Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran.
Sci Rep. 2022 Aug 12;12(1):13772. doi: 10.1038/s41598-022-17969-4.
The association of plant-based diets with health status is underestimated in pediatrics. We aimed to examine the relation between plant-based diets (including overall plant-based index (PDI), healthy plant-based (hPDI) and unhealthy plant-based (uPDI)) and metabolic health status in Iranian adolescents with overweight/obesity. We conducted a cross-sectional study on 203 adolescents with overweight/obesity (12-18 years old) selected by a multistage cluster random-sampling method. Usual dietary intakes were assessed through a validated 147-item food frequency questionnaire (FFQ). Anthropometric indices and blood pressure values were measured and fasting blood samples were drawn. For classification of participants into metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO) groups, two methods of International Diabetes Federation (IDF) and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR) were applied. No significant association was observed between higher adherence to PDI and odds of MUO status defined by both IDF and IDF/HOMA-IR strategies. After adjustments for all potential confounders, adolescents in the highest tertile of hPDI, compared with those in the lowest tertile, had 85% (95% CI 0.05-0.43) and 84% (95% CI 0.05, 0.52) lower odds of being MUO based on IDF and IDF/HOMA-IR criteria, respectively. Greater adherence to uPDI was associated with odd of 3.95 (95% CI 1.41, 11.12) and 4.06 (95% CI 1.31, 12.57) of being MUO based on IDF and IDF/HOMA-IR definitions, after considering all potential confounders. Stratified analysis revealed that these associations were stronger in girls and overweight subjects. Adherence to healthy plant-based foods was inversely associated with odds of MUO status in Iranian adolescents. In contrast, unhealthy plant-based diets was directly associated with MUO in pediatrics. Further studies with prospective nature, are required to affirm these results.
植物性饮食与健康状况的关联在儿科领域被低估了。我们旨在研究伊朗超重/肥胖青少年中植物性饮食（包括整体植物性饮食指数（PDI）、健康植物性饮食（hPDI）和不健康植物性饮食（uPDI））与代谢健康状况之间的关系。我们通过多阶段聚类随机抽样方法选择了 203 名超重/肥胖青少年（12-18 岁）进行横断面研究。通过验证过的 147 项食物频率问卷（FFQ）评估习惯性饮食摄入量。测量了人体测量学指标和血压值，并抽取了空腹血样。为了将参与者分类为代谢健康肥胖（MHO）或代谢不健康肥胖（MUO）组，应用了国际糖尿病联合会（IDF）的两种方法和 IDF 与稳态模型评估胰岛素抵抗（HOMA-IR）的组合。在两种 IDF 策略下，较高的 PDI 依从性与 MUO 状态的几率之间没有显著关联。在调整所有潜在混杂因素后，与最低三分位相比，hPDI 最高三分位的青少年根据 IDF 和 IDF/HOMA-IR 标准，MUO 的几率分别降低了 85%（95%CI 0.05-0.43）和 84%（95%CI 0.05，0.52）。更高的 uPDI 依从性与 MUO 的几率相关，根据 IDF 和 IDF/HOMA-IR 定义，MUO 的几率分别为 3.95（95%CI 1.41，11.12）和 4.06（95%CI 1.31，12.57），在考虑所有潜在混杂因素后。分层分析显示，这些关联在女孩和超重人群中更强。伊朗青少年健康植物性食物的摄入与 MUO 状态的几率呈负相关。相反，不健康的植物性饮食与儿科 MUO 直接相关。需要进行前瞻性研究来证实这些结果。
