Associations of water intake and Intra-Meal fluid consumption with obesity, insulin resistance, and predictors of cardiovascular diseases among Iranian women.

To evaluate the associations of water intake and Intra-Meal Fluid Consumption with obesity, insulin resistance, and predictors of cardiovascular diseases. A cross-sectional study was conducted with 371 women aged 20-50 years in Iran. Physical activity, biochemical, and anthropometric measurements were collected. Dietary intake was collected using a 168-item food frequency questionnaire. Water intake was assessed through three non-consecutive 24-hour dietary recalls, and participants were classified into water intake tertiles, T1 (< 1.5 L/day), T2 (1.5-2.0 L/day), and T3 (> 2 L/day) based on recommended intake levels from the Institute of Medicine. Triglyceride and glucose (TyG) index, lipid accumulation product (LAP) index, Castelli risk indices 1 and 2 (CRI-I and CRI-II), atherogenic index of plasma (AIP), and hypertriglyceridemic waist phenotype were used as predictors of cardiovascular diseases. Women in the second and third tertiles of water intake had significantly lower body weight, BMI, waist circumference, fasting blood glucose, and triglyceride levels compared to those in the lowest tertile (p < 0.05). Higher water intake was also associated with lower odds of TyG index (OR:0.51; 95%CI:0.32,0.81; p = 0.005), LAP index (OR:0.35; 95%CI:0.22,0.56; p < 0.001), CRI-I (OR:0.57, 95%CI:0.33,0.96; p = 0.031), AIP (OR:0.57; 95%CI: 0.36,0.91; p = 0.017), and hypertriglyceridemic waist phenotype (OR:0.20; 95%CI:0.12,0.34; p < 0.001). Higher water intake may be associated with lower odds of obesity, fasting blood glucose, and predictors of cardiovascular disease in Iranian women.