The Effect of Nutritional Education on Inflammatory Markers and the Index of Diet Quality in Obese Women

Background and Objective: Obesity is a low grade inflammatory condition. It seems that there is an association between diet quality and inflammatory markers. Healthy Eating Index (HEI) is one of the important tools to assess diet quality. In this study, we assessed the effect of improving HEI score through nutritional education on serum levels of inflammatory markers in obese women. Materials and Methods: This study was a randomized clinical trial on sixty obese women who were assigned to educated and non-educated groups. Three months of nutritional education, one session in a week, was conducted for education group. The HEI scores of diet for seven days were recorded. Then, the concentrations of inflammatory markers (hs-CRP, TNF-α) and the anthropometric indexes were assessed at the baseline and at the end of the study in both groups. Results: After adjustment for energy intake, weight and age, the HEI score of educated group improved significantly. Prior to receiving education, the HEI mean score was in need of improvement (۶۰.۵۸±۶.۳۱) in the educated group. Throughout education it improved to a good level (۸۳.۳۴±۵.۱۲). After adjustment for energy intake, weight and age, the plasma levels of hs-CRP, TNF-α significantly decreased (all p values were <۰.۰۵). Conclusion: It seems that the quality of diet could be an independent factor in preventing chronic diseases through improving inflammatory condition. References ۱- Zou C, Shao J.Role of adipocytokines in obesity-associated insulin resistance. J Nutr Biochem. ۲۰۰۸ ۱۹: ۲۷۷-۸۶. ۲- Bastard JP, Maachi M, Lagathu C, et al. Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw. ۲۰۰۶ ۱۷: ۴-۱۲. ۳- Azadbakht L, Mirmiran P, Hosseini F, Azizi F. Diet quality status of most Tehranian adults needs improvement. Asia Pac J Clin Nutr. ۲۰۰۵ ۱۴: ۱۶۳-۸. ۴- Fung TT, McCullough ML, Newby PK. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. ۲۰۰۵ ۸۲:۱۶۳-۷۳. ۵- Lee H, Lee IS, Choue R. Obesity, inflammation and diet. Pediatr Gastroenterol Hepatol Nutr. ۲۰۱۳ ۱۶: ۱۴۳-۵۲. ۶- Taechangam S, Pinitchun U, Pachotikarn C. Development of nutrition education tool: healthy eating index in Thailand. Asia Pac J Clin Nutr. ۲۰۰۸ ۱۷: ۳۶۵-۷. ۷- Boynton A, Neuhouser ML, Sorensen B, McTiernan A, Ulrich CM. Predictors of diet quality among overweight and obese postmenopausal women. J Am Diet Assoc. ۲۰۰۸ ۱۰۸: ۱۲۵-۳۰. ۸- Boynton A, Neuhouser ML, Wener MH. Associations between healthy eating patterns and immune function or inflammation in overweight or obese postmenopausal women. Am J Clin Nutr. ۲۰۰۷ ۸۶: ۱۴۴۵-۵۵. ۹- Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. ۲۰۰۲ ۱۳: ۳-۹. ۱۰- Silva KF, Prata A, Cunha DF. Frequency of metabolic syndrome and the food intake patterns in adults living in a rural area of Brazil. Rev Soc Bras Med Trop. ۲۰۱۱ ۴۴: ۴۲۵-۹. ۱۱- Ford ES, Mokdad AH, Liu S. Healthy eating index and C-reactive protein concentration: findings from the national health and nutrition examination survey III, ۱۹۸۸-۱۹۹۴. Eur J Clin Nutr. ۲۰۰۵ ۵۹: ۲۷۸-۸۳. ۱۲- Fargnoli JL, Fung TT, Olenczuk DM, Chamberland JP, Hu FB, Mantzoros CS. Adherence to healthy eating patterns is associated with higher circulating total and high-molecular-weight adiponectin and lower resistin concentrations in women from the nurseschr('۳۹') health study. Am J Clin Nutr. ۲۰۰۸ ۸۸: ۱۲۱۳-۲۴. ۱۳- Acar Tek N, Hilal Yildiran, Gamze Akbulut, et al. Evaluation of dietary quality of adolescents using healthy eating index. Nutr Res Pract. ۲۰۱۱ ۵: ۳۲۲-۸. ۱۴- Patricia M. Guenther, Susan M. Krebs-Smith, Jill Reedy, etal. USDA Center for Nutrition Policy and Promotion and National Cancer Institute, June ۲۰۰۸. www.cnpp.usda.gov/HealthyEatingIndex.htm ۱۵- L. kathleen mahan, Sylvia escott_Stump, Raymond. Krause,s food and nutrition care process. ۲۰۱۲ ۴۶۲_۴۸۴ .www.cnpp.usda.gov/my palte.htm ۱۶- Pourabdollahi P, Zarati M, Razaviyeh V, Dastgiri S, Ghaemmaghami G, Fathiazar E. The effect of nutritional education on awareness of the students of elementary school about the intake of junk food. J Zanjan Unive Med Sci. ۲۰۰۵ ۵۱: ۱۳-۲۰. ۱۷- Fallah F, Pourabbas A, Delpisheh A, Veisani Y, Shadnoush M. Effects of nutrition education on levels of nutritional awareness of pregnant women in Western iran. Int J Endocrinol Metab. ۲۰۱۳ ۱۱: ۱۷۵-۸. ۱۸- Shahril MR, Wan Dali WP, Lua PL. A ۱۰-week multimodal nutrition education intervention improves dietary intake among university students: cluster randomised controlled trial. J Nutr Metab. Epub ۲۰۱۳ Aug ۲۸. ۱۹- Kresis G, Jovamovic G, Zezelj S, Cvijavoc O, Ivezic G. The effect of nutrition knowledge of dietary intake among Croatian university standents. Coll Antropol. ۲۰۰۹ ۱۳۳: ۱۰۴۷-۵۶. ۲۰- Woodruff SJ, Hanning RM, McGoldrick K, Brown KS. Healthy eating index-C is positively associated with family dinner frequency among students in grades ۶-۸ from Southern Ontario, Canada. Eur J Clin Nutr. ۲۰۱۰ ۶۴: ۴۵۴-۶۰. ۲۱- Hurley KM, Oberlander SE, Merry BC, Wrobleski MM, Klassen AC, Black MM. The healthy eating index and youth healthy eating index are unique, nonredundant measures of diet quality among low-income, African American adolescents. J Nutr. ۲۰۰۹ ۱۳۹: ۳۵۹-۶۴. ۲۲- Togo P, Osler M, Sørensen TI, Heitmann BL. Food intake patterns and body mass index in observational studies. Int J Obes Relat Metab Disord. ۲۰۰۱ ۲۵: ۱۷۴۱-۵۱. ۲۳- Esmaillzadeh A, Azadbakht L. Dairy consumption and circulating levels of inflammatory markers among Iranian women. Public Health Nutr. ۲۰۱۰ ۱۳: ۱۳۹۵-۴۰۲. ۲۴- Lopez-Garcia E, Schulze MB, Fung TT, et al. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. ۲۰۰۴ ۸۰: ۱۰۲۹-۳۵. ۲۵- Mueller M, Hobiger S, Jungbauer A. Anti inflammatory activity of extracts from fruits, herbs and spices. Food chemistry ۲۰۱۰ ۱۲۲: ۹۸۷-۹۶. ۲۶- Chry Sohoou C, et al. Adherence to the mediterranean diet attenuates inflammation and coagulation process in healthy adults: the ATTJCA study. J AM Coll cardial. ۲۰۰۴ ۴۴: ۱۵۲-۸. ۲۷- Mantzoros CH, Williams C, Manson J, Meigs J, HU F. Adherence to the Mediterranean dietary pattern is positively associated with plasma adiponectin concentrations in diabetic women.Am J Clin Nutr. ۲۰۰۶ ۸۴: ۳۲۸-۳۵. ۲۸- Giugliano D, Ceriello A, Esposito K. The effects of diet on inflammation. J AM colL Cardiol. ۲۰۰۶ ۴۸: ۶۶۷-۸۵. ۲۹- McKeown NM, Meigs JB, Liu S, Saltzman E, Wilson PW, Jacques PF. Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care. ۲۰۰۴ ۲۷: ۵۳۸-۴۶. ۳۰- McKeown NM, Meigs JB, Liu S, Wilson PW, Jacques PF. Whole-grain intake is favorably associated with metabolic risk factors for type ۲ diabetes and cardiovascular disease in the Framingham Offspring Study. Am J Clin Nutr. ۲۰۰۲ ۷۶: ۳۹۰-۸. ۳۱- Lowe GD, Woodword M, Rumley A, Morrison C, Tunstall-Pedoe H, Stephen K. Total tooth loss and prevalent cardiovascular disease in men and women:possible roles of circus fruit consumption,vitamin C,and inflammatory and thrombotic variables.J Clin Epidemiol ۲۰۰۳ ۵۶ ۶۹۴-۷۰۰. ۳۲- Lopez-Garcia E, Schulze MB, Meigs JB, et al. Consumption of trans fatty acids is related to plasma biomarkers of inflammation and endothelial dysfunction. J Nutr. ۲۰۰۵ ۱۵: ۵۶۲-۶. ۳۳- Bear DJ, Judd JT, Clevidence BA, Tracy RP.Dietary fatty acids affect plasma markers of inflammation in healthy men fed controlled diets:A randomized crossover study. AM J Clin Nutr. ۲۰۰۴ ۷۹: ۹۶۹-۷۳.

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Key words: Healthy eating index ، Inflammation markers ، Obesity