Association between major dietary patterns and metabolic health status in overweight and obese adolescents

The association between major dietary patterns and metabolic health status in adolescents has been understudied, especially in Middle Eastern populations. The aim of this study was to evaluate this association in overweight/obese adolescents.

In this cross-sectional study, the usual of 203 overweight/obese adolescents selected by a multistage, cluster random-sampling method was evaluated through a validated food frequency questionnaire. Anthropometric indices and blood pressure values were measured. Fasting blood samples were obtained to determine insulin, glucose, and lipid profile concentrations. Two methods (modified International Diabetes Federation [IDF] criteria and IDF criteria along with insulin resistance or homeostasis model assessment insulin resistance [HOMA-IR] >3.16) were applied to classify participants into metabolically healthy obese (MHO) or unhealthy obese (MUO).

Two major dietary patterns, Mediterranean-like and Western, were identified. After adjustments for potential confounders, high adherence to Mediterranean-like dietary pattern was related to 72% (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.10-0.76) and 67% (OR, 0.33; 95% CI, 0.11-0.98) lower odds for being MUO based on IDF and HOMA-IR definitions, respectively. Higher adherence to the Western dietary pattern was related to higher odds of being MUO, either in the crude or adjusted models in both metabolic status definitions (for IDF definition: OR, 9.85; 95% CI, 2.75-35.19; for HOMA-IR definition: OR, 9.15; 95% CI, 2.02-41.52, in fully adjusted model).

We found an inverse association between the Mediterranean-like dietary pattern and odds of MUO in Iranian overweight/obese adolescents, whereas the Western dietary pattern was associated with an increased likelihood of being MUO. Further studies, with a prospective nature, are required to confirm these findings.