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.

Association of dietary phytochemical index with cardiometabolic risk factors.

Objective(s): Cardio-metabolic risk factors are becoming a global health concern. To address this problem, one of the proposed ways is to focus on phytochemical-rich foods consumption. Therefore, we aimed to summarize the results of observational studies (cohorts, case-control, and cross-sectional) that investigated the association between dietary phytochemical index (PI) as a new index for evaluating phytochemical-rich food intake and various risk factors of cardio-metabolic disorders. Methods: We conducted a comprehensive systematic review through PubMed, Scopus, and Web of Science databases. The literature search was performed up to August 2021 with no publication year restriction on observational studies investigating the association between PI and cardiometabolic risk factors on adults and children. A random-effect meta-analysis was used. Results: Overall, 16 articles (cross-sectional, case-control, cohort) were eligible for this systematic review and 8 studies with 99771 participants were included in the meta-analysis. Random effect meta-analysis showed that adherence to higher dietary PI decrease the odds of abdominal obesity (OR: 0.73, 95% CI: 0.58, 0.88, I2: 84.90), generalized obesity (OR: 0.84, 95% CI: 0.69, 0.98, I2: 68.10), hypertriglyceridemia (OR: 0.81, 95% CI: 0.73, 0.89, I2: 0.00), hypertension (OR: 0.86, 95% CI: 0.73, 0.99, I2: 7.02), and MetS (OR: 0.79, 95% CI: 0.69, 0.88, I2: 84.90). However, results considering the associations between dietary PI with glycemic indices, and low high-density lipoprotein cholesterol (HDL-C) were not significant (p<0.05). Conclusion: Evidence showed adverse associations between dietary PI and some cardio-metabolic risk factors such as obesity, hypertriglyceridemia, hypertension and metabolic syndrome.

The relationship between dietary phytochemical index and resting metabolic rate mediated by inflammatory factors in overweight and obese women: a cross-sectional study.

BACKGROUND: Unhealthy dietary patterns are the most important modifiable risk factors for obesity and overweight. This study aimed to examine the relationship between Dietary Phytochemical Index (DPI) and resting metabolic rate (RMR), mediated by inflammatory factors, in overweight and obese women. METHODS: A total of 404 women, aged 18-48 years, were included in the cross-sectional study. DPI was calculated using the 147-item food frequency questionnaire (FFQ). Anthropometric measurements, RMR, and blood biomarkers were assessed using standard protocols. RESULTS: There was marginally significant association between adherence to DPI and RMR status in the crude model (OR = 1.41, 95% CI 0.94-2.11, P = 0.09). After adjusting for potential confounders, a significant association was seen between the DPI and increase RMR.per.kg (OR = 2.77, 95% CI 0.98-7.82, P = 0.05). Our results indicated that plasminogen activator inhibitor-1 (PAI-1), transforming growth factor (TGF-ß), and monocyte chemoattractant protein-1 (MCP-1) had a mediatory effect on the association between RMR and DPI (P > 0.05). Indeed, it was shown that, PAI-1, TGF-ß, and MCP-1 destroyed the significance of this association and could be considered as mediating markers. However, no mediating effect was observed for high-sensitivity C reactive protein (hs-CRP). CONCLUSIONS: Adherence to DPI can improve the RMR by reducing levels of inflammatory markers, and may be considered as a treatment for obesity. However, more long-term studies are recommended.

The association of appetite and hormones (leptin, ghrelin, and Insulin) with resting metabolic rate in overweight/ obese women: a case-control study.

OBJECTIVE: Low resting metabolic rate (RMR), as a risk factor for weight gain and obesity, can be influenced by many factors. Empirical research has confirmed the role of appetite and related hormones in obesity and energy intake. This study aimed to investigate the relationship between appetite and related hormones in overweight or obese Iranian women with normal and hypo RMR. METHODS: This case-control study was conducted on 42 Iranian adult women (21 cases, and 21 controls), aged 18-48 years. An impedance body analyzer was used to obtain the body composition and an indirect calorimeter was used to assess the RMR. The Flint questionnaire was used to assess appetite, dietary intake, and physical activity were assessed by FFQ and IPAQ questionnaires respectively, and ELISA kits were used to assess leptin, ghrelin, and insulin hormones. RESULTS: The results of the study demonstrated a negative association between ghrelin hormone level (ß = -0.34, 95%CI = -61.70,-3.86, P-value = 0.027) and RMR, and a positive association between insulin hormone level (ß = 0.48, 95%CI = 9.38-34.35, P-value = 0.001) and RMR. Also, results of the appetite questionnaire showed that, in general, both appetite (ß = 0.32, 95%CI = -0.10-2.99 P-value = 0.044) and hunger variable (ß = 0.30, 95%CI = 0.04-5.87, P-value = 0.047) have a positive association with RMR. There was no significant association between leptin levels and RMR. CONCLUSION: It is evident that appetite and related hormones have a potential role in promoting a normal RMR.

The association between urinary metabolites of polycyclic aromatic hydrocarbons (PAHs) and cardiovascular diseases and blood pressure: a systematic review and meta-analysis of observational studies.

Although epidemiological studies have discerned the association between polycyclic aromatic hydrocarbons (PAHs) exposure and hypertension and/or cardiovascular disease in the general population, the possible mechanisms for this association are not well understood. We sought to examine the association between urinary metabolites of PAHs and cardiovascular diseases (CVDs) and blood pressure in adults, by conducting a meta-analysis of observational studies. We searched PubMed, Scopus, Embase, and Web of science, up to July 2021, for observational studies that investigated the association between urinary metabolites of PAHs and CVDs and blood pressure in adults. Nine prospective studies, including 27,280 participants, were included. Based on overall pooled results, there was a significant positive association between all types of urinary metabolites of PAH and blood pressure (OR: 1.32; 95%, CI: 1.19 to 1.48, p < 0.0001) (I2 = 62.4%, p < 0.0001). There was no significant association between any urinary metabolite of PAH and CHD (OR: 0.93; 95%, CI: 0.83 to 1.03, p = 0.174) (I2 = 0%, p = 0.653). Overall, there was a significant positive association between all urinary metabolites of PAH and CVD (OR: 1.23; 95%, CI: 1.16 to 1.30, p < 0.0001) (I2 = 59.7%, p < 0.0001). The results of the present meta-analysis suggest that different metabolites PAHs are associated with an increased risk of CVD and HTN. Further studies, including randomized clinical trials, are needed to confirm the veracity of our findings.

Soy Foods and the Risk of Fracture: A Systematic Review of Prospective Cohort Studies.

OBJECTIVES: The primary objective of our study was to systematically review all available prospective cohort studies which investigated the association of soy food intake and incident fracture risk. METHODS: We searched PubMed, Scopus, and Embase databases for relevant studies up to June 2021. SYNTHESIS: Of 695 records, a total of 5 cohort studies were included in the current systematic review. Two studies that were performed in China evaluated hip fracture while 2 studies that were done in Singapore evaluated any kind of fractures. The other study was conducted in Japan and evaluated osteoporosis fractures. All studies used a face-to-face interview to assess the dietary intake of soy foods. All 5 cohort studies were determined to be of high quality. One study considered soy food as a part of a vegetables-fruit-soy food dietary pattern. Others reported the association of dietary intake of soy foods with the risk of fractures. CONCLUSION: The evidence from prospective cohort studies was suggestive for a protective role of soy foods, alone or within a dietary pattern, in the risk of incident fracture among Asian women, particularly for those in early menopause and those who used fermented soy products. But for men, the association was not significant. However, more cohort studies, including non-Asian populations, are required to confirm this association fully.

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.

Dietary inflammatory index (DII) may be associated with hypertriglyceridemia waist circumference phenotype in overweight and obese Iranian women: a cross sectional study.

OBJECTIVE: Recent studies have shown that increased dietary inflammatory index (DII) score or consumption of pro-inflammatory foods can lead to increased waist circumference (WC) as well as triglyceride (TG) concentrations in obese people. The purpose of this study is to examine the association between DII and hypertriglyceridemic waist circumference phenotype (HTGWCP) in women with overweight and obesity. RESULTS: There was a positive significant correlation between DII and HTGWCPs. In other words, with an increase in DII score or higher consumption of pro-inflammatory foods, the odds of having abnormal phenotypes including; enlarged waist normal TG (EWNT) (OR = 2.85, 95% CI 1.02 to 7.98, P for trend = 0.04), normal waist enlarged TG (NWET) (OR = 5.85, 95% CI 1.1 to 31.11, P for trend = 0.03) and enlarged waist enlarged TG (EWET) (OR = 3.13, 95% CI 0.95 to 10.27, P for trend = 0.05) increase compared to normal waist normal TG (NWNT) phenotype. In conclusion; increasing DII scores can increase abnormal phenotypes and therefore may increase WC and TG levels in overweight and obese women.

Validity of continuous metabolic syndrome score for predicting metabolic syndrome; a systematic review and meta-analysis.

BACKGROUND: Nowadays, use of continuous metabolic syndrome (cMetS) score has been suggested to improve recognition of metabolic syndrome (MetS). The aim of this study was to evaluate the validity of cMetS scores for predicting MetS. METHODS: We searched the electronic databases included MEDLINE/PubMed, Embase, ISI Web of Science, and Scopus from 1 January 1980 to 30 September 2020. Observational studies on participants with different cMetS scores were included in this meta-analysis. The sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR) and diagnostic odds ratio (DOR) with 95% CI were calculated. RESULTS: Ten studies involving a total of 25,073 participants were included. All studies had cross-sectional design. The pooled sensitivity and specificity of cMetS scores for predicting MetS were 0.90 (95% CI: 0.83 to 0.95) and 0.86 (95% CI: 0.83 to 0.89), respectively. Moreover, cMetS scores had the pooled LR+ of 6.5 (95% CI: 5.0 to 8.6), and a pooled (LR-) of 0.11 (95% CI: 0.063 to 0.21). The pooled DOR of cMetS scores to predict MetS were 57 (95% CI: 26 to 127). CONCLUSIONS: The high sensitivity and specificity of cMetS scores indicates that it has a high accuracy to predict the risk of MetS. Furthermore, the cMetS scores has a good ability to rule out healthy people. STUDY REGISTRATION: This study was registered as PROSPERO CRD42020157273.

Dietary energy density and risk of prostate cancer: (A case-control study).

OBJECTIVE: Some observational studies investigated the association between dietary energy density (DED) and risk of cancers with inconstant results. In addition, there is no study on such association among patients with prostate cancer (PC). The present study was performed to evaluate the association between dietary energy density (DED) and PC risk. METHODS: In this case-control study, one hundred and twenty-five participants were enrolled (62 cases and 63 controls). Dietary intakes were assessed using 160-item semi-quantitative food frequency questionnaire. In addition, demographic characteristics were collected using a general questionnaire and anthropometric indices were measured based on the available guidelines. The association between DED and PC risk was evaluated using multivariable logistic regression. RESULTS: The results showed that higher DED score was associated with increased risk of PC (OR = 2.59; 95% CI= (1.24-5.40)). Interestingly, after adjusting for potential confounders ((smoking, physical activity, energy intake, education, ethnicity, job, anti-hyperlipidemic drugs, antihypertensive drugs, and aspirin) the results remained significant (OR = 2.87; 95% CI= (1.17-7.05)). CONCLUSION: Our findings suggest that DED may increase the risk of PC. However, more prospective studies are warranted to confirm these results.

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 between protein-rich dietary patterns and anthropometric measurements among children aged 6 years.

AIM: The associations between types of dietary protein intake and child anthropometric measurements have not been fully studied. Therefore, we examined dietary protein pattern in relation to anthropometric indicators among 6-year-old children. METHODS: We carried out a cross-sectional study of 788 randomly selected children from health centres in Tehran, Iran. Dietary intake was assessed using a food frequency questionnaire completed by the mothers. Anthropometric measurements were based on standard protocols. Principle component analysis was performed to identify different dietary protein patterns. We used multivariate logistic regression to evaluate how these patterns were associated with child anthropometry. RESULTS: Three dietary protein patterns were identified: pattern 1 (rich in red and processed meats, dairy products and eggs), pattern 2 (rich in fish and poultry) and pattern 3 (rich in soy and legumes). After adjusting for potential confounders (energy intake, socioeconomic status and physical activity), being in the third compared to the first tertiles of pattern 2 was associated with increased (OR = 1.57; 95% CI: 1.09-2.27; P = .01) and decreased (OR = 0.54; 95% CI: 0.32-0.92; P = .02) risk of overweight/obesity and underweight/wasting, respectively. There was no association between other dietary patterns and risk of overweight/obesity or underweight/wasting. CONCLUSIONS: The present study showed inverse association between the fish/white meat pattern and underweight/wasting and also a positive association between higher fish/white meat protein intake and higher risk of overweight/obesity. Further studies are needed to confirm these results.