Nazli Namazi
1 
, Mahnaz Sanjari
2, Mostafa Qorbani
3,4, Bagher Larijani
5, Maryam Aalaa
6, Mohammad-Reza Amini
1, Hossein Adibi
7, Farideh Razi
8, Hamid Reza Aghaei Meybodi
9, Neda Mehrdad
1* 1 Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
3 Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
4 Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
5 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
6 Department of E-Learning in Medical Education, Center of Excellence for E-Learning in Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
7 Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
8 Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
9 Evidence-Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Introduction: Prior studies have indicated that high-quality dietary patterns play a pivotal role in improving metabolic and psychological disorders; however, there are limited studies in this regard for patients with type 2 diabetes mellitus (T2DM). We aimed to examine the association of adherence to some dietary quality indices, cardio-metabolic risk factors, and depression in women with T2DM.
Methods: In this cross-sectional study, 456 women with T2DM were recruited using random multistage cluster sampling. Adherence to dietary patterns, including Dietary Approaches to Stop Hypertension (DASH), Alternate Healthy Eating Index (AHEI), dietary energy density (DED), dietary diversity score (DDS), and Mediterranean scores was examined as suggested by previous publications. The Beck Depression Inventory (BDI) questionnaire was also used to assess depression. Dietary intake was examined using three 24-h dietary recalls. To compare subjects with less or more than the median score for each dietary index, analysis of covariance (ANCOVA) was used. Adjusted logistic regression was performed to examine the association of dietary quality indices and depression.
Findings: The mean age and duration of diabetes were 51.8±7.7 and 6.8±5.9 years, respectively. Overall, the prevalence of depression was 41.3% in the study population. After controlling for potential confounders, we found that total cholesterol (TC) and low-density lipoprotein concentrations (LDL-C) in individuals with high DED scores were significantly higher than those with a low one (P=0.02 for both). However, there were no significant associations among other dietary quality indices, cardio-metabolic risk factors, and depression.
Conclusion: Adherence to a high-energy-dense diet was positively associated with TC and LDL-C concentrations in Iranian women with T2DM. Due to low median scores for all healthy dietary patterns, no differences were found for other biochemical parameters and depression between categories. Prospective studies that used adaptive dietary quality indices for patients with T2DM are required.