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There is scarce research focusing on the relationship between the low-carbohydrate dietary score and the development of a metabolically unhealthy phenotype. Therefore, this cohort study was designed to assess the association between the low-carbohydrate dietary score and the risk of metabolically unhealthy phenotypes (MUP). This study included 1299 adults with healthy metabolic profiles who were followed for 5.9 years. Results indicated an inverse association between the second tertile of the low-carbohydrate dietary score and the risk of developing metabolically unhealthy obesity (MUO) (HR: 0.76, 95% CI: 0.59-0.98). In addition, we found an inverse association between the healthy low-carbohydrate dietary score and the risk of MUO (HR: 0.77, 95% CI: 0.60-0.99). Our results revealed a nonlinear inverse association between the low-carbohydrate dietary score and the risk of MUP only in subjects with overweight or obesity. This relationship was independent of animal protein and fat intake. Also, we found that a lower intake of unhealthy carbohydrates was associated with a lower risk of MUP only in subjects with overweight or obesity.

Background: Individuals with normal weight obesity (NWO) are predisposed to having cardiometabolic disorders. This study aims to investigate the circulating levels of vaspin, leptin and their association with glycemic and lipid profiles in women with NWO., Methods: Forty women with body mass index (BMI) = 18.5-24.9 kg/m 2 and fat mass (FM) ≥ 30% were assigned in the NWO group. Thirty age-matched women with identical BMI range, and FM < 30% (normal weight non-obese; NWNO) were considered as a control group. In addition to anthropometric measurements, glycemic and lipid profiles and circulating levels of leptin and vaspin were measured., Results: The mean ± standard deviation (SD) age of participants was 28.76 ± 4.76 years in the NWO group and 29.23 ± 4.50 years in the control group. The NWO group had the higher mean serum levels of insulin (9.02 ± 4.75 vs. 6.24 ± 2.51, P = 0.009), leptin (17.31 ± 8.10 vs. 9.94 ± 4.30, P < 0.001) and homeostatic model assessment of insulin resistance (HOMA-IR) (33.77 ± 20.71 vs. 23.48 ± 10.03, P = 0.009) compared to the NWNO group. The serum level of vaspin was higher in the NWO group compared to the control group (34.82 pg/ml vs. 27.72 pg/ml, respectively, P = 0.12). In NWO group, the serum levels of leptin had positive correlation with FBS (r = 0.45, P = 0.02), insulin (r = 0.51, P = 0.008), and HOMA-IR (r = 0.46, P = 0.02) and vaspin concentration was associated with insulin (r = 0.36, P = 0.02) and HOMA-IR (r = 0.30, P = 0.06), positively., Conclusion: It is concluded that the concentration of insulin and HOMA-IR index were significantly higher in women with NWO compared to NWNO. Higher concentrations of leptin and vaspin in the NWO group were associated with glycemic profile.

The present study investigated whether dietary patterns could interact with fat mass and obesity-associated (FTO) polymorphisms in relation to changes in BMI and waist circumference (WC) over 3⋅6 years of follow-up. Subjects were selected from participants of the Tehran Lipid and Glucose Study (n 4292, 43⋅2 % male). Dietary data were collected using a valid and reliable FFQ. Dietary patterns were determined using factor analysis. The genotypes of polymorphisms (rs1421085, rs1121980, rs17817449, rs8050136, rs9939973 and rs3751812) were determined. Genetic risk score (GRS) was calculated using the weighted method. Mean ages of men and women were 42·6 (sd 14) and 40⋅4 (sd 13) years, respectively. The healthy (e.g. vegetables and fruits) and the Western dietary patterns (WDP; e.g. soft drinks and fast foods) were extracted. In carriers of the risk alleles rs1121980, rs1421085, rs8050136, rs1781799 and rs3751812, BMI was approximately 2-fold higher in individuals in the higher quartile of WDP score, compared with the first quartile (P &lt; 0⋅05). WC increased with increasing WDP score in carriers of the risk alleles rs1121980 and rs3751812, but not in individuals who did not carry any risk alleles. BMI and WC increased to a greater extent in the high GRS group while increasing quartiles of the WDP score, compared with the low GRS group (BMI change; Q1: 1⋅04 (se 0⋅34) v. Q4: 2⋅26 (se 0⋅36)) (WC change; Q1: 0⋅47 (se 0⋅32) v. Q4: 0⋅95 (se 0⋅34)) (P interaction &lt; 0⋅05). These results suggest that adults with higher genetic predisposition to obesity are more susceptible to the harmful effects of adherence to the WDP, which emphasised the need to reduce the consumption of unhealthy foods for the prevention of obesity.

Objective: The associations of body mass index (BMI) and obesity with ovarian reserve are controversial. This systematic review and meta-analysis was conducted to investigate the associations in reproductive-aged women., Methods: PubMed and Scopus were searched up to December, 2016. Original studies on the association of BMI with ovarian reserve markers, anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), inhibin β, and antral follicle count (AFC), either according to BMI categories or a continuous variable, were selected. Analyses were stratified into three groups based on polycystic ovary syndrome (PCOS) and fertility status of women., Results: Of 4,055 records identified, 45 studies were eligible for inclusion. Comparing the obese with nonobese, the pooled mean differences (MDs) and 95% confidence intervals (CIs) were -1.08 (95% CIs -1.52, -0.63) ng/mL for AMH, -0.22 (95% CIs -0.39, -0.06) mIU/mL for FSH, -0.09 (95% CIs -0.60, 0.42) for AFC, and -21.06 (95% CIs -41.18, -0.85) pg/mL for inhibin β in overall populations. The MDs were significant for AMH in fertile non-PCOS and PCOS women, and for FSH only in PCOS women. Fisher's Z showed significant correlations of BMI with AMH in the overall populations (-0.15 [95% CIs -0.20, -0.11]) and in all subgroups, and with FSH in the fertile non-PCOS women (-0.16 [95% CIs -0.28, -0.04])., Conclusion: Ovarian reserve markers of AMH and FSH are significantly lower in obese than in nonobese women, and BMI is negatively correlated with AMH in all study populations, and with FSH in fertile non-PCOS subgroups. PCOS and fertility status do not appear to affect the associations.

Background: Although various anthropometric methods are available for assessing body composition, these have not been compared in Iranian adolescents. The objective of the present study was to compare body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR) and sum of four skinfolds as predictors of percentage body fat (PBF) and diagnosis of excess adiposity in Iranian adolescents., Methods: In this cross-sectional study, all anthropometric measurements were made in133 adolescents (65 boys and 68 girls), aged 10-18 years.PBF was determined using the bioelectrical impedance analysis method. Linear regression and receiver operating characteristic (ROC) analysis were used to analyze the data. Potential covariates including sex, age, and pubertal stage were adjusted., Results: R(2)adj of models for BMI, WC, WHR, WHtR, and skinfolds were 0.67, 0.56, 0.19, 0.56, and 0.56, respectively (P < 0.001). The AUC value of BMI to differentiate between normal and obese adolescents was 0.92 (P < 0.001). The AUC of BMI was significantly higher than those of WC, WHR, and WHtR (P < 0.05)., Conclusions: The performance of BMI is better than other anthropometric indices in predicting PBF and diagnosing excess adiposity in Iranian adolescents.

Objectives: To determine whether changes in food patterns over a period of 6 years were related to obesity in Tehranian adults., Design: Data on dietary intake, using the food frequency questionnaire, and anthropometry were obtained in 2 periods of the survey (1999-2001 and 2005-2007)., Setting: Participants of the Tehran Lipid and Glucose Study., Participants: Two hundred six adults., Main Outcome Measures: Waist circumference, body mass index, and waist-to-hip ratio., Analysis: Food patterns were derived using factor analysis., Results: Three dietary patterns, the healthful (HDP), the western (WDP), and the mix, were identified. Increased WDP score was directly related to change in body mass index (β = .41, R(2) = 0.22, P < .001) among overweight/obese individuals. Alterations in waist circumference was better predicted by increased WDP score (β = .49, R(2) = 0.21, P < .01) than by increased HDP score (β = -.20, R(2) = 0.11, P < .05). Subjects in the higher quartile of increased HDP score had lesser change in waist-to-hip ratio (β = -.77, R(2) = 0.43, P < .01)., Conclusions and Implications: Results of this study indicate that increased adherence to the WDP and decreased adherence to the HDP could contribute to obesity., (Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Human studies investigating the relationship between macronutrients intake and obesity, have failed to achieve consistent findings. This study was undertaken to assess the relationship between macronutrients intake and body mass index in a group of Tehranians. From 15,005 participants of the Tehran Lipid and Glucose Study, 1290 subjects aged over 10 years (565 males and 725 females) were selected randomly for dietary survey. Anthropometric indices were measured according to standard protocols and BMI was calculated. Dietary data were collected by trained interviewers using two non-consecutive 24-hour dietary recalls. Data on smoking habits, educational level and physical activity were compiled. Under- and over-reporting of energy intake were defined as EI: BMR < 1.35 and > or = 2.4, respectively. Calorie-adjusted amounts of macronutrients were calculated by the residual method, following which energy intakes from all calorie-adjusted macronutrients were simultaneously included in the multiple regression models controlling for age, physical activity, educational level and smoking and mutual effects of macronutrients. Total energy intake was not included to avoid collinearity. BMI increased with age in either gender. Controlling for confounding variables, energy intake from fat was positively associated with BMI in males in the 10-18, 19-24, 25-50 and 51+ year age categories (beta = 0.06, 0.13, 0.33, 0.48, P<0.05 for all, respectively) and females in the 19-24, 25-50 and 51+ age categories (beta = 0.17, 0.43, 0.52, P<0.05 for all, respectively). This relationship remained after excluding misreporters (beta = 0.06, 0.15, 0.36, 0.50 for males and beta = 0.21, 0.46, 0.54 for females in the corresponding age categories, respectively). The correlation of fat intake to BMI was not significant in younger females (10-18 year). No association was seen between energy intake from protein and carbohydrate with BMI in subjects before and after exclusion of misreporters. In conclusion, energy from fat was found to be independently and positively associated with obesity in adults. No other association was observed between energy from protein and carbohydrate with BMI.

Aims: To determine the prevalence and associations of general and central obesity in adults residing in district 13 of Tehran and to examine the associations of obesity with certain factors., Design: Population-based cross sectional study., Setting: Tehran, the capital of Iran., Subjects: A total of 9984 subjects (4164 men and 5820 women) aged 20-70 years., Methods: Demographic data were collected and anthropometric indices including weight, height, and waist and hip circumference were measured, according to standard protocols. Dietary intake was assessed by means of two 24-hour dietary recall forms. To determine the prevalence and association of general and central obesity, the suggested cut-off for Tehranian people, adjusted for their age group, was used. A body mass index (BMI) of > or =24 for men and > or =25 for women was used to determine the characteristic of obesity. Central obesity was determined as a waist-hip ratio (WHR) of > 0.86 for men and WHR > or = 0.78 for women. To determine the associations between general and central obesity and other factors, logistic regression was used., Results: The means of BMI, waist circumference (WC), and WHR were 25.8 +/- 4.1 kg/m2, 88.3 +/- 11.4 cm, and 0.91 +/- 0.07 in men and 27.3 +/- 5.4 kg/m2, 87.5 +/- 12.9 cm, and 0.83 +/- 0.08 in women, respectively. Obesity and central obesity were higher in women than in men; 67% vs. 29% for obesity and 93% vs. 74.1% for central obesity, respectively. Illiteracy (OR = 1.65; 95% CI = 1.13-2.41 in men; OR = 1.87, 95% CI = 1.59-2.21 in women), marriage (OR = 3.84, 95% CI = 3.63-4.29 in men; OR = 3.20, 95% CI = 3.63-4.19 in women), and very low physical activity (OR = 1.35, 95% CI = 1.09-1.53 in men; OR = 1.39, 95% CI = 1.10-1.76 in women) were factors associated with obesity. The risk of being centrally obese for men in the fourth quartile of legumes intake was lower than men in other quartiles (p < 0.05). Women in the first quartile of dairy consumption had the highest risk of being generally and centrally obese (OR = 2.16, 95% CI = 1.72-2.48 for general obesity and OR = 3.01, 95% CI = 2.36-3.67 for central obesity). The risk of obesity for women in the fourth quartile of energy and saturated fatty acid consumption was higher than for those in the first quartile (OR = 2.69, 95% CI = 2.39-3.11 for energy and OR = 1.36, 95% CI= 1.10-1.64 for saturated fatty acids). The risk of being centrally obese was higher for women in the first quartile of protein intake compared with women in the fourth quartile (OR = 1.71, 95% CI = 1.02-2.32)., Conclusions: The results from this national population-based study in Iran show high prevalence of obesity in Tehranian adults. The strong associations between obesity and certain life style factors confirm the necessity of multifactorial intervention.

Background: This study was conducted to evaluate the relationship between waist-to-hip ratio (WHR) and cardiovascular risk factors in overweight and obese women and to determine a point of WHR above which the chances of having cardiovascular risk factors increased., Methods: In this cross-sectional study, 2892 pre- and postmenopausal women aged 20-78 years with body mass index (BMI) > or = 25 selected from among 5791 women of the Tehran Lipid and Glucose Study (TLGS) population (n = 15,005), by multistage cluster random sampling method, were included. Anthropometric indices were measured and BMI and WHR were calculated. Blood pressure was evaluated according to standard protocols. Biochemical indices were measured in the fasting state. Subjects were placed into the high-risk categories for cardiovascular disease on the basis of population-defined norms. Women were divided into quartiles based on their WHR: quartile 1: < 0.78, quartile 2: 0.78- < 0.83, quartile 3: 0.83- < 0.88, quartile 4: > or = 0.88 for premenopausal women, and quartile 1: < 0.84, quartile 2: 0.84- < 0.9, quartile 3: 0.9- < 0.94 and quartile 4: > or = 0.94 for postmenopausal women., Results: A lower proportion of pre- and postmenopausal women with BMI > or = 35 were in quartile 1 and a higher proportion in quartile 4. A significant increasing trend was observed for odds ratio of having low HDL-C, high triglyceride, high total-/HDL-cholesterol and high fasting blood sugar (FBS) with increasing WHR. Controlling for BMI and simultaneously adjusting for confounding variables had no effect on this trend. Although no significant increasing trends were seen for having high total cholesterol, LDL-cholesterol, systolic and diastolic blood pressure with quartiles of WHR in both pre- and postmenopausal women, subjects with higher quartiles of WHR still had higher chances for having high total cholesterol. In the case of postmenopausal women having of higher odds for high LDL-cholesterol and high systolic blood pressure in the fourth quartile of WHR should also be added to the high total cholesterol., Conclusion: The results showed that in overweight and obese women, chances of having cardiovascular risk factors increased with WHR > or = 0.78 for premenopausal and with WHR > or = 0.84 for postmenopausal women.

Under- and over-reporting of energy intake are problems in dietary intake assessment. This study was conducted to assess the correlates of under- and over-reporting of energy intake in Tehranians. Dietary data on 947 participants (415 males and 532 females) of the Tehran Lipid and Glucose Study was collected by trained interviewers using two 24-hour recalls. Weight and height were measured by digital scale and tape measure according to standard protocols and recorded to the nearest 100 g and 1cm, respectively. Under-, normal- and over-reporting of energy intake was defined as ratio of energy intake to basal metabolic rate (EI:BMR) <1.35, 1.35-2.39 and >or = 2.4, respectively. Mean +/- SD of age was 37.3 +/-14.6 and 32.9 +/-13.6 years for men and women, respectively. Men had higher EI:BMR than women (1.72 +/-0.44 vs 1.27 +/-0.44, P<0.001). EI and EI:BMR was highest in the youngest age groups in both sexes. The prevalences of under- and over-reporting were 31% and 5%, respectively. Fewer men than women underreported EI (19% vs 40%, P<0.001). The fraction of over-reporters was significantly higher in men than women (7% vs 3%, P<0.05). EI:BMR decreased with age. Under-reporters were older and had higher BMI than normal-reporters, but their educational level did not differ significantly. Over-reporters were younger and had lower BMI than normal-reporters, but their educational levels did not differ significantly. Most over-reporters had normal BMI. Smoking was more prevalent in over-reporters than in the normal-reporters (28% vs 19% in men and 6% vs 1% in women, P<0.01). The results showed a high prevalence of misreporting of energy intake in Tehran. This phenomenon is related to age, obesity and smoking habits.

Backgrounds: Dietary potassium can play an important role in decreasing inflammatory factors as a protective factor for cancers. In this case-control study, we aimed to assess the possible association between dietary potassium intake and the risk of breast cancer (BC) among Iranian adult women. Methods: The present case-control study was conducted at Shohada and Imam Hossain hospitals, in Tehran. The study included 134 newly diagnosed cases of BC and 267 controls. A validated semi-quantitative 168-item food frequency questionnaire was used to compute the potassium intake. Logistic regression, adjusted for potential confounders, was used to estimate odds ratios(ORs) and 95% confidence intervals(CI) of BC according to tertiles of potassium intake. Results: The mean(M) ± standard deviation(SD) of age and body mass index (BMI) were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m2, respectively. Also, the M ± SD of potassium intake for the control and case groups was 1616 ± 293 and 1542 ± 338 (mg/1000 Kcal), respectively. In the multivariable-adjusted model for potential confounders, the higher total potassium intake was associated with decreased odds of BC (OR: 0.35, 95%CI: 0.19–0.62, P for trend < 0.001). Moreover, an inverse relationship was observed between potassium from plant sources (OR: 0.39, 95%CI: 0.22–0.69, P for trend = 0.001) and fruit and vegetable sources (OR: 0.49, 95%CI: 0.28–0.87, P for trend = 0.016) and odds of BC. Conclusions: Our findings suggested that diet rich in potassium may have a predictive role to reduce the odds of BC. [ABSTRACT FROM AUTHOR]

The present prospective cohort study aimed to determine whether dietary antioxidants were associated with incident type 2 diabetes mellitus (T2DM). Another objective was to find out whether such associations could be modified by the BMI status. A total of 2188 Tehranian adults aged 21–84 years, free of T2DM with the validated FFQ, was entered in the study. Multivariable Cox proportional hazards models adjusting for confounders were used to assess the association between dietary antioxidants and incident T2DM in total population, as well as in subjects with various BMI statuses. During 8·9 (8·1–9·6) years of follow-up, dietary vitamin E significantly decreased the incident T2DM, after adjustment for confounders. However, other dietary antioxidants were not shown to be significantly associated with incident T2DM. The interaction between dietary vitamin E, Mg and BMI status was found to influence the risk of T2DM (P for interaction < 0·05). After stratification of subjects based on BMI status, it was found that vitamin E and Mg decreased the risk of T2DM only among normal-weight individual. Also, an inverse association was found among dietary vitamin C, dietary Zn and the risk of T2DM in individuals with normal weight but not in overweight and obese individuals; however, the interaction test tended to be significant for these dietary variables. Dietary antioxidants including vitamin E, vitamin C, Zn and Mg when accompanied by healthy weight, may bring benefits to the prevention of T2DM. [ABSTRACT FROM AUTHOR]

Background/aim: Evidence from recent studies suggested that the quality of dietary macronutrients can play a possible role in predicting the risk of metabolic disorders. In the current study, we aimed to assess the association of carbohydrate quality index (CQI) and protein score with the risk of metabolic syndrome (MetS) in Iranian adults. Methods: This prospective study was conducted within the framework of the Tehran Lipid and Glucose Study on 1738 individuals aged between 40 and 70 years old, who were followed up for a mean of 6.1 years. A food frequency questionnaire was used to determine CQI and protein scores. The multivariable adjusted Cox regression model was used to calculate the hazard ratio (HR) of MetS across quartiles of protein score and CQI, and its components. Results: The mean ± standard deviation (SD) age and body mass index of the study population (42.5% men) were 49.3 ± 7.5 years and 27.0 ± 4.0 kg/m2, respectively. Mean ± SD scores of CQI and protein for all participants were 12.6 ± 2.4 and 10.3 ± 3.5, respectively. During the study follow-up, 834(48.0%) new cases of MetS were ascertained. In the multivariable-adjusted model, the risk of MetS was decreased across quartiles of CQI (HR = 0.83;95%CI:0.69–1.00, Ptrend=0.025) and protein score (HR = 0.75; 95% CI:0.60–0.94, Ptrend=0.041). Also, Of CQI components, the whole grain/total grains ratio showed a significant inverse association with the risk of MetS (HR = 0.75;95%CI:0.60–0.94, Ptrend=0.012). Conclusion: Our findings revealed that a dietary pattern with higher CQI and protein score may be related to a reduced risk of MetS in adults. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the interaction of the healthy eating index (HEI) and the dietary approach to stop hypertension (DASH) diet scores with FTO polymorphisms in relation to change in obesity traits. A total of 4480 subjects aged ≥ 18 years were selected from participants of the Tehran lipid and glucose study and followed-up 3 years. Selected polymorphisms (rs1421085, rs1121980, rs8050136) were genotyped and genetic risk score (GRS) was computed. HEI and DASH scores were computed based on dietary data. Changes in body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and visceral adiposity index (VAI) were measured. Higher adherence to both DASH and HEI scores were increased with higher ages. Individuals with high GRS had a lower change in BMI when they had higher adherence to HEI, compared to subjects with lower HEI score (P trend = 0.01). Change in WC in participants in the fourth quartile of HEI score in minor allele carriers of FTO variants was lower compared to the first quartile; conversely, higher adherence to the DASH score by this genotypic group was related to increase in WC. No significant interaction was seen between FTO polymorphisms and both diet scores regarding changes in any of obesity traits. In conclusion, in individuals with high GRS higher adherence to HEI score was associated with lower change in BMI and WC, while higher adherence to DASH diet was associated with higher change in WC, compared to individuals with lower adherence to both scores. [ABSTRACT FROM AUTHOR]

Background: Dietary advanced glycation end products(AGEs) may contribute to increased inflammation and oxidative stress as risk factors for chronic diseases such as liver disease. In the current study, we aimed to examine the possible association of dietary AGEs with the odds of non-alcoholic fatty liver disease (NAFLD) in Iranian adults. Methods: A total of 675 participants (225 newly diagnosed NAFLD cases and 450 controls), aged 20–60 years, were recruited for this case-control study. Nutritional data were measured using a validated food frequency questionnaire, and dietary AGEs were determined for all participants. An ultrasound scan of the liver performed the detection of NAFLD in participants of the case group without alcohol consumption and other causes of hepatic disorders. We used logistic regression models, adjusted for potential confounders, to estimate the odds ratios(ORs) and 95% confidence interval(CI) of NAFLD across tertiles of dietary AGEs. Results: Mean ± SD age and body mass index of the participants were 38.13 ± 8.85 years and 26.85 ± 4.31 kg/m2, respectively. The median(IQR) of dietary AGEs in participants was 3262(2472–4301). In the sex and age-adjusted model, the odds of NAFLD were increased across tertiles of dietary AGEs intake(OR:16.48;95%CI:9.57–28.40, Ptrend<0.001). Also, in the final model, after controlling for confounding effects of BMI, smoking, physical activity, marital status, socio-economic status, and energy intake, the odds of NAFLD were increased across tertiles of dietary AGEs intake(OR:12.16; 95%CI:6.06–24.39, Ptrend<0.001). Conclusion: Our results showed that greater adherence to dietary pattern with high dietary AGEs intake was significantly related to increased odds of NAFLD. [ABSTRACT FROM AUTHOR]

Background: Patients undergone bariatric surgery (BS) has long-term risks including decrease in diet quality, nutritional deficiencies and weight regain. This study focus on assessing dietary quality and food group components in patients one year after BS, the relationship between dietary quality score and anthropometric indices, and also evaluating the trend of body mass index (BMI) of these patients three years after BS. Methods: A total of 160 obese patients (BMI ≥ 35 kg/m2) were undergone sleeve gastrectomy (SG) (n = 108) or gastric bypass (GB) (n = 52), participated in this study. They were assessed for dietary intakes using three 24-hour dietary recalls one year after surgery. Dietary quality was assessed using food pyramid for post BS patients and healthy eating index (HEI). Anthropometric measurements were taken pre-surgery and 1, 2 and 3 years after operation. Results: The mean age of patients was 39.9 ± 11 years (79% female). The mean ± SD percentage of excess weight loss was 76.6 ± 21.0 one year after surgery. Intake patterns are generally (up to 60%) not consistent with the food pyramid. The mean total HEI score was 64 ± 12 out of 100. More than %60 of participants is exceeding the recommendations for saturated fat and sodium. The HEI score did not show significant relationship with anthropometric indices. The mean of BMI in SG group increased over three years of follow up, while in GB group, there were no significant differences in BMI during three years of follow up. Conclusions: These findings showed that patients had not healthy pattern intake one year after BS. Diet quality did not show significant relationship with anthropometric indices. The trend of BMI three years after surgery was different based on surgery types. [ABSTRACT FROM AUTHOR]

A metabolically unhealthy phenotype is associated with the risk of cardiometabolic events and can be prevented by adherence to healthy dietary patterns. The present study was designed to investigate the association between high adherence to the Dietary Approaches to Stop Hypertension (DASH), Mediterranean (MeDi), and Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet scores and the incidence of metabolically unhealthy phenotypes in adults across body mass index (BMI) categories. In this cohort study, 512 subjects with metabolically healthy normal weight (MHNW) at baseline and 787 subjects with metabolically healthy overweight/obesity (MHOW/MHO) at baseline were included. Dietary intake was collected by a validated food frequency questionnaire, and DASH, MeDi, and MIND scores were calculated. The Joint Interim Statement (JIS) criteria were used to define a metabolically unhealthy status. A total of 137 and 388 subjects with metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUOW/MUO) phenotypes, respectively, were observed, over a mean of 5.91 years of follow-up. The Cox proportional hazard regression indicated participants in the third tertile of the DASH score had a lower risk of the MUNW phenotype (HR: 0.59; 95% CI: 0.37–0.92) than those in the lowest tertile. Similarly, the highest adherence to the MeDi and MIND scores was also linked to a 46% (HR: 0.54; 95% CI: 0.36–0.81) and 47% (HR: 0.53; 95% CI: 0.34–0.83) lower risk of the MUNW phenotype, respectively. As well, there was an inverse relationship between the highest adherence to the DASH (HR: 0.66; 95% CI: 0.50–0.86), MeDi (HR: 0.74; 95% CI: 0.58–0.93), and MIND (HR: 0.57; 95% CI: 0.43–0.74) scores and the risk of MUOW/MUO. There was no interaction between age and the three dietary patterns in relation to a metabolically unhealthy phenotype. High compliance with the DASH, MeDi, and MIND scores was associated with a lower risk of MUNW. An inverse relationship between these three dietary patterns and the incidence of the metabolically unhealthy phenotype was also observed in individuals who had MHOW/MHO at baseline. [ABSTRACT FROM AUTHOR]

The current study aimed to examine the possible association of the dietary index for insulin resistance (DIR) and the lifestyle index for insulin resistance (LIR), determined by dietary components, body mass index, and physical activity, with the risk of cardiometabolic diseases, including insulin resistance (IR), hypertension (HTN), diabetes, and metabolic syndrome (MetS). This prospective cohort study was performed on 2717 individuals aged ≥ 19 years in the framework of the Tehran Lipid-Glucose Study. Data on nutritional intakes were assessed using a validated food frequency questionnaire. Logistic regression models were used to determine the odds ratio and 95% confidence intervals (ORs and 95% CIs) of cardiometabolic diseases across tertiles of DIR and LIR scores. During 3-years of follow-up, the incidence rate of diabetes, IR, HTN, and MetS was 3%, 13%, 13.9%, and 17%, respectively. In the multi-variables model, after controlling all potential confounders, the risk of IR(OR: 1.65, 95% CI 1.01–2.69, P-trend = 0.047), diabetes (OR: 1.95, 95% CI 1.02–3.74, P-trend = 0.058), and HTN(OR: 1.52, 95% CI 1.07–2.15, P-trend = 0.016) was increased across tertiles of DIR score. Also, the risk of IR (OR: 2.85, 95% CI 1.72–4.73, P-trend < 0.001), diabetes(OR: 2.44, 95% CI 1.24–4.78, P-trend = 0.004), HTN(OR: 1.95, 95% CI 1.35–2.81, P-trend < 0.001), and MetS (OR: 2.87, 95% CI 1.96–4.18, P-trend < 0.001) were increased across tertiles of LIR score. Our findings reported that a dietary pattern with a higher DIR score and a lifestyle with a higher LIR score might be related to increased cardiometabolic disorders, including diabetes, HTN, Mets, and IR in Iranian adults. [ABSTRACT FROM AUTHOR]

Background: Vegetables is the main sources of dietary nitrate. Studies suggested the potential link between nitrate content of vegetables and reduce the risk of chronic diseases. We aimed to assess the association between nitrate-containing vegetables (NCVs) with odds of nonalcoholic fatty liver diseases (NAFLD) in Iranian adults. Method: This case-control study was performed on a total of 225 newly diagnosed NAFLD cases and 450 controls aged 20–60 years. Individuals' dietary intakes were determined using a valid and reliable food frequency questionnaire. Results: The mean ± SD age and BMI of participants were 38.1 ± 8.8 years and 26.8 ± 4.3 kg/m2, respectively. In the fully adjusted model, the odds of NAFLD were decreased across tertiles of total NCVs [(adjusted OR: 0.20, 95%CI: 0.10–0.40), (Ptrend < 0.001)] and low-nitrate vegetables [(adjusted OR: 0.22, 95%CI: 0.11–0.48), (Ptrend < 0.001)]. Our results showed that each one SD increments in nitrate content of vegetables (adjusted OR: 0.73, 95%CI: 0.55–0.97) and nitrate content of fruits (adjusted OR: 0.59, 95%CI: 0.36–0.97) was associated with reduced odds of NAFLD (P < 0.05). However, there was a positive association between each one SD increments in nitrate content of dairy products and meats and processed meats with odds of NAFLD (adjusted OR: 1.34, 95%CI: 1.03–1.74), (P < 0.05). Conclusion: Our finding suggested that a higher intake of vegetable nitrate may be related to a decrease the odds of NAFLD. [ABSTRACT FROM AUTHOR]

Background: Assessment of both behavior and factors of health as ideal cardiovascular health (iCVH) in adolescence could contribute to cardiovascular disease prevention in adulthood.Aims: To explore the changes in the prevalence of iCVH and its components during a decade among Tehranian adolescents.Methods: The 12-19 years old adolescents were selected from the Tehran Lipid and Glucose Study(TLGS). The iCVH score was calculated in the study period 1 (2007-2008; n = 267) and 2 (2015-2017; n = 336). To calculate iCVH, body mass index(BMI), systolic and diastolic blood pressure (BP), total cholesterol, fasting plasma glucose (FPG), physical activity, smoking status, and dietary intakes were measured by standard protocols. The changes in iCVH components between the two study periods were reported by prevalence (95% confidence interval). A logistic regression model was conducted to test the effects of study periods, sex, and age groups on the iCVH(≥ 6 scores).Results: Overall, there was a reduction in the prevalence of ideal FPG (97.4 vs. 91.1%) and ideal BP(91.8 vs. 82.7%). Girls had a decrease in the prevalence of ideal BP(91.2 vs. 79.4%) as well as an increase in non-smoking status(77.6 vs. 89.7%). However, the prevalence of ideal FPG (96.5 vs. 88.5%) and ideal BP(92.2 vs 85.0%) decreased in boys. Study period 2, compared to period 1 was associated with lower odds of having iCVH. Furthermore, boys were 1.57 folds more likely to have ideal CVH factors than girls.Conclusion: There was a decrease in the prevalence of ideal CVD metrics, including FPG and BP, after one decade. Generally, adolescent boys had higher odds of having ideal CVH compared to girls. [ABSTRACT FROM AUTHOR]

Ideal cardiovascular health (CVH) is associated with a lower risk of developing cardiovascular diseases. This study aims to investigate the association of CVH metrics with carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis in young adults. A cross-sectional study was performed on 1295 adults, average age of 29.7 ± 4.0 years, selected from the participants of the Tehran Lipid and Glucose Study. The participants were divided into three groups based on the overall CVH score: ideal, intermediate, and poor CVH. Multivariate-adjusted linear regression was used to determine the association of the CVH score with cIMT. Multivariate-adjusted odds ratios (ORs) were calculated for high cIMT (≥ 95% percentile). Also, the independent effects of each ideal CVH metric on cIMT were analyzed. The prevalence of ideal CVH was 6.4% in men and 12.4% in women, and mean cIMT was obtained 0.53 ± 0.09 mm in men and 0.57 ± 0.08 mm in women. A 1-point increase of the CVH score in men and women was associated with a cIMT decrease of 0.009 and 0.011 mm (men: Beta [SE] = − 0.009 [0.003]; women: − 0.011 [0.007], p < 0.001), rendering the ORs of 0.66 and 0.70 for having a high cIMT (≥ 95% percentile), respectively. Ideal blood pressure in both sexes and body mass index in women had significant inverse association with cIMT. There was an inverse graded association between the CVH score and cIMT among young adults, indicating that ideal CVH metrics were associated with better vascular health in this population. [ABSTRACT FROM AUTHOR]

Background: There is no study regarding developing a valid index to predict insulin-related disorders in the Iranian population based on their dietary habits and lifestyle. In the current study, we aimed to develop and validate insulinemic potential indices of diet and lifestyle in Iranian adults. Methods: In this cross-sectional study, we analysed data of 1063 men and women aged ≥ 25 years among participants of the examination three of Tehran lipid and glucose study (TLGS) (2006–2008). Dietary intakes were assessed using a valid semi-quantitative food frequency questionnaire. Dietary and lifestyle indices were developed using stepwise linear regression analysis based on dietary intakes, body mass index, and physical activity data. Fasting serum insulin concentration and homeostatic model assessment for insulin resistance (HOMA-IR) were used as biomarkers of hyperinsulinemia (HI) and insulin resistance (IR). Validation analyses were performed in examination four of TLGS. Results: We developed four indices related to insulin homeostasis, including the dietary index for HI (DIH), the dietary index for IR (DIR), the lifestyle index for HI (LIH), and the lifestyle index for IR (LIR). Based on multivariable-adjusted models, the relative values of the biomarker in subjects in the highest quartile of indices were 45% for LIH (95% CI 1.36–1.55, Ptrend < 0.001), 28% for DIR (95% CI 1.13–1.42, Ptrend = 0.019), and 51% for LIR (95% CI 1.41–1.61, Ptrend < 0.001), higher than those in the reference quartile, respectively. Conclusion: We designed and validated indices to determine the insulin potential of diet and lifestyle for the Iranian population, according to Iran's demographic and dietary intake characteristics. [ABSTRACT FROM AUTHOR]

The current study aimed to evaluate the interaction of the dietary diversity score (DDS) and FTO polymorphisms concerning obesity phenotypes. The 4480 subjects of this cohort study were selected. The polymorphisms rs1121980, rs14211085 and rs8050136 were selected and genotyped. The weighted method was used to calculate the genetic risk score (GRS). Obesity marker changes were calculated. Those with minor allele carriers of rs1121980 had lower body mass index changes (Q1: 1.58 ± 0.60 vs. Q4: 0.13 ± 0.59) and visceral adiposity index (VAI) (Q1: −0.00 ± 0.02 vs. Q4: −0.04 ± 0.02) when they had higher DDS (P interaction = 0.05). Carriers of the minor allele of rs8050136 had significant VAI change across DDS quartiles (Q1: −0.01 ± 0.02 vs. Q4: −0.02 ± 0.02, P interaction = 0.05). No significant interaction was found between the GRS and DDS on general obesity. The pattern of dietary diversity may have a mediatory role in improving obesity markers in subjects with a more genetic predisposition to adiposity. [ABSTRACT FROM AUTHOR]

Background. Apelin is an adipokine with an intermediatory role in obesity and insulin resistance, which can be modified by dietary intake. Aims. In this study, we aimed to determine the association of the plasma fatty acid composition with apelin plasma concentration and gene expression in visceral (VAT) and subcutaneous (SAT) adipose tissues. Methods. In this cross-sectional study, we recruited 179 patients aged 19-75 years who were candidates for elective surgery. Through the surgery, SAT and VAT were collected to measure apelin gene expression. Anthropometric measurements, fasting blood samples, and dietary intakes were collected before surgery. Free fatty acids (FFAs) in fasting whole plasma were measured using gas chromatography with flame ionization detection. Linear regression models were used to estimate standardized β (STZ β) showing the association of individual and total FFAs with apelin gene expression after adjustment for potential confounding variables. Results. In multivariable analysis, we observed a significant positive association of total plasma free fatty acids (FFAs) (STZ β = 0.241 , P = 0.006), saturated fatty acid (SFA) (STZ β = 0.336 , P < 0.001), and monounsaturated fatty acid (MUFA) (STZ β = 0.313 , P < 0.001) concentrations with apelin gene expression from VAT after controlling for age, sex, body mass index, homeostatic model assessment for insulin resistance (HOMA-IR), physical activity, and energy intake. In the SFA family, there was a direct association with plasma concentration of myristic acid (STZ β = 0.372 , P < 0.001), pentadecanoic acid (STZ β = 0.252 , P = 0.002), and heptadecanoic acid (STZ β = 0.407 , P < 0.001) with apelin mRNA expression in VAT. There was no significant association between FFAs and apelin plasma concentration and SAT mRNA levels. Conclusions. In conclusion, circulating plasma FFAs, SFA, and MUFA had a positive association with apelin gene expression in VAT. It seems that plasma fatty acid composition may regulate apelin gene expression in VAT. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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 β-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 (STZβ = 0.208, P = 0.037) and subcutaneous (STZβ = 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 (STZβ = 0.227, P = 0.023; STZβ = 0.346, P < 0.001, respectively) and subcutaneous (STZβ = 0.227, P = 0.026; STZβ = 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. [ABSTRACT FROM AUTHOR]

Background: Dairy intake has been implicated in later ovarian aging but mechanism underlying the association is unknown. This study aimed to investigate (1) associations between dairy intake and metabolites previously shown related to anti-müllerian hormone (AMH) decline rate; (2) mediating roles of these metabolites in the prospective association of total dairy consumption with odds of AMH fast decline rate. Methods: The participants comprised 186 reproductive-aged women randomly selected from the Tehran Lipid and Glucose Study. AMH was measured at baseline (1999–2001) and the 5th follow-up (2014–2017), and dietary data was collected at the second follow-up (2005–2008) using a food frequency questionnaire. Untargeted metabolomics was performed by gas chromatography–mass spectrometry using fasting-serum samples of the second follow-up. We analyzed dairy intake in association with the eight metabolites linked to the higher odds of AMH fast decline rate using linear regression with the Benjamini–Hochberg false discovery correction. Mediatory roles of the metabolites were assessed by bootstrapping. Results: Mean age and BMI of the participants at metabolomics assessment were 44.7 ± 5.87 years and 28.8 ± 4.88 kg/m2, respectively. Phosphate, branched-chain amino acids (BCAAs), and proline decreased significantly from the first to the third tertile of total dairy intake. Total dairy as a continuous variable inversely associated with phosphate (beta = −0.166; p value = 0.018), valine (beta = −0.176; p value = 0.016), leucine (beta = −0.226; p value = 0.002), proline (beta = −0.219; p value = 0.003), and urea (beta = −0.156; p = 0.035) after accounting for all potential covariates and correction for multiplicity (q-value < 0.1). Fermented dairy showed similar results, but milk did not associate with any of the metabolites. Simple mediation showed significant indirect effects for phosphate, proline, and BCAAs but not urea. Entering the sum of phosphate, proline, and BCAAs as a mediator, the metabolites' total indirect effects were significant [β = −0.12 (95% CIs − 0.26, − 0.04)]. In contrast, the direct association of total dairy intake with the fast decline in AMH was non-significant [β = −0.28 (95% CIs − 0.67, 0.10)]. Conclusions: Total dairy was inversely associated with AMH decline rate-related metabolites. Inverse association of dairy intakes with the odds of AMH fast decline rate was indirectly mediated by lower phosphate, proline, and BCAAs. [ABSTRACT FROM AUTHOR]

Background: In the current study, we aimed to investigate the association of dietary inflammation scores (DIS) and lifestyle inflammation scores (LIS) with the risk of metabolic syndrome (MetS) in a prospective population-based study. Methods: A total of 1625 participants without MetS were recruited from among participants of the Tehran Lipid and Glucose Study(2006–2008) and followed a mean of 6.1 years. Dietary data of subjects were collected using a food frequency questionnaire at baseline to determine LIS and DIS. Multivariable logistic regression models, were used to calculate the odds ratio (ORs) and 95 % confidence interval (CI) of MetS across tertiles of DIS and LIS. Results: Mean ± SD age of individuals (45.8 % men) was 37.5 ± 13.4 years. Median (25–75 interquartile range) DIS and LIS for all participants was 0.80 (− 2.94, 3.64) and 0.48 (− 0.18, − 0.89), respectively. During the study follow-up, 291 (17.9 %) new cases of MetS were identified. Based on the age and sex-adjusted model, a positive association was found between LIS (OR = 7.56; 95% CI 5.10–11.22, P for trend < 0.001) and risk of MetS, however, the association of DIS and risk of MetS development was not statistically significant (OR = 1.30;95% CI 0.93–1.80, P for trend = 0.127). In the multivariable model, after adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, and energy intake, the risk of MetS is increased across tertiles of DIS (OR = 1.59; 95% CI 1.09–2.33, P for trend = 0.015) and LIS(OR = 8.38; 95% CI 5.51–12.7, P for trend < 0.001). Conclusions: The findings of the current study showed that greater adherence to LIS and DIS, determined to indicate the inflammatory potential of diet and lifestyle, are associated with increased the risk of MetS. [ABSTRACT FROM AUTHOR]

We aimed to investigate associations of dietary intakes with unhealthy metabolic phenotype development, in normal weight and overweight/obese adults separately. A total of 1114 individuals, aged ≥19 years, with healthy phenotype in the third examination cycle of Tehran Lipid and Glucose Study were followed until the fifth examination. Dietary intakes were estimated using the food frequency questionnaires, collected during the study. The participants were grouped as normal weight and overweight/obese according to the baseline body mass index (BMI). Unhealthy metabolic status was determined as having more than one component of metabolic syndrome using the Joint Interim Statement. Regardless of BMI, higher intakes of magnesium, dairy products, poultry, apples/pears, citrus fruits, and tea/coffee decreased the risk of developing unhealthy phenotype, while higher intakes of fast foods, organ meats, and potatoes increased the risk. Food intake can influence the transition to unhealthy phenotype in metabolically healthy adults, irrespective of the BMI status. [ABSTRACT FROM AUTHOR]

The objective of the present study was to investigate the association between the apelin gene expression and habitual physical activity among morbid obese and non-obese subjects. Visceral and subcutaneous adipose tissues were obtained from 32 morbidly obese and 32 non-obese age- and sex-matched subjects, who underwent open abdominal surgery. Physical activity was collected using a valid and reliable International Physical Activity Questionnaire (IPAQ)-long form, and the metabolic equivalent of task (MET) was calculated. The mRNA expressions of apelin gene in visceral and subcutaneous adipose tissues were analyzed by Real-Time PCR. The mean age was 39.6 years for both groups and body mass index for morbidly obese and non-obese subjects were 45.3 and 25.7 kg/m2, respectively. Apelin gene expression was more increased in morbid obese than non-obese subjects in subcutaneous (2.82 vs. 0.70,P < 0.05) adipose tissues. After controlling for potential cofounders, apelin expression in subcutaneous adipose tissue was associated with total MET in both non-obese (β = 0.589, p value = 0.001) and morbid obese participants (β = 0.395, p value = 0.038). Among non-obese participants, apelin mRNA levels in visceral fat depots were associated with the total physical activity (β = 0.487, p value = 0.010). Moreover, occupational physical activity was associated with apelin gene expression in the subcutaneous adipose tissue of non-obese and morbid obese participants. Total MET was associated with apelin gene expression in visceral and subcutaneous adipose tissue in non-obese participants and was associated with only mRNA levels in subcutaneous fat depots in morbid obese participants. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective. Limited data are available regarding prognostic value of nitric oxide metabolites (NOx) for clinical hard end points. In this study, we defined optimum cut-off values of serum NOx for predicting all-cause and cardiovascular disease (CVD) mortality events and prospectively investigated their hazards in the presence of traditional risk factors. Design. Serum NOx concentrations were measured at baseline (2006-2008) and 3520 adult men and women were followed during 7.7 years for all-cause and cardiovascular disease (CVD) mortality. To determine the optimal cut-off points of serum NOx, the receiver operator characteristic (ROC) curve analysis was used. Multivariate Cox proportional hazard models were used to estimate the hazard ratios (HRs) with 95% confidence intervals (95% CIs) of all-cause and CVD mortality below and above the defined optimal cut-off points of serum NOx. Results. Mean age of participants was 44.5 ± 16.0 years at baseline and 40.2% were male. Median (inter-quartile range) of serum NOx levels was 25.0 µmol/L (19.0-37.0), at baseline. The optimal cut-off points of serum NOx levels for predicting CVD and all-cause mortality were 30.5 and 32.5 µmol/L, respectively. In the presence of age, sex, body mass index, smoking, type 2 diabetes, hypertension, and history of CVD, a significant increased risk of CVD mortality (HR = 1.98, 95% CI = 1.10-3.58) and all-cause mortality (HR = 1.52, 95% CI = 1.05-2.21) was observed for serum NOx values higher than their cut-offs. Conclusion. Serum NOx level may be predictor of CVD mortality and death, in general populations. [ABSTRACT FROM AUTHOR]

Background: Dietary amino acids have been associated with blood pressure (BP) in previous studies; we conducted this study to examine the association between dietary branched chain amino acids (BCAAs) and the incidence of hypertension among participants of the Tehran Lipid and Glucose Study (TLGS). Methods: Analyses were conducted on 4,288 participants aged 20--70 years, who were free of hypertension at baseline (2008-2011) and were followed for 3 years (2011--2014) to ascertain incident hypertension. Dietary intakes of BCAAs including, valine, leucine, and isoleucine were collected at baseline using the food frequency questionnaire (FFQ). Odds ratio (OR) of hypertension were determined by logistic regression across quartiles of BCAAs, adjusted for sex, age, smoking status, physical activity, body mass index (BMI), diabetes, and some dietary factors. Results: The mean ± standard deviation for age and BMI of participants (41.9% men) were 39.7 ± 12.8 years and 26.9 ± 4.6 kg/ m², respectively. The median intakes of total BCAAs, valine, leucine, and isoleucine was 17.9, 5.5, 7.8, and 4.5 percentage of total amino acids intake, respectively. We documented 429 (10%) hypertension incident cases. The multivariable adjusted OR for the highest vs lowest quartiles of BCAAs was 1.54 (95% confidence interval (CI):1.03-2.32; P for trend = 0.05); furthermore, the OR (95% CI) of hypertension for the highest vs the lowest quartile of valine was 1.61 (1.10-2.36; P for trend = 0.009) in the fully adjusted model. However, we found no significant association between leucine and isoleucine with incidence of hypertension. Conclusion: Findings indicated that higher BCAA intake, in particular valine, is associated with higher risk of incident hypertension. [ABSTRACT FROM AUTHOR]

Abstract Aims The role of gut microbiota in the pathogenesis of diabetes is increasing; this study investigates the effect of multi-strain probiotics on fasting plasma glucose (FPG), plasma insulin and lipid profile among patients. Methods This randomized double blind controlled trial was performed among 60 patients; individuals were randomly assigned into 2 groups of 30 participants in order to take either probiotic supplements or placebo for 6 weeks. The probiotic supplement consisted of 7 viable strains Lactobacillus, Bifidobacterium and Streptococcus. Nutrient intakes were estimated using a 3-day and 24 hour-dietary recall at the beginning and end of study. Fasting blood samples were taken before and after intervention to measure the levels of FPG, plasma insulin and lipid profiles. Results Within group comparisons showed significant decrease and increase in the levels of FPG (P = 0.001) and HDL-C (P = 0.002) in probiotic group, respectively. No significant alterations were observed for within and between group comparisons in the levels of insulin, triglycerides, total cholesterol, insulin resistance and anthropometric measurements, including weight, waist circumference and body mass index (all P > 0.05). Conclusions This study showed a significant decrease in FPG level by multi-strain probiotic supplements in within group comparison; though, further studies are needed to confirm results. (IRCT Code: IRCT2013100714925N1). [ABSTRACT FROM AUTHOR]

Background & Aims: Although dietary patterns have been linked to chronic diseases such as cardiovascular disease, sparse data are available for a relationship between dietary patterns and incident chronic kidney disease (CKD) in West Asian populations. The aim of this study was to evaluate the association of population-based dietary pattern with the risk of incident CKD after 6.1 years of follow-up. Methods: At baseline, habitual dietary intakes of 1630 participants of the Tehran Lipid and Glucose Study (TLGS) who were free of CKD was assessed by a valid and reliable food-frequency questionnaire. The following three major dietary patterns were identified using a principal components analysis: Lacto-vegetarian dietary pattern, traditional Iranian dietary pattern, and high fat, high sugar dietary pattern. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease (MDRD) Study equation and CKD was defined as eGFR < 60 mL/min/1.73m2. Odds ratio (OR) using multivariable logistic regression was calculated for the association of incident CKD with the extracted dietary patterns. Results: After adjusting for age, sex, smoking, total energy intake, physical activity, body mass index, diabetes, and hypertension the OR for participants in the highest compared with those in the lowest tertile of the lacto-vegetarian dietary pattern was 0.57 (95% confidence interval [CI]: 0.41 to 0.80, P-trend = 0.002). In contrast, the high fat, high sugar dietary pattern was positively associated with the incidence of CKD (OR for the third tertile compared with first tertile: 1.46; 95% CI: 1.03–2.09; P-trend = 0.036). Traditional Iranian dietary pattern was not associated with incident CKD. Conclusion: The high fat, high sugar dietary pattern was associated with significantly increased (46%) odds of incident CKD, whereas a lacto-vegetarian dietary pattern may be protective against the occurrence of CKD by 43%. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the association of dietary total antioxidant capacity (TAC) with incidence of CKD in subjects with dysglycemia.Methods: We followed-up 1179 subjects aged ≥30 years with dysglycemia from the Tehran Lipid and Glucose Study (TLGS) for 3 years, who were initially free of CKD. Dietary intakes of TAC, vitamin C, vitamin E, and β-carotene were assessed by a food-frequency questionnaire at the baseline. Dietary TAC was estimated using the oxygen radical absorbance capacity method. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease Study equation and CKD was defined as eGFR <60 mL/min/1.73 m2. Odds ratios (ORs) using multivariable logistic regression were reported for the association of incident CKD with dietary TAC.Results: A total of 197 (16.7%) cases of incident CKD were recorded after 3 years of follow-up. After adjustment for age, sex, smoking, physical activity, body mass index, hypertension, and total energy intake, the top tertile of dietary TAC compared to the bottom was associated with 39% [95% confidence interval (CI) = 0.40-0.93] lower risk of incident CKD (P for trend = 0.025). Furthermore, the highest tertile of vitamin C intake compared to the lowest risk of incident CKD was decreased (OR 0.60; 95% CI 0.38-0.93, P trend 0.023). Intakes of vitamin E and β-carotene were not significantly associated with incident CKD risk.Conclusion: Our findings suggest that diets high in TAC are associated with a lower risk of incident CKD among subjects with hyperglycemia after 3 years of follow-up. [ABSTRACT FROM AUTHOR]

Objective: To examine associations of sex-specific related factors with pre-diabetes in Tehranian non-diabetic adults. Methods: This study has been conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) between 2008–2010. A total of 5568 (55.4% female) non-diabetic adults, aged ≥20 years, selected from among participants of the TLGS, were recruited for the study. Data on socio-behavioral factors, family history of diabetes and cardio-metabolic risk factors were included in the hypothesized model to test their direct and indirect associations with pre-diabetes in men and women separately, using structural equation modeling. Results: Pre-diabetes was diagnosed in 23.6% of participants, with significantly higher prevalence in men compared to women (27.4% and 20.5%, respectively; p<0.001). Body mass index (BMI) and triglycerides (TG) in both sexes and hypertension and high density lipoprotein only in women, were directly associated with pre-diabetes (p<0.05). Poor diet in women was the only behavioral factor directly associated with pre-diabetes (p<0.05). Age in both sexes and education, only in women, were directly associated with pre-diabetes. In both genders, age, marital status, education, employment, poor diet and leisure time physical activity were indirectly associated with pre-diabetes through cardio-metabolic risk factors. Conclusions: The main modifiable factors directly associated with pre-diabetes were TG in women and BMI in men, which need to be prioritized in health policies for diabetes prevention programs in Tehranian adults. Future research should focus on the gender-specific determinants and underlying mechanisms for TG levels and BMI status among this population. [ABSTRACT FROM AUTHOR]

This cohort study was conducted to examine the association of low carbohydrate diet (LCD) score with risk of incident metabolic syndrome (MetS) and its components after 3.6 years of follow-up in 2044 healthy adults within framework of the Tehran Lipid and Glucose Study. The LCD was calculated according to intakes of carbohydrate, monounsaturated fatty acids, refined grains, vegetable protein, fiber, n3/n6 polyunsaturated fatty acids ratio and glycemic load (GL), using a food frequency questionnaire at baseline. In the final model, after adjustment for age, gender, smoking status, physical activity and energy intake, there was significant association between LCD score and fasting plasma glucose (β: −0.002, 95%CI: −0.005, −0.001), triglycerides (TGs) (β: −0.002, 95%CI: −0.004, −0.001), BP (β: −0.001, 95%CI: −0.002, 0.000), WC-BMI (β: −0.003, 95%CI: −0.005, −0.001) and MetS risk Z-scores (β: −0.015, 95%CI: −0.021, −0.002). In conclusion, LCD may be associated with a decreased risk of MetS and its components in adults. [ABSTRACT FROM PUBLISHER]

Background and Objectives: Recent studies focus on vasoactive properties of protein, which is dependent to its source and amino acid composition. Our aim was to evaluate the association between dietary serine intakes and hypertension incident. Materials and Methods: We used the data of 4287 subjects aged 20-70 years, who participated in the fourth phase of Tehran Lipid and Glucose Study (2008-2011) and were followed up to the fifth phase (2011-2014). At baseline, the participants were free of hypertension, cardiovascular diseases, and cancer. Serine dietary data were collected through a valid and reliable food frequency questionnaire. Incidence of hypertension was identified after three years of follow up. To investigate the association of serine intake and incidence of hypertension, multivariable adjusted models of logistic regression were used, and odds ratios (ORs) across quartiles of serine were reported. Results: After three years of follow up, 429 (10%) incident cases of hypertension were ascertained. The OR of the highest quartile of serine intake was 1.43 (95% CI: 1.05-1.95; P for trend: 0.03) compared to the lowest adjusted for age and sex. After further adjustment for body mass index (BMI), diabetes status, physical activity, smoking status, and dietary intake of energy, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, calcium, magnesium, sodium, potassium and fiber, the OR of the highest vs. the lowest quartile of serine intake was 1.70 (95% CI: 1.18-2.44; P for trend=0.005). Conclusions: These findings suggest that dietary serine intake may be directly associated with the risk of hypertension incident. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to test a conceptual model of associations between socio-demographic and behavioral factors and obesity in the Tehran Lipid and Glucose Study (TLGS). Methods: Data from 2747 TLGS adult participants (58.3 % female) were analyzed. Socio-demographic and behavioral factors in the conceptual model were tested for their direct and indirect associations with overweight and central obesity, using structural equation modeling (SEM), conducted by IBM SPSS AMOS software. Results: Overweight and central obesity were found in 61.6 and 48.1 % of respondents, respectively. Fit indices were acceptable for the conceptual model. Daily energy intake had a direct association with overweight and central obesity in both genders; however, poor dietary pattern had direct associations with overweight and central obesity only in men. In women, age, marital status, and level of education had direct associations with overweight and central obesity. In men, only age and marital status had direct associations with overweight and central obesity. Conclusions: Age and marital status in both genders and level of education only in women were among the socio-demographic factors which were directly associated with both overweight and central obesity. Among behavioral factors, daily energy intake was the most important factor that was directly associated with both overweight and central obesity in both genders. Adherence to poor diet directly was associated with overweight and central obesity only in men. The current findings provide beneficial information for designing culturally relevant and effective interventions/strategies for prevention of overweight among Tehranian adults. [ABSTRACT FROM AUTHOR]

Background: It is assumed that obesity adversely affects the health related quality of life (HRQOL) of women with polycystic ovary syndrome (PCOS), not only due to the excess weight, but also due to several other obesity induced metabolic and reproductive consequences. We aimed to compare the effects of excess body weight on the HRQOL between women with PCOS and controls. Methods: This is a case control study of 142 women with PCOS and 140 age- and BMI- matched controls. The Iranian version of short form health survey 36 (SF 36) was used to assess HRQOL. Domains of SF 36 were compared in women with PCOS and controls using multivariate analysis of covariance. The Pearson correlation was used to assess the correlation between body mass index (BMI) and domain scores of SF 36, and the differences between two correlations in cases and controls, using Fisher’s Z test. Results: Women with PCOS had significantly lower scores for both, the physical and the mental component summary scales, compared to controls. In the cases, a significant negative correlations were observed for BMI with physical function (r = - 0.301, P<0.001), bodily pain (r = - 0.23, P = 0.006), and physical summary score (r = -0.3, P = 0.007). In controls, significant correlation was seen for BMI with bodily pain (r = - 0.3, P<0.001) and physical summary score (r = - 0.27, P = 0.001). The differences between correlations of physical function with BMI in PCOS and controls were statistically significant (Z = -2.41, P = 0.008). Conclusion: Although the physical aspects of HRQOL are adversely affected by overweight in both PCOS and controls, these impaired effects are greater in women with PCOS. [ABSTRACT FROM AUTHOR]

Introduction: The objective was to examine whether dietary acid load was associated with chronic kidney disease (CKD) in adults.Materials and Methods: The cross-sectional analyses included 4564 participants, aged 20 years and older, who participated in the 4th phase of the Tehran Lipid and Glucose Study and had complete dietary and serum creatinine data. Dietary data were obtained from using a 147-item food-frequency questionnaire. Dietary acid load was calculated as the potential renal acid load (PRAL). Anthropometrics, blood pressure, and fasting plasma glucose, and lipids were measured. Chronic kidney disease was defined as an estimated glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2 calculated using the Modification of Diet in Renal Disease equation. Risk of CKD was obtained in quartiles of PRAL with logistic recreation.Results: The mean dietary PRAL of the participants was -22.0 mEq/d. After adjustment for age, sex, and body mass index, the odds ratio for CKD in the highest compared to the lowest quartile of PRAL was 1.38 (95% confidence interval [CI], 1.02 to 1.83). After additional adjustment for energy intake and smoking, the odds ratio for CKD in the 4th quartile of PRAL compared to the 1st was 1.42 (95% CI, 1.06 to 1.91). In the final model, after additional adjustment for dietary intake of total fat, carbohydrate, dietary fiber, fructose, sodium, diabetes mellitus, and hypertension, the risk of CKD in the highest dietary PRAL category, compared to the lowest, increased by 42%.Conclusions: After adjusting for possible confounding factors, we found that higher PRAL (more acidic diet) was associated with higher prevalent CKD in Iranian adults. [ABSTRACT FROM AUTHOR]

Aim: Carotenoids may reduce the risk of insulin resistance (IR) due to their antioxidant properties. The aim of the present study was to investigate the relationship between dietary intake of carotenoids and the risk of IR in Iranian adults. Methods: In this longitudinal study, 1106 men and women, aged 19–74 years, were studied within the framework of Tehran Lipid and Glucose Study among Tehran an adults. Fasting serum insulin and glucose were measured at baseline and again after three years of follow up; IR was defined according to optimal cut‐off values. The usual dietary intake of carotenoids including α‐carotene, β‐carotene, lycopene, lutein and β‐cryptoxanthin was measured using a validated 168‐item semi‐quantitative food frequency questionnaire. Logistic regression models were used to estimate the occurrence of IR across tertiles of carotenoids with adjustment for potential confounding variables. Results: Mean age of participants was 40.71 ± 12.14 years, and mean body mass index was 27.23 ± 4.9 kg/m2, at baseline. Mean intake of total carotenoids was 10.1 ± 7.3 mg/day. Highest compared to the lowest dietary intake of β‐carotene was significantly associated with a lower risk of IR (OR = 0.42, 95% CI = 0.25–0.72, P for trend = 0.01). Higher intake of β‐cryptoxanthin was also significantly associated with a lower risk of IR (OR = 0.51, 95% CI = 0.30–0.84, P for trend = 0.01). Conclusions: Higher consumption of dietary carotenoids such as β‐carotene and β‐cryptoxanthin may be associated with a reduced risk of IR. [ABSTRACT FROM AUTHOR]

Background: In this study, we aimed to investigate the association of dietary phytochemical index (DPI) with insulin resistance, β-cell dysfunction, and insulin sensitivity.Methods: This longitudinal study was conducted on 1141 participants of the Tehran Lipid and Glucose Study. Dietary data were collected using a validated semi-quantitative FFQ with 168 food items at baseline and DPI was calculated. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up.Results: After 3-years of follow-up, the risk of hyperinsulinemia significantly decreased by 65 (OR = 0.35, 95% CI = 0.21-0.60) and 86% (OR = 0.14, 0.07-0.29), in the third and fourth quartile categories of DPI, respectively. The occurrence of insulin resistance and insulin insensitivity in participants with higher DPI was significantly lower than the others (OR = 0.48, 95% CI = 0.25-0.93 and OR = 0.11, 95% CI = 0.05-0.24, respectively).Conclusion: Higher consumption of phytochemical-rich foods may have protective effects against development of insulin resistance. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to determine the effect of lentil sprouts [LS] on lipid profiles in overweight and obese patients with type 2 diabetes. Methods: Forty- eight overweight and obese type 2 diabetic patients, September and November2013, 30-65 years, participated in this clinical trial and randomly divided into two groups; LS group and controls. Patients in control group received conventional drug therapy, while patients in LS group received 60 g LS daily during 8 weeks along with routine medication. Significant differences among and between the groups were determined by independent t-test and paired sample t-test using SPSS software. The patients were blinded for the treatment. In this trial the effect of LS on serum lipid profiles were investigated. Results: Thirty-nine patients completed the study. After 8 weeks, serum levels of HDL-C was higher in the LS group compared to control group (48.3 ±1.9 vs. 42.8±1.7, P<0.03). TG and ox-LDL were lower in the LS group compared to controls [(127±13.4 vs. 170± 12.4.P<0.01) and (83.3±29.1 vs. 98.7±28.2.P<0.6)]. Conclusions: LS consumption could have favorable effect on serum lipid profiles. [ABSTRACT FROM AUTHOR]

The interaction of genetic and dietary factors, as an area of CVD research, has been explored poorly. The aim of the present study was to examine the interaction of dietary patterns and three genetic variants of APOA1 and APOC3, both independently and in combination, relative to the risk of the metabolic syndrome (MetS) in Tehranian adults. In the present matched, nested case–control study, 414 subjects with the MetS and 414 controls were selected from the participants of the Tehran Lipid and Glucose Study. Dietary patterns were determined by factor analysis. APOC3 (rs5128 3238C>G) and APOA1 (rs670, − 75G>A and rs5069,+83C>T) SNP were genotyped by the conventional PCR followed by the restriction fragment length polymorphism technique. Overall, three major dietary patterns were extracted: healthy dietary pattern (HDP); Western dietary pattern (WDP); fat–sweet dietary pattern (FSDP). The A and T allele carriers of the APOA1 SNP had a greater risk of developing the MetS in the highest quartile of WDP scores (OR 3·22, 95 % CI 1·21, 8·58, Pinteraction= 0·03). Compared with other genotype combinations, the combined effect of APOC3/APOA1 (CC/GA+AA/CT+TT) genotypes showed a further increase in the risk of the MetS in the highest quartile of WDP scores (OR 1, 2·49, 8·73, 6·32, Ptrend< 0·001, Pinteraction= 0·003). A significant interaction was found between the quartiles of FSDP scores and the APOA1 diplotype (GA+AA/CT+TT). OR for these genotype carriers were 1, 0·65, 0·57 and 0·22 (Ptrend= 0·006) in the lowest to the highest quartile of FSDP scores when compared with the other combined genotypes (Pinteraction= 0·03). Our findings suggest that the WDP and FSDP are associated with APOA1 and APOC3 SNP in relation to the risk of the MetS. [ABSTRACT FROM PUBLISHER]

Background: Consumption of white rice has been proposed as a dietary risk factor for development of metabolic disorders and type 2 diabetes, especially in populations who consume white rice as a staple food. In this study, we investigated the association between consumption of white rice and the occurrence of metabolic syndrome in Tehrani adults after 3 years of follow-up. Methods: This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study on 1476 adults, aged 19-70 years. Dietary intakes were measured using a validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were assessed and documented at baseline (2006-2008) and again 3 years later (2009-2011). Multiple logistic regression models were used to estimate the occurrence of the MetS in each quartile of white rice consumption. Results: The mean age of participants was 37.8 ± 12.3 years, and mean BMI was 26.0 ± 4.5 Kg/m2 at baseline. Participants in the highest quartile of white rice consumption were significantly younger, had lower HDL-C levels, and higher systolic and diastolic blood pressures at baseline (P < 0.01). Higher consumption of white rice was also accompanied by higher increase in serum triglyceride levels after the 3-year follow-up (9.9 ± 2.3 vs. 8.2 ± 2.3%, P < 0.01). After adjustment for all potential confounders, the risk of metabolic syndrome in the highest quartile of white rice consumption compared with the lowest, was 1.66 (95% CI: 1.04-2.66). Moreover, participants with central obesity, low physical activity or low-fiber diet had greater risk of metabolic syndrome if white rice constituted ≥25.6% of total energy. Conclusion: We demonstrated that higher consumption of white rice may be a risk factor for development of metabolic syndrome among Iranian adults. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to evaluate the ability of a low carbohydrate diet score (LCD) to predict the occurrence of the metabolic syndrome (MetS) and its components in a group of Tehrani children and adolescents after 3.6 years of follow-up. Methods: Diet scores were calculated using a validated semi-quantitative food frequency questionnaire for participants aged 6-19 years, selected from the Tehran Lipid and Glucose Study cohort. The LCD was calculated based on intake of carbohydrate, monounsaturated fatty acids, refined grains and vegetable protein intake, expressed as a percentage of energy as well as fiber, n3/n6 polyunsaturated fatty acids and glycemic load. The higher the score, the more closely the participant's diet followed the pattern of LCD. The incidence of MetS and its components was calculated three years later. Results: The mean age of the participants was 13.8 ± 3.6 years and 45.4% were boys. The incidence rates of MetS, high blood pressure, high triglycerides, low HDL-C, abdominal obesity, and high blood glucose were 7.5%, 11%, 15%, 6.9%, 18.3%, and 12.3%, respectively. Compared to those in the lowest quartile of LCD score, after adjusting for age, sex, physical activity, and energy intake, participants in the highest quartile of LCD score had odds ratios of 0.74 (95% CI: 0.24-2.28), 1.16 (95% CI: 0.47-2.81), 0.55(95% CI: 0.21-1.44), 0.49 (95% CI: 0.11-2.08), 0.91 (95% CI: 0.42-1.98), and 1.28 (95% CI: 0.51-3.20) with the incidence of MetS, high blood pressure, high triglycerides, low HDL-C, abdominal obesity, and high blood glucose. Conclusion: No association was found between LCD and the incidence of MetS or its components in children and adolescents in Tehran after 3.6 years of follow up. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate the association of the intakes of ω-3 (including α-linolenic acid [ALA], eicosapentaenoic acid [EPA] plus docosahexaenoic acid [DHA]) and ω-6 polyunsaturated fatty acids (PUFAs), the interaction, and the ratio of these PUFAs with the metabolic syndrome (MetS) in adults. Methods: This cross-sectional study was conducted in a random sample of participants (n = 2451, 19–84 y old) in the Tehran Lipid Glucose Study. Dietary intake was assessed using a validated semiquantitative food-frequency questionnaire. Anthropometric characteristics, blood pressure, and fasting plasma concentrations of glucose and lipids were measured. The MetS was defined according to the Adult Treatment Panel III guidelines. Results: Among the PUFAs, the ALA and ω-6 PUFA intakes were inversely associated with the MetS. Subjects in the highest quartile of ALA and ω-6 fatty acid intakes had a 38% (odds ratio 0.62, 95% confidence interval 0.41–0.95) and a 0.47% (odds ratio 0.53, 95% confidence interval 0.31–0.89) lower prevalence of MetS, respectively, compared with those in the lowest quartile. The dietary ratio of ω-6 to ω-3 fatty acids was not associated with the MetS. When the interaction between ALA and ω-6 fatty acid was assessed, the ALA intake was associated with a lower prevalence of the MetS, without modification by the ω-6 PUFA intake. Subjects with at least the median ALA intake (1084 mg/d) had a lower prevalence of the MetS, irrespective of an ω-6 PUFA intake lower or higher than the median compared with subjects with intakes below the median for both. Conclusion: The ALA intake was inversely associated with the MetS, irrespective of the background intake of ω-6 PUFAs, in adults. [Copyright &y& Elsevier]

Abstract: In this study, we investigated the hypothesis that dietary protein content and type are related to cardiometabolic risk factors including body mass index, waist circumference (WC), serum triglycerides, high-density lipoprotein cholesterol (HDL-C), serum fasting glucose, and blood pressure. This population-based study was conducted on 2537 subjects aged 19 to 70 years and selected from among participants of the Tehran Lipid and Glucose Study (2006-2008). Dietary data were collected using a validated semiquantitative food frequency questionnaire. Associations between intakes of total protein as well as the animal-to-plant (A/P) protein ratio and cardiometabolic risk factors were analyzed using multivariate linear regression models. Dietary protein intakes were 13.7% and 13.6% of energy, in men and women, respectively; the A/P protein ratio in women was significantly higher than in men (1.8±1.4 vs 1.4 ± 0.9). Body mass index was associated with total protein intake in men (β = 0.14, P = .01) and A/P protein ratio in women (β = 0.075, P = .01). Waist circumference was associated with total protein intake (β = −0.048, P = .03) and A/P protein ratio (β=0.031, P = .05) in women. Serum fasting glucose was associated with both total protein intake (β=0.061 and 0.11, P < .05) and the A/P proteinratio (β = −0.078 and −0.056, P < .05) in both men and women, respectively. Serum HDL-C was associated with total protein intake (β = 0.107 and 0.07, P < .05) in both men and women, whereas diastolic blood pressure in women was associated with total protein intake (β = −0.125, P = .01). In conclusion, higher dietary protein intake was associated with enhanced HDL-C levels, WC, and diastolic BP, and a higher ratio of A/P protein intake was related with lower serum fasting glucose andWC. [Copyright &y& Elsevier]