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A structural equation modeling approach for the association of a healthy eating index with metabolic syndrome and cardio-metabolic risk factors among obese individuals.

ABSTRACT: BACKGROUND:Numerous studies have evaluated the association between dietary factors and cardiovascular risk among patients with chronic disease. It is worthwhile to assess these associations in a combination model rather than in an isolated form. In the current study, we aimed to use structural equation modeling (SEM) to assess the association of adherence to a healthy eating index (HEI)-2015 with socio-demographic factors, psychological characteristics, metabolic syndrome (MetS) and other cardio-metabolic risk factors among obese individuals. METHODS:This cross-sectional study was conducted among 188 healthy obese adults (96 males and 92 females) aged 20-50 years in Tabriz. A validated semi-quantitative food frequency questionnaire (FFQ) was used to record dietary intake and to estimate HEI-2015. Anthropometric parameters, blood pressure and biochemical measurements were evaluated according to standard protocols. Interrelationships among socio-demographic parameters and HEI with cardio-metabolic risk factors were analyzed using SEM. RESULTS:The results of SEM analysis revealed that HEI mediated the association between age and several cardio-metabolic risk factors including fat mass (FM), fat free mass (FFM), systolic blood pressure (SBP) and high-density lipoprotein (HDL) (p < 0.05). Moreover, adherence to Dietary Guidelines for Americans (DGA) appears to mediate association between gender and waist circumference (B = -9.78), SBP (B = -4.83), triglyceride (B = -13.01) and HDL (B = 4.31). HEI also mediated indirect negative effects of socioeconomic status on FM (B = -0.56), FFM (B = -0.25), SBP (B = -0.55) and diastolic blood pressure (DBP) (B = -0.3). Additionally, depression and age had indirect unfavorable effects on some insulin resistance indices such as homeostasis model assessment of insulin resistance (B = 0.07; p<0.05, for age) and quantitative insulin sensitivity check index (p<0.05, for age and depression) via HEI. High adherence to HEI was found to be inversely associated with MetS risk (p<0.05). CONCLUSION:Adherence to HEI-2015 seems to mediate the effect of socio-demographic parameters and mental health on cardio-metabolic risk factors as well as MetS risk. Further studies are needed to confirm these findings.

SUBMITTER: Khodarahmi M

PROVIDER: S-EPMC6602284 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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A structural equation modeling approach for the association of a healthy eating index with metabolic syndrome and cardio-metabolic risk factors among obese individuals.

Khodarahmi Mahdieh M Asghari-Jafarabadi Mohammad M Abbasalizad Farhangi Mahdieh M

PloS one 20190701 7

<h4>Background</h4>Numerous studies have evaluated the association between dietary factors and cardiovascular risk among patients with chronic disease. It is worthwhile to assess these associations in a combination model rather than in an isolated form. In the current study, we aimed to use structural equation modeling (SEM) to assess the association of adherence to a healthy eating index (HEI)-2015 with socio-demographic factors, psychological characteristics, metabolic syndrome (MetS) and othe ...[more]

PMID: 31260504

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Project description:BackgroundThe dietary glycemic index (GI) has been introduced as a novel index to elucidate the potential of foods to increase postprandial glucose. According to the limited available data about the association of GI with cardio-metabolic risk factors such as lipid profile, blood glucose markers, and blood pressure in developing countries, the current study was conducted to investigate this association in apparently obese individuals.Method and materialThree hundred forty-seven obese adults were recruited in the present cross-sectional study. A validated 147-food item semi-quantitative food frequency questionnaire (FFQ) was used to evaluate the usual dietary intake of study participants. Dietary GI was calculated using the international GI database. Fatty acid desaturase (FADs)2 gene variants were determined according to polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). ANOVA was used to compare study variables across different tertile of GI.ResultsWe found significant differences in terms of anthropometric parameters [weight (P = 0.038), waist circumference (WC) (P = 0.023), weight to hip ratio (WHR) (P = 0.007), and fat-free mass (FFM) (P < 0.001)] between different tertiles of GI. Similarly, energy and macronutrient intakes had a significant difference across dietary GI, and subjects with a higher dietary intake of energy and macronutrients (carbohydrate, protein, and total fat) were assigned to the third tertile of dietary GI (P < 0.001). While there was no significant difference in terms of cardio-metabolic risk factors in different dietary GI tertiles. Moreover, the total GI score was non-significantly higher in the TT genotype of FADS2 gene polymorphism compared with other genotypes. While no significant difference was observed between FADS2 genotype frequencies in different GI tertiles.ConclusionCalculated dietary GI was associated with several cardio-metabolic risk factors in obese individuals. However, further prospective studies and clinical trials are needed to confirm our findings.

Project description:BackgroundEpidemiologic studies show that cocaine- and amphetamine-regulated transcript prepropeptide (CARTPT) gene polymorphism modifies diet-obesity relationships. However, the interaction between CARTPT gene polymorphism and diet quality indices have not been investigated yet. The current study was aimed to evaluate the interaction between major dietary indices including Diet Quality Index-International (DQI-I) and Healthy Eating Index (HEI)-2015 and CARTPT gene rs2239670 variants among apparently healthy obese Iranians.MethodsThis cross-sectional study was carried out by employing 288 apparently healthy obese adults aged 20-50 years with a BMI of 30-40 kg/m2. Diet quality was evaluated by Diet Quality Index-International (DQI-I) and Healthy Eating Index-2015 (HEI-2015) using a 132-items semi-quantitative validated food frequency questionnaire. The CARTPT gene rs2239670 polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Blood concentrations of glycemic markers, lipid profile, α-melanocyte stimulating hormone (MSH) and agouti-related peptide (AgRP) were also measured. ANCOVA multivariate interaction model was used to analyze gene-diet interactions.ResultsThe significant interactions were identified between CARTPT gene polymorphism and HEI, affecting BMR (PInteraction = 0.003), serum glucose (PInteraction = 0.009) and high density lipoprotein cholesterol HDL concentrations (PInteraction = 0.03) after adjusting for the effects of sex and age. Also we found gene-diet interaction between CARTPT genotypes and DQI-I in terms of fat mass (FM; PInteraction = 0.02), waist circumference (WC; PInteraction < 0.001), body mass index (BMI; PInteraction < 0.001), basal metabolic rate (BMR, PInteraction < 0.001), serum fasting glucose (PInteraction < 0.01) and AgRP (PInteraction = 0.05) in individuals even after adjusting for potential confounders.ConclusionCurrent study showed the effects of interaction between CARTPT genotype with adherence to HEI and DQI-I scores on obesity-related anthropometric and metabolic risk-factors.

Project description:Healthy eating is crucial for optimal growth, development, and the prevention of chronic diseases in adolescents. Our study aimed to develop a comprehensive structural equation model (SEM) to analyze the relationships between knowledge, attitudes, practices (KAP), and healthy eating among adolescents in Chongqing. An online questionnaire was administered to middle school students in 39 districts and counties of Chongqing, China from 2 December to 15 December 2021 to collect sociodemographic and KAP information. SEM models were constructed to examine the relationships between educational environment and healthy eating knowledge, attitudes, and practices. The Monte Carlo test was employed to assess the significance of the mediating effect of relevant variables. The study included 139,832 adolescents aged 14.8 ± 0.7 years, with a 14% rate of overweight and obesity. Health and nutrition knowledge averaged a score of 3.60 ± 1.50 (correct rate: 60%). Participants had positive attitudes (average score: 13.61 ± 2.29) and engaged in healthy eating practices (average score: 12.06 ± 3.08). The results of the SEM revealed a significant influence of the educational environment on adolescents' knowledge (β = 0.235, p < 0.001) and attitude towards healthy eating (β = 0.143, p < 0.001). Knowledge exhibited positive effects on both attitude (β = 0.225, p < 0.001) and practice (β = 0.054, p < 0.001), while attitude exhibited positive effects on practice behavior (β = 0.565, p < 0.001). The indirect effect of knowledge on practices through attitude was more substantial than the direct effect (ratio 2.361). Our study highlights the mediating role of attitude between healthy eating knowledge and practices. A significant association exists between a favorable educational environment and improved knowledge and positive attitudes toward healthy eating among adolescents. In the future, nutrition and health education should prioritize exploring effective ways to translate knowledge into practices.

Project description:Globally, around three billion people are either under- or overweight. Speculating the different roles of psychological factors in body weight between over- and underweight people, it was first hypothesized that whether or not the effects of self-efficacy and coping strategies on body mass index (BMI) is different between these two groups. We secondly predicted that their association is mediated by nutritional factors. Therefore, the present cross-sectional study was conducted to model the impact of self-efficacy and coping strategies on eating behaviors, dietary intake and BMI, using structural equation modeling in two BMI groups: low-to-normal-BMI (LBMI: BMI<21.75 kg/m2) and normal-to-high-BMI (HBMI: 21.75 kg/m2 ≤ BMI). Female participants (N = 250, aged ≥18) were included using convenience sampling method and data of self-efficacy, coping strategies, eating behaviors and dietary intake were collected via questionnaires. The model fit was evaluated and confirmed by fit indices. The analysis revealed in both groups the participants tended to adopt emotion-focused coping strategy (EFCS) more than problem-focused coping strategy (PFCS) (mean score: 61.82 (7.96) vs 49.21 (6.73)). The HBMI group tended to use EFCS more than the LBMI group (P<0.001). In the LBMI group, self-efficacy, PFCS and EFCS had positive effects on BMI. Only the direct effect of self-efficacy (β = 0.314, P<0.001) and the indirect effects of PFCS and EFCS (through increasing unhealthy eating behaviors; β = 0.127, P<0.01, β = 0.095, P<0.05, respectively) were significant. In the HBMI group, self-efficacy had negative effect on BMI (both directly (β = -0.229, P<0.05) and indirectly (β = -0.103, P<0.05) by decreasing unhealthy eating behaviors). PFCS had no effect and EFCS had an indirect, positive effect on BMI (through increasing unhealthy eating behaviors, β = 0.162, P = 0.001). In conclusion, these findings suggest that improving self-efficacy and coping-strategies seems helpful to have a healthy BMI in both BMI groups and further interventions to reduce EFCS should be limited to overweight people.

Project description:ObjectivePolymorphisms of the fatty acid desaturase (FADS) gene cluster have been associated with obesity and its-related consequences. This cross-sectional study aimed to investigate whether the adherence to dietary non-enzymatic antioxidant capacity (NEAC), reflecting the antioxidant potential of the whole diet, modifies the association of FADS2 rs174583 polymorphism with cardio-metabolic risk factors in obese adults.MethodsThe present study included 347 healthy obese adults (aged 20-50 years). Dietary NEAC was assessed by a validated food frequency questionnaire with 147 items and estimated through total radical-trapping antioxidant parameters (TRAP), oxygen radical absorbance capacity (ORAC), and ferric reducing ability of plasma (FRAP) with the use of published databases. FADS2 rs174583 polymorphism was characterized using PCR-RFLP. ANCOVA multivariate interaction model was used to analyze gene-diet interactions.Resultsafter adjustment for the confounding variables (age, physical activity, SES and WC), this study showed significant interactions between rs174583 polymorphism and adherence to dietary ORAC on the serum cholesterol (P Interaction = 0.029), LDL-C (P Interaction = 0.025) and HDL-C levels (P Interaction = 0.049) among the male group; minor allele carriers who had the highest adherence to the NEAC (ORAC) showed a better metabolic profile (lower TG and LDL-C and higher HDL-C) (P < 0.05). Among women, the dietary ORAC-rs174583 interactions were statistically significant for the serum insulin concentration (P Interaction = 0.020), QUICKI (P Interaction = 0.023) and HOMA-IR (P Interaction = 0.017); the highest QUICKI and the lowest HOMA-IR and serum insulin levels were observed in the CC homozygote carriers with the moderate compliance with the dietary ORAC (P < 0.05). In addition, the dietary TRAP modified the association between FADS2 variant and change in LDL-C levels (P Interaction = 0.037); the homozygous wild-type (CC) women who placed in the top tertile of TRAP had significantly the lowest LDL-C levels than those in the second tertile (P < 0.05).ConclusionThese data indicate that the FADS2 rs174583 polymorphism interacts with the dietary NEAC to influence cardio-metabolic risk factors in obese subjects. Replication in prospective cohort studies among other populations is required to confirm the results of our study.

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A structural equation modeling approach for the association of a healthy eating index with metabolic syndrome and cardio-metabolic risk factors among obese individuals.

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A structural equation modeling approach for the association of a healthy eating index with metabolic syndrome and cardio-metabolic risk factors among obese individuals.

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