The mediatory role of inflammatory markers on the relationship between the NOVA classification system and obesity phenotypes among obese and overweight adult women: a cross-sectional study

Mahya Mehri Hajmir; Farideh Shiraseb; Dorsa Hosseininasab; Yasaman Aali; Shabnam Hosseini; Khadijeh Mirzaei

doi:10.3389/fnut.2023.1226162

The mediatory role of inflammatory markers on the relationship between the NOVA classification system and obesity phenotypes among obese and overweight adult women: a cross-sectional study

Front Nutr. 2023 Dec 11:10:1226162. doi: 10.3389/fnut.2023.1226162. eCollection 2023.

Authors

Mahya Mehri Hajmir¹, Farideh Shiraseb², Dorsa Hosseininasab³, Yasaman Aali², Shabnam Hosseini⁴, Khadijeh Mirzaei^{2

5}

Affiliations

¹ Students' Scientific Center, Tehran University of Medical Sciences, Tehran, Iran.
² Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
³ Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran.
⁴ School of Human Nutrition, McGill University, Quebec, QC, Canada.
⁵ Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background: Diet and inflammation both play important roles in the occurrence of obesity. We aimed to investigate the role of inflammation in the development of both metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) individuals.

Methods: This cross-sectional study included 221 overweight and obese women aged 18-56 years. The study assessed the metabolic health phenotypes of the participants using the Karelis criterion score. Additionally, dietary intakes were evaluated using a 147-item semi-quantitative questionnaire and the NOVA classification system (comprising 37 food groups and beverages). The study also collected and analyzed the blood parameters, as well as biochemical and anthropometric indices, for all participants.

Results: Among the women included in the study, 22.9% had MHO phenotypes but 77.1% had MUHO phenotypes. A significant association between the third quartile of the NOVA classification system and the increased likelihood of having the MUHO phenotype was observed (OR = 1.40, 95% CI = 1.09-4.92, p = 0.04). Regarding the potential role of inflammatory markers, high-sensitivity C-reactive protein (hs-CRP) (p = 0.84), transforming growth factor-β (TGF-β) (p = 0.50), monocyte chemoattractant protein-1 (MCP-1) (p = 0.49), plasminogen activator inhibitor-1 (PAI-1) (p = 0.97), and homeostatic model assessment for insulin resistance (HOMA-IR) (p = 0.92) were found to be mediators.

Conclusion: We observed a significant positive association between ultra-processed food (UPF) consumption and the MUHO phenotype in overweight and obese women. This association appeared to be mediated by some inflammatory markers, such as hs-CRP, TGF-β, MCP-1, PAI-1, and HOMA-IR. Additional studies are needed to validate these findings.

Keywords: NOVA classification system; inflammatory markers; metabolic healthy and unhealthy women; phenotypes; ultra-processed foods.

Grants and funding

This study is funded by grants from the TUMS, Tehran, Iran (Grant ID: 98–3–212-46718).