Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran.
BMC Public Health. 2024 Jan 2;24(1):42. doi: 10.1186/s12889-023-17558-8.
There has been lack of evidence on the association between healthy dietary patterns and metabolic health status of adolescents. The present study aimed to evaluate the association between alternative healthy eating index (AHEI) and metabolic health status among a relatively representative sample of Iranian adolescents with overweight/obesity.
Adolescents with extra body weight (n = 203, aged 12-18 y), were selected for this cross-sectional study by a multistage cluster random-sampling method. Habitual dietary intakes and diet quality of individuals were assessed using validated food frequency questionnaire and AHEI-2010, respectively. Data on other covariates were also gathered by pre-tested questionnaires. To determine fasting glucose, insulin and lipid profiles, fasting blood samples were collected. Participants were categorized as having metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO) phenotypes, based on two approaches (International Diabetes Federation (IDF) and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR)).
The overall prevalence of MUO was 38.9% (based on IDF criteria) and 33.0% (based on IDF/HOMA-IR criteria). After considering all potential confounders, participants in highest tertiles of AHEI-2010 had lower odds of MUO profile according to both IDF (OR = 0.05; 95% CI: 0.01-0.15) and IDF/HOMA-IR (OR = 0.05; 95% CI: 0.02-0.19) definitions. This association was stronger in adolescents with overweight compared with obese ones and also among girls than boys. Moreover, each unit increase in AHEI-2010 score was associated with lower risk of MUO based on both criteria.
Higher adherence to AHEI-2010 was inversely associated with odds of MUO in Iranian adolescents with overweight/obesity.
目前缺乏关于健康饮食模式与青少年代谢健康状况之间关联的证据。本研究旨在评估替代健康饮食指数（AHEI）与伊朗超重/肥胖青少年代表性样本代谢健康状况之间的关系。
通过多阶段聚类随机抽样方法，选择了 203 名超重/肥胖的青少年（年龄 12-18 岁）进行这项横断面研究。使用经过验证的食物频率问卷和 AHEI-2010 分别评估个体的习惯性饮食摄入量和饮食质量。还通过预先测试的问卷收集了其他协变量的数据。为了确定空腹血糖、胰岛素和血脂谱，采集了空腹血样。根据两种方法（国际糖尿病联合会（IDF）和 IDF 与稳态模型评估胰岛素抵抗（HOMA-IR）相结合），将参与者分为代谢健康的超重/肥胖（MHO）或代谢不健康的超重/肥胖（MUO）表型。
根据 IDF 标准，MUO 的总体患病率为 38.9%，根据 IDF/HOMA-IR 标准为 33.0%。在考虑所有潜在混杂因素后，根据 IDF（OR=0.05；95%CI：0.01-0.15）和 IDF/HOMA-IR（OR=0.05；95%CI：0.02-0.19）标准，AHEI-2010 最高三分位的参与者患 MUO 表型的可能性较低。这种关联在超重青少年中比肥胖青少年更强，在女孩中比男孩更强。此外，根据两种标准，AHEI-2010 得分每增加一个单位，MUO 的风险就会降低。
较高的 AHEI-2010 依从性与伊朗超重/肥胖青少年 MUO 的几率呈负相关。
