The association between dietary polyphenol intake and the odds of metabolic syndrome

Bibliographic Details
Title:	The association between dietary polyphenol intake and the odds of metabolic syndrome
Authors:	Maede Makhtoomi, Zainab Shateri, Ava Mashoufi, Mehran Nouri, Behnam Honarvar, Parisa Keshani
Source:	Scientific Reports, Vol 14, Iss 1, Pp 1-10 (2024)
Publisher Information:	Nature Portfolio, 2024.
Publication Year:	2024
Collection:	LCC:Medicine LCC:Science
Subject Terms:	Polyphenols, Metabolic syndrome, Waist circumference, Triglyceride, Fasting blood sugar, High-density lipoprotein cholesterol, Medicine, Science
More Details:	Abstract Oxidative stress plays a role in the pathophysiology of metabolic syndrome (MetS), and one of the most important features of polyphenols is their antioxidant properties. However, there is no universal consensus on the effectiveness of polyphenols in treating Mets. Therefore, the present study aimed to investigate the association between polyphenols and MetS in an Iranian sample. This cross-sectional study was conducted on an adult population sample from Shiraz, in southern Iran. MetS was calculated using the criteria of the Adult Treatment Panel III (ATP III), which defines MetS as the presence of three or more of the specified risk factors. A validated food frequency questionnaire (FFQ) was used to measure the participant’s food intake. The association between polyphenol intake and the odds on MetS and its components was assessed using logistic regression. In both univariate and multivariate models, the association between polyphenol intake and the risk of MetS was not significant. However, after adjusting for potential confounders in the multivariate model, each unit change in flavonol, flavanone and isoflavones intake was associated with a lower, higher, and higher odds of MetS, respectively (flavonols: odds ratio (OR) = 0.926, 95% confidence interval (CI) 0.891–0.963, P < 0.001—flavanones: OR = 1.007, 95% CI: 1.001–1.014, P = 0.034—isoflavones: OR = 4.920, 95% CI: 1.057–22.894, P = 0.042). Additionally, no significant association was found between polyphenol intake and the risk of MetS components. However, in the multivariate model, after adjusting for potential confounders, a significant association was observed between polyphenol intake and lower odds of high waist circumference (OR = 0.998, 95% CI: 0.996–0.999, P = 0.032). The present study did not reveal a significant association between overall polyphenol intake and the odds of MetS. However, certain subclasses of polyphenols appear to be associated with the likelihood of MetS and its components.
Document Type:	article
File Description:	electronic resource
Language:	English
ISSN:	2045-2322
Relation:	https://doaj.org/toc/2045-2322
DOI:	10.1038/s41598-024-77335-4
Access URL:	https://doaj.org/article/1f0cd4ce5158478ea61d8f2acae94ff1
Accession Number:	edsdoj.1f0cd4ce5158478ea61d8f2acae94ff1
Database:	Directory of Open Access Journals
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FullText	Links: – Type: pdflink Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHjPtM4BHU3ZchRwgzYmadcigk49r9CVlbU7V5F6lgH7WwHV9vjCXOv89CioapQ1jTgrAAAA4jCB3wYJKoZIhvcNAQcGoIHRMIHOAgEAMIHIBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDAthDehU1gWjHsLEAgIBEICBminUWionAvRnGopuLCxtIC_ww-jNVeY8M0_azjKHCcVMGevA0OzLO4nnSYRkQt-ACW-nYL_2UYOM_rGLtR6BuCZbmBEo3gE4pQXdDfvffM8CBEzg3Q9EVnqj0npD4Z1ucsZlKLMz4tcOM5t3Tl1YoAfpmPJPSf_XXayY11aIAHo2oNMzfwvXyhdKO6qMJIcQTF-4hweuhXvsqrs= Text: Availability: 1 Value: <anid>AN0181944337;[fkqs]30dec.24;2025Mar11.13:04;v2.2.500</anid> <title id="AN0181944337-1">Association between dietary betaine intake and overweight or obesity </title> <p>Betaine exhibits significant physiological functions in organisms and has positive impacts on obesity, alcohol-induced and metabolic-associated liver disease, diabetes, cardiovascular diseases, and certain cancers. However, the evidence from epidemiological studies is limited and inconsistent. This study aimed to investigate the association between dietary betaine intake and the incidence of overweight or obesity. A total of 492 subjects from a dietary survey were equally classified into four groups (Q1, Q2, Q3, and Q4) according to the quartiles of dietary betaine intake and further investigate the correlation of betaine intake with body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (Homa-IR), systolic blood pressure (SBP), and diastolic blood pressure (DBP). The study subjects were further divided into normal-weight and overweight/obesity groups to compare the differences in obesity-related indices and betaine intake between the normal-weight and overweight/obesity individuals. The association between dietary betaine intake and the presence of overweight/obesity was performed by logistic regression. The results indicated that a higher betaine intake was correlated with a lower BMI and HC. And higher intake of calorie and macronutrients, as well as food species like cereals, meats, tubers, fruits, vegetables, nuts, and seeds, were also associated with an increased betaine intake. Cereals, being a main food source of betaine, provided more than 85% of betaine in the daily diet. Furthermore, subjects with normal weight had a higher dietary betaine intake than those with overweight/obesity. Logistic regression showed that the highest quartile (Q4) of betaine intake was associated with a lower incidence of overweight/obesity risk. In conclusion, cereals were the main food source of dietary betaine intake. There was a significant difference in dietary betaine intake between normal weight and overweight/obese individuals. Importantly, the highest betaine intake was associated with a lower risk of overweight/obesity.</p> <p>Keywords: Betaine; Cereals; BMI; Obesity; Overweight; Medical and Health Sciences Nutrition and Dietetics</p> <hd id="AN0181944337-2">Introduction</hd> <p>Obesity is defined as excessive fat deposits that result from an imbalance between energy intake and energy expenditure. It is widely considered one of the metabolic diseases that can lead to serious health consequences, including cardiovascular disease, type 2 diabetes, hypertension, hyperlipidemia, non-alcoholic fatty liver disease, and certain cancers[<reflink idref="bib1" id="ref1">1</reflink>]. In 2022, an estimated 2.5 billion adults (43% of men and 44% of women) worldwide were overweight, including over 890 million adults with obesity[<reflink idref="bib2" id="ref2">2</reflink>]. Obesity is a multifactorial disease due to genetics, physical activity, dietary intake, and psychosocial factors. Among these, diet is an important modifiable factor for preventing or treating obesity[<reflink idref="bib3" id="ref3">3</reflink>]. Several studies have reported that dietary ingredients such as phenolic acids, flavonoids, phytosterols, and alkaloids were negatively associated with obesity and related disorders[<reflink idref="bib4" id="ref4">4</reflink>].</p> <p>Betaine, a metabolite in choline metabolism, can be found in a variety of foods, such as whole grains, spinach, beets, and shellfish. It is either endogenously produced through choline metabolism or obtained by dietary supplementation[<reflink idref="bib5" id="ref5">5</reflink>]. In mammals, betaine primarily serves as an organic osmolyte and a methyl-group donor[<reflink idref="bib6" id="ref6">6</reflink>]. Studies have demonstrated that betaine has positive impacts on obesity, alcohol-induced and metabolic-associated liver disease, cardiovascular diseases, and certain cancers[<reflink idref="bib5" id="ref7">5</reflink>], [<reflink idref="bib6" id="ref8">6</reflink>]–[<reflink idref="bib7" id="ref9">7</reflink>]. In animal models, the supplementation of betaine reduced body fat and increased muscle mass by enhancing fatty acid oxidation and catabolism or inhibiting fatty acid synthesis[<reflink idref="bib8" id="ref10">8</reflink>],[<reflink idref="bib9" id="ref11">9</reflink>]. However, evidence from epidemiological studies is limited and inconsistent. Cholewa et al.[<reflink idref="bib10" id="ref12">10</reflink>] found that short-term betaine supplementation improved body fat in strength-trained men. Gao et al.[<reflink idref="bib11" id="ref13">11</reflink>]reported that high dietary betaine intake was significantly associated with favorable body composition in the adult population. Conversely, another study indicated that higher dietary betaine intake was related to increased body mass index (BMI) and waist-to-hip ratio (WHR) among obese individuals[<reflink idref="bib12" id="ref14">12</reflink>].</p> <p>Therefore, this study was aimed at exploring the association between dietary betaine intake and overweight or obesity (overweight/obesity). The study subjects were equally classified into four groups (Q1, Q2, Q3, and Q4) according to the quartiles of dietary betaine intake to investigate the correlation of betaine with body weight, BMI, waist circumference (WC), hip circumference (HC), WHR, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (Homa-IR), systolic blood pressure (SBP), and diastolic blood pressure (DBP). The study subjects were further divided into normal-weight and overweight/obesity groups to examine the association between dietary betaine intake and the presence of overweight and obesity using logistic regression.</p> <hd id="AN0181944337-3">Methods</hd> <p></p> <hd id="AN0181944337-4">Study participant</hd> <p>Data were obtained from a dietary survey conducted in Hetian, China. According to the inclusion and exclusion criteria, a total of 492 subjects were included in the subsequent analysis. Subjects' age, sex, smoking status, drinking status, and educational level were recorded. The anthropometric indices, including body weight, height, WC, HC, DBP, and SBP, were measured, and then the BMI and WHR were calculated. The exclusion criteria were as follows: being pregnant or lactating; taking any weight-affecting medicine or therapy; and being patients with serious metabolic, endocrine, and cardiovascular diseases.</p> <p>To further study the association between dietary betaine intake and the presence of overweight/obesity, the study subjects were further divided into normal-weight and overweight/obese groups. The normal-weight group was used as a comparison group to better understand the differences in obesity-related indices and betaine intake between the normal-weight and overweight/obese individuals. The subjects with a BMI ranging from 18.5 kg/m<sups>2</sups> to less than 24 kg/m<sups>2</sups> were classified as having normal weight, and the subjects with a BMI of 24 kg/m<sups>2</sups> or above were classified as overweight or obese.</p> <hd id="AN0181944337-5">Determination of blood lipid and glucose concentrations</hd> <p>For each subject, 3 mL of morning fasting blood was drawn. Subsequently, the blood samples were centrifuged at 3000 r/min for 10 min at 4 °C to separate the serum. Moreover, the concentrations of TG, TC, HDL-C, LDL-C, FBG, and FINS in the serum were measured using an automatic biochemistry analyzer (BS-800 M, Mindray, Shenzhen, China). Additionally, Homa-IR was calculated using the following equation:</p> <p>Graph</p> <hd id="AN0181944337-6">Dietary assessments</hd> <p>Dietary intake information was collected from the three in-person 24-h dietary recalls using a semi-quantitative food frequency questionnaire (FFQ). Subsequently, the daily intake of each food item was further calculated. Dietary betaine intake for each food item was calculated based on the United States Department of Agriculture (USDA) food content databases and the Chinese Food Composition Table, following the methods described elsewhere[<reflink idref="bib13" id="ref15">13</reflink>].</p> <hd id="AN0181944337-7">Statistical analysis</hd> <p>Categorical variables were presented as frequency (percentage) and compared using the χ<sups>2</sups> test. Continuous variables were presented as mean ± standard deviation (SD) for normally distributed variables and median (interquartile range) for nonnormally distributed variables and then compared using <emph>t</emph>-test and Mann-Whitney U test (for two groups) or Kruskal-Wallis test (for four groups), respectively. The dietary betaine intake was categorized by quartiles (Q1, Q2, Q3, and Q4), and the lowest quartile (Q1) was used as the reference. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for the dietary betaine intake and incidence of overweight/obesity. The quartiles of betaine intake (Q1-Q4) were employed as an independent variable, whereas the presence or absence of overweight/obesity was used as a dependent variable to determine whether dietary betaine intake is associated with the incidence of overweight/obesity. Model 1 was a crude model without including any covariates. In model 2, calorie intake was included as a covariate. In model 3, age and sex were included as covariates. In model 4, age, sex, calorie intake, education level, smoking status, and drinking status were included as covariates. These variables were commonly considered confounding variables in studies on nutrition and obesity due to their potential influence on dietary habits and body weight[<reflink idref="bib12" id="ref16">12</reflink>]. All statistical analyses were conducted using SPSS 21.0 software, and a <emph>P</emph>-value less than 0.05 was considered statistically significant.</p> <hd id="AN0181944337-8">Ethical aspects</hd> <p>This research was approved by the Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University (approval number: 20170214-150). Each participant signed an informed consent form and was informed of the purpose of the research, the guarantee of anonymity, and the usage of the data. All research procedures were performed in accordance with the Declaration of Helsinki and other relevant guidelines and institutional regulations applicable to studies involving human participants.</p> <hd id="AN0181944337-9">Results</hd> <p></p> <hd id="AN0181944337-10">Characteristics of the study subjects</hd> <p>A total of 492 subjects were equally classified into four groups (Q1, Q2, Q3, and Q4) according to the quartiles of dietary betaine intake (Table 1). The results indicated that subjects in the Q4 group were more associated with males, smokers, and education levels below high school. Importantly, a higher intake of betaine was associated with a lower BMI and HC. Furthermore, this study also observed that higher intake of calorie and macronutrients (proteins, fats, and carbohydrates), as well as food species like cereals, meats, tubers, fruits, vegetables, nuts, and seeds, were also associated with an increased betaine intake.</p> <p>Table 1 Characteristics of dietary betaine intake among the study subjects.</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left"&gt;&lt;p&gt;Variables&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Q1&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Q2&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Q3&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Q4&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;P&lt;/italic&gt;-Value&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Age (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;0.08&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 35 years&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;36 (29.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;29 (23.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;23 (18.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;20 (16.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;35&amp;#8211;44 years&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;32 (26.0)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;22 (17.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;35 (28.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;30 (24.4)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;45&amp;#8211;54 years&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;31 (25.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;39 (31.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;33 (26.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;39 (31.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;55&amp;#8211;64 years&lt;/p&gt;&lt;p&gt;&amp;#8805; 65 years&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;18 (14.6)&lt;/p&gt;&lt;p&gt;6 (4.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;20 (16.3)&lt;/p&gt;&lt;p&gt;13 (10.6)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;14 (11.4)&lt;/p&gt;&lt;p&gt;18 (14.6)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;24 (19.5)&lt;/p&gt;&lt;p&gt;10 (8.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Sex (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Male&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;23 (18.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;40 (32.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;41 (33.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;60 (48.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Female&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;100 (81.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;83 (67.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;82 (66.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63 (51.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Smoking status (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;0.013&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Smoker&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;10 (8.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;14 (11.4)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;11 (8.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;25 (20.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Non-smoker&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;113 (91.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;109 (88.6)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;112 (91.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;98 (79.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Drinking status (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;0.051&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Drinker&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;10 (8.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7 (5.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;10 (8.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;19 (15.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Non-drinker&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;113 (91.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;116 (94.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;113 (91.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;104 (84.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Educational level (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Below high school&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;54 (43.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;64 (52.0)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;70 (56.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;79 (64.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;High school&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;42 (34.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;39 (31.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;44 (35.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;43 (35.0)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Above high school&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;27 (22.0)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;20 (16.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9 (7.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1 (0.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Weight (kg)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;70.00 (62.00&amp;#8211;77.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;66.00 (61.00&amp;#8211;74.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;69.00 (59.00&amp;#8211;76.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;65.00 (58.00&amp;#8211;75.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.163&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;BMI (kg/m&lt;sup&gt;2&lt;/sup&gt;)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;28.70 (24.84&amp;#8211;30.83)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;27.34 (24.24,29.62)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;27.25 (23.43&amp;#8211;29.94)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;26.45 (22.06&amp;#8211;29.59)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.013&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;BMI (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Normal weight&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;23 (18.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;28 (22.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;35 (28.4)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;49 (39.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Overweight and obese&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;100 (81.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;95 (77.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;88 (71.6)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;74 (60.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;WC (cm)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;94.00 (85.00&amp;#8211;102.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;93.00 (84.00&amp;#8211;98.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;94.00 (84.00&amp;#8211;100.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;92.00 (81.00&amp;#8211;101.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.518&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;HC (cm)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;105.00 (99.00&amp;#8211;111.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;102.00 (98.00&amp;#8211;107.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;103.00 (95.00&amp;#8211;103.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;101.00 (92.00&amp;#8211;106.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;WHR&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.90 (0.85&amp;#8211;0.94)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.89 (0.85&amp;#8211;0.94)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.90 (0.85&amp;#8211;0.95)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.91 (0.87&amp;#8211;0.96)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.097&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;TG (mmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.54 (1.12&amp;#8211;2.12)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.55 (1.13&amp;#8211;2.12)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.65 (1.27&amp;#8211;1.83)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.66 (1.27&amp;#8211;2.63)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.994&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;TC (mmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.55 (4.16&amp;#8211;4.74)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.55 (4.17&amp;#8211;4.99)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.52 (4.27&amp;#8211;4.79)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.52 (4.20&amp;#8211;4.65)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.483&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;LDL-C (mmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.25 (1.89&amp;#8211;2.71)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.13 (1.70&amp;#8211;2.55)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.13 (1.34&amp;#8211;2.41)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.13 (1.89&amp;#8211;2.13)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.436&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;HDL-C (mmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.83 (1.34&amp;#8211;1.96)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.73 (1.27&amp;#8211;2.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.94 (1.43&amp;#8211;2.45)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.73 (1.43&amp;#8211;2.15)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.323&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;FBG (mmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;5.24 (4.81&amp;#8211;5.71)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;5.27 (4.89&amp;#8211;5.71)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;5.47 (5.03&amp;#8211;5.72)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;5.20 (5.03&amp;#8211;5.71)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.277&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;FINS (pmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;10.00 (8.67&amp;#8211;10.63)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9.97 (8.67&amp;#8211;10.63)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9.97 (9.23&amp;#8211;10.63)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9.97 (8.67&amp;#8211;10.63)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.261&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Homa-IR&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.44 (1.94&amp;#8211;2.70)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.33 (1.94&amp;#8211;2.70)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.44 (2.05&amp;#8211;2.70)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.34 (1.94&amp;#8211;2.66)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.486&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;SBP (mmHg)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;115.00 (100.00&amp;#8211;130.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;120.00 (104.00&amp;#8211;133.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;120.00 (107.00&amp;#8211;135.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;115.00(105.00&amp;#8211;136.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.731&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;DBP (mmHg)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;74.00 (67.00&amp;#8211;83.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;71.00 (65.00&amp;#8211;84.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;76.00 (68.00&amp;#8211;83.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;77.00 (70.00&amp;#8211;88.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.338&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Calorie intake (kcal/d)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1476.00 (1310.00&amp;#8211;1754.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1845.00 (1647.00&amp;#8211;2082.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2124.00 (1889.00&amp;#8211;2468.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2695.00 (2398.00&amp;#8211;3151.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="6"&gt;&lt;p&gt;&lt;italic&gt;Macronutrients intake (g/d)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Proteins&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;45.30 (38.90&amp;#8211;57.80)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;59.70 (51.40&amp;#8211;68.60)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;67.20 (59.40&amp;#8211;85.10)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;89.40 (78.00&amp;#8211;104.10)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Fats&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;50.10 (40.90&amp;#8211;63.40)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;56.40 (44.60&amp;#8211;71.80)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63.70 (52.80&amp;#8211;75.90)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;76.90 (60.90&amp;#8211;90.20)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Carbohydrates&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;212.00 (182.20&amp;#8211;245.40)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;269.20 (235.20&amp;#8211;306.80)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;313.70 (283.20&amp;#8211;357.40)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;411.10 (359.00&amp;#8211;462.20)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Food species (g/d)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Cereals&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;217.24 (179.09&amp;#8211;250.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;296.68 (254.00&amp;#8211;331.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;343.36 (315.90&amp;#8211;393.80)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;445.69 (400.50&amp;#8211;522.58)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Meats&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;56.87 (41.00&amp;#8211;95.24)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;83.64 (53.01&amp;#8211;123.33)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;88.82 (54.90&amp;#8211;132.82)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;109.02 (65.81&amp;#8211;161.05)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Tubers&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;39.29 (30.00&amp;#8211;52.34)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;40.35 (30.00&amp;#8211;60.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;44.29 (38.71&amp;#8211;58.71)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;48.59 (35.00&amp;#8211;62.59)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Vegetables&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;188.00 (164.00&amp;#8211;215.50)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;193.20 (167.00&amp;#8211;222.67)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;198.00 (180.90&amp;#8211;233.50)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;209.00 (184.60&amp;#8211;229.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Fruits&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;121.60 (73.33&amp;#8211;196.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;135.83 (69.40&amp;#8211;237.10)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;160.43 (102.56&amp;#8211;244.40)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;213.98 (137.77&amp;#8211;289.10)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Dairy&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;28.50 (7.80&amp;#8211;57.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;16.75 (0.00&amp;#8211;71.40)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;21.40 (8.25&amp;#8211;71.50)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;17.88 (8.25&amp;#8211;71.50)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.724&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Eggs&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;18.33 (7.80&amp;#8211;45.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;16.67 (2.75&amp;#8211;39.20)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;16.67 (7.20&amp;#8211;47.19)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;26.84 (7.87&amp;#8211;55.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.077&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Beans&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.66 (0.00&amp;#8211;10.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.00 (0.00&amp;#8211;14.20)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.05 (0.00&amp;#8211;16.50)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.66 (0.00&amp;#8211;10.01)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.952&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Nuts and seeds&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.60 (2.86&amp;#8211;13.58)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.96 (1.72&amp;#8211;13.10)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;8.65 (1.80&amp;#8211;17.89)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;14.01 (6.77&amp;#8211;30.65)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p>(<reflink idref="bib1" id="ref17">1</reflink>) Values are frequency (percentage) for categorical variables; mean ± SD for normally distributed continuous variables; median (interquartile range) for nonnormally distributed continuous variables. (<reflink idref="bib2" id="ref18">2</reflink>) Betaine: Q1: &lt;162.39 mg/d, Q2: 162.39–210.96 mg/d, Q3: 210.96–255.88 mg/d, Q4 ≥ 255.88 mg/d. (<reflink idref="bib3" id="ref19">3</reflink>) A <emph>P</emph>-value &lt; 0.05 was considered statistically significant.</p> <p>The characteristics of study subjects with and without overweight/obesity (BMI ≥ 24 kg/m<sups>2</sups>) are presented in Table 2. The incidence of overweight and obesity was 72.6% in this study. Compared to the normal-weight subjects, the significantly elevated levels of BMI, body weight, WC, HC, WHR, TG, TC, LDL-C, HDL-C, FBG, FINS, Homa-IR, SBP, and DBP were observed in subjects with overweight/obesity (<emph>P</emph> &lt; 0.05). Moreover, age and sex were also significantly different between the two groups.</p> <p>Table 2 Characteristics of subjects with/without overweight or obese.</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left" rowspan="2"&gt;&lt;p&gt;Variables&lt;/p&gt;&lt;/th&gt;&lt;th align="left" colspan="2"&gt;&lt;p&gt;BMI&lt;/p&gt;&lt;/th&gt;&lt;th align="left" rowspan="2"&gt;&lt;p&gt;&lt;italic&gt;P&lt;/italic&gt;-Value&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;tr&gt;&lt;th align="left"&gt;&lt;p&gt;Normal weight&lt;/p&gt;&lt;p&gt;(&lt;italic&gt;n&lt;/italic&gt; = 135)&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Overweight or obese&lt;/p&gt;&lt;p&gt;(&lt;italic&gt;n&lt;/italic&gt; = 357)&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Age (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 35 years&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;42 (31.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;66 (18.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;35&amp;#8211;44 years&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;26 (19.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;93 (26.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;45&amp;#8211;54 years&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;24 (17.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;118 (33.0)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;55&amp;#8211;64 years&lt;/p&gt;&lt;p&gt;&amp;#8805; 65 years&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;21 (15.5)&lt;/p&gt;&lt;p&gt;22 (16.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;55 (15.4)&lt;/p&gt;&lt;p&gt;25 (7.0)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Sex (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Male&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;61 (45.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;103 (28.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Female&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;74 (54.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;254 (71.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Smoking status (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;0.161&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Smoker&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;21 (15.6)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;39 (10.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Non-smoker&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;114 (84.4)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;318 (89.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Drinking status (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;0.409&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Drinker&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;15 (11.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;31 (8.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Non-drinker&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;120 (88.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;326 (91.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Educational level (%)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;0.100&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Below high school&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;69 (51.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;198 (55.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;High school&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;55 (40.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;113 (31.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Above high school&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;11 (8.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;46 (12.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Weight (kg)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;55.00 (50.00&amp;#8211;60.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;72.00 (66.00&amp;#8211;79.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;BMI (kg/m&lt;sup&gt;2&lt;/sup&gt;)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;21.30 (20.40&amp;#8211;22.60)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;29.05 (26.90&amp;#8211;30.80)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;WC (cm)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;80.07 &amp;#177; 0.69&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;96.85 &amp;#177; 0.49&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;HC (cm)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;92.00 (89.00&amp;#8211;96.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;105.00 (101.00&amp;#8211;110.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;WHR&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.87 (0.82&amp;#8211;0.92)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.91 (0.87&amp;#8211;0.96)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;TG (mmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.27 (0.98&amp;#8211;1.46)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.80 (1.26&amp;#8211;2.12)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;TC (mmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.27 (4.24&amp;#8211;4.52)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.55 (4.19&amp;#8211;4.98)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;LDL-C (mmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.89 (1.89&amp;#8211;2.13)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.33 (1.75&amp;#8211;2.70)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;HDL-C (mmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.73 (1.52&amp;#8211;1.73)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.94 (1.28&amp;#8211;2.40)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;FBG (mmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;5.03 (5.00&amp;#8211;5.17)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;5.50 (4.97&amp;#8211;5.77)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;FINS (pmol/L)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;8.67 (8.67&amp;#8211;8.67)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;10.63 (9.97&amp;#8211;10.63)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Homa-IR&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.94 (1.94&amp;#8211;2.25)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.52 (2.29&amp;#8211;2.78)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;SBP (mmHg)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;115.00 (101.00&amp;#8211;128.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;120.00 (105.00&amp;#8211;135.50)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.014&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;DBP (mmHg)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;71.00 (65.00&amp;#8211;80.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;77.00 (69.00&amp;#8211;88.00)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.002&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Betaine intake (mg/d)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;224.77 (181.04&amp;#8211;295.94)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;203.97 (156.94&amp;#8211;246.97)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="4"&gt;&lt;p&gt;&lt;italic&gt;Food sources of betaine (mg/d)&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Cereals&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;193.60 (148.86&amp;#8211;269.79)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;175.33 (123.06&amp;#8211;213.34)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Meats&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;20.90 (12.89&amp;#8211;32.73)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;19.04 (12.58&amp;#8211;30.80)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.418&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Tubers&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.32 (0.07&amp;#8211;4.78)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.30 (0.07&amp;#8211;1.68)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.137&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Vegetables&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.35 (0.27&amp;#8211;0.99)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.45 (0.29&amp;#8211;1.57)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.021&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Fruits&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.24 (0.12&amp;#8211;0.36)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.24 (0.13&amp;#8211;0.40)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.553&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Dairy&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.07 (0.02&amp;#8211;0.29)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.07 (0.01&amp;#8211;0.29)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.487&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Eggs&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.06 (0.01&amp;#8211;0.14)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.05 (0.01&amp;#8211;0.12)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.164&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Beans&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.00 (0.00&amp;#8211;0.02)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.00 (0.00&amp;#8211;0.04)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.364&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Nuts and seeds&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.55 (0.07&amp;#8211;1.66)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.48 (0.06&amp;#8211;1.21)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.366&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p>(<reflink idref="bib1" id="ref20">1</reflink>) Values are frequency (percentage) for categorical variables; mean ± SD for normally distributed continuous variables; median (interquartile range) for nonnormally distributed continuous variables. (<reflink idref="bib2" id="ref21">2</reflink>) A <emph>P</emph>-value &lt; 0.05 was considered statistically significant.</p> <hd id="AN0181944337-11">Betaine intake and its dietary sources</hd> <p>Median intakes of betaine were 224.77 mg/d and 203.97 mg/d for normal-weight and overweight/obese subjects, respectively (Table 2). The current study also observed that cereals were the main food source of betaine and provided more than 85% of that in the daily diet. Compared to the overweight/obese subjects, the higher levels of betaine intake and its dietary sources from cereals and vegetables were observed in the normal weight subjects (<emph>P</emph> &lt; 0.05).</p> <hd id="AN0181944337-12">Association between betaine intake and overweight/obesity</hd> <p>The association between the betaine intake and the presence of overweight/obesity is shown in Table 3. The highest quartile (Q4) was associated with a lower incidence of overweight/obesity risk in all models: OR 0.347, 95% CI (0.195–0.620) in unadjusted model 1; OR 0.467, 95% CI (0.233–0.936) in model 2 adjusted for calorie intake; OR 0.335, 95% CI (0.174–0.646) in model 3 adjusted for age and sex; OR 0.413, 95% CI (0.191–0.891) in model 4 adjusted for age, sex, calorie intake, education level, smoking status, and drinking status.</p> <p>Table 3 Logistic regression analysis of the association between betaine intake and overweight/obesity.</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left" rowspan="2"&gt;&lt;p&gt;Betaine&lt;/p&gt;&lt;/th&gt;&lt;th align="left" colspan="2"&gt;&lt;p&gt;Model 1&lt;/p&gt;&lt;/th&gt;&lt;th align="left" colspan="2"&gt;&lt;p&gt;Model 2&lt;/p&gt;&lt;/th&gt;&lt;th align="left" colspan="2"&gt;&lt;p&gt;Model 3&lt;/p&gt;&lt;/th&gt;&lt;th align="left" colspan="2"&gt;&lt;p&gt;Model 3&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;tr&gt;&lt;th align="left"&gt;&lt;p&gt;OR (95% CI)&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;P&lt;/italic&gt;-value&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;OR (95% CI)&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;P&lt;/italic&gt;-value&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;OR (95% CI)&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;P&lt;/italic&gt;-value&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;OR (95% CI)&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;P&lt;/italic&gt;-value&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Q1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;Reference&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;Reference&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;Reference&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;Reference&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Q2&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.780 (0.420&amp;#8211;1.449)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.432&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.838 (0.448&amp;#8211;1.568)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.581&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.779 (0.409&amp;#8211;1.485)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.448&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.855 (0.443&amp;#8211;1.650)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.641&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Q3&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.578 (0.318&amp;#8211;1.053)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.073&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.685 (0.361&amp;#8211;1.298)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.246&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.555 (0.295&amp;#8211;1.044)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.068&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.633 (0.321&amp;#8211;1.245)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.185&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Q4&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.347 (0.195&amp;#8211;0.620)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.001&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.467 (0.233&amp;#8211;0.936)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.032&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.335 (0.174&amp;#8211;0.646)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.001&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.413 (0.191&amp;#8211;0.891)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.024&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p>(<reflink idref="bib1" id="ref22">1</reflink>) Model 1: non-adjusted model; Model 2: adjusted calorie intake; Model 3: adjusted age and sex; Model 4: adjusted age, sex, calorie intake, education level, smoking status, and drinking status. (<reflink idref="bib2" id="ref23">2</reflink>) Betaine: Q1: &lt;162.39 mg/d, Q2: 162.39–210.96 mg/d, Q3: 210.96–255.88 mg/d, Q4 ≥ 255.88 mg/d. (<reflink idref="bib3" id="ref24">3</reflink>) A <emph>P</emph>-value &lt; 0.05 was considered statistically significant.</p> <hd id="AN0181944337-13">Discussion</hd> <p>This study observed that a higher intake of betaine was correlated with a lower BMI and HC. Additionally, higher intake of calorie and macronutrients, as well as food species like cereals, meats, tubers, fruits, vegetables, nuts, and seeds, were also associated with an increased betaine intake. Cereals, being a main food source of betaine, provided more than 85% of betaine in the daily diet. Furthermore, the subjects with normal weight had a higher dietary betaine intake than those with overweight/obesity. Logistic regression further showed that the highest betaine intake was associated with a lower incidence of overweight and obesity risk.</p> <p>Betaine is a nonessential nutrient and is either endogenously produced by choline metabolism or supplemented by dietary intake. It performs significant physiological functions in organisms and has positive impacts on human health[<reflink idref="bib5" id="ref25">5</reflink>]. Plant-based foods, especially cereal foods, are considered the best food sources of betaine in many populations[<reflink idref="bib14" id="ref26">14</reflink>]. The current study also observed that cereals were the main food sources of betaine in the daily diet. Studies confirmed that, relative to other foods, whole grain wheat and its fractions are the main sources of betaine[<reflink idref="bib14" id="ref27">14</reflink>], [<reflink idref="bib15" id="ref28">15</reflink>]–[<reflink idref="bib16" id="ref29">16</reflink>]. And the highest content of betaine was determined in the wheat bran (2300–7200 µg/g) and wheat germ (3414 µg/g)[<reflink idref="bib14" id="ref30">14</reflink>],[<reflink idref="bib17" id="ref31">17</reflink>]. Meanwhile, the betaine content of whole grain wheat was also higher than that in the refined wheat[<reflink idref="bib15" id="ref32">15</reflink>]. A study estimated that cereal foods provide 60–67% of betaine in Western diets and 20–40% of that in Southeast Asian diets[<reflink idref="bib14" id="ref33">14</reflink>]. In the region of northwest China, especially Xinjiang, people get used to the high intake frequency of cereals. Therefore, it is noteworthy that cereals provided more than 85% of the dietary betaine in this study.</p> <p>Studies have reported that the daily dietary intake of betaine is generally in the range of 100 to 300 mg[<reflink idref="bib18" id="ref34">18</reflink>]. In this study, the median intakes of betaine were 224.77 mg/d and 203.97 mg/d for normal weight and overweight/obesity subjects, respectively. Due to the different dietary habits of people in different regions, there is a large difference in betaine intake. In the Chinese population, the dietary betaine intakes of men and women in Shanghai were 79.1 mg/d and 52.5 mg/d, respectively[<reflink idref="bib19" id="ref35">19</reflink>]; those in Taiwan were 101 mg/d and 78 mg/d, respectively[<reflink idref="bib20" id="ref36">20</reflink>]; and the average dietary betaine intake was 259.0 mg/d in the Guangzhou population[<reflink idref="bib21" id="ref37">21</reflink>]. US cohort studies have found that the intakes of dietary betaine were 154–214.7 mg/d for men and 128–169.5mg/d for women[<reflink idref="bib19" id="ref38">19</reflink>],[<reflink idref="bib22" id="ref39">22</reflink>]. The average dietary intakes of betaine in the Newfoundland population were 114.61 mg/d and 108.45 mg/d for men and women, respectively[<reflink idref="bib11" id="ref40">11</reflink>]. The European Prospective Investigation into Cancer and Nutrition (EPIC) reported that the median dietary betaine intake of European women was 112 mg/d[<reflink idref="bib23" id="ref41">23</reflink>]. A large Swedish cohort reported that mean intakes of betaine were 173 mg/d for men and 163 mg/d for women[<reflink idref="bib24" id="ref42">24</reflink>]. The dietary betaine intakes of Japanese men and women were 287–350 mg/d and 239–288 mg/d, respectively, which are higher than those in other regions of the world[<reflink idref="bib25" id="ref43">25</reflink>]. Studies have suggested that a daily supplement of 1.5 g of betaine provides expected health benefits[<reflink idref="bib16" id="ref44">16</reflink>]. Obviously, the dietary betaine intake of general populations can be considered to be on the low side.</p> <p>Betaine has positive effects in various chronic diseases, such as obesity, diabetes, alcoholic and nonalcoholic fatty liver disease, and certain cancers[<reflink idref="bib16" id="ref45">16</reflink>],[<reflink idref="bib26" id="ref46">26</reflink>]. Recently, several epidemiological studies investigated the correlation between betaine intake and body composition, while some of the results are contradictory. The current study indicated that a higher intake of betaine was associated with a lower BMI and HC. And the betaine intake level was significantly higher in normal-weight subjects when compared with overweight or obese subjects. Logistic regression showed that the highest quartile (Q4) of betaine intake was associated with a decreased incidence of overweight or obesity risk. Gao et al.[<reflink idref="bib11" id="ref47">11</reflink>]also found that dietary betaine intake was associated with better body composition, including body weight, BMI, WC, and WHR, in both men and women. A study reported that an increase in dietary betaine intake over one year was associated with reduced body weight, BMI, WC, TC, TG, and LDL-C[<reflink idref="bib27" id="ref48">27</reflink>]. Cholewa et al.[<reflink idref="bib10" id="ref49">10</reflink>]found that short-term betaine supplementation also improved body fat in strength-trained men. In addition to dietary betaine intake, serum betaine concentration was also inversely correlated with body fat percentages[<reflink idref="bib28" id="ref50">28</reflink>], [<reflink idref="bib29" id="ref51">29</reflink>]–[<reflink idref="bib30" id="ref52">30</reflink>]. Animal studies have provided evidence for the impacts of betaine on obesity and related metabolic disorders. In animal models, betaine treatment effectively reduced body weight and fat accumulation[<reflink idref="bib8" id="ref53">8</reflink>],[<reflink idref="bib9" id="ref54">9</reflink>]. As a main cellular energy sensor and metabolic homeostasis regulator, AMP-activated protein kinase (AMPK) can be activated by betaine[<reflink idref="bib31" id="ref55">31</reflink>]. Activated AMPK could inhibit fatty acid synthesis by reducing the expression of sterol regulatory element-binding protein 1c (SREBP-1c), acetyl-CoA carboxylase (ACC), and fatty acid synthase (FAS)[<reflink idref="bib31" id="ref56">31</reflink>],[<reflink idref="bib32" id="ref57">32</reflink>]. Meanwhile, it also up-regulated the expressions of peroxisome proliferator-activated receptor α (PPARα) and carnitine palmitoyltransferase 1 (CPT1) to promote fatty acid β-oxidation[<reflink idref="bib33" id="ref58">33</reflink>],[<reflink idref="bib34" id="ref59">34</reflink>]. Activation of PPARα could also increase the expression of fibroblast growth factor 21 (FGF21) and uncoupling protein 1 (UCP1) to enhance thermogenic activity in adipose tissue, thereby increasing the energy expenditure[<reflink idref="bib34" id="ref60">34</reflink>]. Betaine also promoted lipolysis by enhancing the activities of hormone-sensitive lipase (HSL) and adipose triglyceride lipase (ATGL)[<reflink idref="bib35" id="ref61">35</reflink>]. Moreover, betaine could elevate the levels of lecithin and very low-density lipoprotein (VLDL) to improve hepatic lipid export[<reflink idref="bib34" id="ref62">34</reflink>]. A study reported that betaine could also attenuate the dysregulated lipid metabolism by upregulating adiponectin and downregulating leptin and resistin in adipose cells[<reflink idref="bib36" id="ref63">36</reflink>]. Overall, the possible mechanism of betaine in weight management may be related to alleviating the imbalance between fatty acid oxidation and synthesis.</p> <p>In conclusion, cereals were the main food source of betaine and provided more than 85% of that in the daily diet. The subjects with normal weight had a higher dietary betaine intake than those with overweight or obesity. Furthermore, a higher intake of betaine was found to be correlated with a lower BMI and HC, and the highest quartile of betaine intake was associated with a lower risk of overweight or obesity. The current study indicated that betaine supplements may be expected to be a dietary strategy for preventing obesity.</p> <hd id="AN0181944337-14">Limitations and strengths</hd> <p>The current study has several limitations. Firstly, this is an observational study that is not enough to testify to cause-effect relationship between dietary betaine intake and overweight/obesity. Secondly, our sample size might not be large enough to detect small effects or subgroup differences. Furthermore, dietary assessments were based on self-reported dietary intake data, which may result in recall bias.</p> <p>This study also has some notable strengths. Our results may have important implications for public health interventions aimed at preventing obesity. And we used a comprehensive dietary assessment method to measure betaine intake and controlled for several potential confounding factors in our analysis. Additionally, previous studies might have mainly focused on the health benefits of dietary fiber in cereals, but the finding that cereals are the main source of betaine in this study helps broaden the understanding of the nutritional value of cereals.</p> <hd id="AN0181944337-15">Author contributions</hd> <p>J.H. designed and supervised the study; D.M., M.L., and M.J. collected the data; W.Y., T.S., and Y.L. processed the data; M.K. and W.Y. analyzed the data; M.K. wrote the original draft; J.H. reviewed and edited the final manuscript. All authors reviewed the manuscript.</p> <hd id="AN0181944337-16">Funding</hd> <p>This research was funded by the National Natural Science Foundation of China (grant number: 82160611) and the 14-th Five-Year Plan Distinctive Program of Public Health and Preventive Medicine in Higher Education Institutions of Xinjiang Uygur Autonomous Region.</p> <hd id="AN0181944337-17">Data availability</hd> <p>The data presented in this study are available on request from the corresponding author.</p> <hd id="AN0181944337-18">Declarations</hd> <p></p> <hd id="AN0181944337-19">Competing interests</hd> <p>The authors declare no competing interests.</p> <hd id="AN0181944337-20">Publisher's note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0181944337-21"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Malik VS, Willett WC, Hu FB. 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Header	DbId: edsdoj DbLabel: Directory of Open Access Journals An: edsdoj.1f0cd4ce5158478ea61d8f2acae94ff1 RelevancyScore: 1047 AccessLevel: 3 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 1047.2685546875
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Items	– Name: Title Label: Title Group: Ti Data: The association between dietary polyphenol intake and the odds of metabolic syndrome – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Maede+Makhtoomi%22">Maede Makhtoomi</searchLink><br /><searchLink fieldCode="AR" term="%22Zainab+Shateri%22">Zainab Shateri</searchLink><br /><searchLink fieldCode="AR" term="%22Ava+Mashoufi%22">Ava Mashoufi</searchLink><br /><searchLink fieldCode="AR" term="%22Mehran+Nouri%22">Mehran Nouri</searchLink><br /><searchLink fieldCode="AR" term="%22Behnam+Honarvar%22">Behnam Honarvar</searchLink><br /><searchLink fieldCode="AR" term="%22Parisa+Keshani%22">Parisa Keshani</searchLink> – Name: TitleSource Label: Source Group: Src Data: Scientific Reports, Vol 14, Iss 1, Pp 1-10 (2024) – Name: Publisher Label: Publisher Information Group: PubInfo Data: Nature Portfolio, 2024. – Name: DatePubCY Label: Publication Year Group: Date Data: 2024 – Name: Subset Label: Collection Group: HoldingsInfo Data: LCC:Medicine<br />LCC:Science – Name: Subject Label: Subject Terms Group: Su Data: <searchLink fieldCode="DE" term="%22Polyphenols%22">Polyphenols</searchLink><br /><searchLink fieldCode="DE" term="%22Metabolic+syndrome%22">Metabolic syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22Waist+circumference%22">Waist circumference</searchLink><br /><searchLink fieldCode="DE" term="%22Triglyceride%22">Triglyceride</searchLink><br /><searchLink fieldCode="DE" term="%22Fasting+blood+sugar%22">Fasting blood sugar</searchLink><br /><searchLink fieldCode="DE" term="%22High-density+lipoprotein+cholesterol%22">High-density lipoprotein cholesterol</searchLink><br /><searchLink fieldCode="DE" term="%22Medicine%22">Medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Science%22">Science</searchLink> – Name: Abstract Label: Description Group: Ab Data: Abstract Oxidative stress plays a role in the pathophysiology of metabolic syndrome (MetS), and one of the most important features of polyphenols is their antioxidant properties. However, there is no universal consensus on the effectiveness of polyphenols in treating Mets. Therefore, the present study aimed to investigate the association between polyphenols and MetS in an Iranian sample. This cross-sectional study was conducted on an adult population sample from Shiraz, in southern Iran. MetS was calculated using the criteria of the Adult Treatment Panel III (ATP III), which defines MetS as the presence of three or more of the specified risk factors. A validated food frequency questionnaire (FFQ) was used to measure the participant’s food intake. The association between polyphenol intake and the odds on MetS and its components was assessed using logistic regression. In both univariate and multivariate models, the association between polyphenol intake and the risk of MetS was not significant. However, after adjusting for potential confounders in the multivariate model, each unit change in flavonol, flavanone and isoflavones intake was associated with a lower, higher, and higher odds of MetS, respectively (flavonols: odds ratio (OR) = 0.926, 95% confidence interval (CI) 0.891–0.963, P < 0.001—flavanones: OR = 1.007, 95% CI: 1.001–1.014, P = 0.034—isoflavones: OR = 4.920, 95% CI: 1.057–22.894, P = 0.042). Additionally, no significant association was found between polyphenol intake and the risk of MetS components. However, in the multivariate model, after adjusting for potential confounders, a significant association was observed between polyphenol intake and lower odds of high waist circumference (OR = 0.998, 95% CI: 0.996–0.999, P = 0.032). The present study did not reveal a significant association between overall polyphenol intake and the odds of MetS. However, certain subclasses of polyphenols appear to be associated with the likelihood of MetS and its components. – Name: TypeDocument Label: Document Type Group: TypDoc Data: article – Name: Format Label: File Description Group: SrcInfo Data: electronic resource – Name: Language Label: Language Group: Lang Data: English – Name: ISSN Label: ISSN Group: ISSN Data: 2045-2322 – Name: NoteTitleSource Label: Relation Group: SrcInfo Data: https://doaj.org/toc/2045-2322 – Name: DOI Label: DOI Group: ID Data: 10.1038/s41598-024-77335-4 – Name: URL Label: Access URL Group: URL Data: <link linkTarget="URL" linkTerm="https://doaj.org/article/1f0cd4ce5158478ea61d8f2acae94ff1" linkWindow="_blank">https://doaj.org/article/1f0cd4ce5158478ea61d8f2acae94ff1</link> – Name: AN Label: Accession Number Group: ID Data: edsdoj.1f0cd4ce5158478ea61d8f2acae94ff1
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RecordInfo	BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1038/s41598-024-77335-4 Languages: – Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 1 Subjects: – SubjectFull: Polyphenols Type: general – SubjectFull: Metabolic syndrome Type: general – SubjectFull: Waist circumference Type: general – SubjectFull: Triglyceride Type: general – SubjectFull: Fasting blood sugar Type: general – SubjectFull: High-density lipoprotein cholesterol Type: general – SubjectFull: Medicine Type: general – SubjectFull: Science Type: general Titles: – TitleFull: The association between dietary polyphenol intake and the odds of metabolic syndrome Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Maede Makhtoomi – PersonEntity: Name: NameFull: Zainab Shateri – PersonEntity: Name: NameFull: Ava Mashoufi – PersonEntity: Name: NameFull: Mehran Nouri – PersonEntity: Name: NameFull: Behnam Honarvar – PersonEntity: Name: NameFull: Parisa Keshani IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 10 Type: published Y: 2024 Identifiers: – Type: issn-print Value: 20452322 Numbering: – Type: volume Value: 14 – Type: issue Value: 1 Titles: – TitleFull: Scientific Reports Type: main
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