Effects of nutrition education on dietary quality and prediabetes-related metabolic parameters in female University students

This study aimed to evaluate the effects of nutrition education on the Healthy Eating Index-2020 (HEI-2020), Planetary Health Diet Index (PHDI), Dietary Carbohydrate Quality Index (CQI), Low-Carbohydrate Diet Score (LCDS), Glycemic Index (GI), and Glycemic Load (GL). Additionally, it assessed its impact on fasting blood glucose, fasting insulin levels, Homeostasis Model Assessment (HOMA-IR), and Quantitative Insulin Sensitivity Check Index (QUICKI), which are biomarkers associated with prediabetes. The case-control study was conducted with female university students in the case (<i>n</i> = 39) and control (<i>n</i> = 37) groups who received nutrition education; dietary components were calculated over 24-hour dietary recall. Findings revealed that HEI-2020 scores were significantly higher (<i>p</i> = 0.006); insulin (<i>p</i> = 0.035), glucose (<i>p</i> = 0.023) and HOMA-IR (<i>p</i> = 0.026) levels were lower, and QUICKI values were higher (<i>p</i> = 0.025) in the case group. In adjusted models, higher tertiles of PHDI (T2-AOR = 12.039; 95%CI: 2.266–63.866), HEI-2020 (T2-AOR = 0.002; 95%CI: 0–0.462 and T3-AOR = 0.010; 95%CI: 0–0.457), and CQI (T2-AOR = 64.713; 95%CI: 4.585–91.775) were associated with lower odds of insulin resistance. Furthermore, a positive association was observed between dietary GI and the odds of insulin resistance (T2-AOR = 7.286; 95%CI: 2.349–52.6054). It was determined that nutrition education improved dietary quality and had positive effects on prediabetes-related metabolic parameters. The dietary quality of the intervention group receiving nutrition education was found to be higher compared to the control group.Fasting blood glucose, fasting insulin and insulin resistance levels, which are important prediabetes-related metabolic parameters, were lower in the intervention group.There was a negative association between dietary quality indices and the odds of insulin resistance.There was a positive relationship between the diet glycemic index and the odds of insulin resistance. The dietary quality of the intervention group receiving nutrition education was found to be higher compared to the control group. Fasting blood glucose, fasting insulin and insulin resistance levels, which are important prediabetes-related metabolic parameters, were lower in the intervention group. There was a negative association between dietary quality indices and the odds of insulin resistance. There was a positive relationship between the diet glycemic index and the odds of insulin resistance.

本研究旨在评估营养教育对健康饮食指数-2020（Healthy Eating Index-2020, HEI-2020）、行星健康饮食指数（Planetary Health Diet Index, PHDI）、膳食碳水化合物质量指数（Dietary Carbohydrate Quality Index, CQI）、低碳饮食评分（Low-Carbohydrate Diet Score, LCDS）、血糖指数（Glycemic Index, GI）及血糖负荷（Glycemic Load, GL）的影响。此外，本研究还探讨了营养教育对与前驱糖尿病相关的生物标志物——空腹血糖、空腹胰岛素水平、稳态模型评估胰岛素抵抗指数（Homeostasis Model Assessment, HOMA-IR）及定量胰岛素敏感性检测指数（Quantitative Insulin Sensitivity Check Index, QUICKI）的影响。本病例对照研究以女性大学生为研究对象，干预组（病例组，n=39）与对照组（n=37）均接受营养教育，膳食摄入情况通过24小时膳食回顾法进行量化计算。研究结果显示，干预组的HEI-2020评分显著升高（p=0.006）；胰岛素（p=0.035）、血糖（p=0.023）及HOMA-IR（p=0.026）水平显著降低，而QUICKI值显著升高（p=0.025）。在校正模型分析中，更高三分位的PHDI（T2-AOR=12.039；95%置信区间：2.266–63.866）、HEI-2020（T2-AOR=0.002；95%置信区间：0–0.462，T3-AOR=0.010；95%置信区间：0–0.457）及CQI（T2-AOR=64.713；95%置信区间：4.585–91.775）与胰岛素抵抗的较低发病风险呈显著相关。此外，膳食GI与胰岛素抵抗发病风险呈正相关（T2-AOR=7.286；95%置信区间：2.349–52.6054）。本研究证实，营养教育可改善膳食质量，并对与前驱糖尿病相关的代谢参数产生积极影响：接受营养教育的干预组膳食质量显著高于对照组，其空腹血糖、空腹胰岛素及胰岛素抵抗等关键前驱糖尿病相关代谢参数水平均低于对照组；膳食质量指数与胰岛素抵抗发病风险呈负相关，而膳食血糖指数与胰岛素抵抗发病风险呈正相关。