Worldwide, the incidence of obesity is significantly rising and is a serious public health problem. It is described as an accumulation of extra body fat that causes serious medical conditions (1, 2). The prevalence of overweight and obesity is high, both in developed and developing countries. In several local surveys in subregions and clinical populations in Iraq, high proportions of obesity have been reported. In a community-based survey (N = 1,480 adults in 2017) in Erbil city, Iraq, the prevalence of overweight was 33.4% and obesity was 40.9%, and in Basrah, Southern Iraq (2003–2010), overweight/obesity was 55.1% (3).

Diet is a modifiable risk factor for obesity. Several research have studied the links between adherence to healthy dietary patterns including Dietary Approaches to Stop Hypertension (DASH) diet (4) and the Mediterranean diet (MD) (5). According to specific research, following the DASH diet was strongly related to body mass index (BMI), serum triglycerides (TG), and HDL cholesterol (6). While adherence to the MD diet was inversely linked with obesity and BMI in the Spanish population, it was not associated with BMI in a large sample of Europeans (7). Moreover, central obesity was negatively correlated with DASH diet adherence, but not overall obesity (8). After 2 months of management with the DASH diet, patients with non-alcoholic fatty livers reported lower weight and BMI (9).

The MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet, based on nourishing and harmful foods for the brain, has recently been proposed (10). It includes 15 components, of which 10 are brain-healthy foods (green leafy vegetables, other vegetables, berries, nuts, beans, whole grains, fish, poultry, olive oil, and wine) and 5 are brain-unhealthy foods (cheese, butter or margarine, fast foods or fried foods, red meat, and pastries or sweets). This food pattern has yet to be extensively studied in the context of chronic diseases. Most studies have discovered a link between strong adherence to this diet and physical activity (PA) and slower cognitive aging, reduced risk of Alzheimer’s disease (11–14). Although the relationship between the DASH and MD diets and obesity has been separately assessed (15, 16), no study is available linking the MIND diet to obesity and lipid profiles. Therefore, we aimed to investigate the association between the use and adherence to the MIND diet with general obesity and blood lipid profiles in Kurdish adults.

Of the 1,328 participants in the study, 686 (51.60%) were female. Most of the participants 637 (47.96%) had moderate physical activity. Significant differences were observed between the three tertiles in terms of BMI, TG, and HDL-C, (P < 0.001). Participants in the third tertile had lower TG and BMI than participants in the second and first tertiles, (P < 0.001) (Table 2).

Table 3 shows the daily intake of dietary types, macronutrients, and micronutrients according to the tertials of the MIND diet score. After adjusting for energy intake, the highest tertials of the MIND diet score had significantly higher daily intakes of whole grains, refined grains, legumes, dairy, fruit, vegetables, red meat, poultry, fish, eggs, nuts, calcium and iron, zinc, potassium, magnesium, and vitamins A, D, B6, B12, C, E, omega-3, omega-6, protein, and lipid, (P = 0.001). While higher tertile of MIND score recorded a lower daily intake of tea and coffee, potatoes, sweets and desserts, sodium, and CHO, (P = 0.001).

Using binary logistic regression analysis, Table 4 shows the relationship between tertials of the MIND diet score and decreased serum HDL, general obesity, and increased serum TG. According to the crude model, those in the third tertile of the MIND diet score were less likely to have increased serum TG and general obesity than those in the first tertile (OR = 0.58; 95% CI 0.38−0.95 and OR = 0.69; 95% CI 0.55−0.91, P = 0.001). This result was still significant when confounders were taken into account. Additionally, we found that adhering to the MIND diet increased the probability of having lower HDL-C values (OR = 0.72; 95% CI 0.55−1.15, P = 0.001). Even after potential confounders were considered, there was still a significant correlation for lower HDL-C levels (OR = 0.72; 95% CI 0.55−1.15, P = 0.001).

In this cross-sectional study, we found a significant association between adherence to the MIND diet and general obesity and lipid profile in Kurdish adults. As far as we know, this is the first study that investigates the association between the MIND diet score and general obesity and lipid profile in the adult Kurdish population.

Obesity and being overweight are linked to a higher risk of morbidity and death (19). In recent years, their occurrence has substantially increased (20, 21). Despite knowledge of numerous dietary patterns to avoid chronic illnesses, such eating suggestions seem to be ineffective in preventing obesity. As a result, more effective nutritional methods may be necessary. The MIND diet has recently been proposed as a new healthy eating pattern that is inversely related to the risk of Alzheimer’s disease and cognitive decline (10, 12). As previously stated, the MIND diet is a synthesis of the DASH and MD diets. DASH and MD contain high amounts of dietary fiber than MIND diet because they are rich in fruits, while MIND diet does not contain all fruits included in the DASH and MD diets (22). In addition, although the MIND diet contains beans, it should be noted that owing to nutritional shift, intake of beans in Asian nations’ traditional diets has decreased (23). Therefore, despite the consideration of bean consumption in the MIND diet, the whole bean intake in the diet was not very high. Another difference between the MIND diet and the other two dietary patterns (DASH and MD) is dairy consumption. Earlier studies have shown that greater dairy intake might be associated with a lower risk of obesity (24, 25). This has even been shown in a meta-analysis that weight-loss diets containing high dairy might decrease body weight and fat much more than diets with a low dairy content (26). In the MIND diet, only cheese consumption was included while in the DASH and MD diets, consumption of all dairy products is encouraged.

One of the important findings of this study was the inverse significant association between the MIND diet and the odds of low serum HDL-C and elevated serum TG, but no significant association was observed between TC and LDL-C. Mohammadpour et al. (27) showed that the MIND diet score is inversely associated with probabilities of lower HDL in a cross-sectional study of 836 Iranian individuals. There is no other study examining the linkage between the MIND diet and lipid profile but Azadbakht et al. (28) showed that an 8-week randomized study (n = 31) on T2D patients might enhance HDL cholesterol by following the DASH diet. In contrast, in the study of Obarzanek et al. (29) the DASH diet showed reduced HDL-C, which is explicable by lower consumption of total dietary fat.

Following adherence to the MIND diet, we also saw a significant decline in general obesity in our study. In this area, the evidence is contradictory. According to their findings, Mohammadpour et al. (27) suggested a beneficial effect of MD on general obesity. In contrast, Aminianfar et al. (22) found that according to their study, there are no causal links between following the MIND diet and the risk of both central and general obesity in either men or women. However, the sample size was modest and olive oil was not factored into their evaluation. Esposito and others (16) reported that energy restriction accelerated MD-induced weight loss and that MD had a positive effect on body weight independent of energy consumption. Another meta-analysis revealed that following the DASH diet effectively decreased body weight, BMI, and waist circumference (approximately 1.42 kg in 8–24 weeks), especially when paired with a low–energy diet (30).

Calcium’s positive impact on fat accumulation prevention may be attributed to the expression of the uncoupled protein (UCP2) in white adipose tissue, which boosts thermogenesis and reduces waist circumference (31). Furthermore, casein and conjugated linolenic acid could help reduce the accumulation of fat (32).

Fruits are an excellent source of phytochemicals, fiber, and antioxidants that may help with weight control (32), inhibit the development of reactive oxygen species and systemic oxidative damage (33, 34). Berries are an excellent source of flavonoids, tannins, phenolic acids, and lignans, among other polyphenols (35). Thirty middle-aged men with abdominal obesity received three different doses (125, 250, and 500 ml/day) of cranberry juice for 4 weeks from Ruel et al. (36). After drinking 250 ml and/or 500 ml, they discovered that waist circumference, BMI, weight, total/HDL cholesterol ratio, HDL cholesterol, apolipoprotein B, and plasma antioxidant capacity were all significantly lower.

The major source of dietary fat and phenolic compounds on the MIND diet may have been olive oil, which also has other health benefits. George et al. (37) found that oxidative stress markers and HDL cholesterol may both be improved by high polyphenol olive oil. Tsartsou et al. (38) indicated that the primary impact of high polyphenol content olive oil is to raise HDL cholesterol levels in the blood. The decrease in overall obesity shown in this research may be due to a few MIND diet components. For example, consuming foods in the third tertile of the MIND diet score has minimal calories (39). This diet also contains plant-based meals with low glycemic loads, high fiber content, and water content (40). Consequently, it promotes weight reduction (41, 42).

The analysis was performed on a large sample size, and statistical controlling for potential confounders is among the strengths of the present study. Also, the major limitation of the present study is its cross-sectional design, which prohibits inferring causal relationships between the MIND diet and general obesity and lipid profile.

Significant associations were found between adherence to the MIND diet and odds of general obesity and lipid profile in this cross-sectional study among Kurdish adults. This finding suggests that despite the usefulness of the MIND diet for having a healthy brain it might be able to predict other chronic conditions like obesity. Given the limitations we had in the study, investigations are needed to further examine the association between this dietary pattern and the risk of obesity.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The studies involving human participants were reviewed and approved by the Ethics Committee of Sulaimani Polytechnic University, Kalar Technical College approved the study (No: KTC: 0629092022). The procedure for obtaining informed consent was approved by the Ethics Committee of Sulaimani Polytechnic University, Kalar Technical College. All methods were carried out by relevant guidelines and regulations. This study was conducted by the Declaration of Helsinki. The patients/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

HF and NK designed the study. SM and HF collected and analyzed the data. All authors prepared the draft of the manuscript, contributed to the article, and approved the submitted version.