Abstract
Purpose
Based on evidence, there is a significant relationship between diet quality and the chronic conditions such as dyslipidemia and liver disorders. In the current study, we investigated the relationship between alternative healthy eating index (AHEI) and some biochemical measurements (lipid profile and liver enzymes).
Methods
In this cross-sectional study, 127 hospital employees were randomly selected (of 250 screened volunteers). AHEI was estimated based on a 168 items food frequency questionnaire. The laboratory data [triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), alanine transaminase (ALT), aspartate transaminase (AST)] were extracted from periodic examinations. The physical activity was also estimated with international physical activity questionnaire (IPAQ).
Results
Among 127 completed data, the mean AHEI score was 47.1. There was a direct relationship between AHEI score and HDL (P = 0.02). Among the AHEI components, the score of nuts and soybeans was directly associated with HDL level (P = 0.007). There was no association between the other AHEI components and selected biomarkers.
Conclusion
Nuts and soybeans consumption—one unit per day—may increase HDL levels. More studies are needed to evaluate the diet quality with the other dietary indices.
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Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author (Dr. Mohammad Hassan Entezari; entezari@hlth.mui.ac.ir), on reasonable request.
Code availability
Not defined.
References
Moravejolahkami AR, Paknahad Z, Chitsaz A. Dietary intake of energy and fiber in MS patients; an approach to prebiotics role. Nutr Food Sci. 2019;49(6):1039–50.
Dinparast F, Sharifi A, Moradi S, Alipour M, Alipour B. The associations between dietary pattern of chronic obstructive pulmonary disease patients and depression: a cross-sectional study. BMC Pulm Med. 2021;21(1):1–8.
Aguilar-Ballester M, Hurtado-Genovés G, Taberner-Cortés A, Herrero-Cervera A, Martínez-Hervás S, González-Navarro H. Therapies for the treatment of cardiovascular disease associated with Type 2 diabetes and dyslipidemia. Int J Mol Sci. 2021;22(2):660.
Moravejolahkami AR, Kermani MAH, Zehi ZB, Mirenayat SMS, Mansourian M. The effect of probiotics on lipid profile and anthropometric indices in diabetic nephropathy; a systematic review and meta-analysis of clinical trials. J Diabetes Metab Disord. 2021;20(1):1–12.
Kimiagar S, Ghaffarpour M, Houshiar Rad A, Hormozdyari H, Zellipour L. Food consumption pattern in the Islamic Republic of Iran and its relation to coronary heart disease. East Mediterr Health J. 1998;4(3):539–47.
Huang F, Wang L, Zhang Q, Wan Z, Hu L, Xu R, et al. Elevated atherogenic index and higher triglyceride increase risk of kidney function decline: a 7-year cohort study in Chinese adults. Ren Fail. 2021;43(1):32–9.
Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease—meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84.
Moghaddasifar I, Lankarani K, Moosazadeh M, Afshari M, Ghaemi A, Aliramezany M, et al. Prevalence of non-alcoholic fatty liver disease and its related factors in Iran. Int J Organ Transplant Med. 2016;7(3):149.
Raza S, Rajak S, Upadhyay A, Tewari A, Sinha RA. Current treatment paradigms and emerging therapies for NAFLD/NASH. Front Biosci (Landmark Ed). 2021;26:206.
Ballestri S, Mantovani A, Baldelli E, Lugari S, Maurantonio M, Nascimbeni F, et al. Liver fibrosis biomarkers accurately exclude advanced fibrosis and are associated with higher cardiovascular risk scores in patients with NAFLD or viral chronic liver disease. Diagnostics. 2021;11(1):98.
Park E-O, Bae EJ, Park B-H, Chae S-W. The associations between liver enzymes and cardiovascular risk factors in adults with mild dyslipidemia. J Clin Med. 2020;9(4):1147.
Lorzadeh E, Akhondi-Meybodi M, Mozaffari-Khosravi H, Mirzaei M, Salehi-Abargouei A. Association between empirically derived dietary patterns and liver function tests in adults: Shahedieh cohort study. Nutrition. 2020;81:110897.
Kalafati I-P, Borsa D, Dimitriou M, Revenas K, Kokkinos A, Dedoussis GV. Dietary patterns and non-alcoholic fatty liver disease in a Greek case–control study. Nutrition. 2019;61:105–10.
Moraeus L, Lindroos AK, Lemming EW, Mattisson I. Diet diversity score and healthy eating index in relation to diet quality and socio-demographic factors: results from a cross-sectional national dietary survey of Swedish adolescents. Public Health Nutr. 2020;23(10):1–12.
McCullough ML, Feskanich D, Rimm EB, Giovannucci EL, Ascherio A, Variyam JN, et al. Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in men. Am J Clin Nutr. 2000;72(5):1223–31.
McCullough ML, Willett WC. Evaluating adherence to recommended diets in adults: the Alternate Healthy Eating Index. Public Health Nutr. 2006;9(1a):152–7.
Wu PY, Huang CL, Lei WS, Yang SH. Alternative health eating index and the Dietary Guidelines from American Diabetes Association both may reduce the risk of cardiovascular disease in Type 2 diabetes patients. J Hum Nutr Diet. 2016;29(3):363–73.
Jacobs S, Boushey CJ, Franke AA, Shvetsov YB, Monroe KR, Haiman CA, et al. A priori-defined diet quality indices, biomarkers and risk for type 2 diabetes in five ethnic groups: the Multiethnic Cohort. Br J Nutr. 2017;118(4):312–20.
Sheps SG. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI). Arch Intern Med. 1997;157:2413–46.
Grundy SM. Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Circulation. 1993;89(3):1333–45.
Min M, Li-Fa X, Dong H, Jing W, Ming-Jie B. Dietary patterns and overweight/obesity: a review article. Iran J Public Health. 2017;46(7):869.
Schulze MB, Martínez-González MA, Fung TT, Lichtenstein AH, Forouhi NG. Food based dietary patterns and chronic disease prevention. BMJ. 2018. https://doi.org/10.1136/bmj.k2396.
Sapp PA, Johnston EA, Petersen K, Fleming J, Kris-Etherton PM. Medical nutrition therapy for lipid and lipoprotein disorders. In: Therapeutic lipidology. Cham: Springer; 2021. pp. 159–71.
Moravejolahkami AR, Paknahad Z, Chitsaz A. Association of dietary patterns with systemic inflammation, quality of life, disease severity, relapse rate, severity of fatigue and anthropometric measurements in MS patients. Nutr Neurosci. 2020;23(12):920–30.
Kaye EA, Sohn W, Garcia RI. The Healthy Eating Index and coronal dental caries in US adults: National Health and Nutrition Examination Survey 2011–2014. J Am Dent Assoc. 2020;151(2):78–86.
McCullough ML, Feskanich D, Stampfer MJ, Giovannucci EL, Rimm EB, Hu FB, et al. Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance. Am J Clin Nutr. 2002;76(6):1261–71.
Fung T, Bromage S, Li Y, Bhupathiraju S, Batis C, Fawzi W, et al. A global diet quality index and risk of Type 2 diabetes in US women. Curr Dev Nutr. 2020;4(Supplement_2):1401.
Hu EA, Steffen LM, Coresh J, Appel LJ, Rebholz CM. Adherence to the healthy eating index-2015 and other dietary patterns may reduce risk of cardiovascular disease, cardiovascular mortality, and all-cause mortality. J Nutr. 2020;150(2):312–21.
Schwingshackl L, Hoffmann G. Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension score, and health outcomes: a systematic review and meta-analysis of cohort studies. J Acad Nutr Diet. 2015;115(5):780-800.e5.
Reedy J, Mitrou P, Krebs-Smith S, Wirfält E, Flood A, Kipnis V, et al. Index-based dietary patterns and risk of colorectal cancer: the NIH-AARP Diet and Health Study. Am J Epidemiol. 2008;168(1):38–48.
Fung TT, Hu FB, McCullough ML, Newby P, Willett WC, Holmes MD. Diet quality is associated with the risk of estrogen receptor-negative breast cancer in postmenopausal women. J Nutr. 2006;136(2):466–72.
Rashidipour-Fard N, Karimi M, Saraf-Bank S, Baghaei MH, Haghighatdoost F, Azadbakht L. Healthy eating index and cardiovascular risk factors among Iranian elderly individuals. Arya Atheroscler. 2017;13(2):56.
Safarian M, Ghayour-Mobarhan M, Esmailie H, Nematy M, Razavi A. Investigation of dietary patterns, healthy eating index and traditional risk factors of cardiovascular disease in 35–65 years old adults of Mashhad. Med J Mashhad Univ Med Sci. 2013;56(4):226–35.
Mertens E, Deforche B, Mullie P, Lefevre J, Charlier R, Knaeps S, et al. Longitudinal study on the association between three dietary indices, anthropometric parameters and blood lipids. Nutr Metab. 2015;12(1):47.
Tardivo AP, Nahas-Neto J, Nahas EA, Maesta N, Rodrigues MA, Orsatti FL. Associations between healthy eating patterns and indicators of metabolic risk in postmenopausal women. Nutr J. 2010;9(1):64.
Hariri N, Nasseri E, Houshiar-Rad A, Zayeri F, Bondarianzadeh D. Association between Alternative Healthy Eating Index and 10-year risk of cardiovascular diseases in male-employees in the public sector in Tehran, 1391. Iran J Nutr Sci Food Technol. 2013;8(2):41–50.
Altamimi M, Zidan S, Badrasawi M. Effect of tree nuts consumption on serum lipid profile in hyperlipidemic individuals: a systematic review. Nutr Metab Insights. 2020;13:1178638820926521.
Nora C, Tsimikas S, Lum T, Hong MY. Effects of mixed nut consumption on LDL cholesterol and lipoprotein (a) in overweight and obese adults. Curr Dev Nutr. 2020;4(Supplement_2):444.
Yari Z, Tabibi H, Najafi I, Hedayati M, Movahedian M. Effects of soy isoflavones on serum lipids and lipoprotein (a) in peritoneal dialysis patients. Nutr Metab Cardiovasc Dis. 2020;30(8):1382–8.
Jiang Z, Yang Z, Zhang H, Yao Y, Ma H. Genistein activated adenosine 5′-monophosphate-activated protein kinase-sirtuin1/peroxisome proliferator-activated receptor γ coactivator-1α pathway potentially through adiponectin and estrogen receptor β signaling to suppress fat deposition in broiler chickens. Poult Sci. 2021;100(1):246–55.
Alshammary SM, Luma W. Protective role of soybean lecithin in reducing hypercholesterolemia and DNA fragmentation inducing by high cholesterol in adult male rats. Kufa J Vet Med Sci. 2018;9(1):35–45.
Zhang Q-S, Tian F-W, Zhao J-X, Zhang H, Zhai Q-X, Chen W. The influence of dietary patterns on gut microbiome and its consequences for nonalcoholic fatty liver disease. Trends Food Sci Technol. 2020;96:135–44.
Jump DB, Lytle KA, Depner CM, Tripathy S. Omega-3 polyunsaturated fatty acids as a treatment strategy for nonalcoholic fatty liver disease. Pharmacol Ther. 2018;181:108–25.
Alavian SM, Esmaillzadeh A, Adibi P, Azadbakht L. Dietary quality indices and biochemical parameters among patients with non alcoholic fatty liver disease (NAFLD). Hepat Mon. 2013. https://doi.org/10.5812/hepatmon.10943.
Asghari G, Mirmiran P, Hosseni-Esfahani F, Nazeri P, Mehran M, Azizi F. Dietary quality among Tehranian adults in relation to lipid profile: findings from the Tehran Lipid and Glucose Study. J Health Popul Nutr. 2013;31(1):37.
Park S-Y, Noureddin M, Boushey C, Wilkens LR, Setiawan VW. Diet quality association with nonalcoholic fatty liver disease by cirrhosis status: the Multiethnic Cohort. Curr Dev Nutr. 2020;4(3):nzaa024.
Yoo ER, Kim D, Vazquez-Montesino LM, Escober JA, Li AA, Tighe SP, et al. Diet quality and its association with nonalcoholic fatty liver disease and all-cause and cause-specific mortality. Liver Int. 2020;40(4):815–24.
Mollahosseini M, Daneshzad E, Rahimi MH, Yekaninejad MS, Maghbooli Z, Mirzaei K. The association between fruit and vegetable intake and liver enzymes (aspartate and alanine transaminases) in Tehran, Iran. Ethiop J Health Sci. 2017;27(4):401–10.
Fazeli H, Mirmiran P, Hajihosseini R, Bahadoran Z, Azizi F. Association of dietary patterns with increased levels of liver enzymes: a cross-sectional study in Tehran lipid and glucose study. Iran J Endocrinol Metab. 2019;20(6):303–11.
Acknowledgements
Thanks to the Faculty of Nutrition Sciences of the University of Isfahan and Isfahan Social Security Organization for supporting this study. Also thanks to the management and staff of Hazrat Fatemeh Al-Zahra Hospital who helped us in this study. This research was supported by Isfahan University of Medical Sciences, Isfahan, Iran (No. 49440). This study has not been duplicate publication or submission elsewhere.
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The authors declare no support from any commercial organization for the submitted study. The authors received no financial support for the research and/or authorship of this article.
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SM: Conceptualization, Investigation, Writing-Original Draft. MK: Data Curation, Visualization, Writing-Review and Editing. AH: Methodology, Software, Validation, Formal analysis. MHE: Resources, Project Administration, Supervision, Funding Acquisition.
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Mirashrafi, S., Kafeshani, M., Hassanzadeh, A. et al. Is any association between alternate healthy eating index (AHEI) with lipid profile and liver enzymes? A cross-sectional Study. J Diabetes Metab Disord 20, 1537–1544 (2021). https://doi.org/10.1007/s40200-021-00898-w
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DOI: https://doi.org/10.1007/s40200-021-00898-w