The present study investigated the association between FBS and INQ in adult women. There was a significant difference between the INQ of vitamin A, Mg, zinc, vitamin K, Mn, and selenium with FBS after adjustments for age, gender, BMI, menopausal status, and total energy intake. Similar to this study, some studies found that vitamin A has both antioxidant and antihyperglycemic potential and, therefore, can be considered a hypoglycemic factor (34, 35). Vitamin A can impact T2DM pathogenesis through several potential molecular mechanisms, including chelation of oxide radicals, improves insulin sensitivity, and beta-cell regeneration (36). Shidfar et al., on the other hand, discovered no correlation between FBS and vitamin A in 48 diabetes mellitus type 1 (DMTI) patients (37). Jafarirad et al. Regarding the association of FBS and dietary phosphorus, Fang et al. 2 diabetic group was significantly lower than that in the control group (46). Besides, Duan et al. T2DM (47). However, other research found that phosphorus had no significant influence on T2DM (48). For instance, one research discovered that diabetic rats also had increased plasma phosphorus amounts (49). The reason for the difference in results may be related to the study population and some of which were performed on animals (49). Phosphorus concentration is a determining factor in regulating the metabolism and rate of oxygen consumption.
In terms of the association between of FBS and Zn, a negative association was found between serum Zn with FBS. Low Zn levels were reported to be associated with poor glycemic control and poor glycemic control is a strong predictor of Zn deficiency (51). Another study reported that there is no definite cause-and-effectrelationship between Zn and the level of FBS (52). The reduced concentration of Zn in T2DM was indicated by Saharia and Goswami (53), which was in line with the present study. Al-Maroof and Al-Sharbatti (54) also reported that Zn levels were lower in diabetic patients compared to the controls, and a strong negative relationship was found between glycosylated hemoglobin levels of diabetic patients with their serum Zn levels. Similar with the results of the present study, high circulating levels of vitamin K were reported to be related to a lower risk of the high amount of FBS (57). Some studies found a lower risk for diabetes mellitus in people with higher vitamin K intakes (58, 59). Rees et al.
60) in a systematic review of studies that evaluated the association of vitamin K deficiency with T2DM concluded that there is no evidence of an effect of vitamin K and a higher level of FBS. The differences in the obtained results can be related to the study population since some studies have been done on diabetics and some others on healthy people. Vitamin K has been shown to reduce insulin resistance by inhibiting inflammation. Tan et al. revealed that pregnant women with impaired glucose tolerance (IGT) or gestational diabetes mellitus (GDM) had lower Glyco Care blood sugar formula selenium levels and discovered an inverse association between FBS and serum selenium levels (65), which was in line with the present study. Moreover, a higher intake of manganese was frequently reported to be associated with a lower level of FBS (68-70). However, another study found that both low and high levels of plasma manganese were associated with higher levels of FBS (71). Manganese plays significant roles in multiple physiological functions, including glucose and Glyco Caresmetabolic wellness lipid metabolism, insulin production, and insulin secretion.
To the best of our knowledge, few studies investigated the association between FBS and the quality of diet. The strengths of the present study were its acceptable sample size and using the index of nutritional quality. However, the results may be affected by some limitations. This study was a cross-sectional study, which could not explain the causal relationship. Future prospective studies should be performed to establish a causal relationship between FBS and the INQ in adult women. Moreover, this study was performed on young women and cannot be generalized to the public. In addition, the semi-quantitative FFQ is not the best indicator to know the amount of micronutrients that are being ingested and, probably, it would be more indicated to carry out an intake analysis with double weighing in future studies. The present study provides the first evidence for an association between FBS and the INQ in adult women. According to the findings of the study, there was a significant inverse association between FBS and the INQ of vitamin A, Mg, P, zinc, vitamin K, Mn, and Se. Prospective cohort studies should be performed to establish a causal relationship between FBS and INQ in adult women.