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Table 3 Characteristics of studies examined the association of dietary inflammatory index with cardio-metabolic risk factors

From: Association of dietary inflammatory potential with cardiometabolic risk factors and diseases: a systematic review and dose–response meta-analysis of observational studies

Reference First author (year) Study design Country Age range/mean age Gender Sample size Diet assessment tool The number of subjects with CMRFs Duration follow-up (years) Number of used dietary factors in DII calculation Outcome variable Measure of outcome Comparison Type of DII variable (categorical/ continuous) Type of effect size measure Effect size measure (95% CI) Study quality Confounders
24 Alkerwi et al. 2014 Cross-sectional Luxembourg 18–69 F/M 1352
F (695)
M (657)
FFQ 430 24 Abdominal obesity Morbidity DII > 1 vs. DII ≤ 1 Categorical OR 1.12 (0.81, 1.56) 7 3, 7, 9, 11, 17, 25
         249    Low HDL-C      1.46 (1.00, 2.13)   
         351    Hyper- triglyceridemia      1.17 (0.82, 1.67)   
         741    HTN      0.85 (0.61, 1.18)   
         307    Hyperglycemia      1.30 (0.90, 1.89)   
         346    MetS      1.18 (0.81, 1.71)   
42 Alkerwi et al. 2015 Cross-sectional Luxembourg 18–69 F/M 1040
F (NR)
M (NR)
FFQ 1040 - NR HDL-C (mmol/l) Morbidity Continuous (each 1-z score difference across the DII) β -Coefficient 0 8 3, 7, 9, 17, 25
            TC (mmol/l)      0.0409   
            TG (mmol/l)      − 0.00003   
            LDL-C (mmol/l)      0.0003   
            ApoA1 (mg/l)      0.02   
            Apo B (mg/l)      0.13   
       1106
F (NR)
M (NR)
  1,106    FBS (mmol/l)      − 0.0002   
            HbA1c (%)      − 0.0001   
            HOMA-IR      − 0.017   
            Insulin (mg/l)      − 0.22   
       1153
F (NR)
M (NR)
  1153    BMI (kg/m2)      − 0.003   
            WC (cm)      0.002   
       1007
F (NR)
M (NR)
  1007    SBP (mmHg)      − 0.001   
            DBP (mmHg)      0.587   
43 Moslehi et al. 2016 Cross-sectional Iran 19–75 F/M 2975
F (1,641)
M (1304)
FFQ 1,007 37 Glucose tolerance abnormality Morbidity Quartile 4 (0.29, 5.23) vs. Quartile 1 (− 5.82, − 2.67) Categorical OR 1.15 (0.90, 1.48) 8 2, 3, 6, 7, 9, 17, 22, 48
         590    IFG      1.09 (0.83, 1.44)   
         259    IGT      1.24 (0.84, 1.81)   
         286    Type 2 diabetes      0.98 (0.66, 1.47)   
         1923    Insulin resistance      1.18 (0.91, 1.51)   2, 3, 6, 7, 9, 17, 22, 48, 54
         2975    FBS levels (mmol/L)   - Continuous β-Coefficient 0.01   
            Postload glucose levels (mmol/L)      0.04   
            Fasting insulin (U/mL)      0.02   
            HOMA-IR      0.02   
            HOMA-B      0.01   
            QUICKI      − 0.02   
25 Naja et al. 2017 Cross-sectional Lebanon  > 18 F/M 330
F (NR)
M (NR)
FFQ 171 25 Abdominal obesity Morbidity Quintile 5 (NR) vs. Quintile 1 (NR) Categorical OR 0.66 (0.29, 1.48) 7 3, 7, 9, 17, 25, 29, 55
         105    Low HDL-C      0.74 (0.31, 1.75)   
         103    Hyper- triglyceridemia      0.84 (0.35, 1.03)   
       329   132    HTN      0.40 (0.23, 1.04)   
       331   151    Hyperglycemia      1.80 (0.80, 4.01)   
       328   114    MetS      0.72 (0.31, 1.67)   
23 Neufcourt et al.. 2015 Cohort France 35–60 F/M 3726
F (2367)
M (1359)
At least 3 valid 24-h dietary records 524 13 36 MetS Morbidity Quartile 4 (mean (IQR) 2.97 (1.27)) vs. Quartile 1 (− 1.76 (1.07)) Categorical OR 1.39 (1.01,1.92) 7 1, 3, 7, 9, 17, 25, 56
22 Ramallal et al.. 2017 Cohort Spain 37.4 F/M 7027
F (4535)
M (2492)
FFQ 1433 overweight (1409)
Obese (24)
10 28 Overweight/Obesity Morbidity Quartile 4 (− 0.59, 4) vs. Quartile 1 (− 5.1, -2.5) Categorical HR 1.32 (1.08, 1.60) 8 1, 2, 3, 7, 9, 17, 34, 35, 36, 39, 57, 58, 59, 60
17 Ramallal et al. 2015 Cohort Spain 38 F/M 18,794
F (NR)
M (NR)
FFQ NR 2 28 HTN Morbidity Quartile 4 (− 0.74, 3.97) vs. Quartile 1 (− 5.14, − 2.68) Categorical OR 1.71 (1.11, 2.64) 7 1, 2, 3, 7, 9, 17, 24, 25, 35, 36, 39, 57
            Hypercholesterolemia      1.04 (0.69, 1.57)   
44 Sen et al. 2018 Cohort USA 2.8- 4.9 F/M 922
F (NR)
M (NR)
FFQ 922 4.5 NR BMI z-score Morbidity - Continues (per 1 point increment in pregnancy DII) β-Coefficient Girls: 0.04 (− 0.09, 0.17)
Boys: 0.16 (0.02, 0.29)
8 9, 17, 25, 18, 53
       775   775    FFM index (kg/m2)      Girls: 0.06 (− 0.13, 0.24)
Boys: 0.19 (− 0.01, 0.39)
  
            FM index (kg/m2)      Girls: 0.14 (− 0.13, 0.40)
Boys: 0.13 (− 0.14, 0.41)
  
            Trunk fat mass index (kg/m2)      Girls: 0.06 (− 0.05, 0.18)
Boys: 0.06 (− 0.06, 0.19)
  
       922   922    WC (cm)      Girls: 0.21 (− 0.77, 1.19)
Boys: 0.93 (− 0.07, 1.92)
  
            SS + Tr (mm)      Girls: 0.31 (− 0.92, 1.53)
Boys: 1.12 (0.01, 2.23)
  
            Fasting insulin (uU/ml)      Girls: -0.06 (− 1.10, 0.97)
Boys: − 0.80 (− 1.85, 0.24)
  
            LDL-C (mg/dl)      Girls: − 0.17 (− 4.11, 3.77)
Boys: − 0.80 (− 1.85, 0.24)
  
       481   481    Mid-childhood metabolic risk score      Girls: 0.04 (− 0.08, 0.16)
Boys: 0.02 (− 0.10, 0.14)
  
28 Sokol et al. 2016 Cross-sectional Poland 45–64 F/M 3862
F (2572)
M (1290)
FFQ 1759 22 Abdominal obesity Morbidity Quartile 4 (− 0.75, 4.00) vs. Quartile 1 (− 4.56,− -2.62) Categorical OR 0.79 (0.61, 1.03) 7 2, 9
               Continuous (per one unit)   0.95 (0.89, 1.02)   
         615    Low HDL-C    Categorical   0.62 (0.48, 0.80)   
               Continuous (per one unit)   0.89 (0.84, 0.95)   
         815    Hyper- triglyceridemia    Categorical   1.04 (0.84, 1.30)   
               Continuous (per one unit)   1.01 (0.95, 1.07)   
         2590    HTN    Categorical   1.05 (0.86, 1.28)   
               Continuous (per one unit)   1.02 (0.97, 1.07)   
         1402    Hyperglycemia    Categorical   1.11 (0.91, 1.34)   
               Continuous (per one unit)   1.04 (0.99, 1.09)   
         1159    MetS    Categorical   0.96 (0.77, 1.19)   
               Continuous (per one unit)   0.99 (0.94, 1.05)   
21 Vahid et al. 2016 Case–control Iran 31–67 F/M 414
F (NR)
M (NR)
FFQ 214 - 27 Pre-diabetes Morbidity Tertile 3 (> − 0.54) vs. Tertile 1 (< − 1.21) Categorical OR 18.88 (7.02, 50.82) 7 1, 2, 3, 7, 9, 17, 25
              - Continuous (per one unit)   3.62 (2.50, 5.22)   
         414    FBS levels (mmol/l)   Tertile 3 (> − 0.54) vs. Tertile 1 (< − 1.21) Categorical β-Coefficient 4.49 (1.89, 7.09)   2, 6, 7, 9, 25, 39, 61, 62
              - Continuous (per one tertile)   2.18 (1.21, 3.15)   
         414    OGTT (mg/dl)   Tertile 3 (> − 0.54) vs. Tertile 1 (< − 1.21) Categorical   8.76 (1.78, 15.73)   
              Continu ous (per one tertile)   4.08 (1.45, 6.71)   
         414    HbA1C (mmol/l)   Tertile 3 (> − 0.54) vs. Tertile 1 (<− -1.21) Categorical   0.30 (0.17, 0.42)   
              - Continuous (per one tertile)   0.12 (0.07, 0.17)   
         414    HDL-C (mg/dl)   Tertile 3 (> − 0.54) vs. Tertile 1 (< − 1.21) Categorical   − 3.39 (− 5.94, − 0.84)   
              Continuous (per one tertile)   − 1.10 (− 2.06, − 0.13)   
         414    LDL-C (mg/dl)   Tertile 3 (>− 0.54) vs. Tertile 1 (<− 1.21) Categorical   16.37 (11.04, 21.69)   
              - Continuous (per one tertile)   5.51 (3.47, 7.54)   
         414    TG (mg/dl)   Tertile 3 (> − 0.54) vs. Tertile 1 (< − 1.21) Categorical   21.01 (8.61, 33.42)   
               Continuous (per one tertile)   12.66 (8.06, 17.27)   
         414    LBM (%)   Tertile 3 (> − 0.54) vs. Tertile 1 (< − 1.21) Categorical   − 3.11 (− 4.83, − 1.39)   
              - Continuous (per one tertile)   − 1.26 (− 1.91, − 0.61)   
         414    Body fat (%)   Tertile 3 (> − 0.54) vs. Tertile 1 (< − 1.21) Categorical   2.41 (0.56, 4.26)   
              - Continuous (per one tertile)   1.10 (0.40, 1.79)   
26 Vissers et al. 2017 Cohort Australia 52 F 7,169 FFQ 1680 12 25 HTN Morbidity DII ≥ 0 vs. DII < 0 Categorical OR 1.24 (1.06, 1.45) 7 1, 2, 3, 6, 7, 9, 25, 40, 45
              - Continuous (per 1 SD increase in DII score)   1.07 (0.99, 1.15)   
  Michael D. Wirth et al. 2014 Cross-sectional United states of America 42.4 ± 8.5 F/M 447
F (112)
M (335)
FFQ 125 - DII (36 food items) MetS Morbidity Presence of at
least three of these components WC of ≥ 102 cm for males or ≥ 88 for females; BP ≥ 130 for systolic or ≥ 85 for diastolic or reported diagno
sed hypertension or antihypertensive medication; HDL-C of < 40 mg/dL in men and < 50 in women; TG
 ≥ 150 mg/dL, and glucose ≥ 100 mg/dL or reported treatment for diabetes
Quartile 4 (2.64, 5.89) vs. Quartile 1 (− 6.27, − 1.26) Categorical OR 0.87 (0.46–1.63)   Age, sex
20 Wirth et al. 2014 Cross-sectional USA 42.4 F/M 447
F (112)
M (335)
FFQ 150 - 36 Abdominal obesity Morbidity Quartile 4 (2.64, 5.89) vs. Quartile 1 (− 6.27, − 1.26) Categorical OR 0.93 (0.52, 1.67) 5 14, 64
       444   185    Low HDL-C      1.03 (0.59, 1.83)   17, 18, 39
       444   136    Hyper-triglyceridemia      0.77 (0.42, 1.42)   17, 18
       447   181    HTN      1.14 (0.64, 2.02)   9, 17, 39
       445   115    Hyperglycemia      2.03 (1.08, 3.82)   9, 17
       444   125    MetS      0.87 (0.46, 1.63)   
46 Tyrovolas et al. 2017 Cross-sectional USA  ≥ 20 F/M 7880
F (NR)
M (NR)
24-h dietary recall NR 27 CVD-RF morbidity index (included obesity, diabetes, hypertension, and hypercholesterolemia. The total number of these risk factors was calculated (range 0–4) for each individual and used as the outcome) Morbidity Quartile 4 (NR) vs. Quartile 1 (NR) Categorical OR 1.39 (1.15, 1.67) 8 3, 7, 9, 17, 18, 25, 29, 33, 59
              Continuous (per one unit)   1.07 (1.03, 1.10)   
19 Wirth et al. 2016 Cross-sectional USA 20–80 F/M 15,666
F (NR)
M (NR)
24-dietary recall 5408 - 27 HTN Morbidity Quartile 4 (1.94, 4.83) vs. Quartile 1 (-5.81, -0.81) Categorical POR 1.19 (1.05, 1.34) 5 2, 7, 9, 46
              - Continuous (per one unit)   1.04 (1.01, 1.06)   
27 Sen et al. 2015 Cohort USA 32.2 F 1779 FFQ 160 6 months 28 Isolated hyperglycemia Morbidity - Continuous (per one unit) OR 0.94 (0.82, 1.07) 7 2, 7, 9, 18, 25, 53
         58    Impaired glucose tolerance      0.88 (0.71, 1.09)   
         96    GDM      0.78 (0.65, 0.95)   
       1775   NR    Inadequate pregnancy weight gain      0.97 (0.86, 1.09)   
            Excessive pregnancy weight gain      0.95 (0.87, 1.03)   
       1772   25    Chronic HTN      0.91 (0.65, 1.28)   
         122    Gestational HTN      0.97 (0.83, 1.14)   
         62    Preeclampsia      1.04 (0.85, 1.26)   
47 Ruiz-Canela et al. 2015 Cross-sectional Spain 56–80 F 4145 FFQ 4145 33 BMI (kg/m2) Morbidity Continues Pearson coefficient (r) 0.06 (0.03, 0.09) 8 1, 3, 6, 7, 9, 22, 25, 29,
            WC (cm)      0.05 (0.02, 0.08)   
            WHtR (%)      0.06 (0.03, 0.09)   
     55–80 M 3091   3091    BMI (kg/m2)      0.05 (0.01, 0.08)   
            WC (cm)      0.08 (0.05, 0.20)   
            WHtR (%)      0.09 (0.06, 0.13)   
48 Camargo-Ramos et al. 2017 Cohort Colombia 39.7 F/M 90
F (NR)
M (NR)
24-dietary record 90 NR 28 DXA total tissue (% fat) Morbidity Categorical (Anti-Inflammatory Diet (− 3.71 to − 0.37) and Inflammatory Diet (0.13–3.64)) Pearson coefficient (r) Anti-inflammatory diet = − 0.122, pro-inflammatory diet = 0.111 7 9, 17
            TC (mg/dL)      Anti-inflammatory diet = -0.210, Pro-inflammatory diet = 0.010   
            TG (mg/dL)      Anti-inflammatory diet = − 0.354, pro-inflammatory diet = − 0.009   
            HDL-C (mg/dL)      Anti-inflammatory diet = − 0.100, Pro-inflammatory diet = 0.028   
            LDL-C (mg/dL)      Anti-Inflammatory Diet = 0.350, Pro-Inflammatory Diet = -0.084   
            FBS (mg/dL)      Anti-inflammatory diet = − 0.422, pro-inflammatory diet = − 0.228   
            MetScore      Anti-inflammatory diet = − 0.282, pro-inflammatory diet = 0.410   
            HbAc1 (%)      Anti-inflammatory diet = 0.004, pro-inflammatory diet = 0.090   
            FMD (%)      Anti-inflammatory diet = 0.261, pro-inflammatory diet = − 0.233   
            PWV (m/s)      Anti-inflammatory diet =− 0.437, pro-inflammatory diet = 0.014   
            Aortic SBP (mm Hg)      Anti-inflammatory diet =− 0.271 pro-inflammatory diet = − 0.126   
            Aortic pulse pressure (mm Hg)      Anti-inflammatory diet =− 0.271, pro-inflammatory diet = − 0.055   
            Brachial augmentation index (%)      Anti-inflammatory diet = − 0.300, pro-inflammatory diet = − 0.209   
            Aortic augmentation index (%)      Anti-inflammatory diet = − 0.299, pro-inflammatory diet = − 0.064   
            MAP (mm Hg)      Anti-inflammatory diet = − 0.011, pro-inflammatory diet = 0.079   
49 Cantero et al. 2017 Cross-sectional Spain 55–80 F/M 794
F (NR)
M (NR)
FFQ 794 NR BMI (kg/m2) Morbidity Continues Pearson coefficient (r) 0.130 8 NR
50 Tabung et al. 2017 Cross-sectional USA 25–42 F 3985 FFQ 3985 38 Adiponectin Morbidity Continues Pearson coefficient (r) − 0.10 8 NR
     40–75 M 4176   4176         − 0.05   
58 Abdurahman et al. 2018 Cross-sectional Iran 19–59 F/M 277
F (233)
M (44)
FFQ 176 32 MUO Morbidity Quartile 4 (7.98) vs. Quartile 1 (− 8.87) Categorical OR 2.58 (1.19, 5.59) 8 2, 3, 9, 17, 65
              - Continues (per one quartile)   1.18 (1.01, 1.39)   
         NR    Abdominal obesity   Quartile 4 (7.98) vs. Quartile 1 (− 8.87) Categorical   0.58 (0.16, 2.05)   
              - Continues (per one quartile)   0.91 (0.73, 1.14)   
         NR    Low HDL-C   Quartile 4 (7.98) vs. Quartile 1 (− 8.87) Categorical   1.19 (0.55, 2.57)   
              - Continues (per one quartile)   1.01 (0.87, 1.18)   
         NR    Hyper- triglyceridemia   Quartile 4 (7.98) vs. Quartile 1 (− 8.87) Categorical   1.66 (0.82, 3.37)   
              - Continues (per one quartile)   1.11 (0.95, 1.13)   
         NR    HTN   Quartile 4 (7.98) vs. Quartile 1 (− 8.87) Categorical   1.66 (0.83, 3.34)   
              Continues (per one quartile)   1.11 (0.96, 1.29)   
         NR    Hyperglycemia   Quartile 4 (7.98) vs. Quartile 1 (− 8.87) Categorical   1.89 (0.92, 3.91)   
              - Continues (per one quartile)   1.13 (0.97, 1.32)   
59 Andrade et al. 2018 Cohort Brazil 43.0 F 132 24-h dietary recall 132 0.5 21 Postoperative weight (kg) Morbidity - Continues (Per one unit) β-coefficient 2.02 (0.33, 3.70) 7 1, 9
            Postoperative body fat mass (kg)      1.78 (0.51, 3.04)   
60 Aslani et al. 2018 Cross-sectional Iran 6–18 F/M 5427
F (2,541)
M (2,886)
FFQ 5427 25 BMI z-score Morbidity Quartile 4 (1.50 to 4.26) vs. Quartile 1 (− 4.42 to − 1.63) Categorical β-coefficient 0.07 (0.01, 0.14) 8 2, 9, 11, 17, 36, 41
              - Continues (per one quartile)   0.01 (-0.002, 0.04)   
            Wrist Circumference (cm)   Quartile 4 (1.50 to 4.26) vs. Quartile 1 (− 4.42 to − 1.63) Categorical   0.06 (− 0.09, 0.21)   
              - Continues (per one quartile)   0.03 (− 0.01, 0.08)   
            NC (cm)   Quartile 4 (1.50 to 4.26) vs. Quartile 1 (− 4.42 to − 1.63) Categorical   − 0.08 (− 0.43, 0.26)   
              Continues (per one quartile)   0.00 (− 0.11, 0.11)   
            WC (cm)   Quartile 4 (1.50 to 4.26) vs. Quartile 1 (− 4.42 to − 1.63) Categorical   0.89 (0.07, 1.70)   
              - Continues (per one quartile)   0.27 (0.01, 0.53)   
            HC (cm)   Quartile 4 (1.50 to 4.26) vs. Quartile 1 (− 4.42 to − 1.63) Categorical   1.13 (0.29, 1.96)   
              - Continues (per one quartile)   0.39 (0.13, 0.65)   
            WHR   Quartile 4 (1.50 to 4.26) vs. Quartile 1 (− 4.42 to − 1.63) Categorical   0.00 (− 0.01, 0.01)   
              - Continues (per one quartile)   − 0.001 (− 0.004, 0.002)   
            WHtR   Quartile 4 (1.50 to 4.26) vs. Quartile 1 (− 4.42 to − 1.63) Categorical   0.004 (− 0.01, 0.02)   
              - Continues (per one quartile)   0.002 (− 0.04, 0.009)   
            Parental BMI (kg/m2)   Quartile 4 (1.50 to 4.26) vs. Quartile 1 (− 4.42 to − 1.63) Categorical   1.05 (0.61, 1.49)   
              - Continues (per one quartile)   0.34 (0.20, 0.48)   
61 Carvalho
et al. 2018
Cross-sectional Brazil 23–25 F 1,034 FFQ 110 35 Insulin resistance Morbidity - Continues (per one unit) PR 0.96 (0.87, 1.07) 7 9, 53
         67    MetS      1.05 (0.91, 1.20)   
      M 942   134    Insulin resistance      0.98 (0.89, 1.08)   
         180    MetS      0.98 (0.91, 1.07)   
62 Phillips et al. 2018 Cross-sectional Ireland 50–69 F/M 1992
F (1016)
M (976)
FFQ NR 26 MetS Morbidity  < Median DII (− 5.10 to − 1.28) vs  > Median DII (− 1.28 to 3.68) Categorical OR 1.37 (1.01, 1.88) 8 2, 9, 17, 66
            large VLDL particles (nmol/L)      1.28 (1.07, 1.54)   
            small HDL particle size (nmol/L)      1.45 (1.21, 1.74)   
            small LDL particle size (nmol/L)      1.54 (1.28, 1.84)   
            Lipoprotein Insulin Resistance score      1.24 (1.10, 1.50)   
63 Correa-Rodríguez et al. 2018 Cross-sectional Spain 18–25 F/M 599
F (414)
M (185)
72-h dietary recall 599 25 BMI (kg/m2) Morbidity Continues (per one unit) β-coefficient − 0.073 (− 0.487, 0.026) 7 1, 9, 17
            FM (kg)      − 0.074 (− 1.052, 0.050)   
            PFM (%)      − 0.047 (0.845, 0.170)   
            FFM (kg)      − 0.059 (− 0.842, − 0.107)   
            VFR      − 0.017 (− 0.217, 0.142)   
64 Denova-Gutiérrez et al. 2018 Cross-sectional Mexico 20–69 F/M 1174
F (515)
M (659)
Semi-quantitative FFQ 201 27 T2DM Morbidity Quintile 5 (NR) vs. Quintile 1 (NR) Categorical OR 3.02 (1.39, 6.58) 8 2, 3, 6, 9, 11, 17, 22, 25, 27, 36, 39, 66, 69
65 Abbasalizad Farhangi et al. 2018 Cross-sectional Iran 35–80 F 120 FFQ 120 28 HbA1C (%) Morbidity Quartile 4) − 29.83 to ≤− 15.05) vs. Quartile 1(− 0.19 to ≤ 7.01( Categorical β-coefficient 0.88 (0.59, 1. 31) 6 2, 6, 9, 17, 25, 67
            TC (mg/dl)      0.67 (0.34, 1.37)   
            TG (mg/dl)      1.08 (0.94, 1.25)   
            LDL-C (mg/dl)      1.46 (0.72, 2.97)   
            HDL-C (mg/dl)      1.42 (0.70, 2.88)   
            Lipoprotein (a) (mg/dl)      0.98 (0.96, 1.00)   
      M 332   332    HbA1C (%)      0.89 (0.71–1.12)   
            TC (mg/dl)      1.02 (0.99–1.04)   
            TG (mg/dl)      0.99 (0.98–0.99)   
            LDL-C (mg/dl)      1.001 (0.98–1.02)   
            HDL-C (mg/dl)       − 0.95 (0.91–1.00)   
            Lipoprotein (a) (mg/dl)      1.01 (0.99–1.02)   
66 Luglio Muhammad et al. 2018 Cross-sectional Indonesia 19–56 F/M 503 FFQ 503 30 BMI (kg/m2) Morbidity Continues (per one unit) β-coefficient (SE) − 0.08 (0.036) 6 1, 2, 3, 9, 17
            Body weight (kg)      − 0.03 (0.09)   
            Body fat (%)      − 0.04 (0.04)   
            WC (cm)      − 0.04 (0.09)   
            HC (cm)      − 0.04 (0.07)   
            SBP (mmHg)      0.03 (0.16)   
            DBP (mmHg)      0.04 (0.10)   
            TG (mmol/L)      0.04 (0.006)   
            HDL-C (mmol/L)      − 0.04 (0.004)   
67 Alam et al. 2018 Cross-sectional Pakistan 54–95 M 651 24-dietary recall 651 NR Body weight (kg) Morbidity - Categorical Tertile 3 (Mean ± SD) 69.05 ± 10.2 8 -
            BMI (kg/m2)      24 ± 1.8   
            WC (cm)      85.5 ± 7.4   
            WHR      0.99 ± 0.11   
68 Kim et al. 2018 Cross-sectional Korea 19–65 F 5609 24-h dietary recall 1044 23 Abdominal obesity Morbidity Quartile 4 (≥ 1.28) vs. Quartile 1 (< -0.85) Categorical OR 1.35 (0.94, 1.94) 8 1, 2, 3, 7, 9, 25, 39
         2092    Low HDL-C      0.85 (0.71, 1.04)   
         1060    Hyper- triglyceridemia      1.07 (0.84, 1.38)   
         1335    HTN      1.10 (0.87, 1.38)   
         1292    Hyperglycemia      0.95 (0.77, 1.18)   
         966    MetS      1.22 (0.91, 1.64)   
      M 3682   1010    Abdominal obesity   Q4 (≥ 1.89) vs. Q1 (< − 0.16)    1.07 (0.72, 1.61)   
         902    Low HDL-C      0.93 (0.71, 1.21)   
         1489    Hyper- triglyceridemia      1.22 (0.97, 1.53)   
         1429    HTN      1.14 (0.88, 1.46)   
         1384    Hyperglycemia      1.30 (1.02, 1.65)   
         1043    MetS      1.40 (1.06, 1.85)   
69 Correa-Rodriguez et al. 2018 Cross-sectional Spain 9–17 F/M 428
F (242)
M (186)
24-h dietary recall 428 28 BMI z-score Morbidity Continues (per one unit) β-coefficient 0.084 (− 0.015, 0.116) 7 1, 9, 17
            WC (cm)      0.100 (− 0.060, 1.296)   
            WHtR      0.128 (0.001, 0.016)   
            WHR      0.004 (− 0.004, 0.004)   
            FM (kg)      0.069 (− 0.182, 0.859)   
            PFM (%)      0.050 (− 0.318, 0.885)   
            FFM (kg)      0.045 (− 0.240, 0.735)   
            SBP (msmHg)      0.010 (− 0.933, 1.114)   
            DBP (mmHg)      − 0.032 (− 0.960, 0.540)   
70 Mazidi et al. 2018 Cross-sectional USA  ≥ 18 F/M 17,689
F (9,082)
M (8,607)
24-h dietary recall NR 18 MetS Morbidity Q4 (1.62 to 4.24) vs. Q1 (− 5.66 to -1.04) Categorical OR 1.23 (1.07, 1.41) 8 1, 2, 7, 9, 17, 18, 25, 29
            Obesity      1.28 (1.17, 1.52)   
            HTN      1.21 (1.02, 1.43)   
71 Mirmajidi et al .2018 Cross-sectional Iran 18–60 F/M 150
F (74)
M (76)
FFQ 150   34 BMI (kg/m2) Morbidity - Continuous (per one unit) β-coefficient 0.351 (0.258, 1.247) 6 1, 3, 9, 17
            FBS (mg/dl)      0.402 (0.826, 3.040)   
            Insulin (mg/dl)      0.166 (− 0.425, 2.217)   
            HOMA-IR (mg/dl)      0.214 (− 0.038, 0.590)   
            HOMA-B (mg/dl)      0.112 (− 0.160, 0.433)   
            QUICKI      − 0.239 (− 0.009, 0.000)   
            Chemerin (ng/mL)      0.317 (59.09, 331.45)   
            Omentin (ng/ml)      − 0.192 (29.272, 3.405)   
            LBP (mg/ml)      0.223 (0.469, 3.146)   
72 Moe San et al. 2018 Cross-sectional Myanmar 25–60 F 244 24-h dietary recall and Semi-quantitative FFQ 116 31 High BMI Morbidity Higher DII (> 1.07) vs. lower DII (< 1.07) Categorical OR 1.40 (0.80, 2.30) 6 2, 9, 29, 68
         91    Abdominal obesity      1.40 (0.80, 2.40)   
         196    Body fat mass      1.10 (0.50, 2.10)   
73 Nikniaz Et al. 2018 Cross-sectional Iran 18–64 F/M 606
F (324)
M (282)
FFQ NR 30 Abdominal obesity Morbidity Quartile 4 (NR) vs. Quartile 1 (NR) Categorical OR 0.86 (0.39, 1.91) 7 2, 3, 7, 9, 17
            Low HDL-C      0.83 (0.44, 1.55)   
            Hyper- triglyceridemia      1.31 (0.66, 2.58)   
            HTN      1.18 (0.47, 2.96)   
            Hyperglycemia      2.56 (1.01, 7.05)   
            MetS      2.26 (1.03, 4.92)   
75 Park et al. 2018 Cross-sectional Korea  ≥ 50 F 1344 24-h dietary recall 334 - 42 Osteopenic obesity Morbidity Higher DII (> − 0.07) vs. lower DII (≤ − 0.07) Categorical OR 2.757 (1.398, 5.438) 8 2, 7, 9, 25, 37, 53
         110    Sarcopenic obesity      1.968 (0.951, 4.073)   
         445    Steosarcopenic obesity      2.186 (1.182, 4.044)   
74 Shivappa et al. 2018 Case–control Iran 18–40 F 388 FFQ 122 32 GDM Morbidity Tertile 3 (> − 0.38) vs. tertile 1 (≤ − 1.32) Categorical OR 2.10 (1.02, 4.34) 7 1, 2, 3, 6, 7, 9, 27
              - Continuous (per one unit)   1.20 (0.94, 1.54)   
45 Winkvist et al. 2018 Cohort Sweden 30–60 F 8345 FFQ NR 10 30 BMI (kg/m2) Morbidity - Continuous (per one percent) β-coefficient ± SE 0.000 ± 0.001 8 3, 7, 9, 25, 63
            TG (mmol/l)      0.000 ± 0.000   
            TC (mmol/l)      0.000 ± 0.000   
            SBP (mmHg)       − 0.006 ± 0.003   
      M 7641      BMI (kg/m2)      0.000 ± 0.001   
            TG (mmol/l)      0.000 ± 0.000   
            TC (mmol/l)      0.000 ± 0.000   
            SBP (mmHg)      − 0.001 ± 0.004   
76 Ren et al. 2018a Cross- sectional China 18–75 F/M 1712
F (1130)
M (582)
24-h dietary recall NR 21 Abdominal obesity Morbidity Tertile 3 (1.12 to 3.49) vs. tertile 1 − 3.50 to 0.04) Categorical OR 0.86 (0.59–1.24) 8 2, 7, 9, 17, 25
              - Continues (per one unit)   0.93 (0.81–1.06)   
            Low HDL-C   Tertile 3 (1.12 to 3.49) vs. tertile 1 − 3.50 to 0.04) Categorical   1.17 (0.88–1.56)   
              - Continues (per one unit)   1.02 (0.92–1.12)   
            Hyper- triglyceridemia   Tertile 3 (1.12 to 3.49) vs. tertile 1 − 3.50 to 0.04) Categorical   1.03 (0.78–1.37)   
              - Continues (per one unit)   0.99 (0.90–1.09)   
            HTN   Tertile 3 (1.12 to 3.49) vs. tertile 1 -3.50 to 0.04) Categorical   1.40 (1.03–1.89)   
              - Continues (per one unit)   1.06 (0.96–1.18)   
            Hyperglycemia   Tertile 3 (1.12 to 3.49) vs. tertile 1 − 3.50 to 0.04) Categorical   0.85 (0.64–1.14)   
              - Continues (per one unit)   0.91 (0.82–1.00)   
            MetS   Tertile 3 (1.12 to 3.49) vs. tertile 1 − 3.50 to 0.04) Categorical   1.02 (0.75–1.40)   
              - Continues (per one unit)   0.93 (0.83–1.04)   
  1. 1—total energy intake, 2—body mass index, 3—physical activity, 4—systolic blood pressure, 5—total cholesterol, 6—diabetes, 7—smoking, 8—postsecondary academic education, 9—age, 10—energy expended in physical activity, 11—socioeconomic status, 12—use of low-dose aspirin, 13—use of antihypertensive medication, 14—use of statins, 15—prevalent atherosclerotic vascular disease, 16—treatment code, 17—sex, 18—race, 19—HbA1c, 20—overweight/obesity, 21—waist to height ratio, 22—hypertension, 23—dyslipidemia, 24—family history of premature cardiovascular disease, 25—educational level, 26—stratified by intervention group and center, 27—supplementation, 28—number of 24-h records, 29—marital status, 30—treatment allocation group (placebo or active), 31—diastolic blood pressure, 32—waist circumference, 33—previous history of other cardiovascular diseases, 34—following a special diet, 35—hours spent sitting down, 36—hours spent watching television, 37—hormone replacement therapy use, 38—prevalent cancer (yes/no), 39—alcohol intake, 40—survey number, 41—place of residence, 42—ratio of total cholesterol and high density lipoprotein cholesterol, 43—poverty index, 44—coffee consumption, 45—menopausal status, 46—family member, 47—occupational grade, 48—use of lipid-lowering drugs, 49—high density lipoprotein cholesterol, 50—longstanding illness, 51—country of birth, 52—socio-economic indexes for areas quintile, 53—income, 54—glucose lowering medication, 55—crowding index, 56—number of available dietary records, 57—snacking between meals, 58—parental history of obesity, 59—depression (previous or incident), 60—analgesic use, 61—triglyceride, 62—low density lipoprotein cholesterol, 63—year of study participation, 64—years of police work, 65—history of chronic diseases, 66—medication use, 67—myocardial infarctioyn, 68—use of contraceptives, 69—tobacco use
  2. CMRFs cardio-metabolic risk factors, DII dietary inflammatory index, F female, M male, FFQ food frequency questionnaire, HDL-C high density lipoprotein-cholesterol, LDL-C low density lipoprotein-cholesterol, VLDL very low density lipoprotein, LBP lipopolysaccharide-binding protein, TC total cholesterol, TG triglyceride, TC total cholesterol, HTN hypertension, SBP systolic blood pressure, DBP diastolic blood pressure, MetS metabolic syndrome, OR odds ratio, HbA1c glycated hemoglobin, FBS fasting blood sugar, HOMA-IR homeostasis model assessment of insulin resistance, HOMA-B homeostatic model assessment of β-cell function, QUICKI quantitative insulin-sensitivity check index, IFG impaired fasting glucose, IGT impaired glucose tolerance, OGTT oral glucose tolerance test, GDM gestational diabetes mellitus, BMI body mass index, WC waist circumference, HC hip circumference, WHR waist to hip circumference, WHtR waist to height ratio, FM fat mass, FFM fat free mass, PFM percentage fat mass, VFR visceral fat ratio, SS+Tr subscapular + triceps skinfold thickness, LBM lean body mass, DXA Dual energy X-ray absorptiometry, FMD flow-mediated vasodilation, PWV pulse wave velocity, MAP mean arterial pressure, MUO metabolically unhealthy obese, NR Not reported