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Empirical Dietary and Lifestyle Indices for Hyperinsulinemia and Insulin Resistance in Relation to Metabolic Health in Overweight and Obese Children and Adolescents Publisher

Summary: Can dietary scores flag metabolic risk in youth? A study linked insulin-related diet and lifestyle indices with unfavorable markers in overweight adolescents. #MetabolicHealth #Nutrition

Nikparast A ; Nourian N Z ; Tabatabaeyan A ; Razavi M ; Khoshnezhad Afkham E ; Etesami E ; Asghari G
Authors

Source: Journal of Diabetes and Metabolic Disorders Published:2026


Abstract

Purpose: Empirical dietary and lifestyle indices reflecting hyperinsulinemia and insulin resistance have been associated with adverse metabolic outcomes in adults, but pediatric evidence is limited. We examined associations with metabolic health phenotypes in youth with excess weight. Methods: In this cross-sectional study, 427 Iranian participants aged 6–18 years with overweight or obesity were classified as metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO) using established cardiometabolic criteria. Dietary intake was assessed with a validated food frequency questionnaire. Modified versions of the empirical dietary and lifestyle indices for hyperinsulinemia (EDIH and ELIH) and insulin resistance (EDIR and ELIR) were calculated using the components available in the Iranian FFQ. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with subgroup analyses by age and sex. Results: Higher adherence to ELIH and ELIR was significantly associated with increased odds of MUO (OR for Q4 vs. Q1: 3.19 and 2.41, respectively; P-trend < 0.05), while no significant associations were observed for EDIH or EDIR. Exploratory subgroup analyses showed ELIH-MUO associations in participants aged < 10 years and boys, EDIR-MUO associations in girls, and ELIR-MUO associations in girls and, for the Q4-versus-Q1 comparison only, participants aged ≥ 10 years (P-trend = 0.09). Conclusions: Higher lifestyle-based insulinemic scores, particularly ELIH and ELIR, were associated with an unfavorable metabolic phenotype in youth with excess weight. Because these modified indices are empirical biomarker-prediction tools, their component weights should not be interpreted as causal effects of individual foods. Prospective and population-specific validation studies are warranted. Trial registration: Not applicable. © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2026.
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