The Association between Healthy Beverage Index and Healthy and Unhealthy Obesity Phenotypes among Obese Women: A Cross-Sectional Study

Abstract

Background. Metabolic phenotypes are new dimensions of obesity. Two important types of these phenotypes are metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). Studies showed that the components of the healthy beverage index (HBI) such as sugar-sweetened beverages (SSBs), milk, and fruit juices might have an association with MHO and MUO phenotypes. Methods. This cross-sectional study was performed on 210 women with the age range of 18–65 years and a body mass index (BMI) ≥25 kg/m2. The age range of the study population was the main inclusion criterion. Dietary intakes were assessed using a 147-item food frequency questionnaire (FFQ), as well as biochemistry and anthropometric parameters, in all participants. Metabolic health phenotypes were considered using the Karelis score, whilst HBI was evaluated based on 8 categories of beverages consumed. Analysis was carried out using binary logistic regression. Result. After controlling for a wide variety of confounding variables such as age, energy intake, BMI, education, physical activity, marriage, economic status, job, and supplementation, we found that the participants in the highest tertile of HBI had a lower risk of abnormal metabolic status than those in the lowest tertile (OR = 0.49; 95% CI: 0.07–3.21; $P$ trend: 0.04), and it was not statistically significant, but we saw a significant trend. Conclusion. In conclusion, it seems that higher adherence to HBI can minimize the risk of metabolic abnormality, based on a significant trend.