The association of dietary insulin index and carbohydrate quality index with body composition among Paralympic athletes with hemophilia or hemodialysis: a cross-sectional Study

Abstract

Results: Multiple linear regression analysis revealed a significant association between DII and some BIA-derived parameters such as body fat mass (BFM) (P = 0.02) and percent body fat (PBF) (P = 0.006), as well as PBF measurements from the 7-point method (P = 0.03) in athletes with hemophilia. Additionally, DII was significantly associated with certain parameters obtained from the BIA method in athletes undergoing hemodialysis, including fat-free mass (FFM) (P = 0.005), percent fat-free mass (PFFM) (P = 0.01), and percent muscle mass (PMM) (P = 0.005). However, no significant association was found between CQI and body composition in athletes with hemophilia or those undergoing hemodialysis. Conclusion: This study indicates that DII was positively associated with BFM and PBF in athletes with hemophilia. Moreover, an inverse association was reported between DII with FFM and PMM in athletes undergoing hemodialysis. However, no significant association was observed between CQI and body composition in athletes with hemophilia or those undergoing hemodialysis. Further prospective studies are needed to confirm these data.

Key words: dietary insulin index (DII), carbohydrate quality index (CQI), body composition, Paralympic athletes, hemophilia, hemodialysis

ABSTRACT Background: Diet is an essential component, influencing both health and athletic performance. Additionally, body composition, a key indicator of nutritional status, is also considered a crucial determinant of success in sports. Thus, evaluating the dietary patterns of athletes, particularly those with health issues, is critically important. Nutritional indices such as the dietary insulin index (DII) and carbohydrate quality index (CQI) are effective measures of diet quality. However, limited studies have explored the relationship of these indices with body composition. Therefore, this study aimed to investigate the association of DII and CQI with body composition among Paralympic athletes with hemophilia or those undergoing hemodialysis. Methods: This cross-sectional study involved 100 Paralympic athletes aged 25-45 years, who were recruited through convenience sampling. DII and CQI were computed based on data from a 147-item semi-quantitative food frequency questionnaire. Anthropometric and body composition parameters were assessed using two methods: bioelectrical impedance analysis (BIA) (TANITA BC-418) and skinfold thickness measurements at seven sites (pectoral, axillary, abdominal, suprailiac, subscapular, thigh, and triceps). The Pearson correlation coefficient was utilized to examine the relationship of DII and CQI with body composition. A multiple linear regression model was then applied to adjust for potential confounding variables, including age, gender, sleep patterns, physical activity levels, and smoking status.