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 Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Int J Clin Pract. 2022 Aug 8;2022:9925267. doi: 10.1155/2022/9925267. eCollection 2022.
Obesity is becoming more prevalent around the world and greatly contributes to chronic disease progression. Previous studies have investigated individual food groups in relation to metabolic health status of adolescents, mainly in Western countries. Limited data are available on the association between dietary patterns and metabolic health in Middle East nations, where childhood overweight/obesity is increasing drastically. Therefore, we investigated the relationship between the Mediterranean diet and metabolic health status among Iranian adolescents.
This cross-sectional study was conducted on 203 overweight/obese adolescents. Dietary intakes were evaluated by a validated food frequency questionnaire. Anthropometric parameters and blood pressure were measured. Fasting blood samples were obtained to determine circulating insulin, glucose, and lipid profile. Two different methods were applied to classify participants as metabolically healthy obese (MHO) or unhealthy obese (MUO): International Diabetes Federation (IDF) criteria and IDF along with insulin resistance (HOMA-IR) criteria.
A total of 79 (38.9%) and 67 (33.0%) adolescents were, respectively, categorized as MUO, based on IDF and IDF/HOMA definitions. Considering IDF criteria, higher adherence to the Mediterranean diet was related to lower odds of being MUO, both in the crude (OR: 0.17; 95%CI: 0.08-0.37) and fully adjusted model (OR: 0.33; 95% CI: 0.13-0.84). Excluding each component from the score made the association insignificant, except for two components of meat and dairy products. Based on the IDF/HOMA-IR criteria, there was no significant association between Mediterranean diet score and MUO, after considering all potential confounders (OR: 0.47; 95% CI: 0.17-1.30).
We found an inverse association between the Mediterranean diet and odds of MUO among Iranian adolescents, based on IDF criteria. No significant relation was found when MUO was defined based on HOMA-IR/IDF criteria. Further prospective cohort studies are needed to confirm these findings.
肥胖在全球范围内变得越来越普遍，极大地促进了慢性病的进展。以前的研究已经调查了与青少年代谢健康状况有关的个别食物组，主要在西方国家进行。关于饮食模式与中东国家儿童超重/肥胖急剧增加的代谢健康之间的关系，数据有限。因此，我们研究了地中海饮食与伊朗青少年代谢健康状况之间的关系。
这是一项横断面研究，共纳入 203 名超重/肥胖青少年。通过验证的食物频率问卷评估饮食摄入量。测量了人体测量参数和血压。采集空腹血样以确定循环胰岛素、葡萄糖和血脂谱。应用两种不同的方法将参与者分为代谢健康肥胖（MHO）或不健康肥胖（MUO）：国际糖尿病联合会（IDF）标准和 IDF 联合胰岛素抵抗（HOMA-IR）标准。
根据 IDF 和 IDF/HOMA 定义，分别有 79（38.9%）和 67（33.0%）名青少年被归类为 MUO。考虑到 IDF 标准，地中海饮食的更高依从性与 MUO 的较低可能性相关，在粗模型（OR：0.17；95%CI：0.08-0.37）和完全调整模型（OR：0.33；95%CI：0.13-0.84）中均如此。在排除评分中的每个成分后，除了肉类和奶制品的两个成分外，其余成分的关联均不显著。根据 IDF/HOMA-IR 标准，在考虑所有潜在混杂因素后，地中海饮食评分与 MUO 之间没有显著关联（OR：0.47；95%CI：0.17-1.30）。
我们发现，根据 IDF 标准，伊朗青少年中地中海饮食与 MUO 的几率呈负相关。当 MUO 根据 HOMA-IR/IDF 标准定义时，没有发现显著的关系。需要进一步的前瞻性队列研究来证实这些发现。
