A structural equation modeling approach for the association of a healthy eating index with metabolic syndrome and cardio-metabolic risk factors among obese individuals

BackgroundNumerous studies have evaluated the association between dietary factors and cardiovascular risk among patients with chronic disease. It is worthwhile to assess these associations in a combination model rather than in an isolated form. In the current study, we aimed to use structural equation modeling (SEM) to assess the association of adherence to a healthy eating index (HEI)-2015 with socio-demographic factors, psychological characteristics, metabolic syndrome (MetS) and other cardio-metabolic risk factors among obese individuals.MethodsThis cross-sectional study was conducted among 188 healthy obese adults (96 males and 92 females) aged 20–50 years in Tabriz. A validated semi-quantitative food frequency questionnaire (FFQ) was used to record dietary intake and to estimate HEI-2015. Anthropometric parameters, blood pressure and biochemical measurements were evaluated according to standard protocols. Interrelationships among socio-demographic parameters and HEI with cardio-metabolic risk factors were analyzed using SEM.ResultsThe results of SEM analysis revealed that HEI mediated the association between age and several cardio-metabolic risk factors including fat mass (FM), fat free mass (FFM), systolic blood pressure (SBP) and high-density lipoprotein (HDL) (p ConclusionAdherence to HEI-2015 seems to mediate the effect of socio-demographic parameters and mental health on cardio-metabolic risk factors as well as MetS risk. Further studies are needed to confirm these findings.