Saturated fats network identified using Gaussian graphical models is associated with metabolic syndrome in a sample of Iranian adults.

BACKGROUND: Gaussian graphical models (GGM) are an innovative method for deriving dietary networks which reflect dietary intake patterns and demonstrate how food groups are consuming in relation to each other, independently. The aim of this study was to derive dietary networks and assess their association with metabolic syndrome in a sample of the Iranian population. METHODS: In this cross-sectional study, 850 apparently healthy adults were selected from referral health care centers. 168 food items food frequency questionnaire was used to assess dietary intakes. Food networks were driven by applying GGM to 40 food groups. Metabolic syndrome was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III). RESULTS: Three GGM networks were identified: healthy, unhealthy and saturated fats. Results showed that adherence to saturated fats networks with the centrality of butter, was associated with higher odds of having metabolic syndrome after adjusting for potential confounders (OR = 1.81, 95% CI 1.61-2.82; P trend = 0.009) and higher odds of having hyperglycemia (P trend = 0.04). No significant association was observed between healthy and unhealthy dietary networks with metabolic syndrome, hypertension, hypertriglyceridemia and central obesity. Furthermore, metabolic syndrome components were not related to the identified networks. CONCLUSION: Our findings suggested that greater adherence to the saturated fats network is associated with higher odds of having metabolic syndrome in Iranians. These findings highlight the effect of dietary intake patterns with metabolic syndrome.

Association of health literacy and nutritional literacy with sun exposure in adults using structural equation modelling.

BACKGROUND: Inadequate health and nutritional literacy is a common problem among adults, associated with poor health outcomes. Therefore, this study aimed to investigate the relationship between health literacy and nutritional literacy to sun exposure behaviour. METHODS: We conducted a cross-sectional study on 261 adults (18-65 years) in Iran. Data was collected on knowledge, motivation, health literacy, nutritional literacy, and sun exposure behaviour using an interview-assisted questionnaire. Using the information-motivation-behavioural skills model and structural equation modeling, we tested whether health and nutritional literacy were associated with the relationships between knowledge of vitamin D, attitudes toward sun exposure, and sun exposure behaviour. Different models using structural equation modeling were performed to analyze the data. RESULTS: The finding showed that health literacy (ß = 0.29, p < 0.001) and nutritional literacy (ß = 0.14, p = 0.02) was directly associated with sunlight exposure. Indirect relationships also existed between knowledge and sunlight exposure through health literacy (ß = 0.33, p < 0.001) and nutritional literacy (ß = 0.22, p = 0.01). The model had good fit (x2/df = 1.422; RMSEA = 0.040; CFI = 0.851; NFI = 0.657). There was no significant relationship between health literacy and motivation (ß = 0.11, p = 0.16), nutritional literacy and motivation (ß = 0.06, p = 0.42) and motivation and sun exposure (ß = 0.01, p = 0.91). CONCLUSIONS: The findings showed that individuals with sufficient health literacy and nutritional literacy were more likely to have exposure to sunlight. Health and nutritional literacy should be considered when educating adults about vitamin D supplements and sunlight exposure.

Meal-specific dietary patterns and their contribution to habitual dietary patterns in the Iranian population.

Recent studies have focused on habitual intake without addressing meal-specific intakes. We aimed to identify meal-specific dietary patterns and their contribution to habitual dietary patterns. This cross-sectional study was conducted on 838 adults, both sexes who attended the health centres in Tehran. Dietary data were recorded by three 24-h dietary recalls (24hDR). Dietary patterns were identified by using principal component analysis on meal-specific and overall food intakes. Intraclass correlation (ICC) was used as a measurement of consistency across meals and days. Correlation analysis and linear regression (partial R2) were used for meals contribution. Four habitual dietary patterns were derived from average dietary intake of 3-d 24hDR labelled as 'Western', 'Healthy', 'Traditional' and 'Legume and broth'. Also, we identified two major dietary patterns on each meal level (factor 1 and 2 for breakfast, lunch, afternoon snack and dinner). The highest contribution of energy intake was observed in lunch (25·7 %), followed by dinner (20·81 %). Consistency of food groups was the highest across days (ICC tea = 0·58) and breakfasts (ICC tea = 0·60). Dinner had a strong correlation coefficient with the 'Western' habitual dietary pattern then followed by lunch. Similarly, dinner and lunch contributed the most (r and partial R2) to the 'Western' habitual dietary pattern. Our results suggest that habitual dietary patterns to several extents are formed at meal levels, and dinner has a greater contribution to the habitual dietary patterns in Iranian people. This may help planning for local dietary guidelines according to the time of eating to promote public health.

Association of Dietary and Lifestyle Inflammation Score With Cardiorespiratory Fitness.

Objective: We aimed to assess the potential association of dietary (DIS) and lifestyle inflammation score (LIS) and their joint association (DLIS) with cardiorespiratory fitness (CRF) in Tehranian adults. Design: The present study was designed cross-sectional. Participants: A total of 265 males and females aged 18-70 years (mean ± SD: 36.9 ± 13.3) were entered in the present cross-sectional study. Eligible participants were healthy men and women who were free of medications and had no acute or chronic infection or inflammatory disease. Measures: The DIS was calculated by the use of data from 18 anti- and pro-inflammatory dietary components, and the LIS by three non-dietary components including physical activity, smoking status, and general adiposity, with higher scores indicating a more pro-inflammatory diet and lifestyle, respectively. The DLIS was calculated by summing the DIS and LIS. CRF was assessed by the Bruce protocol and VO2 max was measuredas the main variable of CRF. The odds ratio (OR) and 95% confidence interval (CI) of CRF across tertiles of the DIS, LIS, and DLIS were estimated by logistic regression analysis with considering age, gender, energy intake, marital and education status, and occupation as confounders. Results: The DLIS ranged from -2.10 to 0.38 (mean ± SD: -1.25 ± 0.64). In the model that controlled for all variables, the ORs of CRF for the second and third tertiles of the DLIS as compared to the first tertile were 0.42 (95%CI: 0.20, 0.90) and 0.12 (95%CI: 0.05, 0.32), respectively (P-trend < 0.001). There was a strong inverse association between the LIS and CRF (ORthirdvs.firsttertile: 0.12, 95%CI: 0.05, 0.32). There was no association between DIS and CRF. Conclusion: The present study examined the joint association of inflammation-related lifestyle behaviors with CRF and found a strong inverse association between a pro-inflammatory lifestyle with CRF. We did not find any association between dietary inflammatory properties with CRF. Future studies should address the relationship between the inflammatory potential of the diet and CRF.

Association of nightly fasting duration, meal timing and frequency with the metabolic syndrome among Iranian adults.

Accumulative evidence indicates that meal timing is associated with cardiometabolic risks by deteriorating circadian rhythms. However, evidence is unclear. This cross-sectional study aimed to investigate the relation between nightly fasting duration, meal timing and frequency and metabolic syndrome (MetS) among Iranian adults. Eight hundred fifty adults were recruited in this study. Dietary data were collected by 24-h dietary recalls. Time-related eating patterns were determined as nightly fasting duration, occasions of eating, time and energy proportion of first and last meal and meal frequency on a day. The MetS was recognised on the basis of the National Cholesterol Education Program Adult Treatment Panel III criteria. A binary logistic regression was applied to examine the relation between meal timing and MetS. A significant inverse relation between habitual nightly fasting duration with MetS (OR = 0·74, 95 % CI 0·55, 0·99, P = 0·04) and 'increased TAG' (OR = 0·73, 95 % CI 0·55, 0·98, P = 0·03) was found after confounder adjustment. Also, habitual first and last meal energy had no significant connection with MetS. However, the odds of 'increased fasting blood glucose' were lower in subjects who consumed ≥25% of habitual energy intake in the last meal (OR = 0·60, 95 % CI 0·42, 0·85, P = 0·005). Having longer nightly fasting duration may be useful for decreasing the risk of both MetS and 'elevated TAG'. These findings introduce a new insight that time-related eating patterns, instead of nightly fasting duration alone, might be related to cardiometabolic risks in Iranian adults.

Association of Dietary and Lifestyle Inflammation Score With Metabolic Syndrome in a Sample of Iranian Adults.

Objective: We aimed to evaluate the association between the dietary and lifestyle inflammation score (DLIS) and metabolic syndrome (MetS) and its components in a sample of Iranian adults. Design: Population-based cross-sectional study. Setting: General adult population living in Tehran, Iran. Subjects: We included 827 adult men and women with an age range of 18-59 years who were referred to health centers in different districts of Tehran, Iran. Dietary intake was assessed by a semiquantitative food frequency questionnaire with 168 items. The DLIS was calculated based on four components, including dietary inflammation score, physical activity, cigarette smoking, and general obesity. Higher DLIS represents a more proinflammatory diet and lifestyle. The odds ratio (OR) and 95% confidence interval (CI) of the MetS across quartiles of the DLIS was calculated by using logistic regression analysis, controlling for age, sex, energy intake, marital status, education status, and occupation. Results: A total of 827 participants (31% men) were included, with a mean age of 44.7 ± 10.7 years. The prevalence of the MetS was 30.5%. The DLIS ranged between -2.35 and +3.19 (mean ± SD: 0.54 ± 1.09). There was a significant positive association between the DLIS and odds of MetS (OR fourthvs.thefirstquartile: 1.57, 95% CI: 1.01-2.45) in the fully adjusted model. Conclusion: Our results showed a significant positive association between the DLIS and odds of MetS. The results of the present crosssectional study suggested that having a more proinflammatory lifestyle can be associated with MetS. More prospective studies are needed to confirm the findings.

Dietary networks identified by Gaussian graphical model and general and abdominal obesity in adults.

BACKGROUND: Gaussian graphical model (GGM) has been introduced as a new approach to identify patterns of dietary intake. We aimed to investigate the link between dietary networks derived through GGM and obesity in Iranian adults. METHOD: A cross-sectional study was conducted on 850 men and women (age range: 20-59 years) who attended the local health centers in Tehran. Dietary intake was evaluated by using a validated food frequency questionnaire. GGM was applied to identify dietary networks. The odds ratios (ORs) and 95% confidence intervals (CIs) of general and abdominal adiposity across tertiles of dietary network scores were estimated using logistic regression analysis controlling for age, sex, physical activity, smoking status, marital status, education, energy intake and menopausal status. RESULTS: GGM identified three dietary networks, where 30 foods were grouped into six communities. The identified networks were healthy, unhealthy and saturated fats networks, wherein cooked vegetables, processed meat and butter were, respectively, central to the networks. Being in the top tertile of saturated fats network score was associated with a higher likelihood of central obesity by waist-to-hip ratio (OR: 1.56, 95%CI: 1.08, 2.25; P for trend: 0.01). There was also a marginally significant positive association between higher unhealthy network score and odds of central obesity by waist circumference (OR: 1.37, 95%CI: 0.94, 2.37; P for trend: 0.09). Healthy network was not associated with central adiposity. There was no association between dietary network scores and general obesity. CONCLUSIONS: Unhealthy and saturated fat dietary networks were associated with abdominal adiposity in adults. GGM-derived dietary networks represent dietary patterns and can be used to investigate diet-disease associations.

Water intake and risk of type 2 diabetes: A systematic review and meta-analysis of observational studies.

BACKGROUND AND AIMS: The association of water intake with type 2 diabetes mellitus (T2DM) is still unclear. Therefore, the aim of this systematic review and meta-analysis was to synthesize the knowledge about the relationship between water intake and the risk of T2DM. METHODS: We conducted a systematic search in PubMed and Scopus up to June 2018 for observational studies. Risk ratios (RR)s and 95% confidence intervals (95% CI)s were calculated and fixed effects models were used. RESULTS: Overall, 6 studies were included in the meta-analyses. There was an inverse relationship between water intake and risk of T2DM (RR: 0.94; 95% CI: 0.91-0.97, P < 0.001) with low heterogeneity (I2 = 24%, P = 0.24). CONCLUSION: Our findings indicated that the intake of water was correlated with reduced risk of type 2 diabetes in women and men. These results support the current recommendations of water intake as an inseparable part of a diet with the lowest risk of diabetes mellitus.

Association between carbohydrate quality index and general and central obesity in adults: A population-based study in Iran.

Introduction: To determine whether dietary carbohydrates quality index (CQI), glycemic index, and glycemic load is associated with general and abdominal obesity. Methods: 850 participants, 20 to 59 years old, were enrolled in a cross-sectional study from five Tehran districts through health houses. The 168 items in the semi--quantitative food frequency questionnaire were used to assess dietary intake. The CQI was calculated by using the following four components: glycemic index, total fiber, solid carbohydrate to total carbohydrate ratio, and whole grains: total grains ratio. Results: After adjusting for confounding factors, the chance of obesity in men (OR=0.38, 95% CI 0.15to 0.95; P =0.04) measured by waist circumference (WC) was significantly lower in the fourth quintile of CQI in comparison with the first quintile. In addition, OR for obesity in men (OR=2.53, 95% CI0.52 to 1.37; P =0.04) was significantly 2.5 times higher among those in the fourth quintile of glycemic index compared with those in the lowest quintile. There was no significant association between dietary carbohydrates with general obesity in men and women. Conclusion: In summary, dietary CQI is significantly inversely related to central obesity in men,according to this study. Additionally, adherence to a diet with a higher glycemic index in men is positively associated with central obesity.

Associations between adherence to MIND diet and metabolic syndrome and general and abdominal obesity: a cross-sectional study.

BACKGROUND: There is a lack of studies examining the association between Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) and metabolic syndrome (MetS) and obesity. Thus, this study aimed to investigate the association of adherence to the MIND diet with MetS and general and abdominal obesity. METHODS: This cross-sectional study was performed on 836 Iranian adults, 18-75 years old. A 167-item food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. Anthropometric measurements, blood pressure, fasting blood glucose and lipid profile of each participant were recorded. The guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III) was used to define MetS. RESULTS: Mean age of study participants was 47.7 ± 10.7 years. The prevalence of MetS was 36.1% and mean body mass index (BMI) and waist circumference (WC) was 27.7 ± 4.69 kg/m2 and 92.0 ± 12.4 cm respectively. Those who were in the third tertile of the MIND diet score compared to the first tertile had 12% lower odds of having the MetS (ORs: 0.88; 95% CI 0.62-1.24) but the association was not significant (P = 0.77). There was a significant inverse association between the MIND diet score and odds of reduced high-density lipoprotein cholesterol (HDL-C) (ORs: 0.59; 95% CI 0.41-0.85; P = 0.008) and general obesity (ORs: 1.190.80-1.78; 95% CI 0.80-1.78; P = 0.02) in crude model and after controlling for confounders. CONCLUSIONS: We found that the MIND diet score is inversely associated with odds of reduced HDL and general obesity in Iranian adults.