To assess the association between dietary energy density and the prevalence of cardiometabolic risk factors among Iranian adult women.
Tehran, Islamic Republic of Iran.
We assessed habitual dietary intakes of 486 Iranian adult women by the use of a validated FFQ. Dietary energy density (DED) was calculated as each individual's reported daily energy intake (kJ/d, kcal/d) divided by the total weight of foods (excluding beverages) consumed (g/d). Fasting plasma glucose (FPG), lipid profiles and blood pressure were measured. Diabetes (FPG ≥ 126 mg/dl), dyslipidaemia (based on the National Cholesterol Education Program Adult Treatment Panel III) and hypertension (based on the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure) were determined. The presence of ‘at least one risk factor’ and ‘at least two risk factors’ of the three major risk factors for CVD (hypertension, dyslipidaemia and diabetes) was also evaluated. To explore the associations between DED and cardiometabolic risk factors, we obtained prevalence ratios in different models accounting for confounders.
Mean DED was 7·41 (sd 1·46) kJ/g (1·77 (sd 0·35) kcal/g). Consumption of energy-dense diets was associated with higher intakes of energy, dietary fat, cholesterol, vegetable oils, refined grains and high-fat dairy products, along with lower intakes of dietary carbohydrates, fruits, vegetables, and meat and fish. Adherence to an energy-dense diet was associated with elevated levels of serum TAG, total cholesterol and LDL cholesterol and lower levels of serum HDL cholesterol. Women in the top quartile of DED were more likely to have dyslipidaemia (61 % v. 31 %, P < 0·05), at least one (68 % v. 35 %, P < 0·05) and at least two (29 % v. 10 %, P < 0·05) cardiometabolic risk factors compared with those in the bottom quartile. Consumption of energy-dense diets was significantly associated with a greater chance of having dyslipidaemia (prevalence ratio in top quartile v. bottom quartile: 1·78; 95 % CI 1·33, 2·58), at least one (1·81; 1·44, 2·49) and at least two cardiometabolic risk factors (2·81; 1·51, 5·24). Additional control for BMI and total energy intake slightly attenuated the associations. No overall significant associations were found between consumption of energy-dense diets and risk of having diabetes or hypertension either before or after adjustment for confounders.
Consumption of energy-dense diets was significantly related to the high prevalence of dyslipidaemia, at least one and at least two cardiometabolic risk factors among Iranian adult women. Prospective studies are required to confirm our findings.