ArticleNutrients2026
A Global Nutritional Tool for Monitoring Westernized Dietary Transition: Validation of the Westernized Diet Index Using a Large Population Sample and Biomarkers of Metabolic Health.
Article in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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4 authors.
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Abstract
backgroundDietary transitions toward Westernized patterns (WDPs) (high in processed foods, sugars, and fats) pose a global public health challenge. The Westernized Diet Index (WDI) measures adherence to these patterns. However, its validity with respect to metabolic biomarkers warrants thorough evaluation for use in epidemiological and clinical research.
objectivesThis study validates the WDI using metabolic biomarkers (including anthropometrics, blood pressure, fasting blood glucose (FBG), triglycerides, HDL-c, LDL-c, and total cholesterol), examines its association with metabolic syndrome (MetS), and compares scoring methods to identify the most effective measure of WDPs adherence.
methodsData from 10,146 participants in the Fasa Adult Cohort Study (FACS) were used. We calculated the WDI using global (WDI-G) and population (WDI-P) Z scores and food group (WDI-FG)-based algorithms. Validation employed logistic and linear regression, ROC (receiver operating characteristic) curves, Youden's index, and k-means clustering.
resultsAll WDI scoring methods (across all methods, higher scores indicated lower adherence to WDPs) demonstrated a strong, significant association with all three MetS definitions (WHO, NCEP: ATPIII, and IDF) and nearly all investigated metabolic biomarkers. In fully adjusted logistic models, WDI Global (WDI-G) (OR: 0.23) and WDI Food Groups (WDI-FG) (OR: 0.26) were significantly associated with MetS (based on the WHO definition). Also, in fully adjusted linear regression models, a 10% increase (reflecting lower adherence to WDPs) in the WDI-G score (range: -2.03 to 1.11) was significantly associated with a 3.96 mg/dL reduction in FBG and a 2.61 cm reduction in waist circumference. Additionally, ROC curves (AUC: 0.57-0.61) demonstrated that WDI predicts MetS with moderate accuracy. The strongest associations were observed with population-based scoring. In addition, based on comparative performance, WDI-G, WDI-P, and WDI-FG appear most suitable for cross-population, within-cohort, and mechanistic or intervention-focused research, respectively.
conclusionsThe WDI shows promise as a nutritional tool for assessing adherence to WDPs and exploring associations with metabolic health outcomes, including MetS. These findings suggest that the WDI may be useful in future dietary, public health, and clinical research, although further validation in diverse populations is warranted.
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