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Improving National Health Screening Using the Nutritional Risk Index: A Low-Cost Strategy for Screening Individuals at Risk for Cardiovascular Diseases in Iran
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M Jabbari *   , H Eini-Zinab , A Hekmatdoost |
| Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran , jabbari.m@sbmu.ac.ir |
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Abstract: (126 Views) |
Background and Aims: Given the heavy economic burden of non-communicable diseases on the Iranian health system and the need to shift from treatment-oriented to smart prevention, access to low-cost, indigenous screening tools is a national necessity. This study aimed to respond to this need and develop an applicable scoring system based on nutritional indicators to predict the eight-year risk of cardiovascular disease mortality.
Methods: In this study, a risk prediction model for cardiovascular disease mortality was developed using data from 43878 participants in the Golestan Cohort Study. The final model included nine available variables including age, physical activity level, waist-to-hip ratio, and six usual nutritional indicators in the Iranian dietary pattern including daily consumption of tea, vegetables, white meat, salt, dairy products, and percentage of daily energy intake from protein. The discrimination power and accuracy of the model were also evaluated in two stages of development and validation.
Results: The proposed model achieved acceptable resolution in both stages, which is competitive with expensive laboratory models. Also, the high calibration index of 0.81 indicates high prediction accuracy in the Iranian population. This tool, in the form of a simple scoring system, allows for rapid classification of individuals into four risk levels.
Conclusions: Given its high accuracy and ease of implementation, integrating this nutritional index into the electronic health record (SIB system) and using it as an alternative to costly tests in deprived areas can be an effective step in improving national screening and preventing premature cardiovascular deaths. This tool is a practical stimulus not only for specialists, but also for lifestyle modification at the community level. |
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| Keywords: Cardiovascular disease, Nutritional variables, Policy brief, Risk prediction model, Scoring system |
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Full-Text [PDF 457 kb]
(41 Downloads)
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Article type: Brief Policy |
Subject:
nutrition
Received: 2026/05/26 | Accepted: 2026/01/30 | Published: 2026/06/1
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| References |
1. Hajifathalian K, Ueda P, Lu Y, Woodward M, Ahmadvand A, Aguilar-Salinas CA, Azizi F, Cifkova R, Di Cesare M, Eriksen L, Farzadfar F. A novel risk score to predict cardiovascular disease risk in national populations (Globorisk): a pooled analysis of prospective cohorts and health examination surveys. The lancet Diabetes & endocrinology. 2015 May 1;3(5):339-55. [ DOI:10.1016/S2213-8587(15)00081-9] 2. Adil SO, Uddin F, Musa KI, Khan A, Shakeel A, Shafique K, Islam MA. Risk assessment for cardiovascular disease using the Framingham risk score and Globorisk score among newly diagnosed metabolic syndrome patients. International journal of general medicine. 2023 Dec 31:4295-305. [ DOI:10.2147/IJGM.S423151] 3. Jabbari M, Barati M, Kalhori A, Eini-Zinab H, Zayeri F, Poustchi H, Pourshams A, Hekmatdoost A, Malekzadeh R. Development of a CVD mortality risk score using nutritional predictors: A risk prediction model in the Golestan Cohort Study. Nutrition, Metabolism and Cardiovascular Diseases. 2025 Jan 1;35(1):103770. [ DOI:10.1016/j.numecd.2024.10.008] |
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