a validated Persian version of Beck's depression inventory. Dietary behaviors were pre-defined and assessed in ten domains using a standard questionnaire. To investigate the association between dietary behaviors and depression score, the linear regression analysis in crude and adjusted models was used. RESULTS: 67.7% of participants had no or minimal depression symptoms and 32.3% of participants were categorized with mild-to-severe depression symptoms. There were significant inverse relationships between main meal consumption (Beta: -0.141; 95% CI: - 3.644 to - 1.000; P = 0.001), snack consumption (Beta: -0.100; 95% CI: - 2.400 to - 0.317; P = 0.002), regular meal consumption (Beta: 0.23; 95% CI: 0.13-0.42; P = 0.001) and food chewing (Beta: -0.152; 95% CI: - 2.279 to - 0.753; P = 0.03) with depression score. These associations remained significant after adjustment for confounding variables. In addition, frequency of intra-meal fluid intake (Beta: 0.096; 95% CI: 0.288 to 1.535; P = 0.004) and spicy foods consumption (Beta: 0.076; 95% CI: 0.098 to 1.508; P = 0.02) were directly associated with depression score in the crude model. These significant relations were disappeared in full adjusted model. No significant association was found between breakfast consumption, intake of fried foods, chewing ability, and tooth loss with depression score (P > 0.05). CONCLUSIONS: Significant associations were observed between specific eating behaviors with depression score. Prospective studies are needed to confirm these findings.

The protective effects of dietary intake of flavonoids and its subclasses on metabolic syndrome incidence.

This study aimed to evaluate the association between the intake of total flavonoids and flavonoid subclasses and metabolic syndrome (MetS) risk and to assess the modulating effects of lifestyle factors on these associations. A total of 1915 participants from the Tehran Lipid and Glucose Study were followed-up during 2006-2008 and 2016-2018. Their dietary intake was assessed by a food frequency questionnaire at baseline and within three-year intervals afterward. Moreover, the modifying effect of weight gain on the association between total flavonoids and MetS was assessed by Cox regression analysis. Participants in the highest tertile of flavonoid, flavonol, and flavone had a significantly lower MetS risk as compared to those in the lowest tertile. Also, in participants with weight gain <7%, all flavonoid subclasses had a more pronounced risk-reducing effect. Overall, the total flavonoid, flavonol, and flavone reduced the risk of MetS; this association could be modified by weight gain.

Elevated miR-143 and miR-34a gene expression in human visceral adipose tissue are associated with insulin resistance in non-diabetic adults: a cross-sectional study.

OBJECTIVE: We aimed to evaluate the association of miR-143 and miR-34a expression in human visceral (VAT) and subcutaneous (SAT) adipose tissues with insulin resistance (IR). METHODS: VAT and SAT were obtained from 176 participants without diabetes. miR-143 and miR-34a expressions in VAT and SAT were measured using qRT-PCR. Fasting serum insulin and glucose concentration, homeostatic model assessment of IR index (HOMA-IR) and ß-cell function (HOMA-B), and quantitative insulin-sensitivity check index (QUICKI) were calculated. RESULTS: After adjustment for age, sex and body mass index (BMI), VAT miR-143 expression was positively associated with fasting plasma glucose (FPG), insulin, and HOMA-IR, and negatively associated with HOMA-B and QUICKI. miR-34a expression in VAT was directly associated with FPG, insulin, and HOMA-IR and negatively associated with QUICKI. In SAT, miR-34a expression was positively associated with insulin and negatively associated with QUICKI. The interaction terms of HOMA-IR and BMI categories were significant for both miR gene expressions in VAT. After stratifying participants based on BMI, the association of miR-143 and miR-34a expressions in VAT with IR indices remained significant only in obese patients. CONCLUSION: miR-143 and miR-34a expressions in VAT were independent predictors of IR in people without diabetes, and that this association was conditional on the degree of obesity. LEVEL OF EVIDENCE: Level of evidence III, cross-sectional analytic study.

Daily vitamin D3 in overweight and obese children and adolescents: a randomized controlled trial.

PURPOSE: To assess the efficacy of different doses of vitamin D3 on serum 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone(iPTH), calcium, phosphorus, and alkaline phosphatase concentrations in overweight and obese school-children. METHODS: A total of 378 children and adolescents, 6-13 years of age, with age- and sex-specific body mass index(BMI) Z-score ≥ 1(according to the World Health Organization criteria) were allocated to receive 600, 1000, and 2000 IU vitamin D3/days. 25(OH)D, iPTH, calcium, phosphorus, and alkaline phosphatase concentrations were measured at baseline, 6, and 12 months. In this intention-to-treat analysis, we fitted a linear mixed effect model involving a random effect of participants within treatment groups and fixed effects of dose, time, and their interactions. RESULTS: Mean(SD) of age and BMI Z-score were 9.3 (1.7) years and 2.55 (0.73), respectively. The median (IQR) for 25(OH)D was 11.5 (8.9), 11.7 (10.5), 12.2 (10.2) ng/mL (28.75, 29.25, and 30.50 nmol/L) at baseline and 23.1 (8.0), 25.6 (8.3), 28.6 (10.4) ng/mL (57.75, 64.00, and 71.50 nmol/L) at the end of 12 months in 600, 1000, and 2000 IU, respectively (p values for dose, time, and the interaction being < 0.0001, < 0.0001,and 0.082, respectively). Prevalence of vitamin D deficiency (< 20 ng/mL) was 80.2, 77.5, and 75.5% in 600, 1000, and 2000 IU groups at baseline, respectively, which decreased to 34, 18.4, and 7.5%, respectively, at 12 months. Patterns of iPTH, calcium, phosphorus, and alkaline phosphatase response over time did not differ significantly among groups (p values = 0.452, 0.670, 0.377, 0.895, respectively). CONCLUSIONS: Increases in 25(OH)D concentration were found with supplementation of 1000 and 2000 IU, compared with 600 IU/days, whereas there was no evidence of iPTH suppression or change in serum calcium, phosphorus, and alkaline phosphatase among children with excess weight.

The association of dietary and plasma fatty acid composition with FTO gene expression in human visceral and subcutaneous adipose tissues.

PURPOSE: The human obesity susceptibility gene, FTO, associates with body mass and obesity in humans through regulation of energy expenditure and intake. We aimed to determine how fatty acids in plasma and in diet associate with FTO gene expression in subcutaneous and visceral adipose tissues. METHODS: In this study, 97 participants aged ≥ 18 years were selected from patients admitted to the hospital for abdominal surgeries. Habitual dietary intake of participants was collected using a valid and reliable food frequency questionnaire (FFQ), from which the intake of fatty acids was quantified. Plasma fatty acids were assessed by gas-liquid chromatography. The mRNA expression of the FTO gene in visceral and subcutaneous adipose tissues obtained by biopsy was measured by Real-Time Quantitative Reverse Transcription PCR. Standardized ß-coefficients were calculated by multivariable linear regression. RESULTS: After adjusting for age, homeostasis model insulin resistance index (HOMA-IR), and body mass index, total fatty acid intake was significantly associated with FTO gene expression in visceral (STZß = 0.208, P = 0.037) and subcutaneous (STZß = 0.236, P = 0.020) adipose tissues. Dietary intake of monounsaturated fatty acid (MUFA) and polyunsaturated fatty acids (PUFA) had positive significant associations with the expression of FTO in visceral (STZß = 0.227, P = 0.023; STZß = 0.346, P < 0.001, respectively) and subcutaneous (STZß = 0.227, P = 0.026; STZß = 0.274, P = 0.006, respectively) adipose tissues. There were no associations between plasma fatty acids and FTO mRNA expression in either subcutaneous or visceral adipose tissues. CONCLUSION: The weak association of dietary total fatty acids, MUFA, and PUFA with FTO gene expression in both adipose tissues may highlight the importance of dietary fatty acids composition along with total fat intake in relation to FTO gene expression.

Association of plasma fatty acids pattern with omentin gene expression in human adipose tissues: A cross-sectional study.

BACKGROUND AND AIMS: Omentin, as an adipokine, has been reported to improve insulin resistance and inflammation may be related to fatty acids (FAs). Plasma FAs can be used as biomarkers of dietary FAs and endogenous FA exposure. We aimed to evaluate the association between plasma FAs pattern and omentin gene expression in adipose tissue (AT). METHODS AND RESULTS: Visceral and subcutaneous AT and fasting blood were gathered from 97 adults aged >18 years. Participants were already admitted to hospitals for elective abdominal surgery. Dietary intakes were assessed using a food frequency questionnaire. The relative omentin gene expression in visceral and subcutaneous AT was measured by Real-Time PCR and plasma FAs was determined by gas chromatography. The principal component analysis was performed to derive the FAs pattern from plasma individual FAs. Three patterns were derived from plasma FAs, 1) high de-novo lipogenesis (DNL), 2) high trans saturated fatty acids (SFA), and docosahexaenoic acid (trans-SFA/DHA), and 3) high long-chain SFA (LC-SFA). After adjustment for age, sex, and insulin concentration, only the LC-SFA pattern was associated with omentin gene expression in visceral AT (ß = 2.25, P = 0.03). Other patterns were not associated with omentin gene expression in visceral and subcutaneous AT. CONCLUSION: A pattern characterized by high levels of myristic acid (14:0), heptadecanoic acid (17:0), pentadecanoic acid (15:0), and Cis_heptadecanoic acid (17:1), which named LC-SFA was related to omentin gene expression in visceral AT.

Changes in dairy product consumption and subsequent type 2 diabetes among individuals with prediabetes: Tehran Lipid and Glucose Study.

BACKGROUND: People with prediabetes can postpone or even reverse progression to type 2 diabetes (T2D) by making dietary changes. This study aimed to examine the association of changes in consumption of total and specific types of dairy products with the subsequent risk of incident T2D among individuals with prediabetes. METHOD: This cohort study included 639 individuals (50% female, mean age 47.3 years) of the Tehran Lipid and Glucose Study (TLGS) who had prediabetes at baseline. We assessed 3-year changes in the consumption of dairy products using a food frequency questionnaire. Using multivariable logistic regression, odds ratios (OR) and 95% confidence intervals (CI) were calculated for the association of changes in intake of total and subtypes of dairy products during a 3-year interval with the risk of incident T2D in the subsequent 3 years. RESULTS: After almost 9 years of follow-up, the incidence of T2D was 25.2%. Compared with individuals whose intake remained relatively stable over 3 years, those who decreased consumption of total dairy (> 0.5 servings/day) had a higher T2D risk (OR = 1.56; 95% CI: 1.02 to 2.41). Increasing low-fat dairy consumption by 0.50 serving/d was associated with a lower risk of T2D (OR = 0.56; 95% CI: 0.35 to 0.90) compared with stable consumption. Those who increased consumption of low-fat milk (OR = 0.59; 95% CI: 0.37 to 0.92) and low-fat yogurt (OR = 0.55; 95% CI: 0.33 to 0.93) had a lower risk of T2D than those who were relatively stable in their consumption. Replacing low-fat milk and yogurt with regular cheese was associated with 66 and 47% higher risk of T2D, respectively. CONCLUSION: In individuals with prediabetes, increasing consumption of low-fat dairy, low-fat milk, and low-fat yogurt had reduced risk of subsequent T2D. These data suggest a role of low-fat dairy products in the prevention of T2D among prediabetes patients.

Dietary intakes of total polyphenol and its subclasses in association with the incidence of chronic kidney diseases: a prospective population-based cohort study.

BACKGROUND: As chronic kidney disease (CKD) is amongst the current global health challenges, this study is aiming to evaluate the long-term intake of total polyphenol and its subclasses in association with CKD incidence. METHODS: For the purpose of this study, a sample of 3021 Iranian adults (47 % men, aged 20-79 years) with no CKD diagnosis at baseline, were selected from the Tehran Lipid and Glucose Study population. The total intake of polyphenol and its major subclasses were assessed by a validated food frequency questionnaire and categorized as flavonoids, phenolic acids, stilbenes, and lignans. Although the morphological abnormalities of the kidneys or 3-month persistent urinalysis can distinctively define CKD, the glomerular filtration rate (eGFR) reduction is accepted as a more precise index of renal function. Therefore, eGFR < 60 mL/min/1.73m2 was the exclusive index of CKD diagnosis in the current study. The eGFR was calculated by the Modification of Diet in Renal Disease Study equation. Cox-regression analysis was used to assess the hazard ratio and 95 % confidence intervals of CKD in quartiles of the total polyphenols. RESULTS: In this study, 355 CKD cases over 11,058.464 person-years was reported. The median (IQR) age of participants was 36 years (27-46) at baseline. Moderate intake of lignans (≤ 6.8 mg) was negatively associated with the incidence of CKD in the adjusted model. No significant associations were detected between higher amounts of lignin and total polyphenols (HR: 0.97, 95 % CI 0.67-1.40) and CKD incidence. CONCLUSIONS: Based on the current findings, moderate intake of lignin possess CKD-protective properties by approximately 32 %. No independent associations were observed between higher amounts of lignins and CKD incidence.

Secular trend in dietary patterns of Iranian adults from 2006 to 2017: Tehran lipid and glucose study.

BACKGROUND: Based on data regarding nutrition transition in the Middle East and North Africa, this study aim to investigate the general structure and secular trend of dietary patterns reported from the Tehran Lipid and Glucose Study (TLGS) and adherence to these dietary patterns among Iranian population from 2006 till 2017. METHODS: We investigated on four examination waves of TLGS, including wave 1 (2006-2008), wave 2 (2009-2011), wave 3 (2012-2014), and wave 4 (2015-2017), using a validated and reliable food frequency questionnaire. Generalized Estimating Equations was used to assess secular trends in anthropometric, biochemical, and dietary variables across the study period. To identify general structure and secular trend of dietary patterns during each waves, principle component analysis (PCA) and K-mean cluster analysis were used, respectively. RESULTS: After adjusting for potential confounders including age, sex, body mass index, and total energy intake, the carbohydrate and protein intake gradually increased and the total fat intake decreased during study period (P-value< 0.001), although total energy intake remained stable. During the study period, participants consumed noticeably less refined grains, solid fat, dairy products, and simple sugars. Snack and dessert consumption increased and meat intakes showed no significant changes during a decade (all P-values< 0.001). Three dietary patterns extracted using PCA, included: Healthy dietary pattern characterized by higher intakes of vegetable, fruit, dairy products, liquid oil, nuts and seeds, and honey and jam; Western dietary pattern featured by refined grain, solid fat, meat, snack and dessert, potato, and soft drink, and the Mixed dietary pattern, highlighted by tea and coffee, and simple sugar. Based on cluster analysis, 27.8% of participants in wave 4 followed a Western dietary pattern, and 34.1% followed the Mixed dietary pattern. The Healthy dietary pattern was stable among the study population during the last decade. CONCLUSIONS: The structure and the type of foods that participants preferred to eat changed since 2006, a new secular trend in dietary patterns, including a stability of Healthy dietary pattern, a decline of the Western dietary pattern and an increase in the Mixed dietary pattern was obsereved in our investigation.

Dietary approaches to stop hypertension (DASH) score and obesity phenotypes in children and adolescents.

BACKGROUND: The prevalence of obesity and its two important phenotypes, the metabolically healthy obese (MHO) and the metabolically unhealthy obese (MUO) are 10.9, 9.1, and 1.8%, respectively, among children and adolescents in Iran. Data on the link between diet quality indices and obesity phenotypes in children and adolescents is scarce. The present study aimed to assess the association of the Dietary Approaches to Stop Hypertension (DASH) score with MHO and MUO, as well as with cardiometabolic risk factors (RFs) in children and adolescents with excess weight. METHODS: This cross-sectional study was conducted on 341 children and adolescents with excess weight aged 6-13 years, selected from primary schools of Tehran. The DASH score was determined based on eight components using a valid and reliable food frequency questionnaire. Anthropometric measures, insulin, fasting plasma glucose, lipid profile, and physical activity levels were collected. MUO was classified based on two definitions: having 2 or more cardiometabolic RFs, or being insulin resistant determined by a homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 3.16. Multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for MUO phenotypes and cardiometabolic RFs in each tertile of the DASH score after adjustment for confounders. RESULTS: The mean ± SD for age and DASH score was 9.3 ± 1.7 years and 24.0 ± 4.9, respectively. The prevalence of MUO was 62.2% based on RFs, and 43.4% based on HOMA-IR. Participants in the highest tertile of the DASH score had significantly decreased odds for MUO based on HOMA-IR (OR = 0.49; 95% CI: 0.28-0.87) compared with those in the lowest tertile, after adjustment for confounders. However, there were no associations between the DASH score and any of cardiometabolic RFs, or MUO based on RFs (OR = 0.68; 95% CI: 0.38-1.20). CONCLUSION: The DASH score was inversely associated with MUO based on HOMA-IR, but not associated with MUO based on cardiometabolic RFs in this sample of children and adolescents. A DASH-style diet may have favourable effects on insulin sensitivity among children and adolescents with excess weight. Universal definitions for MHO/MUO are required, and longitudinal studies recommended to shed light upon this subject.

A prospective study on total protein, plant protein and animal protein in relation to the risk of incident chronic kidney disease.

BACKGROUND: The link between dietary protein intake and the risk of kidney dysfunction is always a challenging issue. This study aimed to investigate the relationship between total protein, plant protein, and animal protein intake with the risk of incident chronic kidney disease (CKD). METHODS: This study was performed on 1639 adults aged ≥27 years who participated in the Tehran Lipid and Glucose Study. Dietary data were evaluated using a valid and reliable semi-quantitative food frequency questionnaire (FFQ). Total protein content, plant protein, and animal protein of each participant were calculated. Glomerular filtration rate (GFR) less than 60 mL / min / 1.73 m2 has been considered as the definition of CKD. Odds Ratio (OR) was calculated using logistic regression to show the association between the risk of incident CKD and dietary exposures. RESULTS: After adjusting for age, sex, body mass index, smoking, total energy intake, total fiber intake, dietary fat, physical activity, diabetes, and hypertension, there was no significant association of total protein and animal protein consumptions with the incidence of CKD. After adjustment for confounders, compared with the lowest tertile of plant protein consumption, OR of incident CKD in the highest tertile was 0.29 (95% confidence interval [95% CI] 0.15 to 0.55) with a significant trend (P for trend < 0.001). CONCLUSION: The results of this study confirmed an inverse association between plant protein intake and the risk of incident CKD, which demonstrates the protective role of plant-based protein in a diet on kidney function.

A Prospective Study of Dietary Meat Intake and Risk of Incident Chronic Kidney Disease.

OBJECTIVE: The aim of the present study was to investigate the association of different meat intake and substitution of them with risk of incident chronic kidney disease (CKD). METHODS: At the baseline, habitual dietary intakes of 4881 participants of the Tehran Lipid and Glucose Study who were free of CKD were assessed by a valid and reliable food-frequency questionnaire. Logistic regression, adjusted for age, sex, smoking, total energy intake, triglycerides, body mass index, physical activity, hypertension, and diabetes, was used to assess the relationship between major protein sources of food (total red meat, unprocessed red meat, and processed red meat) and incident CKD. Odds ratios (ORs) and 95% confidence intervals (CIs) for the CKD were estimated for substituting one serving of total red meat with one serving of low-fat dairy, nuts, whole grains, and legumes. RESULTS: The mean ± standard deviation age of participants was 40.1 ± 12.8 years. After adjustment for confounders, compared with the lowest quartile of total red meat intake, OR of incident CKD in the highest quartile was 1.73 (95% CI: 1.33 to 2.24; P for trend <0.001) in the final model. OR for participants in the highest compared with that in the lowest quartile of processed red meat was 1.99 (95% CI: 2.54 to 2.56; P for trend <0.001). In the substitution analyses, replacing 1 serving of total red meat and processed meat with 1 serving of low-fat dairy, nuts, whole grains, and legumes was associated with a lower risk of incident CKD. CONCLUSIONS: Higher consumption of total red meat and processed meat was associated with increased risk of incident CKD. Furthermore, substitution of total red and processed meat in the diet with other sources of dietary protein was associated with lower CKD risk.

Dietary Inflammatory Index in Relation to Carotid Intima Media Thickness among Overweight or Obese Children and Adolescents.

BACKGROUND: Low-grade systematic inflammation triggers atrial wall thickening, which predisposes to several cardiovascular events. Since diet is a strong moderator of systematic inflammation, the literature review-based dietary inflammatory index (DII®) score has been recently introduced for evaluating inflammatory properties of an individual's diet. The aim of the present study was to assess the association of DII, with carotid intima media thickness (cIMT) among overweight or obese children and adolescents. METHODS: A total of 339 children and adolescents (48% girls) aged from 6 to 13 years, with WHO body mass index z-score >1 were enrolled in this cross-sectional study. A valid and reliable semi-quantitative food frequency questionnaire was used to collect dietary intakes and calculate DII score. cIMT was measured in the common carotid artery with high-resolution ultrasonography. RESULTS: In this cross-sectional study, the mean ± SD age of participants was 9.3 ± 1.7 years. Among participants, 68% were obese and 83% were in the pubertal stage. DII ranged from -5.43 to 4.42, with the mean of -2.83 in the lowest, and 1.25 in the highest tertile of DII. When fit as a continuous variable, DII score had no significant association with cIMT after adjusting for potential confounders. However, the participants in the highest DII score tertile compared to the lowest had 2.46-fold increased risk of high cIMT in the multivariable adjusted model (p for trend = 0.02). DISCUSSION/CONCLUSION: Higher DII scores were associated with increased risk of high cIMT.

Modified Healthy Eating Index and Incidence of Metabolic Syndrome in Children and Adolescents: Tehran Lipid and Glucose Study.

OBJECTIVE: To assess the relationship between modified healthy eating index (mHEI) with the development of metabolic syndrome (MetS) among children and adolescents. STUDY DESIGN: Dietary data were collected using a food frequency questionnaire among 424 healthy subjects, aged 6-18 years. The components of mHEI were grains, vegetables and fruits, dairy, red to white meat ratio, butter, sweet snacks, sweetened beverages, salty snacks, and fast food. Multivariable logistic regression models were used to estimate the incidence of MetS after 3.6 years of follow-up in each quartile of the mHEI score, adjusted for baseline age, sex, total energy intake, physical activity, and body mass index. RESULTS: The mean ± SD age and mHEI scores of participants were 13.6 ± 3.7 years and 55.9 ± 10.0, respectively, at baseline. MetS developed in 11% of the participants at the end of follow-up. After adjustment for confounders, the occurrences of MetS decreased in the highest quartile compared with the lowest quartile of the mHEI score (OR = 0.35, 95% CI 0.13-0.98, P for trend = .025). In addition, higher scores of mHEI components including fruits, salty snacks, and fast food were associated with lower risk of MetS. CONCLUSIONS: Higher scores of mHEI as an indicator of diet quality may hinder the development of MetS among children and adolescents.

Adherence to low-sodium Dietary Approaches to Stop Hypertension-style diet may decrease the risk of incident chronic kidney disease among high-risk patients: a secondary prevention in prospective cohort study.

Background: Considering the fact that subjects with dysglycemia, dyslipidemia or high blood pressure are at high risk for chronic kidney disease (CKD), long-term adherence to the Dietary Approaches to Stop Hypertension (DASH)-style diet may contribute to the prevention of CKD. This study, examined the association between adherence to the low-sodium DASH-style diet and incident CKD among high-risk adults over 3 years of follow-up. Methods: In this prospective cohort study (followed up for 3 years, 2012-15), we selected 1100 subjects with dysglycemia, 2715 with dyslipidemia and 2089 with high blood pressure, all of whom were free of CKD at baseline (2009-11) in a subgroup of the Tehran Lipid and Glucose Study. The low-sodium DASH-style diet was designed based on eight foods and nutrients using a food frequency questionnaire. Estimated glomerular filtration rate (eGFR) was calculated and CKD was defined as eGFR <60 mL/min/1.73 m2. Results: After 3 years of follow-up, among subjects with dysglycemia, dyslipidemia or high blood pressure, the rate of incident CKD was ∼16%. In multivariable-adjusted analyses for participants in the highest compared with the lowest quartile of the low-sodium DASH-style diet score, the odds ratio was 0.58 [95% confidence interval (CI) 0.36-0.92] for subjects with dysglycemia, 0.64 (95% CI 0.48-0.87) for subjects with dyslipidemia and 0.62 (95% CI 0.44-0.87) for subjects with high blood pressure. Conclusions: Higher adherence to the low-sodium DASH-style diet might be associated with a lower risk of incident CKD among high-risk adults, highlighting the importance of adherence to the low-sodium DASH-style diet in substantially reducing both the occurrence of CKD and the burden imposed by it in the future.