Abstract
The current study aimed at investigating the association between Dietary Approach to Stop Hypertension (DASH) diet and odds of obesity phenotypes, is a cross sectional study conducted on 3218 Iranian overweight or obese participants (BMI >25 kg/m2), aged ≥20 years, who participated in the fourth phase (2009–2011) of the Tehran Lipid and Glucose Study. Using a valid and reliable food-frequency questionnaire, DASH diet scores between 8 and 40 points were determined. Obesity phenotypes including metabolic unhealthy obesity (MUHO) and metabolic healthy obesity (MHO) were defined using criteria of the Joint International statement(JIS) for metabolic syndrome. Multivariable logistic regression was used to determine the odds ratio (OR) for obesity phenotypes according to the tertiles of the DASH diet. Mean ± SD age of participants (43.5% male) was 39.2 ± 9.5 years and median (25–75 interquartile range) DASH diet score was 24 (21–27); percentages of MHO and MUHO subjects were 33.4 and 66.6%, respectively. In the multivariable adjusted model, after controlling for age, sex, BMI, physical activity, smoking status, socioeconomic status, and energy intake, participants in the highest tertile of DASH diet had lower odds of MUHO (OR:0.79;95%CI:0.64–0.98), in comparison to those in the lowest one (P for trend = 0.040). Our findings indicate that adherence to DASH diet may be favourable in prevention of metabolic abnormalities in overweight and obese individuals.
Highlights
Obesity represents a rapidly growing public health problem worldwide over the last few decades[1]
Some studies with controversial results have explored the association between healthy diet indices such as Dietary Approach to Stop Hypertension (DASH) diet, Mediterranean diet, and food pyramid compliance with odds of obesity phenotypes[14,15]; greater adherence to the Mediterranean was positively associated with metabolic healthy obesity (MHO), compared to metabolic unhealthy obesity (MUHO), and higher adherence to DASH diet score was related with lower odds of metabolically unhealthy normal weight phenotype in comparison to metabolically healthy normal weight younger adults, no significant association of Mediterranean diet and DASH index with obesity phenotypes was found in the elderly[15]
We investigated the association of DASH score as a continuous variable with odds of obesity phenotypes in our population, and the statistical significance of findings was attenuated: the odds of MUHO, in comparison to MHO, based on one score change in the DASH diet was small (OR: 0.91, 95% confidence interval (CI): 0.85–1.01; P for trend = 0.100), (Table 4)
Summary
Obesity represents a rapidly growing public health problem worldwide over the last few decades[1]. Some evidence shows that the metabolically unhealthy obese phenotype had higher risk of chronic diseases, compared to the healthy one[9]. Some studies with controversial results have explored the association between healthy diet indices such as DASH diet, Mediterranean diet, and food pyramid compliance with odds of obesity phenotypes[14,15]; greater adherence to the Mediterranean was positively associated with MHO, compared to MUHO, and higher adherence to DASH diet score was related with lower odds of metabolically unhealthy normal weight phenotype in comparison to metabolically healthy normal weight younger adults, no significant association of Mediterranean diet and DASH index with obesity phenotypes was found in the elderly[15]. We aim to investigate associations of higher adherence to the DASH diet with metabolically healthy and unhealthy obesity phenotypes among an Iranian population
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