Romina Davoudpour - Student Research Committee, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Afsane Ahmadi - Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Reza Homayounfar - Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
Morteza Zare - Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Mojtaba Farjam - Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
Najmeh Hejazi - Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

Background: Metabolic syndrome (MetS) is a significant health concern both in developed and developing countries. This cohort Prospective Epidemiological Research Study in Iran (PERSIAN) aimed to determine the association of diet quality, assessed by the Healthy Eating Index-۲۰۱۵ (HEI-۲۰۱۵) and Mediterranean Diet Score (MDS), with MetS components among individuals with MetS in Fasa, southern Iran.Methods: In this cross-sectional study, ۹۰۷ individuals with MetS aged ۳۵-۶۵ years were recruited from the Fasa PERSIAN Cohort Study, Fasa, Iran. The National Cholesterol Education Program Adult Treatment Panel III (ATP III) and Iranian National Committee of Obesity criteria were used to define MetS. A ۱۲۵-item food frequency questionnaire wasemployed to evaluate dietary intake. The association between the quartiles of dietary scores and MetS components analyzed by Multivariate linear regression with the backward method.Results: The mean age of the individuals (۶۷.۳% female) was ۴۸.۷۵±۸.۲۲ years. After adjusting for covariates, the highest HEI-۲۰۱۵ quartile was positively correlated with fasting blood sugar (FBS, β=۷.۳۰, ۹۵%CI=۱.۰۳, ۱۳.۵۸) and triglyceride levels (β=۳۲.۷۱, ۹۵%CI=۹.۰۹, ۵۶.۳۳). The MDShad a significant negative association with the systolic blood pressure (SBP) in both crude and adjusted models (β=-۳.۱۴, ۹۵%CI=-۶.۲, -۰.۰۱۹). The triglyceride (TG, β=۲۶.۰۰۸, ۹۵%CI=۴.۳۲, ۴۷.۶۹) and FBS (β=۵.۷۷, ۹۵%CI=۰.۰۵۷, ۱۱.۴۹) levels also were positively correlated with thehighest MDS quartile.Conclusion: The SBP was shown to be inversely associated with the MDS, wherease higher adherence to HEI-۲۰۱۵ and MDS values were also linked with increased FBS and TG levels.

Mediterranean diet, Healthy eating index-۲۰۱۵, Metabolic Syndrome, Prospective Epidemiological Research Study in Iran (PERSIAN), Cohort study