Association Between Diet Quality Enhancement and Lower Metabolic Endotoxemia in Women with Different Body Mass Index: A Case-Control Study

Background: Chronic low-grade inflammation can cause obesity, with diet playing an important role in promoting or reducing inflammation. Primary Study Objective: Examining the relationship between diet quality and the soluble cluster of differentiation 14 (sCD14), lipopolysaccharide (LPS), lipopolysaccharide binding protein (LBP), and toll-like receptor-4 (TLR4) levels in obese individuals compared to healthy people. Methods/Design: Body weight, height, waist, hip, and neck circumference were measured, and body mass index (BMI), waist/hip, and waist/height ratio were calculated. Tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), high sensitive C-reactive protein (hs-CRP), LPS, LBP, sCD14, and TLR4 were analysed. Diet Quality Index-International was calculated using the 3-day food consumption record. Setting: Conducted in Ankara Numune Training and Research Hospital Endocrine Outpatient Clinic in Turkey. Participants: 40 women of ages 20-45 with no systemic disease and a BMI between 30.0-39.9 kg/m2 were enrolled in the case group; while 40 healthy women with BMI and age distribution similar to the case group were enrolled in the control group. Intervention: Anthropometric measurements, blood samples, and food consumption records were collected. Results: While there was no statistically significant difference between the case and control groups in serum sCD14, LPS, LBP, and TLR4 levels (P > .05), the difference in IL-6, TNF-α, and hsCRP levels was found to be statistically significant (P < .05). The mean Diet Quality Index-International total score was 49.88 ± 6.29 in the case group and 54.77 ± 7.41 in the control group (P < .05). A low-level, negative, but significant relationship was detected between the serum sCD14, LBP, and TLR4 means of the case and control groups and Diet Quality Index-International total score. It was determined that a high Diet Quality Index-International total score was correlated with decreased IL-6, TNF-α, hsCRP, sCD14, and TLR4. Conclusion: Increased nutritional quality in women with different BMI was associated with lower metabolic endotoxemia.