Background Metabolic syndrome (MetS) is a common global issue linked to the quality of one’s eating occasions. The current cross-sectional study evaluates the association between a novel index, the Main Meal Quality Index (MMQI), and MetS among Iranian adults. Methods A total of 824 men and women were recruited, and a 24-hour dietary recall assessed the dietary intake of the participants. Lunch was selected as the main meal based on energy density. The MMQI score was calculated based on ten components of dietary intake, with a higher score indicating more adherence to the index, with the final scores ranging from 0 to 100 points. The associations were assessed using binary logistic regression. Results The mean age was 42.2 years and the range of the calculated MMQI was 22 to 86 (mean in total participants: 56.62, mean in women: 56.82, mean in men: 55.64). The total prevalence of MetS in the sample was 34%. After adjustments for potential confounders, the participants at the top quartile of MMQI had a lower odds ratio for hypertriglyceridemia and low high-density lipoprotein (HDL) level, and a higher odds ratio for hypertension, hyperglycemia, abdominal obesity, and MetS. The sex-specific analysis also did not show any significant associations between adherence to MMQI and MetS and its components. Conclusion Overall, MMQI is not associated with MetS and its components in a sample of Iranian men and women. More research is needed to examine MMQI and its possible association with current health-related problems including MetS.
Objective: Traditional pairwise meta-analyses indicated that nuts consumption can improve blood pressure. We iamed to determine the dose-dependent effect of nuts on systolic (SBP) and diastolic blood pressure (DBP) in adults. Methods: A systematic search was undertaken in PubMed, Scopus, and ISI Web of Science till March 2021. Randomized controlled trials (RCT) evaluating the effects of nuts on SBP and DBP in adults were included. We estimated change in blood pressure for each 20 g/d increment in nut consumption in each trial and then, calculated mean difference (MD) and 95%CI using a random-effects model. We estimated dose-dependent effect using a dose-response meta-analysis of differences in means. The certainty of evidence was rated using the GRADE instrument, with the minimal clinically important difference being considered 2 mmHg. Results: A total of 31 RCTs with 2784 participants were included. Each 20 g/d increase in nut consumption reduced SBP (MD: -0.50 mmHg, 95%CI: -0.79, -0.21; I2 = 12%, n = 31; GRADE = moderate certainty) and DBP (MD: -0.23 mmHg, 95%CI: -0.38, -0.08; I2 = 0%, n = 31; GRADE = moderate certainty). The effect of nuts on SBP was more evident in patients with type 2 diabetes (MD: -1.31, 95%CI: -2.55, -0.05; I2 = 31%, n = 6). The results were robust in the subgroup of trials with low risk of bias. Levels of SBP decreased proportionally with the increase in nuts consumption up to 40 g/d (MD40g/d: -1.60, 95%CI: -2.63, -0.58), and then appeared to plateau with a slight upward curve. A linear dose-dependent reduction was seen for DBP, with the greatest reduction at 80 g/d (MD80g/d: -0.80, 95%CI: -1.55, -0.04). Conclusions: The available evidence provides a good indication that nut consumption can result in a small improvement in blood pressure in adults. Well-designed trials are needed to confirm the findings in long term follow-up.
Objective: Evidence on the relationship between sleep duration and irregularity in daily energy intake with diet quality in Iranian adults is scarce. We aimed to evaluate the association of sleep duration with diet quality and irregularity in daily energy intake. Design: This is s cross-sectional study Setting: The study was carried in health care centers in Tehran. Participants: 739 adults aged 20-59 years were recruited. Dietary intake was assessed by a food frequency questionnaire and three, 24-h dietary recalls. Diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015). An irregularity score of daily energy intake was calculated based on the deviation from the 3-day mean energy intake. Sleep duration was estimated using self-reported nocturnal sleep duration by each person. Results: Mean age of study participants was 44.4±10.7 years; 70% were women. The mean of nocturnal sleep duration, HEI score, and irregularity score were 6.7±1.22 hours/day, 52.5±8.55, and 22.9+19, respectively. After adjusting for potential confounders, sleep duration was not associated with adherence to HEI-2015 (OR: 1.16; 95% CI: 0.77-1.74). Longer sleep duration was marginally associated with a lower odd of irregularity in daily energy intake. However, after adjustment for various confounders, this association was not significant (OR: 0.82; 95% CI: 0.50-1.33; P trend=0.45). No significant interaction was observed between sleep duration and irregularity in daily energy intake in relation to adherence to HEI-2015 (P-interaction= 0.48). Conclusions: We found that sleep duration was not associated with adherence to HEI-2015 and irregularity in daily energy intake. Further prospective studies are warranted.
Background This study aimed to evaluate the association of meals-specific food-based dietary inflammatory index (FDII), with cardiovascular (CVD) risk factors and inflammation among Iranian adults. Methods In this cross-sectional study, we recruited 816 participants living in Tehran via two-staged cluster sampling. Three non-consecutive 24-h dietary recalls (two working days and one day off) were obtained from individuals to specify the main meals and meal-specific FDIIs. Anthropometric measures were done. Insulin and high-sensitivity c-reactive protein (hs-CRP) were measured. Multiple linear regressions were used to investigate the association of FDII with Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), hs-CRP, Triglyceride Glucose Index (TyG), and Lipid Accumulation Product Index (LAP). Results The range of FDIIs for breakfast, lunch, and dinner were (-2.47,1.98), (-2.66,3.23) and (-4.09,3.13) in order, and the mean age was 42.2 ± 10.5 years. We found that there was no significant association between FDII and hs-CRP level in the three meals (β = -0.003; 95% CI: -0.030, 0.025 for breakfast,β = -0.020; 95% CI: -0.041, 0.001 for lunch, and β = 0.006; 95% CI: -0.016, 0.028 for dinner) after adjusting for age, sex, education, occupation, maritage, physical activity, smoking, morningness-eveningness score, energy, body mass index, and other FDIIs. Also, we found no significant association between breakfast, lunch, and dinner-specific FDII and HOMA-IR (β = -0.368, -0.223, 0.122), TyG index (β = -0.009, 0.060, -0.057) and LAP (β = 2.320, -0.278, -0.297). Conclusions We found no associations between meal-based FDII scores and CVD and inflammation. Further research of prospective nature is needed to confirm these findings.
We aimed to investigate the association of main meals' specific protein intake with cardiometabolic risk factors including general and abdominal obesity, serum lipid profile, and blood pressure. This cross-sectional study was conducted on 850 subjects aged 20–59 years. Dietary intakes were assessed by completing three 24-hour recalls and the protein intake of each meal was extracted. Anthropometric measures, lipid profile, fasting blood sugar, and blood pressure was measured. Multivariate logistic regression controlling for age, physical activity, sex, marital status, smoking status, body mass index (BMI), and energy intake was applied to obtain odds ratios (OR) and confidence intervals (CIs). The mean age was 42 years and the mean BMI of the participants was 27.2. The mean protein intake for breakfast, lunch, and dinner was 12.5, 22.2, and 18.7 grams/day, respectively. After adjustment for confounders, higher protein intake was not associated with any of the cardiometabolic risk factors including low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), total cholesterol (TC), triglyceride (TG), body weight, blood pressure (BP), and fasting plasma glucose (FPG), in any of the three main meals consumed within a day. Adherence to a higher protein intake at each meal was not associated with cardiometabolic risk factors in Iranian adults. Further prospective studies are needed to justify our findings.
Objective: The present study examined the association between low-carbohydrate diet (LCD) score, glycemic index (GI), and glycemic load (GL) with visceral fat level (VFL) and lipid accumulation product (LAP). Methods: This cross-sectional study was conducted on 270 adults (118 men and 152 women) aged between 18–45 living in Tehran, Iran, between February 2017 and December 2018. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Body composition were also assessed. We used analyses of covariance and binary logistic regression to explore associations after controlling for age, energy intake (model 1), education, smoking status, physical activity, occupation, marriage and metabolic diseases. Results: There were no significant differences between tertiles of GI, GL and LCD for means of anthropometric measures, LAP and VFL index in men, while women in the highest tertile of GI and GL had significantly higher mean LAP in the crude model (p=0.02) and model 1(p=0.04), which disappeared after controlling for other confounders(p=0.12). Moreover, the OR and CIs for having high LAP and VFL was not associated with dietary GI, GL and LCD in crude and adjusted models. However, chance of high VFL reduced by 65% and 57% among women with high adherence to LCD score (OR=0.35, 95% CI=0.16-0.78, P=0.01) and model 1 (OR=0.43, 95% CI=0.18-1, p=0.05), respectively. However, this significant association disappeared after controlling for other confounders(p=0.07). Conclusion: Overall, we found carbohydrate quality and LCD score are not associated with LAP and VFL index. However, gender-specific relationship should not be neglect and warrants further investigation.
Recent evidence reported that a higher concentration of 25-hydroxyvitamin D [25[OH] D] has been associated with greater cardiorespiratory fitness [CRF] and muscle strength in both sexes. Low levels of 25[OH]D may be related to hypertrophy of myocardial, high blood pressure, and endothelial dysfunction, which is related to decreased amino acid uptake, prolonged time to peak muscle contraction and relaxation, dysregulation of intracellular Ca2+, muscle weakness, myalgia, impaired neuromuscular function, and hypotonia. Because CRF is defined as a function of maximal cardiac output and maximal arteriovenous oxygen difference, low levels of 25[OH]D may lead to deleterious effects on CRF. Recent findings also indicated vitamin D3 supplementation that leads to an increase in muscle fiber especially type 2, the cross-sectional area of muscle fibers, and improved muscle strength. In this chapter, we will systematically review the observational studies and randomized controlled trials that evaluated the association of vitamin D with CRF and muscle strength.
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