The association of dietary acid load (DAL) with estimated skeletal muscle mass and bone mineral content: a cross-sectional study.

BACKGROUND & AIMS: Dietary patterns that promote mild metabolic acidosis may have a negative effect on bone and muscle, and a high dietary acid load (DAL) may be detrimental to skeletal muscle mass and bone mineral content. However, the association between skeletal muscle mass and bone mineral content with dietary acid load has not been consistently reported in previous studies. The objective of the study was to evaluate the association of potential renal net acid load (PRAL) and net endogenous acid production (NEAP) with bone mineral content and skeletal muscle mass in pre-menopause women with overweight or obesity in Iran. METHOD: Three hundred and ninety women with a body mass index (BMI) of 25 were included in this cross-sectional study. We used a validated 147-item semi-quantitative food frequency questionnaire (FFQ) for evaluating the dietary intake. Based on the dietary data, potential renal net acid load (PRAL) and net endogenous acid production (NEAP) were calculated. Muscle mass and bone mineral content were estimated by a bioelectrical impedance analyzer (BIA). RESULTS: After controlling for potential confounders, we discovered a significant linear relationship between PRAL (ß = -0.027, 95%CI = -0.049 to -0.004, P = 0.02) and NEAP (ß = -0.05, 95%CI = -0.097 to -0.003, P = 0.03) and skeletal muscle mass index. However, there was no significant difference between SMM and BMC across PRAL and NEAP tertiles. CONCLUSION: PRAL and NEAP were found to be inversely related to skeletal muscle mass index among overweight/obese women. Further research is required to establish whether this relationship is important for musculoskeletal health in these populations.

The effect of folic acid supplementation on body weight and body mass index: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND OBJECTIVE: Several trials have evaluated the effects of folate supplementation on obesity indices. However, their results were inconsistent. Therefore, the current meta-analysis was conducted to summarize data from available randomized clinical trials (RCTs) about the impact of folate supplementation on weight and body mass index (BMI). METHOD: Medline/PubMed, Scopus, Embase, and ISI web of science were searched to identify relevant articles up to December 2020. The effect sizes were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI) using the random-effects model. RESULTS: Pooled data from nine studies showed that folic acid supplementation did not change body weight (WMD: -0.16 kg, 95%CI: -0.47 to 0.16, P = 0.32) and BMI (WMD: -0.23 kg/m2, 95%CI: -0.49 to 0.03, P = 0.31), but there was significant heterogeneity between the included studies for BMI (I2 = 90.1%, P < 0.001). Moreover, subgroup analyses in level of homocysteine and health status indicated significant effect of folic acid supplementation on BMI in those with homocysteine level ≥15 µmol/L (WMD: -0.17 kg/cm2, -0.33 to -0.01, p = 0.03) and in women with polycystic ovary syndrome (PCOS) (WMD: - 0.30kg/cm2, -0.54 to -0.06, p = 0.01). CONCLUSION: Our outcomes demonstrated that folic acid improves BMI in those with homocysteine levels ≥15 µmol/L and women with PCOS.

The negative relationship of dietary inflammatory index and sleeping quality in obese and overweight women.

Background and aims: Substantial evidence have linked low grade inflammation with the pathophysiology of chronic diseases and psychological impairment. An integral component underlying the link is pro-inflammatory diet. While sleeping is another significant contributor, few studies have addressed the relationship between the sleep quality and inflammatory cascade with the dietary quality as a moderator. The current study assesses the relation between inflammatory potential of the diet and sleep quality in Iranian obese and overweight women. Method: A total of 219 obese and overweight adult women were enrolled in this cross-sectional study. A standard 147-item food-frequency-questionnaire was used to record the dietary intakes; then, the dietary inflammatosry index (DII) was derived from the result-consolidated questionnaires. Pittsburgh Sleep Quality Index (PSQI) was utilized to withdraw the sleep quality and quantity. Results: The mean (±standard deviation) age, body mass index, and PSQI of individuals were 36.49 (8.38) years, 31.04 (4.31) kg/m2, and 5.78(3.55), respectively. Patients in the highest DII quartile were the ones with the higher consumption of pro-inflammatory food, and, ~58% of participants who were in the higher quartile had a sleep disturbance status. Results revealed an inverse relationship between sleep quality and DII in the crude model (ß=-0.17, p=0.01) as well as full-adjusted model (ß=0.24, p<0.001), such that women with higher DII had the poorest sleep quality. Conclusion: Based on the present observational study, obese and overweight females with higher adherence of the anti-inflammatory diet may have better sleeping status.

Associations between adherence to the MIND diet and prevalence of psychological disorders, and sleep disorders severity among obese and overweight women: A cross-sectional study.

BACKGROUND: The effect of dietary patterns on sleep disorders and mental illness has previously been investigated. However, these studies have reported contradictory findings, and thus, the present study aimed to assess the association of the MIND diet on the sleep pattern and mental health in obese women. METHODS: This is a cross-sectional study in which 282 women, aged 18-56 years with BMI ≥ 25 kg/m2.with no underlying diseases and malignancies, and participated. We used a semi-quantitative food frequency questionnaire (FFQ) to collect participant's dietary intake. The Pittsburgh Sleep Quality Index (PSQI) and Depression Anxiety Stress Scales (DASS) were used to measure the status of sleep disturbance and psychological disorders, including depression, anxiety, and stress respectively. RESULTS: A decreasing trend for psychological stress was observed in the highest quartiles of MIND diet score vs. the lowest quartiles (OR = 0.6 CI: 0.23-1.5 vs. 1.16 CI: 0.55-2.47). No significant difference was observed between severity of depression (OR = 0.87 95%, CI: 0.7-1.09, P = 0.23), anxiety (OR = 1.02, 95% CI: 0.81-1.27, P = 0.86), stress (OR = 0.99 95%, CI: 0.79-1.23, P = 0.92), and MIND diet adherence in the crude and adjusted models. CONCLUSION: The main finding from this study was that there is no significant association between adherence to the MIND diet and studied psychological disorders.

The association between the Healthy Eating Index (HEI-2015) score and body composition among Iranian soccer players and referees: a cross-sectional study.

For an optimal performance, soccer players and referees need to consume a high-quality diet. The Healthy Eating Index (HEI) is a tool that can estimate diet quality and has been shown to be associated with body composition. The aims of the present study were first to determine the HEI-2015 score of the diets consumed by athletes and second its association with different body composition parameters of athletes. We conducted a cross-sectional study on 198 soccer players and referees. Dietary intakes were recorded using a validated food frequency questionnaire (FFQ), and HEI scores were calculated. Body composition parameters were measured using the bioelectrical impedance analysis. The mean score for the HEI-2015 was 65⋅04. A multiple linear regression model showed significant associations of the HEI-2015 score with percent body fat (PBF), percent muscle mass (PMM), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in male soccer players aged <18 years, body mass index (BMI) in male soccer players aged ≥18 years and BMI and waist-to-height ratio (WHtR) in male soccer referees after adjustment for covariates (P < 0⋅05). The mean overall score for the HEI-2015 shows that Iranian soccer players and referees have an acceptable quality of diet. We also found significant associations between the HEI-2015 score and different body composition parameters in male soccer players and referees but we did not find any significant association in female athletes (P > 0⋅05).

The Interaction Between Dietary Total Antioxidant Capacity and MC4R Gene and HOMA-IR in Metabolically Healthy and Unhealthy Overweight and Obese Women.

Introduction: The current prevalence of the metabolically healthy obesity is about 3%. Genetic and nutrition are influencers of such phenotypes. The main goal of this study was to assess the interaction between Dietary Total Antioxidant Capacity (DTAC) and the genotypes of MC4R and Insulin resistance in metabolically healthy/unhealthy overweight and obese women in Iran. Material And Methods: This cross-sectional study was conducted on 237 overweight-obese women with a mean age of 36. The value of Dietary total antioxidant capacity (DTAC) was calculated using the following indices: Total reactive antioxidant potential (TRAP), Trolox equivalent antioxidant capacity (TEAC), and ferric reducing ability of plasma (FRAP). The Metabolic health status was evaluated using the Karelis criteria. Melanocortin 4 receptor single nucleotide polymorphisms were determined by the restriction fragment length polymorphism (PCR-RFLP) method. Also, insulin resistance was evaluated through homeostasis model assessment (HOMA). Result: Our data noted that 72.96% of participants presented Unhealthy Metabolically and 26.94% Healthy Metabolically including 33.5% of the total had T/T genotype, 23.8% had the C/T genotype, and 42.5% had the C/C genotype (P = .05). A linear regression model test showed that the probability of metabolically healthy obesity was significantly higher in patients with the T/C genotype. The test value was statistically significant (95% CI: 0.000-0.001; P = .056, ß = 0). No statistically significant relation was observed between study parameters and DTAC values. HOMA-Index was higher in all unhealthy subjects significantly. Conclusions: The findings indicated that there are significant associations between genotypes of rs1333048 SNP and DTAC. The C/C genotype subjects with higher DTAC had a better lipid profile and were metabolically healthier.

Association between Dietary Inflammatory Index Scores and Diabetes Sensorimotor Polyneuropathy in Patients with Type 2 Diabetes Mellitus: A Case-Control Study.

Background: Diabetes sensorimotor polyneuropathy (DSPN) is a common complication of diabetes. Diet has been previously related to DSPN. However, no studies have investigated the relationship between the inflammatory potential of the whole diet and DSPN. So, we aimed to examine the association between dietary inflammatory index (DII) and DSPN in Iranian adults. Methods: A total of 185 subjects with DSPN and 185 sex- and age-matched controls were selected in this case-control study. A 168-item validated food frequency questionnaire (FFQ) was used to assay dietary intakes. DII was calculated based on the developed formula. The Toronto clinical neuropathy score was applied to define DSPN. Binary logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) of DII in relation to DSPN. Results: Mean values of age and BMI for all the participants were reported as 50.79 and 28.60, respectively. Also, the median (IQR) of DII for all the participants was estimated as -0.091 (-0.93, 1.07). Our findings suggest that participants in the highest quartile of the DII had higher odds of DSPN (OR = 1.76; 95% CI: 1.03, 3.36) (p-trend = 0.01) compared to subjects in the lowest quartile of DII scores after adjustment for age and sex. Additionally, a strong association was observed after adjusting for energy intake, physical activity, education, smoking status, economic status, marital status, job, BMI, and WC in model 2 (OR = 2.23, 95% CI = 1.13-4.39) (p-trend = 0.0048). Conclusion: Higher DII score was associated with an increased risk of DSPN. Therefore, it is possible that a diet rich in anti-inflammatory nutrients and foods could improve and prevent DSPN.

Relationship between the double burden of malnutrition and mental health in overweight and obese adult women.

The co-existence of overweight or obesity with concurrent deficiency of one or more nutrients is referred to as double burden of malnutrition (DBM), and numerous mental health impairments have been associated with a variety of nutrient deficiencies. Although DBM is relevant for several health outcomes, the ubiquitous involvement of vitamin D across multiple systems and tissues suggests D insufficiency as a viable target for nutritional modification. The present study aimed to evaluate the contribution of DBM and mental health among adult women. Study participants included 300 women, aged 18-59 years, who presented to one of the 25 health centres in Tehran. Participants with a body mass index (BMI) of greater than 25 kg/m2 and a plasma concentration of 25-hydroxy vitamin D [25(OH)D] of >20 ng/ml were considered to have DBM. The 147-item food frequency questionnaire was used to estimate their dietary intake. Mental health status was assessed using the depression, anxiety and stress scales-21 (DASS-21). The mean ± standard deviation age, weight and BMI of the participants were 36⋅49 ± 8⋅38, 80⋅89 ± 12⋅45 kg and 31⋅04 ± 4⋅31 kg/m2, respectively. DBM was significantly associated with stress, after adjusting for potential confounders, including age, energy and marital status in model 1 (OR = 1⋅28, 95 % confidence interval (CI) 1⋅00, 1⋅65, P < 0⋅04) v. the crude model (OR = 1⋅22; 95 % CI 0⋅96, 1⋅55, P = 0⋅09). No significant association was seen among DBM and DASS-21 outcomes. In this cross-sectional study, stress and DBM were significantly associated. While vitamin D insufficiency was associated with mental health and obesity in opposing directions. Elucidation of whether vitamin D supplementation can improve mental health impairments requires further evaluation.

The relationship between dietary nutrients patterns and intensity and duration of migraine headaches.

Migraine is a complicated brain disorder which affects approximately 12 % of the population, whilst the presence of migraine headaches is typically higher in women than men. Several nutrients are posited to improve headache severity. The aim of this study was to investigate the relationship between dietary nutrients patterns and intensity and duration of migraine headaches. This cross-sectional study was conducted with 266 women. Physical activity, general characteristics, anthropometric values and dietary intake were collected. Nutrient patterns were derived using principal component analysis with varimax rotation, and based on the correlation matrix, after completing the 147 item semi-quantitative FFQ, we discerned three nutrients patterns. The validated Migraine Disability Assessment (MIDAS) questionnaire and visual analogue scale (VAS) were used for assessing migraine intensity. Duration of headaches were defined as the hours the participants had headache in 1 d in last month. ANOVA, χ2 and linear regression tests were used to interrogate the data. Linear regression showed there was a positive relationship between second pattern rich in vitamin B1, carbohydrate, vitamin B3, vitamin B9, protein, and total fibre and VAS and pain duration. Furthermore, there was an inverse relationship between MIDAS and the first nutrient pattern characterised by dietary Ca, vitamin A, vitamin K, vitamin C, vitamin B6, vitamin B2, and Mg among women. Furthermore, there was a positive significant association between vitamin D and B12 (pattern 3) and headache duration. Dietary nutrients patterns should be monitored closely in individuals suffering with migraine.

Nutrient pattern of unsaturated fatty acids and vitamin E increase resting metabolic rate of overweight and obese women.

Objectives: Obesity plays an important role in the development of chronic diseases including cardiovascular disease and diabetes. A low resting metabolic rate (RMR) for a given body size and composition is a risk factor for obesity, however, there is limited evidence available regarding the association of nutrient patterns and RMR. The aim of this study was to determine the association of nutrient patterns and RMR in overweight and obese women. Study design: This cross-sectional study was conducted on 360 women who were overweight or obese. Method: Dietary intake was assessed using a semi-quantitative standard food frequency questionnaire (FFQ). Nutrient patterns were also extracted by principal components analysis (PCA). All participants were evaluated for their body composition, RMR, and blood parameters. Result: Three nutrient patterns explaining 64% of the variance in dietary nutrients consumption were identified as B-complex-mineral, antioxidant, and unsaturated fatty acid and vitamin E (USFA-vit E) respectively. Participants were categorized into two groups based on the nutrient patterns. High scores of USFA-vit E pattern was significantly associated with the increase of RMR (ß = 0.13, 95% CI = 0.79 to 68.16, p = 0.04). No significant associations were found among B-complex-mineral pattern (ß = -0.00, 95% CI = -49.67 to 46.03, p = 0.94) and antioxidant pattern (ß = 0.03, 95% CI -41.42 to 22.59, p = 0.56) with RMR. Conclusion: Our results suggested that the "USFA-vit E" pattern (such as PUFA, oleic, linoleic, vit.E, α-tocopherol and EPA) was associated with increased RMR.

The interaction between dietary approaches to stop hypertension and MC4R gene variant in predicting cardiovascular risk factors.

Objective: The genetic variants near the melanocortin-4 receptor gene (MC4R), a key protein regulating energy balance and adiposity, have been related to obesity and cardiovascular risk factors. However, qualitative and quantitative aspects of diet may modulate the association of this polymorphism with obesity and cardiovascular diseases (CVDs). The aim of this study was to evaluate interactions among MC4R rs17782313, the Dietary Approaches to Stop Hypertension (DASH) diet and risk factors for CVDs. Method: This cross-sectional study was conducted on 266 Iranian women categorized by body mass index (BMI) range of 25-40 kg/m2 as overweight or obese. CVD risk factors included waist circumference (WC), lipid profile, blood pressure, insulin circulation and fasting blood sugar (FBS). Insulin and FBS were used to calculate homeostatic model assessment insulin resistance (HOMA-IR) Body composition was assessed by a multi-frequency bioelectrical impedance analyzer, InBody 770 scanner. Results: The findings of this study show that high adherence to the DASH diet in the CC groups were associated with decreased SBP and DBP compared to the TT group. In addition, a significant difference between women with high adherence to the DASH diet compared to low adherence was observed for body weight (p < 0.001), fat free mass (FFM) (p = 0.01) and BMI (p = 0.02). Women with the CC genotype had higher insulin (mg/dl) (mean and SD, for TT: 14.6 ± 4.6, TC: 17.3 ± 9.2, CC: 15.3 ± 4.8, p = 0.04) and HOMA-IR (mean for and SD, TT: 3.1 ± 1.07, TC: 3.9 ± 2.4, CC: 3.2 ± 1.1, p = 0.01) than TT group. Inclusion of potential confounding variables (age, physical activity, BMI and daily caloric intake) did not attenuate the difference. Conclusion: Among overweight/obese Iranian women with the CC genotype, incorporating the DASH diet may serve as a dietary prescription to decrease CVD risk. A dietary intervention trial is warranted.

Association of maternal intake of nitrate and risk of birth defects and preterm birth: a systematic review and dose-response meta-analysis.

In this study, the high versus low analysis method was applied to evaluate the association of maternal nitrate intake and risk of heart defect, limb deficiency, cleft lip, and preterm birth. Also, linear and non-linear dose-response associations between maternal intake of nitrate and risk of heart defects were investigated. In high versus low intake, the risk of heart defects in infants is directly associated with the level of nitrate exposure, but no significant relationship was found between the cleft lip, limb deficiency, and preterm birth. The linear dose-response meta-analysis was associated with risk of heart defects (RR: 1.03; 95% CI: 1.00 to 1.05, P = 0.400, I2= 0%, P heterogeneity= 0.602, n = 3) and nonlinear dose-response meta-analysis showed that maternal intake of nitrate higher than ∼4 mg/day is positively associated with heart defects risk (P non-linearity= 0.012).

Nutrient patterns and their relation to obesity and metabolic syndrome in Iranian overweight and obese adult women.

PURPOSE: Nutrient patterns have been associated with an increased risk for chronic disease. Evidence to confirm a direct relationship between nutrient patterns and obesity and metabolic syndrome (MetS) throughout population-based differences including cultural contexts add complexity is not well established yet. The aim of this study is to investigate the association between nutrient patterns and MetS among overweight and obese Iranian women. METHODS: Three hundred and sixty obese and overweight women (25 < BMI < 40) were included in this cross-sectional analysis. Dietary intake of 19 nutrients was evaluated by a semi-quantitative standard food frequency questionnaire (FFQ). MetS was determined by abdominal obesity > 88 (cm) in females, Triglycerides ≥ 150 (mg/dL), dyslipidemia (HDL < 50 mg/dL), systolic blood pressure > 130/85 (millimeters), and glucose > 100 (mg/dL). Body composition was assessed by a multi-frequency bioelectrical impedance analyzer, InBody 770 scanner. Principle components analysis was applied and four nutrient patterns were identified as following: Pattern 1 (thiamin, iron, carbohydrate, zinc, niacin, protein, magnesium, phosphorus, riboflavin), represented the carbo-vitamin group. Lipid group was showed in pattern 2 (PUFAs, MUFA, vitamin E, trans fatty acids, and Pattern 3 (beta-carotene, vitamin K, vitamin A, vitamin C) represented the anti-oxidant group, finally Pattern 4 was the indicator of the milk group (vitamin D, calcium). RESULTS: A significant positive association was observed between the anti-oxidant group and obesity (OR 1.40; 95% CI 1.09-1.8; P = 0.01). No relationship between other nutrient pattern and MetS was observed. CONCLUSIONS: The nutrient patterns that are highly loading of beta-carotene, vitamin K, vitamin A, and vitamin C in nutrient patterns may be associated to higher risk of obesity in overweight and obese Iranian women. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

The relationship between Dietary approaches to stop hypertension diet adherence and inflammatory factors and insulin resistance in overweight and obese women: A cross-sectional study.

BACKGROUND: Although there is abundant evidence for an association between dietary pattern, weight, and other related factors, such as homeostatic model assessment for insulin resistance (HOMA-IR) and inflammatory markers; there is limited information pertaining to levels of plasminogen activator inhibitor-1 (PAI-1) and Monocyte Chemoattractant Protein -1 (MCP-1). Therefore, this study sought to examine the association between adherence to the dietary approaches to stop hypertension (DASH) diet and levels of inflammatory factors PAI-1, MCP-1, and HOMA-IR. METHODS: This cross-sectional study was performed on 305 obese and overweight women. The typical food intake of individuals was assessed using the 147 items semi-quantitative food frequency questionnaire (FFQ). Body components were measured for all participants. Insulin resistance was estimated by homeostasis model assessment (HOMA), and biochemical parameters were examined. RESULTS: No significant relationship was observed between the DASH diet and MCP-1 (P-trend = 0.70), PAI-1 (P-trend = 0.92), or HOMA-IR (P-trend = 0.08) in the crude model. However, there was a significant inverse relationship between the DASH diet and HOMA-IR (P-trend = 0.03) after adjusting for age, BMI, and physical activity. CONCLUSION: This study showed that higher adherence to DASH pattern is inversely correlated with HOMA-IR in overweight and obese women.

Variants of the cry 1 gene may influence the effect of fat intake on resting metabolic rate in women with overweight of obesity: a cross-sectional study.

BACKGROUND: Previous studies have shown that the minor allele (C allele) for Cry 1 rs2287161, may be associated with increased risk of cardiovascular diseases (CVDs). Low resting metabolic rate (RMR) caused by the diet has been shown to have, potentially, unfavorable effects on obesity. This study sought to investigate the interactions between the Cry 1 Gene and fat intake on RMR in women with overweight of obesity. METHODS: This comparative cross-sectional study was conducted on 377 Iranian women with overweight of obesity. A food frequency questionnaire (FFQ), with 147 items, was used to assess dietary intake. Individuals were categorized into two groups based on the rs2287161 genotype. Body composition, dietary intake, and RMR were assessed for all participants. RESULTS: There was a significant difference between genotypes for fasting blood sugar (FBS) (P = 0.04), fat free mass (FFM) (P = 0.0009), RMR per FFM (P = 0.05), RMR per body mass index (BMI) (P = 0.02), and RMR deviation (P = 0.01). Our findings also showed significant interactions between total fat and C allele carrier group on RMR per kg body weight, RMR per body surface area (BSA), RMR per FFM, and RMR deviation (P for interaction < 0.1), in addition to a significant interaction between CC + CG group genotype and polyunsaturated fatty acids (PUFA) intake on RMR per BMI (P for interaction =0.00) and RMR per kg (P for interaction = 0.02) and RMR per BSA (P = 0.07), compared to the GG group, after control for confounder factors. CONCLUSION: These results highlight that dietary compositions, gene variants, and their interaction, should be acutely considered in lower RMR.

Elevated Plasma Concentrations of Vitamin D-Binding Protein Are Associated with Lower High-Density Lipoprotein and Higher Fat Mass Index in Overweight and Obese Women.

(1) Background: Observational studies have established that vitamin D-binding protein (DBP) and 25-hydroxyvitamin D3 (25(OH)D) concentrations are the major factors affecting the bioavailability of 25(OH)D. It has also been shown that poor 25(OH)D bioavailability elevates the risk of obesity and its related cardio-metabolic disorders. However, the relationship between 25(OH)D and DBP concentrations with cardio-metabolic risk factors in overweight and obese cohorts has not been established. Consequently, we evaluated the association between DBP and 25(OH)D concentrations with lipid profile, blood pressure (BP), and body composition in overweight and obese women. (2) Methods: In this cross-sectional study of 236 overweight and obese women, DBP and 25(OH)D concentrations were measured using an enzyme-linked immunosorbent assay. Body composition was assessed via bioelectrical impedance analysis. Lipid profile and BP were assessed by an auto-analyzer and digital BP monitor, respectively. The associations were examined by multivariate logistic regression. (3) Results: The indicated showed an inverse relationship between DBP and high-density lipoprotein (HDL) (p = 0.010) concentrations (where individuals with higher DBP had lower HDL) which, after adjusting for possible cofounders, remained significant (p = 0.006). Moreover, DBP concentration was positively associated with fat mass index (FMI) after adjustment (p = 0.022). No significant relationships were observed among 25(OH)D and target variables. (4) Conclusions: In conclusion, lower concentrations of HDL and higher values of FMI are associated with higher concentrations of DBP in overweight and obese women. These findings present novel awareness regarding the association of DBP with some metabolic and body composition variables in overweight and obese women. However, a two-way causal relationship between DBP and target variables should be considered.

The possible mediatory role of adipokines in the association between low carbohydrate diet and depressive symptoms among overweight and obese women.

BACKGROUND: Previous studies showed the possible association between obesity, dietary pattern, and depressive symptoms. Due to the lack of enough data to confirm the association of obesity and depression in the Middle East, here, we aimed to explore the possible mediatory role of adipokines Galectin-3, transforming growth factor-beta (TGF-ß), and endothelial plasminogen activator inhibitor (PAI-1) in the association between low carbohydrate diet (LCD) and depressive symptoms. METHODS: A total of 256 women aged 17-56 years old were grouped based on their LCD score. Depression anxiety stress scales-21 (DASS-21) self-administered questionnaire was used to evaluate the three negative emotional states of stress, depressive symptoms, and anxiety. Body composition and dietary intake were assessed. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of Galectin-3, TGF-ß, and PAI-1. RESULTS: No significant difference was observed regarding Galectin-3, TGF-ß, and PAI-1 levels between the groups with dissimilar adherence to LCD or the groups with different levels of depressive symptoms (P>0.05). However, there was a negative association between LCD score as a covariant and depressive symptoms as an independent variable (P = 0.02) and remarkably, a regression model linear analysis using Galectin-3, TGF-ß, and PAI-1 as confounding variables indicated the mediatory role of these adipokines in this association (P>0.05). In other words, adipokines eliminated the significance of the relationship between adherence to LCD and depressive symptoms. CONCLUSION: It seems that higher adherence to LCD is probably associated with a lower prevalence of depressive symptoms in obese adults through the mediatory role of adipokines.

High carbohydrate intakes may predict more inflammatory status than high fat intakes in pre-menopause women with overweight or obesity: a cross-sectional study.

OBJECTIVE: The associations between dietary carbohydrate, fat intake, and inflammation are controversial. Most existing data are from industrialized societies which low-carbohydrate and high-fat diet is common and so their attribution to other populations remains unclear. We evaluated the association of fat and carbohydrate intakes with inflammatory markers in pre-menopause women with overweight or obesity in Iran. RESULTS: Three hundred and sixty women with body mass index (BMI) ≥ 25 were included to this study. The levels of monocyte chemoattractant protein-1 (MCP-1) indicated a trend towards significance across tertiles of total dietary carbohydrate. We found that the levels of galectin-3 were negatively associated with dietary carbohydrate in adjusted model. In addition, the levels of MCP-1 and transforming growth factor beta (TGF-ß) were positively correlated to dietary carbohydrate. No significant relationship was demonstrated between inflammatory parameters and total fat intake). However, there was a borderline significant negative association between total fat intake and TGF-ß level in adjusted model. Therefore, a total dietary carbohydrate were related to elevated inflammation risk, while a total fat intake were not associated to higher inflammation. This study suggests reconsideration of applying global dietary guidelines in societies with high carbohydrate diet.

Association of vitamin D-binding protein and vitamin D3 with insulin and homeostatic model assessment (HOMA-IR) in overweight and obese females.

OBJECTIVE: Equivocal association the contribution of 25-hydroxyvitamin D (25(OH)D) and the well-accepted role of vitamin D-binding protein (VDBP) on bioavailability of 25(OH)D or its independent roles, has led to possible association of the VDBP in glucose metabolism. This study was conducted to evaluate the relationships among 25(OH)D, VDBP, glucose/insulin metabolism and homeostatic model assessment (HOMA-IR). Blood samples were collected from 236 obese and overweight women. VDBP and 25(OH)D levels, and biochemical parameters were measured using an enzyme-linked immunosorbent assay (ELISA). An impedance fat analyzer was utilized to acquire the body composition. RESULTS: Using the multivariate linear regression, a reverse relationship was observed between VDBP and (HOMA-IR), such that women with higher VDBP displayed lower insulin resistance. The relationship was independent of age, body mass index, standardized energy intake and physical activity (p = 0.00). No significant relationship between 25(OH)D levels, FBS, body composition or insulin resistance were observed (p > 0.2). Current study observed that higher level of VDBP may be associated with lower levels of insulin and HOMA-IR, thus the evaluation of VDBP in diverse population groups seems to have significant clinical value in evaluating the prevalence of DM or early stage of glucose intolerance.

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.