The Relationship Between Diet Quality And Body Weight Management In Pre-Obese And Obese Women Diet quality and obesity in pre-obese and obese women

Main Article Content

Irem Dagoglu https://orcid.org/0000-0003-4110-4466
Ozlem Persil-Ozkan https://orcid.org/0000-0003-2871-0090

Keywords

Diet quality, Mediternean diet, Obesity, Body fat, Nutritional behaviours

Abstract

Objectives: The aim of this study was to investigate the relationships between "KIDMED, Mediterranean Diet Quality Index", "Diet Quality Index International (DQI-I)" scales and Body Mass Index (BMI), body fat percentage, biochemical parameters  of preobese and obese women.


Methods: This descriptive and cross-sectional study was conducted on 125 participants who applied to Fırat University Hospital Nutrition and Diet Policlinic between 11 April 2019 and 31 May 2019 in Elazıg/Turkey. Nutritional habits were evaluated with KIDMED and DQI-I. Food frequency questionare was used to collect data on dietary patterns. Chi-square test, T-test, ANOVA were used to analyze data. Scheffe or Tamhane tests were used in the binary comparisons of the groups. Pearson Correlation was used to evaluate the relation of quantitative variables with each other.


Results: The mean age of the participants was 39,09±14,36  (min 19- max 69) years and %52 (n:65) were pre-obese and % 48 (n:60) were obese according to BMI. Mean scores of  KIDMED and DQI-I of pre-obeses were significantly higher than obeses. BMI, body fat percentage, total cholesterol level were inversely associated with both DQI-I and KIDMED.  The relationship between total cholesterol level and dietary total fat, saturated fat, cholesterol, empty calorie food, and fatty acid ratio scores was negatively significant for each component.


Conclusion: The majority of pre-obese people were in the good and average categories of KIDMED, while the obese were mostly in the average and poor categories.The relationship between BMI and DQI-I total score was stronger than KIDMED.

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References

References
1. WHO/Europe | Nutrition - Body mass index - BMI.
2. Albataineh SR, Badran EF, Tayyem RF. Overweight and obesity in childhood: Dietary, biochemical, inflammatory and lifestyle risk factors. Obes Med. 2019;15(May):100112. doi:10.1016/j.obmed.2019.100112
3. Palmer BF. The sexual dimorphism of obesity. Mol Cell Endocrinol. 2013;31(3):477-479. doi:10.1016/j.immuni.2010.12.017.Two-stage
4. Chang E, Varghese M, Singer K. Gender and Sex Differences in Adipose Tissue. Curr Diab Rep. 2018;18(9):69. doi:10.1007/s11892-018-1031-3
5. GHO | By category | Body Mass Index (BMI).
6. Medina-Remón A, Kirwan R, Lamuela-Raventós RM, Estruch R. Dietary patterns and the risk of obesity, type 2 diabetes mellitus, cardiovascular diseases, asthma, and neurodegenerative diseases. Crit Rev Food Sci Nutr. 2018;58(2):262-296. doi:10.1080/10408398.2016.1158690
7. Türkiye İstatistik Kurumu, Türkiye Sağlık Araştırması, 2019.
8. Echouffo-Tcheugui JB, Ahima RS. Does diet quality or nutrient quantity contribute more to health? J Clin Invest. 2019;129(10):3969-3970. doi:10.1172/JCI131449
9. Hruby A, Manson JAE, Qi L, et al. Determinants and consequences of obesity. Am J Public Health. 2016;106(9):1656-1662. doi:10.2105/AJPH.2016.303326
10. Bälter K, Möller E, Fondell E. The effect of dietary guidelines on cancer risk and mortality. Curr Opin Oncol. 2012;24(1):90-102. doi:10.1097/cco.0b013e32834e0531
11. Teixeira PJ, Carraça E V., Marques MM, et al. Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators. BMC Med. 2015;13(1):84. doi:10.1186/s12916-015-0323-6
12. Sanches Machado d’Almeida K, Ronchi Spillere S, Zuchinali P, Corrêa Souza G. Mediterranean Diet and Other Dietary Patterns in Primary Prevention of Heart Failure and Changes in Cardiac Function Markers: A Systematic Review. Nutrients. 2018;10(1):58. doi:10.3390/nu10010058
13. Asghari G, Mirmiran P, Yuzbashian E, Azizi F. A systematic review of diet quality indices in relation to obesity. Br J Nutr. 2017;117(8):1055-1065. doi:10.1017/S0007114517000915
14. Kim S, Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index-International (DQI-I) Provides an Effective Tool for Cross-National Comparison of Diet Quality as Illustrated by China and the United States. J Nutr. 2003;133(11):3476-3484. doi:10.1093/jn/133.11.3476
15. Serra-Majem L, Ribas L, Ngo J, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutr. 2004;7(7):931-935. doi:10.1079/phn2004556
16. Kontogianni MD, Farmaki AE, Vidra N, Sofrona S, Magkanari F, Yannakoulia M. Associations between Lifestyle Patterns and Body Mass Index in a Sample of Greek Children and Adolescents. J Am Diet Assoc. 2010;110(2):215-221. doi:10.1016/j.jada.2009.10.035
17. Association AD. Practice Paper of the American Dietetic Association: Using the Dietary Reference Intakes. J Am Diet Assoc. 2011;111(5):762-770. doi:10.1016/j.jada.2011.03.022
18. Bountziouka V, Bathrellou E, Giotopoulou A, et al. Development, repeatability and validity regarding energy and macronutrient intake of a semi-quantitative food frequency questionnaire: Methodological considerations. Nutr Metab Cardiovasc Dis. 2012;22(8):659-667. doi:10.1016/j.numecd.2010.10.015
19. D’Innocenzo S, Biagi C, Lanari M. Obesity and the Mediterranean Diet: A Review of Evidence of the Role and Sustainability of the Mediterranean Diet. Nutrients. 2019;11(6):1306. doi:10.3390/nu11061306
20. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008;337(sep11 2):a1344-a1344. doi:10.1136/bmj.a1344
21. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003;348(26):2599-2608. doi:10.1056/NEJMoa025039
22. Pilis W, Stec K, Zych M, Pilis A. Health benefits and risk associated with adopting a vegetarian diet. Rocz Państwowego Zakładu Hig. 2014;65(1):9-14.
23. Yokoyama Y, Levin SM, Barnard ND. Association between plant-based diets and plasma lipids: A systematic review and meta-analysis. Nutr Rev. 2017;75(9):683-698. doi:10.1093/nutrit/nux030
24. Rogerson D, Maçãs D, Milner M, Liu Y, Klonizakis M. Contrasting Effects of Short-Term Mediterranean and Vegan Diets on Microvascular Function and Cholesterol in Younger Adults: A Comparative Pilot Study. Nutrients. 2018;10(12):1897. doi:10.3390/nu10121897
25. DASH Diet. In: Handbook of Disease Burdens and Quality of Life Measures. New York, NY: Springer New York; 2010:4184-4184. doi:10.1007/978-0-387-78665-0_5446
26. Chiavaroli L, Viguiliouk E, Nishi SK, et al. DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Nutrients. 2019;11(2):338. doi:10.3390/nu11020338
27. Gregory CO, McCullough ML, Ramirez-Zea M, Stein AD. Diet scores and cardio-metabolic risk factors among Guatemalan young adults. Br J Nutr. 2008;101(12):1805-1811. doi:10.1017/S000711450813584X
28. Fung TT, McCullough ML, Newby PK, et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. 2005;82(1):163-173. doi:10.1093/ajcn/82.1.163
29. Quatromoni PA, Pencina M, Cobain MR, Jacques PF, D’Agostino RB. Dietary Quality Predicts Adult Weight Gain: Findings from the Framingham Offspring Study*. Obesity. 2006;14(8):1383-1391. doi:10.1038/oby.2006.157
30. Lassale C, Fezeu L, Andreeva VA, et al. Association between dietary scores and 13-year weight change and obesity risk in a French prospective cohort. Int J Obes. 2012;36(11):1455-1462. doi:10.1038/ijo.2011.264
31. Asghari G, Mirmiran P, Rashidkhani B, Asghari-Jafarabadi M, Mehran M, Azizi F. The association between diet quality indices and obesity: Tehran lipid and glucose study. Arch Iran Med. 2012;15(10):599-605.
32. Huo R, Du T, Xu Y, et al. Effects of Mediterranean-style diet on glycemic control, weight loss and cardiovascular risk factors among type 2 diabetes individuals: A meta-analysis. Eur J Clin Nutr. 2015;69(11):1200-1208. doi:10.1038/ejcn.2014.243
33. Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB. The effect of mediterranean diet on metabolic syndrome and its components: A meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol. 2011;57(11):1299-1313. doi:10.1016/j.jacc.2010.09.073
34. Romaguera D, Norat T, Vergnaud AC, et al. Mediterranean dietary patterns and prospective weight change in participants of the EPIC-PANACEA project. Am J Clin Nutr. 2010;92(4):912-921. doi:10.3945/ajcn.2010.29482
35. Nishida C, Barba C, Cavalli-Sforza T, et al. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-163. doi:10.1016/S0140-6736(03)15268-3
36. Ho-Pham LT, Campbell L V., Nguyen T V. More on Body Fat Cutoff Points. Mayo Clin Proc. 2011;86(6):584. doi:10.4065/mcp.2011.0097
37. Ortega FB, Sui X, Lavie CJ, Blair SN. Body Mass Index, the Most Widely Used but Also Widely Criticized Index Would a Criterion Standard Measure of Total Body Fat Be a Better Predictor of Cardiovascular Disease Mortality? Mayo Clin Proc. 2016;91(4):443-455. doi:10.1016/j.mayocp.2016.01.008


References
1. WHO/Europe | Nutrition - Body mass index - BMI.
2. Albataineh SR, Badran EF, Tayyem RF. Overweight and obesity in childhood: Dietary, biochemical, inflammatory and lifestyle risk factors. Obes Med. 2019;15(May):100112. doi:10.1016/j.obmed.2019.100112
3. Palmer BF. The sexual dimorphism of obesity. Mol Cell Endocrinol. 2013;31(3):477-479. doi:10.1016/j.immuni.2010.12.017.Two-stage
4. Chang E, Varghese M, Singer K. Gender and Sex Differences in Adipose Tissue. Curr Diab Rep. 2018;18(9):69. doi:10.1007/s11892-018-1031-3
5. GHO | By category | Body Mass Index (BMI).
6. Medina-Remón A, Kirwan R, Lamuela-Raventós RM, Estruch R. Dietary patterns and the risk of obesity, type 2 diabetes mellitus, cardiovascular diseases, asthma, and neurodegenerative diseases. Crit Rev Food Sci Nutr. 2018;58(2):262-296. doi:10.1080/10408398.2016.1158690
7. Türkiye İstatistik Kurumu, Türkiye Sağlık Araştırması, 2019.
8. Echouffo-Tcheugui JB, Ahima RS. Does diet quality or nutrient quantity contribute more to health? J Clin Invest. 2019;129(10):3969-3970. doi:10.1172/JCI131449
9. Hruby A, Manson JAE, Qi L, et al. Determinants and consequences of obesity. Am J Public Health. 2016;106(9):1656-1662. doi:10.2105/AJPH.2016.303326
10. Bälter K, Möller E, Fondell E. The effect of dietary guidelines on cancer risk and mortality. Curr Opin Oncol. 2012;24(1):90-102. doi:10.1097/cco.0b013e32834e0531
11. Teixeira PJ, Carraça E V., Marques MM, et al. Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators. BMC Med. 2015;13(1):84. doi:10.1186/s12916-015-0323-6
12. Sanches Machado d’Almeida K, Ronchi Spillere S, Zuchinali P, Corrêa Souza G. Mediterranean Diet and Other Dietary Patterns in Primary Prevention of Heart Failure and Changes in Cardiac Function Markers: A Systematic Review. Nutrients. 2018;10(1):58. doi:10.3390/nu10010058
13. Asghari G, Mirmiran P, Yuzbashian E, Azizi F. A systematic review of diet quality indices in relation to obesity. Br J Nutr. 2017;117(8):1055-1065. doi:10.1017/S0007114517000915
14. Kim S, Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index-International (DQI-I) Provides an Effective Tool for Cross-National Comparison of Diet Quality as Illustrated by China and the United States. J Nutr. 2003;133(11):3476-3484. doi:10.1093/jn/133.11.3476
15. Serra-Majem L, Ribas L, Ngo J, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutr. 2004;7(7):931-935. doi:10.1079/phn2004556
16. Kontogianni MD, Farmaki AE, Vidra N, Sofrona S, Magkanari F, Yannakoulia M. Associations between Lifestyle Patterns and Body Mass Index in a Sample of Greek Children and Adolescents. J Am Diet Assoc. 2010;110(2):215-221. doi:10.1016/j.jada.2009.10.035
17. Association AD. Practice Paper of the American Dietetic Association: Using the Dietary Reference Intakes. J Am Diet Assoc. 2011;111(5):762-770. doi:10.1016/j.jada.2011.03.022
18. Bountziouka V, Bathrellou E, Giotopoulou A, et al. Development, repeatability and validity regarding energy and macronutrient intake of a semi-quantitative food frequency questionnaire: Methodological considerations. Nutr Metab Cardiovasc Dis. 2012;22(8):659-667. doi:10.1016/j.numecd.2010.10.015
19. D’Innocenzo S, Biagi C, Lanari M. Obesity and the Mediterranean Diet: A Review of Evidence of the Role and Sustainability of the Mediterranean Diet. Nutrients. 2019;11(6):1306. doi:10.3390/nu11061306
20. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008;337(sep11 2):a1344-a1344. doi:10.1136/bmj.a1344
21. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003;348(26):2599-2608. doi:10.1056/NEJMoa025039
22. Pilis W, Stec K, Zych M, Pilis A. Health benefits and risk associated with adopting a vegetarian diet. Rocz Państwowego Zakładu Hig. 2014;65(1):9-14.
23. Yokoyama Y, Levin SM, Barnard ND. Association between plant-based diets and plasma lipids: A systematic review and meta-analysis. Nutr Rev. 2017;75(9):683-698. doi:10.1093/nutrit/nux030
24. Rogerson D, Maçãs D, Milner M, Liu Y, Klonizakis M. Contrasting Effects of Short-Term Mediterranean and Vegan Diets on Microvascular Function and Cholesterol in Younger Adults: A Comparative Pilot Study. Nutrients. 2018;10(12):1897. doi:10.3390/nu10121897
25. DASH Diet. In: Handbook of Disease Burdens and Quality of Life Measures. New York, NY: Springer New York; 2010:4184-4184. doi:10.1007/978-0-387-78665-0_5446
26. Chiavaroli L, Viguiliouk E, Nishi SK, et al. DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Nutrients. 2019;11(2):338. doi:10.3390/nu11020338
27. Gregory CO, McCullough ML, Ramirez-Zea M, Stein AD. Diet scores and cardio-metabolic risk factors among Guatemalan young adults. Br J Nutr. 2008;101(12):1805-1811. doi:10.1017/S000711450813584X
28. Fung TT, McCullough ML, Newby PK, et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. 2005;82(1):163-173. doi:10.1093/ajcn/82.1.163
29. Quatromoni PA, Pencina M, Cobain MR, Jacques PF, D’Agostino RB. Dietary Quality Predicts Adult Weight Gain: Findings from the Framingham Offspring Study*. Obesity. 2006;14(8):1383-1391. doi:10.1038/oby.2006.157
30. Lassale C, Fezeu L, Andreeva VA, et al. Association between dietary scores and 13-year weight change and obesity risk in a French prospective cohort. Int J Obes. 2012;36(11):1455-1462. doi:10.1038/ijo.2011.264
31. Asghari G, Mirmiran P, Rashidkhani B, Asghari-Jafarabadi M, Mehran M, Azizi F. The association between diet quality indices and obesity: Tehran lipid and glucose study. Arch Iran Med. 2012;15(10):599-605.
32. Huo R, Du T, Xu Y, et al. Effects of Mediterranean-style diet on glycemic control, weight loss and cardiovascular risk factors among type 2 diabetes individuals: A meta-analysis. Eur J Clin Nutr. 2015;69(11):1200-1208. doi:10.1038/ejcn.2014.243
33. Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB. The effect of mediterranean diet on metabolic syndrome and its components: A meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol. 2011;57(11):1299-1313. doi:10.1016/j.jacc.2010.09.073
34. Romaguera D, Norat T, Vergnaud AC, et al. Mediterranean dietary patterns and prospective weight change in participants of the EPIC-PANACEA project. Am J Clin Nutr. 2010;92(4):912-921. doi:10.3945/ajcn.2010.29482
35. Nishida C, Barba C, Cavalli-Sforza T, et al. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-163. doi:10.1016/S0140-6736(03)15268-3
36. Ho-Pham LT, Campbell L V., Nguyen T V. More on Body Fat Cutoff Points. Mayo Clin Proc. 2011;86(6):584. doi:10.4065/mcp.2011.0097
37. Ortega FB, Sui X, Lavie CJ, Blair SN. Body Mass Index, the Most Widely Used but Also Widely Criticized Index Would a Criterion Standard Measure of Total Body Fat Be a Better Predictor of Cardiovascular Disease Mortality? Mayo Clin Proc. 2016;91(4):443-455. doi:10.1016/j.mayocp.2016.01.008

References
1. WHO/Europe | Nutrition - Body mass index - BMI.
2. Albataineh SR, Badran EF, Tayyem RF. Overweight and obesity in childhood: Dietary, biochemical, inflammatory and lifestyle risk factors. Obes Med. 2019;15(May):100112. doi:10.1016/j.obmed.2019.100112
3. Palmer BF. The sexual dimorphism of obesity. Mol Cell Endocrinol. 2013;31(3):477-479. doi:10.1016/j.immuni.2010.12.017.Two-stage
4. Chang E, Varghese M, Singer K. Gender and Sex Differences in Adipose Tissue. Curr Diab Rep. 2018;18(9):69. doi:10.1007/s11892-018-1031-3
5. GHO | By category | Body Mass Index (BMI).
6. Medina-Remón A, Kirwan R, Lamuela-Raventós RM, Estruch R. Dietary patterns and the risk of obesity, type 2 diabetes mellitus, cardiovascular diseases, asthma, and neurodegenerative diseases. Crit Rev Food Sci Nutr. 2018;58(2):262-296. doi:10.1080/10408398.2016.1158690
7. Türkiye İstatistik Kurumu, Türkiye Sağlık Araştırması, 2019.
8. Echouffo-Tcheugui JB, Ahima RS. Does diet quality or nutrient quantity contribute more to health? J Clin Invest. 2019;129(10):3969-3970. doi:10.1172/JCI131449
9. Hruby A, Manson JAE, Qi L, et al. Determinants and consequences of obesity. Am J Public Health. 2016;106(9):1656-1662. doi:10.2105/AJPH.2016.303326
10. Bälter K, Möller E, Fondell E. The effect of dietary guidelines on cancer risk and mortality. Curr Opin Oncol. 2012;24(1):90-102. doi:10.1097/cco.0b013e32834e0531
11. Teixeira PJ, Carraça E V., Marques MM, et al. Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators. BMC Med. 2015;13(1):84. doi:10.1186/s12916-015-0323-6
12. Sanches Machado d’Almeida K, Ronchi Spillere S, Zuchinali P, Corrêa Souza G. Mediterranean Diet and Other Dietary Patterns in Primary Prevention of Heart Failure and Changes in Cardiac Function Markers: A Systematic Review. Nutrients. 2018;10(1):58. doi:10.3390/nu10010058
13. Asghari G, Mirmiran P, Yuzbashian E, Azizi F. A systematic review of diet quality indices in relation to obesity. Br J Nutr. 2017;117(8):1055-1065. doi:10.1017/S0007114517000915
14. Kim S, Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index-International (DQI-I) Provides an Effective Tool for Cross-National Comparison of Diet Quality as Illustrated by China and the United States. J Nutr. 2003;133(11):3476-3484. doi:10.1093/jn/133.11.3476
15. Serra-Majem L, Ribas L, Ngo J, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutr. 2004;7(7):931-935. doi:10.1079/phn2004556
16. Kontogianni MD, Farmaki AE, Vidra N, Sofrona S, Magkanari F, Yannakoulia M. Associations between Lifestyle Patterns and Body Mass Index in a Sample of Greek Children and Adolescents. J Am Diet Assoc. 2010;110(2):215-221. doi:10.1016/j.jada.2009.10.035
17. Association AD. Practice Paper of the American Dietetic Association: Using the Dietary Reference Intakes. J Am Diet Assoc. 2011;111(5):762-770. doi:10.1016/j.jada.2011.03.022
18. Bountziouka V, Bathrellou E, Giotopoulou A, et al. Development, repeatability and validity regarding energy and macronutrient intake of a semi-quantitative food frequency questionnaire: Methodological considerations. Nutr Metab Cardiovasc Dis. 2012;22(8):659-667. doi:10.1016/j.numecd.2010.10.015
19. D’Innocenzo S, Biagi C, Lanari M. Obesity and the Mediterranean Diet: A Review of Evidence of the Role and Sustainability of the Mediterranean Diet. Nutrients. 2019;11(6):1306. doi:10.3390/nu11061306
20. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008;337(sep11 2):a1344-a1344. doi:10.1136/bmj.a1344
21. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003;348(26):2599-2608. doi:10.1056/NEJMoa025039
22. Pilis W, Stec K, Zych M, Pilis A. Health benefits and risk associated with adopting a vegetarian diet. Rocz Państwowego Zakładu Hig. 2014;65(1):9-14.
23. Yokoyama Y, Levin SM, Barnard ND. Association between plant-based diets and plasma lipids: A systematic review and meta-analysis. Nutr Rev. 2017;75(9):683-698. doi:10.1093/nutrit/nux030
24. Rogerson D, Maçãs D, Milner M, Liu Y, Klonizakis M. Contrasting Effects of Short-Term Mediterranean and Vegan Diets on Microvascular Function and Cholesterol in Younger Adults: A Comparative Pilot Study. Nutrients. 2018;10(12):1897. doi:10.3390/nu10121897
25. DASH Diet. In: Handbook of Disease Burdens and Quality of Life Measures. New York, NY: Springer New York; 2010:4184-4184. doi:10.1007/978-0-387-78665-0_5446
26. Chiavaroli L, Viguiliouk E, Nishi SK, et al. DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Nutrients. 2019;11(2):338. doi:10.3390/nu11020338
27. Gregory CO, McCullough ML, Ramirez-Zea M, Stein AD. Diet scores and cardio-metabolic risk factors among Guatemalan young adults. Br J Nutr. 2008;101(12):1805-1811. doi:10.1017/S000711450813584X
28. Fung TT, McCullough ML, Newby PK, et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. 2005;82(1):163-173. doi:10.1093/ajcn/82.1.163
29. Quatromoni PA, Pencina M, Cobain MR, Jacques PF, D’Agostino RB. Dietary Quality Predicts Adult Weight Gain: Findings from the Framingham Offspring Study*. Obesity. 2006;14(8):1383-1391. doi:10.1038/oby.2006.157
30. Lassale C, Fezeu L, Andreeva VA, et al. Association between dietary scores and 13-year weight change and obesity risk in a French prospective cohort. Int J Obes. 2012;36(11):1455-1462. doi:10.1038/ijo.2011.264
31. Asghari G, Mirmiran P, Rashidkhani B, Asghari-Jafarabadi M, Mehran M, Azizi F. The association between diet quality indices and obesity: Tehran lipid and glucose study. Arch Iran Med. 2012;15(10):599-605.
32. Huo R, Du T, Xu Y, et al. Effects of Mediterranean-style diet on glycemic control, weight loss and cardiovascular risk factors among type 2 diabetes individuals: A meta-analysis. Eur J Clin Nutr. 2015;69(11):1200-1208. doi:10.1038/ejcn.2014.243
33. Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB. The effect of mediterranean diet on metabolic syndrome and its components: A meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol. 2011;57(11):1299-1313. doi:10.1016/j.jacc.2010.09.073
34. Romaguera D, Norat T, Vergnaud AC, et al. Mediterranean dietary patterns and prospective weight change in participants of the EPIC-PANACEA project. Am J Clin Nutr. 2010;92(4):912-921. doi:10.3945/ajcn.2010.29482
35. Nishida C, Barba C, Cavalli-Sforza T, et al. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-163. doi:10.1016/S0140-6736(03)15268-3
36. Ho-Pham LT, Campbell L V., Nguyen T V. More on Body Fat Cutoff Points. Mayo Clin Proc. 2011;86(6):584. doi:10.4065/mcp.2011.0097
37. Ortega FB, Sui X, Lavie CJ, Blair SN. Body Mass Index, the Most Widely Used but Also Widely Criticized Index Would a Criterion Standard Measure of Total Body Fat Be a Better Predictor of Cardiovascular Disease Mortality? Mayo Clin Proc. 2016;91(4):443-455. doi:10.1016/j.mayocp.2016.01.008