Association between Food Insecurity and Vision Impairment among Older Adults: A Pooled Analysis of Data from Six Low- and Middle-Income Countries.

OBJECTIVES: Food insecurity has gained attention as a potential risk factor for vision impairment. However, research on this topic is limited. This objective of this study was to investigate the relationship between food insecurity and visual impairment among adults aged 50 years or older using data from six low-and middle-income countries (LMIC). DESIGN AND SETTING: Data from the longitudinal Study on global AGEing and adult health (SAGE) were analyzed in a community-based, cross-sectional, and nationally representative sample. PARTICIPANTS: Adults aged 50 years or older from six low- and middle-income countries (LMICs) including China, India, Mexico, Russia, South Africa, and Ghana. MEASUREMENTS: Food insecurity was evaluated using a questionnaire comprised of two questions that addressed the frequency of eating inadequately and hunger due to a lack of food in last 12 months. Distance and/or near vision impairment was considered as a visual acuity score of less than 6/18 in the eye with better vision. RESULTS: The analytical sample consisted of 29,804 adults (mean (SD) for age: 63.2 (9.54) years; 54.3% female). The prevalence of food insecurity, near vision and distance vision impairment in the sample was 16.4%, 36.7%, and 13.9%, respectively. Adjusted pooled analyses across countries revealed a significant association between food insecurity and distance (OR: 1.16; 95% CI: 1.01, 1.33; P=0.04, significant individually in India and South Africa) and near (OR: 1.12; 95% CI: 1.02, 1.22; P=0.01, significant individually in South Africa) vision impairment, and a between-country heterogeneity of 46.30% and 25.99%, respectively. CONCLUSION: Food insecurity was associated with both distance and near vision impairment in adults aged 50 years or older across six LMIC. Food policies and intervention programs targeted at decreasing food insecurity in vulnerable households are essential.

Dietary carbohydrate intake and risk of bone fracture: a systematic review and meta-analysis of observational studies.

OBJECTIVE: Despite growing evidence for the association between other dietary macronutrients and bone health, limited and inconsistent knowledge is available regarding carbohydrate intake. In this systematic review and meta-analysis, we purposed to clarify and synthesize the knowledge about the relation between carbohydrate intake and the risk of fracture. STUDY DESIGN: Systematic review and meta-analysis of observational studies. METHODS: In this study, PubMed and Scopus were used to conduct a comprehensive search for articles published up to September 2018. The screening was done independently by two authors. Pooled effect sizes were calculated using fixed and random effect models for the highest versus lowest intake categories. The dose-response nature of the relationship was also investigated. RESULTS: No association was observed between carbohydrate intake and the risk of fracture in high versus low intake meta-analysis (overall relative risk [RR]: 1.24; 95% confidence interval [95% CI]: 0.84-1.84; P = 0.27) with moderate heterogeneity (I2 = 57.7%, P heterogeneity = 0.05). Moreover, there was no relationship between carbohydrate intake and the risk of fracture in both linear (overall RR: 1.00; 95% CI: 0.94-1.05; P = 0.88) (I2 = 68.1%, P heterogeneity = 0.48) and nonlinear (Pnon-linearity = 0.14) models. CONCLUSION: No association was observed between carbohydrate intake and the risk of fracture.

A Systematic Review of Nutrition Recommendation Systems: With Focus on Technical Aspects.

BACKGROUND: Nutrition informatics has become a novel approach for registered dietitians to practice in this field and make a profit for health care. Recommendation systems considered as an effective technology into aid users to adjust their eating behavior and achieve the goal of healthier food and diet. The purpose of this study is to review nutrition recommendation systems (NRS) and their characteristics for the first time. MATERIAL AND METHODS: The systematic review was conducted using a comprehensive selection of scientific databases as reference sources, allowing access to diverse publications in the field. The process of articles selection was based on the PRISMA strategy. We identified keywords from our initial research, MeSH database and expert's opinion. Databases of PubMed, Web of Sciences, Scopus, Embase, and IEEE were searched. After evaluating, they obtained records from databases by two independent reviewers and inclusion and exclusion criteria were applied to each retrieved work to select those of interest. Finally, 25 studies were included. RESULTS: Hybrid recommender systems and knowledge-based recommender systems with 40% and 32%, respectively, were the mostly recommender types used in NRS. In NRS, rule-based and ontology techniques were used frequently. The frequented platform that applied in NRS was a mobile application with 28%. CONCLUSION: If NRS was properly designed, implemented and finally evaluated, it could be used as an effective tool to improve nutrition and promote a healthy lifestyle. This study can help to inform specialists in the nutrition informatics domain, which was necessary to design and develop NRS.

Association between the dietary inflammatory index and the incidence of cancer: a systematic review and meta-analysis of prospective studies.

OBJECTIVE: Although many risk factors for cancers have been well defined, the effects of dietary inflammation have remained controversial. We aimed to summarize the association between the dietary inflammatory index (DII) and the risk of cancer. STUDY DESIGN: A systematic review and meta-analysis on prospective studies. METHODS: Electronic databases including PubMed/MEDLINE, Scopus, and Web of Science were searched to find relevant articles published in English up to February 2017. Prospective studies that reported the relative risk (RR) or hazard ratio for the most pro-inflammatory vs the most anti-inflammatory diets and cancer were included. Random effects model was used to pool the effect sizes. RESULTS: Finally, 11 effect sizes from 10 prospective studies were included. Findings indicated that the most pro-inflammatory vs the most anti-inflammatory diets were significantly associated with an increased risk for total cancer (overall RR: 1.17; 95% confidence interval [CI]: 1.09-1.26) with a substantial heterogeneity (I2: 85.5%, P < 0.001). Subgroup analysis revealed that the association between DII and breast cancer was 1.04 (95% CI: 1.02, 1.07; I2:0%; P = 0.66), while it was 1.26 (95% CI: 1.17, 1.36; I2 = 58.1%; P = 0.03) for colorectal cancer. CONCLUSIONS: Although the findings of the current meta-analysis support the hypothesis that diets with high pro-inflammatory components can increase the risk of cancer, the heterogeneity was high. Therefore, further studies are required to clarify this association.

The association of neck circumference with risk of metabolic syndrome and its components in adults: A systematic review and meta-analysis.

BACKGROUND & AIMS: Several prior studies suggested that neck circumference (NC) is a reliable diagnostic tool for risk of metabolic syndrome (MetS) and its features. However, not all studies support this view. Therefore, we aimed to perform a meta-analysis to summarize the association between NC with MetS and its components in adult populations. METHODS AND RESULTS: PubMed/Medline, Web of Knowledge, and Scopus electronic databases were searched until May 31, 2017 to find relevant English-language papers. We included studies that examined the association of NC with risk of MetS, or at minimum, one of its components as outcomes. Of 2628 publications identified, 19 papers met selection criteria. We found no association between NC and MetS (odd ratio (OR): 0.73; 95% CI: 0.003, 1.47). However, there was a positive association between NC and waist circumference (WC) (r = 0.85; 95%: 0.75, 0.95; I2: 98.2%; p = 0.0001), BMI: (r:0.88; 95% CI: 0.74, 0.91, I2:97.3%), triglycerides (TG) (OR: 1.87; 95% CI: 1.60, 2.19; I2:58.4%; p = 0.03), TC (r:0.14; 95%CI: 0.05, 0.23, I2:94.1%), LDL-C (r: 0.18; 95%CI: 0.07, 0.29, I2:94.3%), hypertension (OR: 1.94; 95% CI:1.43, 2.64, I2:87.3%), systolic (r: 0.21, 95%CI: 0.19, 0.23; I2:67.1%) and diastolic blood pressures (r: 0.20, 95%CI: 0.16, 0.23; I2:79.7%), low HDL-C (r:-0.21; 95% CI: -0.26, -0.15, I2 = 92.5%), as well as fasting blood sugar (FBS) concentrations (r: 0.20, 95%CI: 0.16, 0.24; I2:88.1%). CONCLUSION: Subjects with higher NC were at approximately two-fold higher risk for hypertriglyceridemia compared to those with lower NC. We found positive associations between NC, WC, BMI, hypertension, FBS, TC, LDL-C, SBP, DBP, and low HDL-C concentrations. However, heterogeneity was considerably high. Therefore, the findings should be taken with caution. Future studies using longitudinal designs are needed to further understand the association between NC and features of MetS.

Dietary glycaemic index and glycaemic load and upper gastrointestinal disorders: results from the SEPAHAN study.

BACKGROUND: Little is known about the effects of carbohydrate, particularly any association between dietary glycaemic index or glycaemic load and uninvestigated heartburn or uninvestigated chronic dyspepsia in the community. The present study aimed to determine associations between dietary glycaemic index or glycaemic load and uninvestigated heartburn or uninvestigated chronic dyspepsia. METHODS: This cross-sectional study was conducted in 2987 adults. Dietary glycaemic index and glycaemic load were estimated using a validated food-frequency questionnaire. Uninvestigated heartburn and uninvestigated chronic dyspepsia were determined using a modified and validated version of the Rome III questionnaire. RESULTS: After controlling for various confounders, high glycaemic load was associated with an increased risk of uninvestigated heartburn [odds ration (OR) = 1.75; 95% confidence interval CI = 1.03, 2.97; P = 0.04] and uninvestigated chronic dyspepsia (OR = 2.14; 95% CI: 1.04, 4.37; P = 0.04) in men but not in women. In normal-weight individuals, high glycaemic index was related to an increased risk of uninvestigated heartburn (OR = 1.52; 95% CI: 1.07, 2.15; P = 0.02) and high glycaemic load to an increased risk of uninvestigated chronic dyspepsia (OR=1.78; 95% CI: 1.05, 3.01; P = 0.03). No significant associations were observed in subjects with excess body weight. CONCLUSIONS: Our data suggest that there are body mass index- and sex-specific associations between dietary carbohydrate quality with uninvestigated heartburn and uninvestigated chronic dyspepsia.

Adherence to Healthy Eating Index-2010 is inversely associated with metabolic syndrome and its features among Iranian adult women.

BACKGROUND/OBJECTIVES: Nowadays, metabolic syndrome (MetS) is deemed as a major public health challenge in both developed and developing countries. Therefore, the aim of this study was to determine the association between Healthy Eating Index-2010 (HEI-2010) score and MetS and its features among Iranian female nurses. SUBJECTS/METHODS: This cross-sectional study was performed among 1036 Iranian women. A validated, self-administered, dish-based, semiquantitative food frequency questionnaire was used to assess the habitual intake of participants. HEI-2010 score was used to assess diet quality of participants. MetS was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Multivariate logistic regression adjusted for potential confounders was used to assess the relation between HEI-2010 and MetS. RESULTS: After adjusting for potential confounders, participants in the highest quartile of HEI-2010 had the lowest risk of MetS compared with those in the first quartile (odds ratio: 0.72; 95% confidence interval: 0.50-0.96). Furthermore, the risk of MetS features including abdominal obesity, high blood pressure, high serum triacylglycerol and low serum high-density lipoprotein-cholesterol significantly decreased across HEI-2010 quartiles (P<0.05). CONCLUSIONS: Higher HEI-2010 scores were inversely associated with lower risk of MetS and its components among Iranian women.

Adherence to the Healthy Eating Index and Alternative Healthy Eating Index dietary patterns and mortality from all causes, cardiovascular disease and cancer: a meta-analysis of observational studies.

BACKGROUND: This meta-analysis investigated the association of diet quality indices, as assessed by HEI and AHEI, and the risk of all-cause, cardiovascular and cancer mortality. METHODS: We used PubMed, ISI Web of Science and Google Scholar to search for eligible articles published before July 2015. A total of 12 cohort studies (38 reports) and one cross-sectional study (three reports) met the inclusion criteria and were included in our meta-analysis. RESULTS: The highest level of adherence to the Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI) was significantly associated with a reduced risk of all-cause mortality [relative risk (RR) = 0.77, 95% confidence intterval (CI) = 0.76-0.78], cardiovascular mortality (RR = 0.77, 95% CI = 0.74-0.80) and cancer mortality (RR = 0.83, 95% CI = 0.81-0.86). Egger regression tests provided no evidence of publication bias. CONCLUSIONS: The present study indicates that high adherence to HEI and AHEI dietary patterns, indicating high diet quality, are associated with reduced risk of all-cause mortality (as well as cardiovascular mortality and cancer mortality).

Rice Bran Oil Decreases Total and LDL Cholesterol in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.

Cardiovascular disease (CVD) has become a concerning health problem because of its increasing prevalence. Vegetable oils such as rice bran oil may improve blood lipids, risk factors for CVD. We performed a systematic review and meta-analysis to identify and quantify the effects of rice bran oil on lipid profiles in humans. Literature databases (Pubmed, Scopus, Science Direct, Proquest, Ovid, and Google Scholar) were systematically searched until the end of November 2015, with no restrictions regarding study design, time, or language. The variables extracted for the meta-analysis included low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triacylglycerol (TAG), VLDL-C, apoA, apoB, Lp(a), TC/HDL-C, and LDL-C/HDL-C. From 415 identified articles, 11 randomized controlled trials met the eligibility criteria and were included in our review. Rice bran oil consumption resulted in a significant decrease in concentrations of LDL-C (-6.91 mg/dl, 95% CI, -10.24 to -3.57; p<0.001) and TC (-12.65 mg/dl; 95% CI, -18.04 to -7.27; p<0.001). The increase in HDL-C levels were considerable only in men (6.65 mg/dl; 95% CI, 2.38-10.92; p=0.002). Results of our meta-analysis provided no evidence of a significant effekt of rice bran oil on other lipid profile components. In conclusion, consumption of rice bran oil can reduce LDL-C and TC concentrations, which may lead to prevention and control of CVD. It also has favorable effects on HDL-C concentrations in men. However, changes related to other lipid profile components are not considerable.

The Impact of a Low Glycemic Index Diet on Inflammatory Markers and Serum Adiponectin Concentration in Adolescent Overweight and Obese Girls: A Randomized Clinical Trial.

Although the effects of dietary glycemic index (GI) on insulin resistance are well documented in adults, the complex interaction among glucose intolerance, inflammatory markers, and adipokine concentration has not been well studied, especially among adolescents. We investigated the effect of a low glycemic index (LGI) diet on insulin concentration, fasting blood sugar (FBS), inflammatory markers, and serum adiponectin concentration among healthy obese/overweight adolescent females. In this parallel randomized clinical trial, 2 different diets, an LGI diet and a healthy nutritional recommendation diet (HNRD) with similar macronutrient composition were prescribed to 50 obese and overweight adolescent girls with the same pubertal status. Biochemical markers FBS, serum insulin concentration, high sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and adiponectin were measured before and after a 10 week intervention. Using an intention-to-treat analysis, data from 50 subjects were analyzed. According to a dietary assessment, GI in the LGI group was 43.22±0.54. While the mean for FBS, serum insulin concentration, the homeostasis model assessment (HOMA), the quantitative insulin sensitivity check index (QUICKI), and adiponectin concentration did not differ significantly within each group, the average hs-CRP and IL-6 decreased significantly in the LGI diet group after the 10 week intervention (p=0.009 and p=0.001; respectively). Comparing percent changes, we found a marginally significant decrease in hs-CRP in the LGI group compared with the HNRD group after adjusting for confounders. Compliance with an LGI diet may have favorable effect on inflammation among overweight and obese adolescent girls.

Dietary diversity score and obesity: a systematic review and meta-analysis of observational studies.

BACKGROUND/OBJECTIVES: Studies examining the association between dietary diversity score (DDS) and obesity have led to inconsistent findings. Therefore, the purpose of this review is to summarize and elucidate the source of heterogeneous results reported in different studies. METHODS: PubMed, ISI Web of Science, Scopus and Google Scholar were searched through December 2013 to identify all relevant articles. Sixteen publications met the inclusion criteria for the systematic review and 10 articles were entered into the meta-analysis. Eight studies had data on the odds ratio (OR) for overweight/obesity and eight compared the mean body mass index (BMI) among subjects with highest versus the lowest DDS. RESULTS: A meta-analysis on eligible studies failed to show a significant association on either overweight/obesity OR (OR: 0.72; 95% confidence interval (CI): 0.45-1.16; P=0.174) or mean differences (MD) in BMI (MD: 0.22; 95% CI: -0.70-1.14; P=0.643) comparing the highest and lowest diverse diets. Between-study heterogeneity was high, and subgroup analysis failed to identify the source of heterogeneity. CONCLUSIONS: Our systematic review and meta-analysis showed that there was no significant association between DDS and BMI status, which may be due to use of different methods for assessing dietary intake and determination of DDS. Thus, well-designed prospective studies with similar approaches to assess DDS are highly recommended.

The effect of low calorie diet on adiponectin concentration: a systematic review and meta-analysis.

Adiponectin secreted from adipose tissue is proposed to be inversely related to the body fat mass. However, the magnitude of the effect of low calorie diet on adiponectin concentrations remains unknown. The present study was aimed to conduct a systematic review and meta-analysis on clinical trials that access the effect of low calorie diet on adiponectin concentration. We searched PubMed, SCOPUS, ISI web of science, and Google scholar for RCTs until January 2015. Totally, 13 trials were found, which examined the effect of low calorie diet on adiponectin concentration compared control group without low calorie diet.Our meta-analysis showed that weight loss diet can substantially increase the adiponectin concentration in overall (Hedges' g=0.34, 95% CI:0.17-0.50, p<0.001). Subgroup analysis also revealed that the low calorie diet can substantially enhance adiponectin concentrations when prescribed for ≤16 weeks (Hedges' g=0.48, 95% CI: 0.12-0.83, p=0.01) compared to >16 weeks (Hedges' g=0.30, 95% CI: 0.11-0.48, p=0.002). Weight loss diet beneficially affects blood adiponectin concentrations. More clinical trials are recommended to clear this effect among different genders and nationalities, and assess the magnitude of the effect based on changes in fat mass.

Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: a systematic review and meta-analysis on randomized controlled trials.

BACKGROUND AND AIMS: Findings were not consistent on the therapeutic effect of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure. We aimed to review systematically and perform a meta-analysis to assess the magnitude of the effect of the DASH diet on blood pressure in randomized controlled trials (RCTs) among adults. METHODS AND RESULTS: We conducted a systematic review and random effects meta-analysis of all RCTs which evaluated the effect of the DASH diet on blood pressure including published papers until June 2013, using PubMed, ISI Web of Science, Scopus and Google scholar database. Subgroup analysis and meta-regression were used to find out possible sources of between-study heterogeneity. Seventeen RCTs contributing 20 comparisons with 2561 participants were included. Meta-analysis showed that the DASH diet significantly reduced systolic blood pressure by 6.74 mmHg (95%CI: -8.25, -5.23, I(2) = 78.1%) and diastolic blood pressure by 3.54 mmHg (95%CI: -4.29, -2.79, I(2) = 56.7%). RCTs with the energy restriction and those with hypertensive subjects showed a significantly greater decrease in blood pressure. Meta-regression showed that mean baseline of SBP and DBP was explained 24% and 49% of the variance between studies for SBP and DBP, respectively. CONCLUSION: The results revealed the profitable reducing effect of the DASH-like diet on both systolic and diastolic blood pressure in adults; although there was a variation in the extent of the fall in blood pressure in different subgroups.

Is there a relationship between red or processed meat intake and obesity? A systematic review and meta-analysis of observational studies.

A body of literature exists regarding the association of red and processed meats with obesity; however, the nature and extent of this relation has not been clearly established. The aim of this study is to conduct a systematic review and meta-analysis of the relationship between red and processed meat intake and obesity. We searched multiple electronic databases for observational studies on the relationship between red and processed meat intake and obesity published until July 2013. Odds ratios (ORs) and means for obesity-related indices and for variables that may contribute to heterogeneity were calculated. A systematic review and a meta-analysis were conducted with 21 and 18 studies, respectively (n = 1,135,661). The meta-analysis (n = 113,477) showed that consumption of higher quantities of red and processed meats was a risk factor for obesity (OR: 1.37; 95% CI: 1.14-1.64). Pooled mean body mass index (BMI) and waist circumference (WC) trends showed that in comparison to those in the lowest ntile, subjects in the highest ntile of red and processed meat consumption had higher BMI (mean difference: 1.37; 95% CI: 0.90-1.84 for red meat; mean difference: 1.32; 95% CI: 0.64-2.00 for processed meat) and WC (mean difference: 2.79; 95% CI: 1.86-3.70 for red meat; mean difference: 2.77; 95% CI: 1.87-2.66 for processed meat). The current analysis revealed that red and processed meat intake is directly associated with risk of obesity, and higher BMI and WC. However, the heterogeneity among studies is significant. These findings suggest a decrease in red and processed meat intake.

Macro and Micro-Nutrients Intake, Food Groups Consumption and Dietary Habits among Female Students in Isfahan University of Medical Sciences.

BACKGROUND: Improving the dietary intake among different groups and population is important for improving the health status. This study determines the nutrients and food group intake as well as dietary habits among female students in Isfahan University of Medical Sciences. METHODS: Two hundreds and eighty nine healthy female youths who were randomly selected among students of Isfahan University of Medical Sciences in Isfahan, Iran were enrolled. A validated semi quantitative food frequency questionnaire was used. RESULTS: Folate, iron, calcium and fiber intake were lower than the recommended dietary allowances (RDA) amounts (70, 76, 90, 56% of RDA, respectively). Forty five percent of the population consumed fast foods 2 times a week and 35% used the frying oils for cooking most of the time. CONCLUSION: Female youths had lower amount of some micronutrients. Consuming frying oils, hydrogenated vegetable oils, and fast food intake should be limited among this group.

Dietary energy density and the metabolic syndrome among Iranian women.

BACKGROUND/OBJECTIVES: In a comparison of women worldwide, Iranian women were found to have the highest prevalence of the metabolic syndrome. Furthermore, specific characteristics of diet in Middle-Eastern countries might provide additional information on the diet-disease relations. This study was performed to assess the association between dietary energy density and prevalence of the metabolic syndrome among Iranian women. SUBJECTS/METHODS: Usual dietary intakes were assessed in a cross-sectional study of 486 Iranian adult women by the use of a food frequency questionnaire. Dietary energy density was calculated as each individual's reported daily energy intake (kcal/d) into total weight of foods (excluding beverages) consumed (g/d). Anthropometric measures, fasting plasma glucose, serum lipid profiles and blood pressure were evaluated. The metabolic syndrome was defined according to Adult Treatment Panel III guidelines. RESULTS: Mean dietary energy density was 1.77 ± 0.35 kcal/g. Individuals in the top tertile of dietary energy density had 80% (odds ratio: 1.80; 95% confidence interval: 1.17, 3.15) greater odds of having the metabolic syndrome. Even after further adjustment for body mass index, this association remained significant. Higher dietary energy density was also significantly associated with greater odds of having abdominal adiposity (4.23; 2.51, 7.18), high-serum triacylglycerol concentrations (3.55; 2.31, 5.93) and low-serum high-density lipoprotein cholesterol levels (1.80; 1.13, 2.84). No overall significant associations were found between higher dietary energy density and risk of having elevated blood pressure or abnormal glucose homeostasis. CONCLUSIONS: Higher dietary energy density was significantly associated with a greater risk of the metabolic syndrome and most of its components. Further studies are required to focus on lowering dietary energy density as a probable strategy for preventing metabolic syndrome.

Predictors of cardiovascular risk factors in Tehranian adults: diet and lifestyle.

We carried out a dietary intake assessment in 486 adults 20 from the Tehran Lipid and Glucose Study. There was a strong positive association between body mass index (BMI) and serum triglycerides (beta = 1.6, P < 0.05) and carbohydrate intake and triglycerides (beta = 2.4, P < 0.05). There was also an association between low-density lipoprotein cholesterol and weight (beta = 1.1, P < 0.05), age (beta = 1.6, P < 0.05) and cholesterol intake (beta = 0.7, P < 0.01). For 1 unit increase in either BMI, waist to hip ratio or saturated fatty acid intake, diastolic blood pressure increased 0.6, 0.9 and 0.1 mmHg, respectively (P < 0.05). Dietary and non-dietary factors have an association with, and play a role as predictors of, CVD risk factors.

Predictors of cardiovascular risk factors in Tehranian adults: diet and lifestyle

We carried out a dietary intake assessment in 486 adults 20 from the Tehran Lipid and Glucose Study. There was a strong positive association between body mass index [BMI] and serum triglycerides [beta = 1.6, P < 0.05] and carbohydrate intake and triglycerides [beta = 2.4, P < 0.05]. There was also an association between low-density lipoprotein cholesterol and weight [beta = 1.1, P < 0.05], age [beta = 1.6, P < 0.05] and cholesterol intake [beta = 0.7, P < 0.01]. For 1 unit increase in either BMI, waist to hip ratio or saturated fatty acid intake, diastolic blood pressure increased 0.6, 0.9 and 0.1 mmHg, respectively [P < 0.05]. Dietary and non-dietary factors have an association with, and play a role as predictors of, CVD risk factors

Dietary diversity score is favorably associated with the metabolic syndrome in Tehranian adults.

OBJECTIVE: Assessing overall diet instead of the effects of a single nutrient on diet-disease relations may be more informative. This study was conducted to evaluate the relationship between dietary diversity score (DDS) and metabolic syndrome in Tehranian adults. DESIGN: Cross-sectional study. SUBJECTS: A representative sample of 581 healthy subjects aged over 18 y selected randomly from among participants of the Tehran Lipid and Glucose Study. MEASUREMENTS: Usual dietary intake was assessed using a validated semi quantitative food frequency questionnaire. DDS was calculated based on scoring to the five-food group. The DDS range was 0-10. Weight and height were measured according to standard protocols and body mass index (BMI) was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Metabolic syndrome was defined according to ATPIII. Subjects were categorized based on quartile cut-points of DDS. RESULTS: Means (+/-s.d.) of age and BMI were 37+/-12 y and 25.7+/-4.3 kg/m(2), respectively. Mean (+/-s.d.) of DDS was 6.15+/-1.02. The probability of having metabolic syndrome decreased with quartiles of DDS (odds ratios among quartiles: 1.00, 0.82, 0.76, 0.70, P<0.05, and odds ratios among quartiles after further adjustment for BMI: 1.00, 0.88, 0.80, 0.77, P<0.05). After controlling for confounders, a significantly decreasing trend was observed for the risk of having high blood pressure, impaired glucose homeostasis and high triglyceride levels. CONCLUSION: DDS had inverse association with metabolic syndrome and some of its features in this cross-sectional study. A higher dietary diversity, therefore, might be associated with lower possibility of having some metabolic disorders.

Variety scores of food groups contribute to the specific nutrient adequacy in Tehranian men.

OBJECTIVE: To examine the relationship between variety scores of food groups (between and within food groups) and the probability of nutrient adequacy in Tehranian men. DESIGN: A cross-sectional study assessing food intake by two 24-h recall questionnaires. Dietary diversity was defined according to diet quality index revised, which was used by Haines et al in 1999. The mean probability of adequacy across 14 nutrients was calculated using the Dietary Reference Intakes. SETTING: District 13 of Tehran, Iran. SUBJECTS: A total of 295 males, aged 18 y and over. RESULTS: Whole grain variety mostly correlated with protein and vitamin B2 (r=0.3, P<0.05). Fruit variety was correlated with vitamin C (r=0.4, P<0.05). Dairy variety was correlated with calcium intake (r=0.4, P<0.05). Meat variety was correlated with protein intake (r=0.3, P<0.05). Most subjects failed to meet vitamin B6, zinc, magnesium, calcium, copper, and vitamin B12 adequacy. Energy intake was a strong predictor of the mean probability of adequacy in models controlled for age, body mass index, education level and job status (model R2=0.48). Adding the number of servings from each of the food group to the models significantly improved the model fit (model R2=0.55). Adding the dietary variety improved the model fit significantly (model R2=0.61). Dairy variety and meat variety had the strongest association with improved nutrient adequacy. CONCLUSION: Variety of different food groups is a useful indicator of specific nutrient adequacy. Hence, to determine the adequacy of a specific nutrient, the variety scores of specific food groups should be taken into account.