Table 1. General characteristics of the study participants according to quartiles of DPI; n= 2326
|
Pa Q4 Total Q1 Q2 Q3 Variables
|
DPI [range]
|
|
<16.7
|
16.7-21.6
|
21.7-27.7
|
27.7 <
|
|
BMI [kg/m2]
|
27.11 ± 4.99
|
26.88 ± 4.84
|
26.87 ± 4.96
|
27.25 ± 5.05
|
27.43 ± 5.08
|
0.14
|
WC[cm]
|
93.19 ±13.11
|
93 ±13.19
|
92.5 ± 13.1
|
93.1 ± 13.3
|
94.1 ± 12.7
|
0.2
|
Age; n (%)
|
|
|
|
|
|
0.04
|
20-29
|
452(19.6)
|
128(22.1)
|
112(19.3)
|
99(17.2)
|
113(19.6)
|
30-39
|
494(21.4)
|
139(24)
|
119(20.5)
|
118(20.5)
|
118(20.5)
|
40-49
|
567(24.5)
|
121(20.9)
|
149(25.7)
|
169(29.3)
|
128(22.2)
|
50-59
|
457(19.8)
|
106(18.3)
|
123(21.2)
|
103(17.9)
|
125(21.7)
|
60-69
|
342(14.8)
|
85(14.7)
|
77(13.3)
|
87(15.1)
|
93(16.1)
|
Sex; n (%)
|
|
|
|
|
|
0.93
|
Male
|
1097(47.3)
|
270(46.7)
|
273(47)
|
281(48.4)
|
273(47.2)
|
Female
|
1220(52.7)
|
308(53.3)
|
308(53)
|
299(51.6)
|
305(52.8)
|
Marital status; n (%)
|
|
|
|
|
|
0.62
|
Married
|
2004(86.6)
|
510(88.1)
|
494(85.6)
|
508(87.6)
|
492(85)
|
Single
|
227(9.8)
|
48(8.3)
|
63(10.9)
|
54(9.3)
|
62(10.7)
|
Divorced or widowed
|
84(3.6)
|
21(3.6
|
20(3.5)
|
18(3.1)
|
25(4.3)
|
Physical activity; n (%)
|
|
|
|
|
|
0.62
|
Sedentary
|
688(30.9)
|
170(30.4)
|
170(30.4
|
181(32.1
|
167(30.6)
|
Moderate
|
809(36.3)
|
211(37.7)
|
189(33.8)
|
210(37.3)
|
199(36.4)
|
Active
|
730(32.8)
|
178(31.8)
|
200(35.8)
|
172(30.6)
|
180(33)
|
Education; n (%)
|
|
|
|
|
|
0.62
|
Lower than diploma
|
1234(53.5)
|
301(52.5)
|
304(52.7)
|
324(56.2)
|
305(52.8)
|
High school diploma
|
700(30.4)
|
182(31.7)
|
180(31.2)
|
164(28.5)
|
174(30.2)
|
Smoking; n (%)
|
|
|
|
|
|
0.75
|
Never and former
|
2074(91.6)
|
531(93)
|
519(91.7)
|
512(90.1)
|
512(91.7)
|
Current
|
189(8.4)
|
40(7)
|
47(8.3)
|
56(9.9)
|
46(8.2)
|
Job status; n (%)
|
|
|
|
|
|
0.86
|
Not employed
|
1373(59.7)
|
347(60)
|
338(59)
|
339(58.9)
|
349(61)
|
Employed
|
926(40.3)
|
231(40)
|
235(41)
|
237(41.1)
|
223(39)
|
Chronic diseases family history; n (%)
|
|
|
|
|
|
0.49
|
No
|
654(33.6)
|
141(44.8)
|
124(39.4)
|
124(41.1)
|
115(39.7)
|
Yes
|
1292(66.4)
|
174(55.2)
|
191(60.6)
|
178(58.9)
|
175(60.3)
|
Metabolic syndrome; n (%)
|
1005(45.2)
|
227(41)
|
255(45.5)
|
253(45.3)
|
270(49.2)
|
0.05
|
Abdominal obesity; n (%)
|
1025(44.5)
|
237(41.1)
|
257(44.4)
|
249(43.2)
|
282(49.2)
|
0.04
|
Elevated blood pressure; n (%)
|
559(26.8)
|
126(22.6)
|
154(27.4)
|
157(27.9)
|
162(29.2)
|
0.06
|
Hypertriglyceridemia; n( %)
|
1423(61.2)
|
368(63.3)
|
343(58.9)
|
349(60)
|
363(62.5)
|
0.36
|
Low serum HDL-C; n (%)
|
813(35.1)
|
209(36.2)
|
207(35.6)
|
207(35.7)
|
190(32.9)
|
0.63
|
High serum FBS; n (%)
|
718(30.9)
|
175(30.1)
|
178(30.6)
|
185(31.8)
|
180(31)
|
0.93
|
Abbreviations: BMI= Body mass index, WC = waist circumference, DPI= dietary phytochemical index, Q= quartile, HDL-C= High- density lipoprotein cholesterol, SD= Standard deviation. FBS= fasting blood sugar.
Data are shown mean ± SD for BMI, WC.
Data are shown n (%) for all categorical variables. pvalue from ANOVA for continious variables and Chi – square test for categorical.
aP values < 0.05 were considered significant.
Table 2. Mean dietary intake of participants by categories of DPI; n=2326
|
pa
|
Q4
|
Q3
|
Q2
|
Q1
|
Total
|
|
|
SD
|
mean
|
SD
|
mean
|
SD
|
mean
|
SD
|
mean
|
SD
|
mean
|
|
<0.001
|
9.2
|
36.08
|
1.79
|
24.53
|
1.36
|
19.4
|
3.15
|
12.5
|
9.95
|
23.13
|
Dietary PI
|
<0.001
|
1157.02
|
2789.73
|
1110.39
|
2495.22
|
1219.47
|
2650.68
|
1440.08
|
3520.42
|
1298.27
|
2863.76
|
Energy intake(kca/day )
|
<0.001
|
55.18
|
111.65
|
46.91
|
102.37
|
57.99
|
107.93
|
69.13
|
133.26
|
58.98
|
113.8
|
Protein(g/day)
|
<0.001
|
184.49
|
403.52
|
160.65
|
345.38
|
177.14
|
363.92
|
277.58
|
498.40
|
213.28
|
402.76
|
Carbohydrate(g/day)
|
<0.001
|
54.41
|
96.24
|
52.12
|
92.27
|
59.99
|
101.80
|
93.97
|
156.78
|
72.15
|
111.76
|
Total Fat(g/day)
|
<0.001
|
248.73
|
337.64
|
261.88
|
352.21
|
325.27
|
385.51
|
578.68
|
501.18
|
382.97
|
394.11
|
Cholesterol(mg/day)
|
<0.001
|
13.29
|
26.38
|
13.60
|
26.84
|
16.17
|
29.47
|
23.15
|
41.75
|
18.12
|
31.11
|
SFA (g/day)
|
<0.001
|
18.16
|
29.13
|
17.59
|
28.07
|
21.08
|
31.65
|
32.36
|
48.61
|
24.52
|
34.36
|
MUFA (g/day)
|
<0.001
|
24.98
|
28.85
|
15.67
|
23.20
|
20.29
|
25.40
|
31.02
|
36.71
|
24.21
|
28.54
|
PUFA (g/day)
|
<0.001
|
0.05
|
0.02
|
0.07
|
0.02
|
0.1
|
0.02
|
0.09
|
0.02
|
0.08
|
0.02
|
EPA(mg/day)
|
<0.001
|
0.14
|
0.06
|
0.19
|
0.07
|
0.26
|
0.07
|
0.25
|
0.07
|
0.21
|
0.07
|
DHA(mg/day)
|
<0.001
|
20.31
|
29.71
|
22.51
|
24.48
|
15.83
|
22.83
|
33.24
|
33.70
|
24.21
|
27.68
|
Total Fiber(g/day)
|
<0.001
|
10.67
|
10.02
|
10.44
|
10.52
|
11.20
|
11.49
|
12.92
|
12.43
|
11.38
|
11.12
|
Vitamin E (mg/day)
|
<0.001
|
55.62
|
34.57
|
18.52
|
20.07
|
27.55
|
19.77
|
15.64
|
19.11
|
33.91
|
23.38
|
Vitamin A (RAE/day)
|
<0.001
|
1.04
|
1.18
|
2.33
|
1.48
|
1.73
|
1.46
|
3.67
|
1.85
|
2.40
|
1.49
|
Vitamin D(µg/day)
|
<0.001
|
182.90
|
152.70
|
175.61
|
160.26
|
224.99
|
160.03
|
349.82
|
191.19
|
243.82
|
166.04
|
Vitamin K(µg/day)
|
<0.001
|
269.46
|
279.43
|
142.61
|
202.85
|
135.30
|
182.77
|
111.82
|
164.09
|
181.14
|
207.27
|
Vitamin C(mg/day)
|
<0.001
|
.96
|
2.35
|
.84
|
2.06
|
.89
|
2.08
|
1.13
|
2.32
|
0.97
|
2.20
|
VitaminB1(mg/day)
|
<0.001
|
.99
|
2.23
|
.99
|
2.14
|
1.09
|
2.22
|
1.42
|
2.82
|
1.17
|
2.35
|
VitaminB2(mg/day)
|
<0.001
|
12.62
|
27.99
|
12.40
|
25.2
|
13.39
|
26.56
|
20.24
|
33.71
|
15.35
|
28.36
|
VitaminB3(mg/day)
|
<0.001
|
1.27
|
2.47
|
1.26
|
2.2
|
1.38
|
2.32
|
1.80
|
2.95
|
1.47
|
2.50
|
VitaminB6(mg/day)
|
<0.001
|
257.21
|
431.26
|
169.03
|
341.72
|
200.11
|
336.60
|
194.99
|
377.25
|
211.10
|
371.68
|
Folic acid(µg/day)
|
<0.001
|
6.02
|
5.1302
|
4.33
|
5.42
|
5.75
|
6.07
|
7.01
|
7.51
|
5.92
|
6.03
|
VitaminB12(µg)
|
<0.001
|
4.40
|
7.28
|
2.73
|
6.04
|
2.69
|
5.87
|
3.12
|
6.61
|
3.35
|
6.45
|
Pantothenic (mg/day)
|
<0.001
|
14.73
|
22.73
|
13.02
|
21.07
|
12.63
|
20.88
|
26.04
|
23.70
|
17.52
|
22.09
|
Biotin(mg/day)
|
<0.001
|
416.80
|
957.90
|
459.49
|
916.33
|
437.01
|
913.69
|
603.06
|
1062.17
|
488.02
|
962.48
|
Calcium (mg/day)
|
<0.001
|
182.63
|
362.64
|
154.04
|
307.91
|
165.64
|
308.04
|
176.91
|
363.17
|
172.25
|
335.41
|
Magnesium(mg/day)
|
<0.001
|
2536.55
|
4629.36
|
1869.87
|
3810.11
|
1823.79
|
3652.56
|
1950.44
|
4197.37
|
2098.04
|
4072.06
|
Potassium(mg/day)
|
<0.001
|
5.67
|
11.98
|
4.71
|
10.77
|
5.63
|
11.17
|
7.05
|
13.66
|
5.93
|
11.90
|
Zinc (mg/day)
|
<0.001
|
81.72
|
52.29
|
44.42
|
39.77
|
44.58
|
38.99
|
46.98
|
38.28
|
56.92
|
42.33
|
Fe(mg/day)
|
<0.001
|
745.9
|
855.89
|
418.80
|
604.30
|
356.73
|
495.06
|
264.58
|
386.67
|
512.03
|
585.45
|
Fruits( g/day )
|
<0.001
|
267.4
|
253.82
|
297.83
|
215.69
|
158.86
|
196.85
|
235.6
|
198. 7
|
246.33
|
216.26
|
Vegetables (g/day )
|
<0.001
|
83.09
|
58.55
|
36.19
|
44.11
|
38.98
|
40.95
|
59.78
|
45.42
|
58.01
|
47.25
|
Legumes (g/day )
|
<0.001
|
49.18
|
31.01
|
22.16
|
18.02
|
20.59
|
17.21
|
34.20
|
25.84
|
34.01
|
23.01
|
Nuts (g/day )
|
<0.001
|
92.54
|
99.11
|
59.27
|
77.01
|
51.01
|
68.66
|
53.29
|
49.41
|
68.49
|
73.55
|
Whole grains (g/day )
|
DPI= dietary phytochemical index, Q= quartile.
Data are shown mean ± SD for all dietary intakes .
aPvalues from ANOVA and < 0.05 were considered significant.
Abbreviations: MUFA= mono-unsaturated fatty acid, PUFA= poly-unsaturated fatty acid, SFA= saturated fatty acid,
Table 3. ORs (95% CIs) for metabolic syndrome and its components according to quartiles of DPI; n= 2326
|
|
Q1
|
Q2
|
Q3
|
Q4
|
P for trend
|
Metabolic syndrome
|
|
|
|
|
|
Crude
|
1(ref.)
|
0.71 (0.56 - 0.91)
P=0.006
|
0.86(0.68-1.09)
P=0.20
|
0.85(0.67-1.08)
P=0.20
|
0.01
|
Model 1a
|
1(ref.)
|
0.72 (0.55-0.93)
P=0.01
|
0.88 (0.68-1.13)
P=0.32
|
0.88(0.68-1.13)
P=0.33
|
0.02
|
Model 2b
|
1(ref.)
|
0.58 (0.38-0.88)
P=0.01
|
0.9 (0.6-1.33)
P=0.59
|
0.79(0.53-1.18)
P=0.26
|
0.02
|
Model 3c
|
1(ref.)
|
0.63 (0.41-0.96)
P= 0.03
|
0.92 (0.61-1.39)
P=0.72
|
0.78(0.51-1.17)
P=0.23
|
0.08
|
Abdominal obesity
|
|
|
|
|
|
Crude
|
1(ref.)
|
0.72(0.57-0.91)
P=0.006
|
0.82(0.65-1.03)
P=0.10
|
0.78(0.62-0.98)
P=0.03
|
0.01
|
Model 1a
|
1(ref.)
|
0.70(0.53-0.93)
P=0.01
|
0.81(0.62-1.07)
P=0.1
|
0.75(0.58-0.99)
P=0.04
|
0.03
|
Model 2b
|
1(ref.)
|
0.66(0.42-1.02)
P=0.06
|
0.82(0.54-1.25)
P=0.36
|
0.83(0.54-1.26)
P=0.38
|
0.08
|
Model 3c
|
1(ref.)
|
0.74(0.43-1.27)
P=0.28
|
0.86(0.51-1.44)
P=0.58
|
0.73(0.43-1.23)
P=0.24
|
0.41
|
Elevated blood pressure
|
|
|
|
|
|
Crude
|
1(ref.)
|
1.28(0.98-1.69)
P=0.06
|
1.32(1.01-1.73)
P=0.04
|
1.41(1.07-1.85)
P=0.01
|
0.01
|
Model 1a
|
1(ref.)
|
1.28(0.95-1.72)
P=0.09
|
1.32(0.98-1.77)
P=0.06
|
1.35(1.01-1.81)
P=0.03
|
0.05
|
Model 2b
|
1(ref.)
|
0.59(0.38-0.92)
P=0.02
|
0.81(0.53-1.22)
P=0.31
|
0.96(0.64-1.45)
P=0.87
|
0.01
|
Model 3c
|
1(ref.)
|
0.62(0.40-0.96)
P=0.03
|
0.83(0.55-1.26)
P=0.39
|
0.96(0.63-1.45)
P=0.84
|
0.03
|
High serum hypertriglyceridemia
|
|
|
|
|
|
Crude
|
1(ref.)
|
0.83(0.65-1.05)
P=0.12
|
0.86(0.68-1.09)
P=0.23
|
0.96(0.76-1.22)
P=0.76
|
0.86
|
Model 1a
|
1(ref.)
|
0.99(0.77-1.27)
P=0.94
|
0.83(0.65-1.06)
P=0.14
|
0.86(0.68-1.1)
P=0.25
|
0.8
|
Model 2b
|
1(ref.)
|
1.38(0.94-2.02)
P=0.09
|
1.2(0.83-1.73)
P=0.31
|
0.99(0.69-1.44)
P=0.99
|
0.05
|
Model 3c
|
1(ref.)
|
1.33(0.9-1.96)
P=0.14
|
1.16(0.8-1.68)
P=0.42
|
0.99(0.68-1.45)
P=0.99
|
0.1
|
Low serum HDL-C
|
|
|
|
|
|
Crude
|
1(ref.)
|
1.15(0.9-1.47)
P=0.24
|
1.13(0.88-1.44)
P=0.32
|
1.13(0.88-1.44)
P=0.31
|
0.27
|
Model 1a
|
1(ref.)
|
1.16(0.9-1.5)
P=0.23
|
1.12(0.87-1.44)
P=0.34
|
1.15(0.9-1.48)
P=0.24
|
0.27
|
Model 2b
|
1(ref.)
|
1.04(0.7-1.55)
P=0.82
|
1.1(0.75-1.6)
P=0.62
|
1.06(0.72-1.56)
P=0.75
|
0.78
|
Model 3c
|
1(ref.)
|
1.05(0.7-1.55)
P=0.80
|
1.09(0.75-1.6)
P=0.63
|
1.06(0.72-1.56)
P=0.75
|
0.77
|
High serum FBS
|
|
|
|
|
|
Crude
|
1(ref.)
|
0.96(0.74-1.23)
P=0.75
|
0.98(0.76-1.25)
P=0.88
|
1.03(0.81-1.33)
P=0.76
|
0.65
|
Model 1a
|
1(ref.)
|
1.02(0.78-1.34)
P=0.84
|
1.02(0.79-1.33)
P=0.84
|
1.08(0.83-1.41)
P=0.53
|
0.94
|
Model 2b
|
1(ref.)
|
0.91(0.6-1.37)
P=0.66
|
0.91(0.61-1.35)
P=0.65
|
1.09(0.73-1.62)
P=0.66
|
0.48
|
Model 3c
|
1(ref.)
|
0.94(0.62-1.42)
P=0.77
|
0.92(0.62-1.38)
P=0.71
|
1.08(0.72-1.6)
P=0.70
|
0.59
|
Abbreviations: OR= odds ratio; CIs= confidence intervals; DPI= dietary phytochemical index, Q= quartile. HDL-C= High- density lipoprotein cholesterol, FBS= fasting blood sugar.
Multivariable logistic regression models were used with adjustment of potential confounders.
P for trend to evaluate general trend of odds, DPI of quartiles as ordinal variable was used in logistic regression models
a Adjusted for age, sex and energy intake (Kcal/day), b Additional adjustment for marriage status (married/single/divorce or widowed), physical activity (sedentary/moderate/active), education level (less than high school diploma/college/ university), Smoking (never or former, current), job status (Not employed, employed), house status (owner, not owner), family size(less than 4, more than five), house in meters (less than 100 meters, between 100 to 200 meters, more than 200 metres), ethnicity (yazdi or not from yazd), disease history (yes/ no). c Additional adjustment for BMI (kg/m2).
Table 4. ORs (95% CIs) for metabolic syndrome according to quartiles of DPI stratify by BMI; n= 2326
|
Stratify of BMI
|
Q1
|
Q2
|
Q3
|
Q4
|
P for trend
|
BMI≤24.9
|
|
|
|
|
|
Crude
|
1(ref.)
|
0.79(0.49-1.27)
P=0.33
|
1(0.63-1.59)
P=0.98
|
0.78(0.48-1.27)
P=0.33
|
0.56
|
Model 1a
|
1(ref.)
|
0.79(0.48-1.29)
P=0.35
|
0.96(0.6-1.55)
P=0.88
|
0.79(0.48-1.3?)
P=0.35
|
0.54
|
Model 2b
|
1(ref.)
|
0.38(0.16-0.90)
P=0.02
|
0.96(0.44-2.07)
P=0.92
|
0.98(0.44 -2.17)
P=0.96
|
0.03
|
BMI>24.9
|
|
|
|
|
|
Crude
|
1(ref.)
|
0.71(0.53-0.95)
P=0.02
|
0.85(0.63-1.14)
P=0.29
|
0.89(0.66-1.2)
P=0.46
|
0.02
|
Model 1a
|
1(ref.)
|
0.71(0.52-0.99)
P=0.04
|
0.87(0.64-1.19)
P=0.4?
|
0.89(0.65-1.22)
P=0.5
|
0.05
|
Model 2b
|
1(ref.)
|
0.76(0.46-1.25)
P=0.29
|
0.95(0.59-1.53)
P=0.84
|
0.75(0.46-1.21)
P=0.24
|
0.48
|
Abbreviations: OR= odds ratio; CIs= confidence intervals; DPI= dietary phytochemical index, Q= quartile.
Multivariable logistic regression models were used with adjustment of potential confounders.
P for trend to evaluate general trend of odds, DPI of quartiles as ordinal variable was used in logistic regression models
a Adjusted for age, sex and energy intake (Kcal/day), b Additional adjustment for marriage status (married/single/divorce or widowed), physical activity (sedentary/moderate/active), education level (less than high school diploma/college/ university), Smoking (never or former, current), job status (Not employed, employed), house status (owner, not owner), family size(less than 4, more than five), house in meters (less than 100 meters, between 100 to 200 meters, more than 200 metres), ethnicity (yazdi or not from yazd), disease history (yes/ no).
Table 5. ORs (95% CIs) for metabolic syndrome according to quartiles of DPI stratify by gender; n=2326
|
Stratify of sex
|
Q1
|
Q2
|
Q3
|
Q4
|
P for trend
|
Male
|
|
|
|
|
|
Crude
|
1(ref.)
|
0.72(0.49-1.05)
P=0.09
|
1.04(0.72-1.49)
P=0.83
|
1.03(0.72-1.48)
P=0.83
|
0.12
|
Model 1a
|
1(ref.)
|
0.71(0.48-1.06)
P=0.09
|
1(0.69-1.44)
P=0.99
|
1.02(0.71-1.48)
P=0.88
|
0.12
|
Model 2b
|
1(ref.)
|
0.43(0.23-0.83)
P=0.01
|
1.25(0.71-2.19)
P=0.42
|
1.28(0.72-2.26)
P=0.39
|
0.02
|
Model 3c
|
1(ref.)
|
0.54(0.27-1.07)
P=0.08
|
1.39(0.77-2.51)
P=0.27
|
1.36(0.74-2.4)
P=0.31
|
0.15
|
Female
|
|
|
|
|
|
Crude
|
1(ref.)
|
0.66(0.47-0.92)
P=0.01
|
0.72(0.51-1)
P=0.05
|
0.73(0.52-1.02)
P=0.06
|
0.02
|
Model 1a
|
1(ref.)
|
0.75(0.52-1.09)
P=0.13
|
0.82(0.58-1.17)
P=0.29
|
0.79(0.55-1.13)
P=0.19
|
0.18
|
Model 2b
|
1(ref.)
|
0.76(0.41-1.04)
P=0.38
|
0.64(0.35-1.17)
P=0.15
|
0.44(024-0.80)
P=0.008
|
0.74
|
Model 3c
|
1(ref.)
|
0.74(0.4-1.38)
P=0.35
|
0.62(0.34-1.14)
P=0.12
|
0.41(0.22-0.76)
P=0.005
|
0.70
|
Abbreviations: OR= odds ratio; CIs= confidence intervals; DPI= dietary phytochemical index, Q= quartile.
Multivariable logistic regression models were used with adjustment of potential confounders.
P for trend to evaluate general trend of odds, DPI of quartiles as ordinal variable was used in logistic regression models
a Adjusted for age, sex and energy intake (Kcal/day). b Additional adjustment for marriage status (married/single/divorce or widowed), physical activity (sedentary/moderate/active), education level (less than high school diploma/college/ university), Smoking (never or former, current), job status (Not employed, employed), house status (owner, not owner), family size(less than 4, more than five), house in meters (less than 100 meters, between 100 to 200 meters, more than 200 metres), ethnicity (yazdi or not from yazd), disease history (yes/ no). c Additional adjustment for BMI (kg/m2).