| Background
Numerous 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.
Methods
This 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.
Results
The 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 < 0.05). Moreover, adherence
to Dietary Guidelines for Americans (DGA) appears to mediate association between gender
and waist circumference (B = -9.78), SBP (B = -4.83), triglyceride (B = -13.01) and HDL (B =
4.31). HEI also mediated indirect negative effects of socioeconomic status on FM (B = |