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Background: Colorectal cancer (CRC) is the fourth and third most common cancer in Iran and the world, respectively. Carbohydrates can lead to the proliferation of cancer cells, including CRC. The current study aimed to investigate the association between glycemic load (GL), insulin load (IL), glycemic index (GI), insulin index (II), low-carbohydrate diet score (LCDS), and carbohydrate quality index (CQI) with CRC odds. Methods: The present case-control study was performed on 71 CRC cases and 142 controls in the Hospital Cancer Organization and three general hospitals in Tehran, Iran. We calculated the dietary GI, GL, IL, II, CQI, and LCDS by a validated food frequency questionnaire. Results: The results indicated that people who were in the highest tertile of the GI had higher odds of CRC compared to the lower tertile (in the adjusted model: odds ratio (OR) = 3.89; 95% confidence interval (CI): 1.71–8.84). On the contrary, people who were in the highest tertile of the CQI and LCDS had significantly lower odds of CRC compared to the lower tertile (in the adjusted model: tertile (T) 2-OR = 0.24; 95% CI: 0.11–0.53 and T3-OR = 0.15; 95% CI: 0.06–0.39 for CQI and T2-OR = 0.33; 95% CI: 0.13–0.79 and T3-OR = 0.28; 95% CI: 0.10–0.82 for LCDS). Also, IL was positively associated with the odds of CRC after adjusting for confounding factors (T2-OR = 2.46; CI: 1.08–5.61 and T3- OR = 2.80; 95% CI: 1.07–7.31). Regarding the GL, only individuals who were in the second tertile had significantly higher odds of CRC compared to the first tertile (OR = 2.42; CI: 1.07–5.47). Conclusion: According to the findings, it is recommended to use a diet with high-quality carbohydrates and low GI and GL to minimize the odds of developing CRC. People should also be encouraged to have a balanced carbohydrate intake. [ABSTRACT FROM AUTHOR]

Background: The association between different dietary approaches and quality of life (QoL) has been well-demonstrated in previous research. However, the relationship between glycemic index (GI) and glycemic load (GL) with different dimensions of QoL has not been established. Therefore, we aimed to investigate the relationship between GI and GL with QoL in overweight and obese women. Methods: Two hundred seventy-six overweight and obese women (body mass index (BMI) ≥ 30 kg/m2), aged 18–64 years old, were included in this cross-sectional study. The amount of dietary intake and GI and GL indexes were established using a valid and reliable Food Frequency Questionnaire (FFQ) containing 147 items. Body composition (using bioimpedance analysis), anthropometrics, and physical activity were assessed. Insulin resistance (HOMA-IR) and hs-CRP were also measured, whilst QoL was measured using the SF-36 (short-form-36), self-administered, questionnaire. Result: Analyses were performed using multivariable linear regression, considering a wide range of confounding variables, such as age, physical activity, BMI, education, job, smoking, and marriage. We found a significant negative association between glycemic load and quality of life (β = -0.07, 95%CI = -0.13_ -0.01, p = 0.01). No significant associations were observed between glycemic index and quality of life (β = -0.03, 95%CI = -0.81_ 0.75, p = 0.93). Conclusion: We observed a significant negative association between QoL and GL, but not GI, among overweight and obese women in Iran. Our results need to be confirmed with further well-designed and adequately powered studies that control for clinical confounders. [ABSTRACT FROM AUTHOR]

Although glycemic index (GI) and load (GL) have been linked with several health outcomes, no information is available linking dietary GI and GL with glioma. This study aimed to investigate the relationship between dietary GI and GL and odds of glioma. This hospital-based case-control study was conducted between November 2009 and September 2011 in the hospital affiliated to Shahid Beheshti University of Medical Sciences. We recruited 128 newly diagnosed cases of glioma and 256 age- and sex-matched controls. All cases were pathologically diagnosed with glioma patients, with no history of any type of other pathologically confirmed cancers and chemotherapy or radiotherapy (due to cancers). Dietary GI and GL were measured by using a validated, self-administered, dish-based, semi-quantitative food-frequency questionnaire. A significant positive association was found between dietary GI and glioma (OR: 3.01; 95% CI: 1.75–5.17, P < 0.001); such that after considering for potential confounders, participants in the highest tertile of dietary GI had 3.51 times greater risk of glioma than those in the lowest tertile (OR: 3.51; 95% CI: 1.69–7.28, Ptrend = 0.001). Furthermore, we observed a significant positive association between dietary and glioma (OR: 3.74; 95% CI: 1.97–6.11, Ptrend < 0.001). This association remained significant even after further controlling for potential confounders (OR: 2.42; 95% CI: 1.02–5.69, Ptrend = 0.04). We observed a significant positive association between dietary GI and GL and risk of glioma in adults. However, prospective cohort studies are required to confirm this association. [ABSTRACT FROM AUTHOR]

Background: Recent studies have shown that dietary carbohydrate quantity and quality as well as genetic variants may contribute to determining the metabolic rate and general and central obesity. This study aimed to examine interactions between melanocortin 4 receptor gene (MC4R) rs17782313 and dietary carbohydrate intake, glycemic index (GI), and glycemic load (GL) on body mass index (BMI), waist circumferences (WC), basal metabolic rate (BMR), and BMR/kg in overweight/obese women. Methods: A total of 282 Iranian women (BMI ≥ 25) aged 18–56 years were enrolled in this cross-sectional study. All participants were assessed for blood parameters, body composition, BMR, and dietary intake. Dietary carbohydrate intake, GI, and GL were determined using a valid, reliable 147-item food frequency questionnaire. MC4R rs17782313 was genotyped by the restriction fragment length polymorphism (PCR-RFLP) method. Results: After adjustment for age and energy intake, significant interactions were observed between carbohydrate intake and MC4R rs17782313 in terms of BMI (P Interaction = 0.007), WC (P Interaction = 0.02), and BMR/kg (P Interaction = 0.003) in this way that higher carbohydrate intake, compared with lower intake, was associated with an increase in BMI and WC for individuals with C allele carriers (TC + CC genotypes), while related to an increase in BMR/kg for those carrying the TT genotype. No significant interaction was found between MC4R rs17782313 and GI and GL on BMI, WC, BMR/kg, and BMR. Conclusions: Interactions between the MC4R rs17782313 and carbohydrate intake probably can have an effect on BMI, WC, and BMR/kg in overweight/obese women. [ABSTRACT FROM AUTHOR]

Background and Aims: The association between glycemic index (GI), glycemic load (GL), total carbohydrate intake, and risk of cardiovascular diseases has been controversial. Premature coronary artery disease (PCAD) is characterized by the age of onset lower than 55 and 65 respectively in men and women. The aim of the current study is to investigate the relationship between GI, GL and carbohydrate levels and the risk of PCAD in Iran., Methods and Results: In total, 419 healthy people and 553 patients struggling with PCAD have participated in this case-control study. Dietary GI and GL were calculated using a validated food frequency questionnaire at the baseline. Crude and multivariable logistic regression were used to assess the relationship between GI, GL, and total carbohydrate intake and risk of PCAD. The mean age of participants was 51.13 ± 6.90 and 46 % of them were women. A significant direct relationship was observed between higher carbohydrate intake (OR: 1.74, 95%CI: 1.27-2.38) and GL levels (OR: 1.56, 95 % CI:1.14-2.14) and risk of PCAD. These associations were not significant after adjusting for potential variables. No significant association has been observed between GI and odds of PCAD even after controlling for all covariates., Conclusion: We found no significant association between GI, GL, and total carbohydrate intake and risk of premature coronary heart disease. Further observational and clinical trials are required to assess this relationship., (Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Introduction: Dietary intake is a risk factor related to elevated blood pressure (EBP). Few studies have investigated an association of dietary glycemic index (GI) and glycemic load (GL) with the EBP. The aim of the current study was to examine the association of dietary GI and GL with the EBP among a group of healthy women. Methods: This population-based cross-sectional study was conducted on 306 healthy women. Dietary GI and GL were measured using a validated semi-quantitative food frequency questionnaire (FFQ). Blood pressure (BP) was measured twice by a mercury sphygmomanometer from the right arm. Anthropometric measurements were also assessed according to the standard protocols. Results: Before controlling for potential confounders, no significant association was seen between dietary GI/GL and SBP/DBP. Also after controlling for potential confounders, the associations did not change between dietary GI and SBP (odds ratio [OR]: 0.96; 95% CI: 0.42-2.17, P = 0.87), between GI and DBP (OR: 0.72; 95% CI: 0.35-1.45, P = 0.37), as well as between GL and SBP (OR: 1.04; 95% CI: 0.43-2.49, P = 1.00) and between GL and DBP (OR: 1.20; 95% CI: 0.56-2.00, P = 0.61). In a stratified analysis by obesity and overweight, differences between tertiles of GI were not significant (OR: 0.75; 95% CI: 0.42-1.31, P = 0.31), even after adjustment for the potential confounders (OR: 1.54; 95% CI: 0.70-3.40, P = 0.26). Conclusion: This study did not show a significant association between dietary GI/GL and the risk of high SBP/DBP. In addition, no significant association was found between dietary GI/GL and odds of overweight or obesity in adult women. [ABSTRACT FROM AUTHOR]

Objective: The role of dietary glycemic index (GI) and glycemic load (GL) in the development of obesity has been debated globally. The relationship with body shape and fat distribution was examined in this cross-sectional association study among apparently healthy Iranian adults.Methods and Materials: A study population of 265 (126 males and 139 females) aged 18-55 years participated in this cross-sectional study from the communities of Tehran based on cluster sampling. GI and GL were assessed by the 147-item food frequency questionnaire (FFQ) completed by a trained dietitian. Weight, height, waist circumference (WC), and hip circumference of the participants were measured, and body mass index (BMI), waist-to-hip ratio (WHR), and A Body Shape Index (ABSI) were further calculated. Fat mass and fat-free mass were also measured using a body composition analyzer, and fat mass index (FMI) and fat-free mass index (FFMI) were then calculated. Multivariate regression models were fitted to assess the association between GI/GL and fat distribution measures such as FMI, FFMI, WC, BMI, WHR, and ABSI, considering potential confounding factors such as sex, age, BMI, and physical activity.Results: There was a statistically significant inverse association between GL and WC, BMI, and ABSI found in the adjusted model. GL was inversely associated with WC for both the adjusted model (p-trend = 0.027) and the crude model. Also, an inverse association was seen between GL and BMI (p-trend = 0.019) in the adjusted model but a marginal association in the crude model. GL was also inversely associated with ABSI (p-trend = 0.089) in the highest tertile.Conclusion: Dietary GL but not GI is inversely associated with fat distribution measures such as WC, BMI, and ABSI in the study population. This result may suggest a beneficial role of higher-GL diets in the prevention of obesity. [ABSTRACT FROM AUTHOR]

The present study examined the association between low-carbohydrate diet (LCD) score, glycemic index (GI), and glycemic load (GL) with visceral fat level (VFL) and lipid accumulation product (LAP). This cross-sectional study was conducted on 270 adults (118 men and 152 women) aged between 18-45 living in Tehran, Iran, between February 2017 and December 2018. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Body composition were also assessed. We used analyses of covariance and binary logistic regression to explore associations after controlling for age, energy intake (model 1), education, smoking status, physical activity, occupation, marriage and metabolic diseases. There were no significant differences between tertiles of GI, GL and LCD for means of anthropometric measures, LAP and VFL index in men, while women in the highest tertile of GI and GL had significantly higher mean LAP in the crude model ( P = 0·02) and model 1( P = 0·04), which disappeared after controlling for other confounders ( P = 0·12). Moreover, the OR and CIs for having high LAP and VFL was not associated with dietary GI, GL and LCD in crude and adjusted models. However, chance of high VFL reduced by 65% and 57% among women with high adherence to LCD score (OR = 0·35, 95% CI = 0·16-0·78, P = 0·01) and model 1 (OR = 0·43, 95% CI = 0·18-1, P = 0·05), respectively. However, this significant association disappeared after controlling for other confounders ( P = 0·07). Overall, we found carbohydrate quality and LCD score are not associated with LAP and VFL index. However, gender-specific relationship should not be neglect and warrants further investigation.

Background: Potential associations between dietary glycemic index (GI) and glycemic load (GL) with psychological disorders remain uncertain. Objective: We investigated the relations of dietary GI and GL with psychological distress, anxiety, and depression. Design: A total of 3363 nonacademic members of the staff of Isfahan University of Medical Sciences were included in this cross-sectional study. GI and GL were assessed by using a validated, self-administered, dish-based, semiquantitative food-frequency questionnaire. Validated Iranian versions of the Hospital Anxiety and Depression Scale and General Health Questionnaire-12 were used to assess anxiety, depression, and psychological distress. Results: After control for potential confounders, individuals in the top tertile of GI had greater odds of depression (OR: 1.44; 95% CI: 1.03, 2.02; P-trend = 0.03) and a trend for greater odds of anxiety (OR: 1.52; 95% CI: 0.97, 2.38; P trend = 0.06) compared with those in the first tertile. Higher GL values were linked to lower odds for mental disorders (OR: 0.66; 95% CI: 0.49, 0.90; P-trend = 0.009), depression (OR: 0.69; 95% CI: 0.51, 0.93; P-trend = 0.02), and psychological distress (OR: 0.67; 95% CI: 0.48, 0.92; P-trend = 0.01). Significant interactions were observed between GI and sex for depression (P = 0.01) and psychological distress (P = 0.046) in the crude model. In stratified analyses by sex, after control for potential confounders, a greater GI was linked to a higher odds of depression (OR: 1.52; 95% CI: 1.20, 1.94; P-trend = 0.001) and psychological distress (OR: 1.66; 95% CI: 1.28, 2.14; P-trend = 0.001) in women but not in men. Conclusion: Our findings support a direct link between the odds of depression and dietary GI but inverse associations between GL and mental disorders, depression, and psychological distress. This trial was registered at clinicaltrials.gov as NCT02362113. [ABSTRACT FROM AUTHOR]

Background: Carbohydrates are the primary energy source in Asian countries, including Iran. An emerging method can be used to measure the quality of carbohydrates, including the carbohydrate quality index (CQI), which includes a variety of components. Low-carbohydrate diet score (LCDS) has been proposed as a new method of scoring micronutrient intake that could provide a reasonable explanation for the link between diet and the risk of chronic diseases., Objective: This study aimed to investigate the relationship between CQI, LCDS, glycemic index (GI), glycemic load (GL), insulin load (IL), and insulin index (II) with bone mass density (BMD) in postmenopausal women., Method: In this case-control study, 131 postmenopausal women with osteoporosis/osteopenia and 131 healthy postmenopausal women aged 45-65 participated. The dual-energy X-ray absorptiometry (DEXA) method measured the BMD of the lumbar vertebrae and femoral neck. A validated semi-quantitative food frequency questionnaire was used to assess dietary intake. Logistic regression were used to evaluate the relation between GI, GL, II, IL, CQI, and LCDS with BMD., Results: Diets with higher GI increased the risk of osteopenia and osteoporosis, but LCDS and CQI decreased the risk of osteopenia and osteoporosis., Conclusion: These findings suggest that a higher intake of fruits and vegetables and receiving various dietary vitamins, minerals, and antioxidant compounds may be a useful way to prevent osteopenia in Iranian women., (© 2023. The Author(s).)

Background: Depression, anxiety, and stress are common mental problems. The aim of this cross-sectional study was to investigate the association between two indexes that measure postprandial insulin response to different food, dietary insulin index (DII) and insulin load (DIL), with psychological disorders., Method: Participants (n = 10,000) aged 20-69 were randomly selected from 200 clusters in Yazd from the recruitment phase of the Yazd Health Study. The dietary intake of participants was collected by a reliable and validated food frequency questionnaire (FFQ) consisting of 178 food items. DII and DIL were calculated from the FFQ data using previously published reference values. To assess psychological disorders an Iranian validated short version of a self-reported questionnaire (Depression Anxiety Stress Scales 21 [DASS21]) was used., Results: No significant association was observed between DIL and DII with odds of depression or anxiety using crude or adjusted models. However, individuals in the highest quartiles of DIL had the lowest odds of stress (OR: 0.69; 95% CI 0.48-1.01, P-trend = 0.047). This association remained significant after adjustment for potential confounders in model II including marital status, smoking, education, job status, salt intake, and multi-vitamin supplement use (OR: 0.38; 95% CI 0.16-0.91, P-trend = 0.039) and the third and final model which is further adjusted for BMI (OR: 0.39; 95% CI 0.16-0.91, P-trend = 0.041)., Conclusion: Overall, consumption of foods with higher DII as well as DIL were associated with lower stress scores; however, no significant relationship was observed between DII or DIL with respective depression or anxiety scores., (© 2022. The Author(s).)

Objective: Previous studies on the association between glycaemic index (GI) and glycaemic load (GL) in relation to breast cancer risk are contradictory. The aim of this study was to examine the association between dietary GI and GL and risk of breast cancer in Iranian women., Design: Population-based case-control study. Dietary GI and GL were assessed using a validated Willett-format 106-item semi-quantitative FFQ., Setting: Isfahan, Iran., Participants: Cases were 350 patients with newly diagnosed stage I-IV breast cancer, for whom the status of breast cancer was confirmed by physical examination and mammography. Controls were 700 age-matched apparently healthy individuals who were randomly selected from general population., Results: After controlling for potential confounders, individuals in the highest tertile of dietary GI had 47 % higher odds of breast cancer than women in the lowest tertile (OR: 1·47; (95 % CI 1·02, 2·12)). Stratified analysis by menopausal status showed such association among postmenopausal women (OR: 1·51; (95 % CI 1·02, 2·23)). We found no significant association between dietary GL and odds of breast cancer either before (OR: 1·35; (95 % CI 0·99, 1·84)) or after adjustment for potential confounders (OR: 1·24; (95 % CI 0·86, 1·79)). In addition, stratified analysis by menopausal status revealed no significant association between dietary GL and odds of breast cancer., Conclusions: Our findings showed a significant positive association between dietary GI and odds of breast cancer. However, we observed no significant association between dietary GL and odds of breast cancer.

Consuming fruits and vegetables as low glycemic index (GI) foods are recommended in the weight loss and also diabetic management. Recognition of GI of fruits in different regions enables us to develop and cultivate low GI fruits. To determine the GI of variety of fruits which are exportable in Iran, groups of 8 healthy nondiabetics male volunteers aged 20-28 within School of Medicine, randomly assigned to each of fruits including: apricots, prunes, cherries, bluberries, Golab apples, Green apples, Golden no-seed grapes and Red sultanas. GIs were calculated as the ratios of the incremental areas under these response curves to those for glucose ingestion. GIs of fruits were compared using repeated measure ANOVA and a test of within subjects contrast to compare the mean GI of certain tested fruits. Mean GI of variety of fruits were 39 ± 5, 41 ± 6, 50 ± 6, 34 ± 7, 29 ± 4, 28 ± 6, 48 ± 6, 49 ± 7 respectively for Golab apple, Green apple, apricots, prunes, cherries, blueberries, Golden no-seed grapes and Red sultanas. The GIs were significantly different between the 8 tested fruits (P > 0.002 for overall effect). Serving size of blueberries, cherries, Golab apples, Green apples, prunes, and apricots were low glycemic load (GL) fruits while golden no-seed grapes considered medium (GL= 13) and Red sultans with GL = 23 had the highest GL among tested fruits. All tested fruits were low GIs. The tested fruits can be recommended for diabetics and weight loss management. Consumption of one serving size sultanas will have high GL and is not suitable for diabetics. [ABSTRACT FROM AUTHOR]

Background: Psychological disorders including depression, anxiety, and stress comprise a huge public health problem. The aim of this cross-sectional study is to assess the relationship between dietary glycemic index (DGI) and glycemic load (DGL) and mental disorders., Method: Participants (n = 10,000) aged 20-69 were randomly selected from 200 clusters in Yazd from the recruitment phase of Yazd Health Study. The dietary intake of study participants was collected by a reliable and validated food frequency questionnaire consisting of 178 food items. DGI and DGL were calculated from the FFQ data using previously published reference values. To assess psychological disorders an Iranian validated short version of a self-reported questionnaire Depression Anxiety Stress Scales 21 was used., Results: There were no significant associations between DGI and DGL with odds of depression or anxiety in crude and adjusted models. However, individuals in the highest quartiles of DGL had the lowest odds of stress (OR: 0.69; 95% CI 0.47-1, P-trend = 0.023). This association remained significant after adjustment for potential confounding variables in model I (OR: 0.45; 95% CI 0.22-0.9, P-trend = 0.023), model II (OR: 0.46; 95% CI 0.22-0.96, P-trend = 0.039) and model III (OR: 0.46; 95% CI 0.22-0.96, P-trend = 0.042)., Conclusion: In conclusion, consumption of foods with higher GL was associated with lower odds of stress; however, no significant association was found between DGI or DGL and risk of depression and anxiety. Performing further studies with longitudinal design is suggested to confirm these results., (© 2022. The Author(s).)

Background: Inconsistent findings have been reported for associations between dietary indices and bacterial vaginosis (BV). The aim of this study was to examine the association of dietary glycemic index (DGI), glycemic load (DGL), insulin index (DII), and insulin load (DIL) with BV among Iranian women., Methods: The current case-control study consisted of 144 new cases of BV and 151 controls. The diagnosis of BV was made based on the Amsel criterion in hospital clinics in Tehran, Iran, from November 2020 until June 2021. DGI, DGL, DII, and DIL were calculated from a validated semiquantitative food frequency questionnaire. The association between dietary carbohydrate indices and odds of BV were assessed adjusting for potential confounders through an estimation of two multivariate regression models., Results: The multivariate adjusted odds ratio (OR) comparing the highest tertile of dietary DGI and DGL with the lower tertile was 2.99 (95% confidence interval (CI): 1.47-6.81; P trend = 0.003) and 4.01 (95% CI: 1.22-5.91; P trend = 0.029), respectively. In a fully adjusted model, the top tertile of dietary fiber compared to the bottom was associated with 88% (95% CI: 0.14-0.33) lower odds of BV ( P trend < 0.001). DII and DIL were not significantly associated with odds of BV in both crude and adjusted regression models., Conclusion: The findings support the hypothesis of moderate, direct associations between DGI or DGL and BV. Also, a diet high in fiber decreases odds of BV., Competing Interests: None of the authors had any conflicts of interest to report., (Copyright © 2022 Morvarid Noormohammadi et al.)

Objective: This study investigated the association between quality and quantity of carbohydrate by assessing low carbohydrates diet score (LCDS), carbohydrate quality score (CQI), glycemic index (GI), dietary glycemic load (GL), and dietary carbohydrate intake, and risk of breast cancer (BrCa) among Iranian women., Methods: This hospital-based case-control study was carried out in the Cancer Research Center of Imam Khomeini hospital, Iran. We included One hundred and fifty newly diagnosed BrCa cases and one hundred and fifty healthy controls in this study. Socio-demographic and dietary data and anthropometric measures were recorded., Results: We found that a higher CQI than a lower score was associated with a decrease in odds of BrCa ( P  = 0.04). After adjusting for potential confounders, we observed that CQI was not associated with BrCa development ( P  = 0.05). An increase in odds of BrCa among women in the highest tertiles of GL ( P  = 0.12), GI ( P  = 0.48), and dietary carbohydrate intake ( P  = 0.06) was seen, which was not statistically significant. There was also a non-significant lower chance of having BrCa with adherence to the LCDS ( P  = 0.09)., Conclusion: Our findings suggest that CQI was not related to BrCa risk among Iranian women. This relation deserves to be investigated in prospective studies.

Previous studies have presented a few evidences on the relationship between dietary carbohydrate intake, glycemic index (GI), glycemic load (GL), with the prostate cancer risk. We performed a case-control study to evaluate these associations in 50 men with histologically confirmed prostate cancer and 100 control men. Odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were derived using logistic regression. The fully adjusted ORs for the top vs. the bottom quartile were 15.02 ( P trend = 0.004), 1.04 ( P trend = 0.003), and 10.35 ( P trend = 0.002) for carbohydrate intake, GI and GL, respectively. Significant associations with prostate cancer remained only among men with reduced fiber intake for carbohydrate intake, GI and GL and among those had increased fiber intake for GI. These findings support the hypothesis that diet with high carbohydrate, GI and GL enhance risk of prostate cancer.

Background & Aims: Current data on the association between dietary glycemic index (GI) and glycemic load (GL) and sleep duration are limited and controversial. The present cross-sectional study aimed to investigate the relationship between dietary GI and GL with sleep duration in a large number of adults living in central Iran., Methods: Baseline data from two Iranian cohorts were pooled for the current analysis: the YaHS-TAMYZ (n = 9962) and Shahedieh (n = 9977) studies. Demographic data as well as dietary intakes, sleep duration, and possible confounders, were collected by interview. Anthropometric measurements were also conducted by trained interviewers. Participants were categorized based on sleep duration [short (<6 h), normal (6-8 h), and long (>8 h)]. Multivariable logistic regression was used to determine the relationship between dietary GI/GL and the likelihood of short and long sleep duration., Results: In total, 10,451 participants aged 20-70 years were included in the analyses. After controlling for all possible confounders, no significant association was observed between dietary GI and short or long sleep duration (P > 0.05). Individuals in the highest quartile of dietary GL had a higher chance for long sleep duration compared to participants in the lowest quartile (OR = 1.41; 95% CI: 1.14, 1.74, P trend  = 0.001). No significant association was observed between dietary GL and short sleep duration., Conclusion: Dietary GL is positively associated with the likelihood of long sleep duration. Future prospective studies are required to confirm the current findings., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background and Aim: The aim of this study was to investigate the association of dietary insulin index(II), insulin load(IL), glycemic index(GI), and glycemic load(GL) with risk of developing diabetes among the Tehranian adults., Methods: This study was conducted within the framework of the Tehran Lipid and Glucose Study on 1149 subjects, aged ≥30 years, who were followed-up for a mean of 8.04 years. Food frequency questionnaire was used to calculate the dietary GI, GL, II, IL at the baseline. Multivariate Cox proportional hazard regression models, adjusted for the potential confounders, were used to estimate the risk of diabetes based on the dietary indices., Results: Mean age of the study population was 44.8 ± 10.4 years and 46.3% of them were men. During a mean of 8.04 ± 2.1 years of follow-up, 76 (6.6%) new cases of diabetes were identified. The mean ± SD of the II, IL, GI, and GL of the participants were 52.4 ± 6.5, 234.9 ± 88.8, 61.8 ± 7.9, and 200.6 ± 74.5, respectively. After adjusting for age, sex, smoking, physical activity, daily energy intake, and body mass index, higher dietary scores of the II[HR = 1.33 (95%CIs = 1.06-1.68)], IL[HR = 1.70(95%CIs = 1.10-2.60)], GI[HR = 1.28(95%CIs = 1.03-1.60)], and GL[HR = 1.84 (95%CIs = 1.19-2.84)] were found to be associated with the increased risk of diabetes incidence per each ones SD increment in the scores. Considering the tertiles of the dietary scores, the risk of developing diabetes was increased significantly from tertile 1 into 3 of the GL, and after adjusting for all the potential covariates (p-trend = 0.002); the diabetes risk was 3.40 (95%CI:1.48-7.83) in those with highest tertile of GL compared to those in the lowest tertile of GL., Conclusion: Our findings suggest that the diet with high GL, GI, II, and IL can increase the incidence of diabetes. The glycemic and insulin load can strongly predict the risk of diabetes rather than the glycemic index and insulin index., Competing Interests: Conflict of Interest The authors declared there is no conflict of interest., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Objectives: The aim of this case-control study was to investigate the relationships between carbohydrate consumption, glycemic load (GL), glycemic index (GI), and the risk of Helicobacter pylori infection among adults admitted to an Iranian hospital., Methods: In this case-control study, we recruited 150 participants with H. pylori infection and 302 healthy participants ages 18 to 55. Dietary GI and GL were assessed using a validated 168-item quantitative food frequency questionnaire. Dietary GL was calculated as a function of GI, carbohydrate content, and the frequency of intake of certain foods., Results: After adjustment for potential confounders, and comparing the highest tertile with the lowest tertile, a significant direct association was observed between the consumption of carbohydrates (odds ratio [OR] = 2.87; 95% confidence interval [CI], 1.18-6.96; P for trend = 0.017), GI (OR = 3.70; 95% CI, 2.01-6.81; P for trend < 0.001), GL (OR = 3.06; 95% CI, 1.43-6.54; P for trend = 0.001), the consumption of bread and refined-grain products (OR = 4.24; 95% CI, 2.22-8.11; P for trend < 0.001), and the odds of H. pylori infection (OR = 2.22; 95% CI, 1.30-3.79; P for trend = 0.003)., Conclusions: Our data suggest that a high dietary GL, high GI, and high consumption of dietary carbohydrates significantly elevate the risk of H. pylori infection. Also, the amount of bread and refined-grain products consumed had a significant positive relationship with H. pylori infection., (Copyright © 2020. Published by Elsevier Inc.)

Limited studies have conducted on the association between carbohydrate intake, glycemic index (GI), glycemic load (GL), and BC risk among Middle Eastern women. Our objective was to examine whether intake of carbohydrates, GI and GL would lead to more risk of BC among Iranian women. In this case-control study, 136 women with histologically confirmed BC and 272 control women were recruited. Dietary intake was assessed using a validated 168-item food frequency questionnaire (FFQ) from which GI and GL were estimated. We calculated Odds ratios (OR) using logistic regression. The multivariate OR for the highest vs . the lowest quartile was 2.49 (95% CI 1.28-4.82; P trend = 0.005) for GI with a significant trend. OR for GI and GL among postmenopausal women were 4.45 (95% CI 1.59-12.47; P trend = 0.002) and 4.15 (95% CI 0.87-19.67; P trend = 0.03), respectively. OR for GI among women with reduced vegetable intake was 13.55 (95% CI 3.90-46.99; P trend <0.001). Our data suggest that high GI and GL play an important role in the risk of BC particularly among postmenopausal woman.

Aims: This study aimed to investigate the association between dietary GI and GL and risk of GDM in a group of pregnant women in Iran., Methods: A number of 812 pregnant women were recruited in their first trimester in a prospective study. A validated 117-item semi-quantitative food frequency questionnaire was used to assess usual dietary intakes of participants at study baseline. Dietary GI and GL were calculated based on earlier publications. GDM was diagnosed based on the results of a fasting plasma glucose concentration and a 50-g, 1-h oral glucose tolerance test at 24-28 weeks of gestation. Cox proportional hazards model was used to compute relative risks (RRs) and 95% confidence intervals (CI) for GDM., Results: Mean ± SD of age and BMI of study participants was 29.4 ± 4.84 y and 25.14 ± 4.08 kg/m 2 , respectively at study baseline. Mean ± SD of dietary GI was 58 ± 7 and that of dietary GL was 176 ± 42. Overall, 28.4% (n = 231) of study population developed GDM at weeks 24-28 of pregnancy. After adjustment for potential confounding variables, we found that women in the highest tertile of dietary GL were 43% more likely to develop GDM than those in the lowest tertile (95% CI: 1.01, 2.00; P-trend = 0.03). However, no significant association was seen between dietary GI (RR for the highest tertile compared to the lowest: 0.85; 95% CI: 0.61, 1.20; P-trend = 0.37), and risk of GDM., Conclusions: We found that women with the highest dietary GL were at a greater risk of developing GDM during pregnancy. No significant association was seen between dietary GI and risk of GDM., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: The present study was conducted to investigate the association of dietary insulin index(II), insulin load(IL), glycemic index(GI), and glycemic load(GL) with the risk of cardiovascular disease(CVD)., Methods: This cohort study was conducted within the framework of the Tehran Lipid and Glucose Study on 2198 subjects, aged≥19 years old, who were followed-up for a median (IQR) 6.7 (6.1-7.1) years. Dietary GI, GL, II, and IL were calculated using a food frequency questionnaire at the baseline. Multivariate Cox proportional hazard regression models were used to estimate the risk of CVD across quartiles of dietary insulin and glycemic indices., Results: Mean ± SD age of the subjects(44.9% men) was 38.3 ± 13.4 years. During a mean of 2406 ± 417 person-years of follow-up, 76(3.5%) new cases of the CVD were ascertained. The mean ± SD of II, IL, GI, and GL of participants were 51.7 ± 6.5, 235.8 ± 90.2, 61.9 ± 7.8, and 202.2 ± 78.1, respectively. After adjusting for the variables of age, sex, smoking, physical activity, daily energy intake, body mass index, diabetes, and hypertension, the hazard ratio (HR) of the highest quartile of dietary GL was 2.77(95%CI:1.00-7.69,P for trend:0.033) compared to the lowest one. Also, each one SD increase in the GL score was associated with a higher risk of CVD[(RR:1.46;CI:1.00-2.16),P-value = 0.047]. However, there was no significant association between the dietary GI, II, and IL and risk for CVD incidence., Conclusions: Our results suggested that a high GL diet can increase the incidence of CVD, whereas high dietary II and IL were not associated with the risk of CVD among adults.

Aim: To identify the association between the dietary carbohydrate indexes, such as dietary glycemic index (DGI) and load (DGL), dietary insulin index (DII) and load (DIL), with the possibility of cataract., Method: This case-control study consisted of 101 new cases of cataract and 202 controls. DGI and DGL were computed through DGI values previously published. DII was also calculated based on dietary insulin index data published previously., Results: There was a significant positive association between the highest quartiles of DGI (OR = 6.56; 95% CI = 2.67-16.06; P < 0.001), DGL (OR = 6.17; 95% CI = 1.93-19.37; P = 0.002) and DIL (OR = 4.17; 95% CI = 1.41-12.27; P = 0.004) with risk of cataract, compared to those on the lowest quartile, but not for DII (OR = 0.85; 95% CI = 0.39-1.86; P = 0.82). Furthermore, after stratifying groups by BMI, a significant direct association between highest quartile of DGI (OR = 6.76; 95% CI = 2.49-18.38; P < 0.001) and DGL (OR = 3.45; 95% CI = 0.96-12.37; P = 0.05) with risk of cataract was evident in individuals with elevated BMI (BMI≥25)., Conclusion: We found a significant, direct, relationship between DGI, DGL and DIL with risk of cataract. However, the association between DII and the risk of cataract was not significant, even after adjusting for related confounders., Competing Interests: Declaration of competing interest None of the authors have any conflicts of interest related to this article., (Copyright © 2020 Diabetes India. All rights reserved.)

Background & Aims: Although the association between dietary Glycemic Index (GI), Glycemic Load (GL) and general/abdominal obesity has extensively been examined, limited data are available in this regard in developing countries. The aim of this study was to examine the association between dietary GI and GL with general and abdominal obesity., Methods: This cross-sectional study was conducted among adults in Isfahan, Iran. Dietary GI and GL were assessed using a validated dish-based 106-item semi-quantitative food frequency questionnaire (DS-FFQ). Data regarding height, weight and waist circumference were collected using a self-reported questionnaire. Overweight or obesity was defined as body mass index ≥25 kg/m 2 , and abdominal obesity was defined as waist circumference ≥80 cm for women and ≥94 cm for men., Results: There was no significant association between dietary GI and GL and general obesity. After adjustment for potential confounders, participants in the highest quintile of dietary GI had a higher chance for abdominal obesity (OR: 1.29; 95% CI: 1.01-1.64), compared with those in the lowest quintile. No significant association was observed between dietary GL and abdominal obesity. After adjustment for potential confounders, women in the top quintile of dietary GI had higher chance for abdominal obesity compared with those in the bottom quintile (OR: 1.48, 95% CI: 1.02-2.15). No significant association was found between dietary GI and abdominal obesity among men. We failed to find any significant association between dietary GI and general obesity in either gender [Comparing top vs. bottom quintiles, for men: OR: 0.97; 95% CI: 0.74-1.29 and for women: OR: 1.01; 95% CI: 0.75-1.40]. No significant association was found between dietary GL and general [for men: OR: 1.13; 95% CI: 0.85-1.49 and for women: OR: 1.01; 95% CI: 0.76-1.35], as well as abdominal obesity [for men: OR: 1.21; 95% CI: 0.88-1.67 and for women: OR: 1.25; 95% CI: 0.88-1.77]., Conclusions: We found a significant positive association between dietary GI and abdominal obesity. When we conducted analyses stratified by gender, we also observed such association in women, but not in men. No other significant associations were observed between dietary GI and GL with general or abdominal obesity., (Copyright © 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background & Aims: Pregnancy-induced hypertension (PIH) is a pregnancy-specific disorder that increases maternal and infant mortality and morbidity. The quantity and quality of consumed carbohydrates are probably the main dietary factors affecting blood pressure. The present study aimed to evaluate the association of carbohydrate quality and quantity with PIH., Methods: This case-control study was performed on 202 pregnant women with or without PIH. The dietary data were collected using 168-item semi-quantitative food frequency questionnaires. Daily glycemic index (GI) and glycemic load (GL), ratio of whole grains to total grains, ratio of solid carbohydrates to total carbohydrates, dietary fiber and carbohydrate intake, and carbohydrate quality index (CQI) were calculated and their associations with PIH were evaluated using logistic regression. We eliminated collinearity within independent variables using factor analysis and then with evaluating the relationship between extracted factors and PIH., Results: In pregnant women in whom the daily carbohydrate intake and GL were higher than median increased frequency of PIH compared to whom had lower than median ones (OR = 3.23, 95% CI 1.46-7.17, and P = 0.004; OR = 2.60, 95% CI 1.21-5.56; and P = 0.035, respectively). Furthermore, we showed a significant inverse association between extracted factor that was mostly related to total fiber intake frequency of PIH (OR = 0.45; 95% CI 0.20-0.97, and P = 0.049 when higher than median values compared to lower than ones). The GI, ratio of whole grains to total grains, ratio of solid carbohydrates to total carbohydrates, and CQI did not associate with PIH., Conclusions: These findings suggest that carbohydrate intake and GL are related to higher and daily fiber intake to lower frequency of PIH., (Copyright © 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Several studies have indicated the association between intake of foods high in dietary glycemic index (GI) and glycemic load (GL) with an increased risk of digestive tract cancers. We hypothesized that GI and GL may be associated with risk of esophageal squamous cell carcinoma (ESCC) in a high-risk population in Iran. In total, we interviewed 47 cases with incident of ESCC and 96 frequency-matched hospital controls, then calculated the average dietary GI and GL via a validated food frequency questionnaire. Dietary GL was calculated as a function of GI, carbohydrate content, and frequency of intake of certain foods. Dietary GI and GL levels were significantly higher among the ESCC cases compared with the controls (P < .05). After adjustment for potential confounders, those in the highest tertile of dietary GI had 2.95 times higher risk of ESCC compared with those in the lowest (95% confidence interval, 1.68-3.35; P for trend = .002). In addition, being in the highest tertile of dietary GL was positively associated with an ESCC risk (odds ratio, 3.49; 95% confidence interval, 2.98-4.41; P for trend = .001). Findings of the present study indicate that diets with high GI and GL might have potentially unfavorable effects on ESCC risk and suggest a possible role for excess circulating insulin and related insulin-like growth factor 1 in esophageal cancer development., (© 2013.)