Diet Quality index (DQI), cardiovascular risk factors and psychological health: Food based or nutrient based DQI

Most ofdietary quality indexes which used in epidemiological studies constructed with both nutrients and foods.These dietary indexesrequire an excess step of entering the food intake data in a nutrient database for nutrient analysis; therefore, they may be associated with more bias.However, food quality scores only need foods .Food quality index (FQS) has been associated with chronic disease including cardiovascular disease (CVD), metabolic syndrome (MetS), diabetes, obesity and even psychological disorders.Therefore, the current study was conducted to compare food-based DQI with nutrient based DQI on cardiovascular risk factors and psychological disorders.Design:The components of FQS were vegetables, fruit, nuts and legumes, whole grains, yogurt, sugar-sweetened beverages, red meats, processed meats, refined grains, desserts and ice cream, potatoes, potato chips, coffee and fried food from outside the home. Food classified on healthy(yogurt, nuts, whole grains, fruits, vegetables, and coffee) and unhealthy (red meats, processed meats, desserts and ice cream, refined grains, potatoes, potato chips, fried foods prepared away from home, and sugar-sweetened beverages) groups. We ranked intakes of participants into tertiles and assign the scores of 1–3 to healthy foods or foods group and assign reversed tertile rankings (scores of 3down to 1) for the unhealthy foods or food groups. The score of each food group was summed to give an overall score (total of 14 food groups with a possible score range of 14–42). A higher score represented a healthier diet.Epidemiological studies in Iran investigated association of DQI, cardiovascular risk factors and psychological disorders. In study examined the association of FQS with psychological disorders, obesity and abdominal obesity, FQS could lower depression (p=0.001), anxiety (p<0.001), psychological distress (p=0.001) significantly. However, FQS was not associated with abdominal obesity (p=0.066) and obesity (p=0.26). In a cross-sectional study in Iran on elderly men ,the Elderly Dietary Index (EDI), which consists of 10 food items, has been associated with a lower risk of obesity (p=0.004), low density lipoprotein cholesterol (LDL-C) (p<0.001). However, there was no significant association between EDI and diabetes (p=0.15) as well as hypertriglyceridemia (p=0.45). Moreover, higher EDI was associated with lower body weight, body mass index, waist circumference, insulin resistance, fibrinogen, liver enzymes and diastolic blood pressure (p<0.05 for all). However, there were significant inverse association between the EDI and the serum levels of high density lipoprotein cholesterol and insulin sensitivity (p<0.05 for all).In an epidemiological study in Iran examined the association of healthy eating index (HEI), consists of both nutrients and foods, and CVD risk factors, participantswith high HEI were less likely to be diabetics (P=0.003). However, other CVD risk factors did not changed significantly.Haghighatdoost et al., found inverse association between moderate adherence to Dietary Approach to StopHypertension (DASH) dietary pattern and depression, anxiety but no association with psychological distress.Conclusions: Findings failed to show a negative association between high FQS with obesity and abdominal obesity. The EDI was not associated with diabetes and hypertriglyceridemia. However, EDI could lower obesity and high LDL-C. Moreover, a negative association was found between higher FQS and depression, anxiety, and psychological distress. Therefore, food-based DQI could not decrease cardiovascular risk factors compared nutrient-based one. However, FQS can strongly reduce psychological disorders.