BackgroundThe aim of this study was to investigate the relationship between dietary insulin load (DIL) and insulin index (DII) and the risk of insulin resistance in Tehranian adults.MethodsIn this study, 927 men and women, aged 22–80 years, participated in Tehran Lipid and Glucose Study were included. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up. Usual dietary intakes were measured using a validated 168 item semi-quantitative food frequency questionnaire and DIL and DII were calculated. Logistic regression models were used to estimate the occurrence of the IR across tertile categories of DIL and DII with adjustment for potential confounding variables.ResultMean age of participants was 40.71 ± 12.14 y, and mean body mass index (BMI) was 27.23 ± 4.9 kg/m2, at baseline. Mean of DIL and DII was 937 ± 254 and 84.0 ± 6.3. Participants with higher DIL had higher weight and waist circumference at baseline (P < 0.05). A borderline positive association was observed between DII and the risk of insulin resistance in fully adjusted model (odds ratio = 1.66, 95 % confidence interval = 0.96–2.86, P for trend = 0.06). After adjustment of potential confounders, highest compared to the lowest tertile of DIL was also significantly associated with increased risk of insulin resistance (odds ratio = 1.69, 95 % confidence interval = 1.01–2.89, P for trend = 0.06).ConclusionDietary insulin load and DII could be considered as independent dietary risk factors for development of insulin resistance.

This study used a locally designed and validated questionnaire to describe the distribution of food and nutrition literacy (FNLIT) in a cross-sectional sample of 803 students aged 10-12 years from elementary schools in Tehran city, Iran. Logistic regression was used to assess the extent to which various independent covariates were associated with low FNLIT. The data were used to identify significant differences using a range of social and cultural variables relevant to the context of school students in Iran. The results of the study showed that although the total FNLIT level was good, this headline finding masked important differences in the sub-domains. More than half of the children (69%) had high levels of FNLIT in the cognitive domain, but in the skills domain, very few (3%) scored highly. The study also identified some associations between the total FNLIT and its subscales and sociodemographic variables including gender, parent's education and age, birth order. These results highlighted groups within the school population who were at higher risk of having lower FNLIT levels. They also indicate that girls feel more able to exert choice and control over food and nutrition decisions than boys are but may be less able to do so in practice. Overall, these results are a general reminder to schools of the different learning needs of children from different family backgrounds. The article highlights the need for continuous improvement in the health education curriculum of schools in Iran, particularly highlighting the importance of giving greater attention to the development of practical food and nutrition skills alongside more traditional food and nutrition knowledge. Additional studies (with long-term follow-up) are needed to more fully assess and understand the predictors of FNLIT.

Beneficial effects of Dietary Approaches to Stop Hypertension trial (DASH) diet on features of metabolic syndrome have been indicated in clinical studies. In this study, we aimed to assess possible association of DASH diet score and the risk of insulin resistance in an Iranian population. In this prospective cohort study, 927 adult men and women, were recruited. Fasting serum insulin and glucose were measured at baseline and again after 3 years. Usual dietary intakes were measured using a validated 168 item semi-quantitative food frequency questionnaire and DASH score was calculated. Multivariate logistic regression models were used to estimate the occurrence of the insulin resistance across tertiles of DASH diet. To investigate possible superiority of DASH score over other scoring system, we also assessed the association of healthy eating index and Mediterranean diet score with the risk of insulin resistance. Mean age of the participants was 40.34 ± 12.14 years old. The incidence rate of insulin resistance was 12.8%. Participants with higher DASH score had also higher intakes of potassium, calcium, magnesium, fiber, and lower intakes of cholesterol (p<0.05). After 3-years of follow-up, a significant negative association was observed between DASH score and the risk insulin resistance in the highest compared to the lowest tertile (OR = 0.39, 95% CI = 0.20–0.76, p for trend = 0.007). There was no significant association between healthy eating index and Mediterranean diet score with the incidence of insulin resistance. In conclusion, adherence to the DASH dietary pattern may be associated with a lower risk of insulin resistance and its related metabolic outcomes.