This study was the first cross-sectional study that investigated the association between DII and HTGWCP among overweight and obese women.
We have shown that DII is significantly associated with HTGWCP. Our findings suggested that, increasing DII scores or consuming pro-inflammatory foods can increase the odds of abnormal phenotypes including; EWNT, NWET, EWET phenotypes compared to NWNT phenotype. According to the results of this study; there was a significant correlation between DII and variables including; age (positively), HOMA-IR and TG (negatively) so in this study increased DII did not increase TG and HOMA-IR. However, there was a positive significant relationship between abnormal phenotypes and variables such as insulin, HOMA-IR, TG, weight, height, BMI, SMM, FFM, WHR and WC. We also found positive correlation between abnormal phenotypes and some dietary intake components.
In a cohort study, it was found that the HTGWCP had a similar prevalence to MetS among participants and was associated with the low-grade inflammation seen in obese individuals [28].
Previous studies have shown that obesity and high anthropometric indices such as WC can be a consequence of previous chronic low-grade inflammation. Therefore, there is a relationship between obesity, especially abdominal obesity and inflammation [
25]. Some studies acknowledge that abnormal lipid metabolism plays an important role in the inflammatory response and prognosis of the conditions like obesity and hypertriglyceridemia [
26,
27]. In a cohort study, it was found that the HTGWCP had a similar prevalence to MetS among participants and was associated with the low-grade inflammation seen in obese individuals [
28]. Many studies, such as a cross-sectional study and the Spanish SUN (Seguimiento Universidad de Navarra) cohort, have been shown that DII was correlated with anthropometric components such as weight and WC, and by increasing this score which indicates a higher consumption of pro-inflammatory foods by Individuals, these indicators have also increased A study has shown that the most pro-inflammatory diet had a stronger association with WC than with other anthropometric indices, both among women and men [
4,
29]. Many studies in Western societies suggest that the inflammatory properties of diet are positively associated with predictors of cardiovascular disease, such as increased plasma TG levels and decreased HDL cholesterol concentrations. For example Neufcourt et al. showed in a large (n = 3726) cohort of French adults that after a follow up of 13 years, the DII score was significantly associated with higher triglyceride and lower HDL cholesterol levels [
15,
16,
30].
One investigation concluded that among police officers, higher DII scores were associated with elevated high-sensitivity C-reactive protein (hs-CRP) values and the components of MetS[31]. It has been found in several literatures that lower hs-CRP concentration has been associated with a higher intake of some foods and nutrients including; fruits and vegetables [32–34], legumes [35], nuts [36], low-fat dairy consumption [37]fiber intake [38]), vitamin E and vitamin C intake [39]Consumption of some anti-inflammatory foods, including; onion, garlic and tea are associated with improving health status by reducing body fat, increasing the resistance of lipoprotein to oxidation by their antioxidant properties and also increased adiponectin as an anti-inflammatory adipokine and may be effective as a cholesterol-lowering food agents. The high intake of these anti-inflammatory foods may have increased the synergy of anti-inflammatory potential to inhibit the development of MetS components such as hypertriglyceridemia and abdominal obesity [40–42]. Further studies are needed to determine the exact link between anti-inflammatory foods and abdominal obesity and hypertriglyceridemia, and the contribution of each nutrient to the increase of two components.
Current study was the first study to examine the association between DII and HTWCP among obese women and it may represent as a possible novel insight in treatment of obesity and its complications. We evaluated the relationship between some body composition indicators and biochemical parameters and DII, as well as HTGWCP in our study and also we also examined the correlation between some dietary intake components and phenotypes. Studies on women's health have increased in recent years but not enough yet, also, women are known as one of the most sensitive groups in the society, which shows the importance of conducting studies on their health so we selected the women as a target group to help improve their health. We tried to select and adjust some confounders socio-economically because of the correlation between hypertriglyceridemia and abdominal obesity and such factors. Some limitations of the current study should be considered. Briefly, since the study was a cross-sectional study, causality cannot be proven, only correlation, therefore, more studies, especially clinical trial studies, are needed to investigate this relationship. There may be more socioeconomic factors affecting the sleep quality. We calculated the DII using FFQ that is recognized to had under-reporting or over-reporting bias.