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Increased dietary salt content is one of the effective factors of hypertension and a major public health challenge globally. Although the positive effects of dietary salt reduction on health are universally accepted, people can hardly reduce their salt intake. The purpose of this study is to identify the inhibitory factors of dietary salt reduction among 20–65-year-old women in Yazd City, Iran.

This study was conducted using a deductive content analysis approach based on the communication for the behavioral impact (COMBI) framework. The purposeful sampling method was applied with maximum variation in terms of different educational levels, age groups, occupational status and residential areas to select the participants. Snowball sampling was used to select health-care professionals. Furthermore, semi-structured interviews and focus-group discussions were conducted with 31 local women and 11 health-care professionals working in the City until data saturation was achieved. Data were analyzed using Graneheim and Landsman’s method.

After data analysis, 617 initial codes were extracted over the perceived barriers. After merging similar codes, 223 codes were extracted. The barriers were classified into five main categories of family, personal, organizational, educational and socio-cultural barriers.

Based on the COMBI framework, the results demonstrated that the most important barriers for reducing salt intake were negative attitude toward restrictions on dietary salt intake, insufficient and incorrect beliefs about the health risk of salt, lack of family support, inadequate health literacy and low self-efficacy in Yazd City. Among these barriers, lack of family support was considered as the most effective factor in reducing salt consumption. So, by focusing on this area and providing the community with the required education, the amount of salt consumed by families can be reduced.

Dietary intake is a modifiable risk factor for metabolic syndrome (MetS). Therefore, this study aims to evaluate the association between the Healthy Eating Index-2015 (HEI-2015) and MetS.

MetS was diagnosed among 2,326 adults. Dietary intake was assessed by a validated food frequency questionnaire. The HEI-2015 was administered to assess the diet qualities. Multivariate logistic regression was also used to evaluate the relationship of HEI-2015 with MetS and its components.

The odds of MetS was lower in women who were in the third quintile of HEI-2015 compared with those in the first quintile after adjusting for age and energy intake (OR: 0.62, CI: 0.41 to 0.93). In addition, moderate adherence to HEI-2015 reduced the odds of high fasting blood glucose levels in both men and women (OR men: 0.30, CI: 0.11 to 0.85 OR women: 0.34, CI: 0.14 to 0.79). However, these relations were not linear. Adherence to HEI-2015 had no significant relationship with the prevalence of MetS and its components in the whole population.

A significant relationship was observed between moderate adherence to HEI-2015 and fasting blood glucose in both men and women. Moreover, moderate adherence to this dietary pattern decreased the prevalence of MetS in women.

Established data revealed a relationship between obesity and increasing the risk of mortality and morbidity of chronic diseases. There are conflicting data regarding the association between adherence of dietary approach to stop hypertension (DASH) and obesity. Therefore, this study aims to investigate this relationship among a large sample of Iranian adults.

This cross-sectional study was performed by 10,693 individuals; 6750 individuals related to Yazd Health Study living in the urban area and 3943 individuals related to Shahedieh cohort study living in the suburb area. Dietary intake was evaluated by using a validated food frequency questionnaire. In all participants, anthropometric indices including body mass index were measured. The DASH score was considered using gender-specific quintiles of DASH items. To evaluate the relationship of DASH diet and obesity, multivariate logistic regression analysis was used.

By adjusting confounders, participants in highest quintiles of DASH diet were compared to the lowest have lower odds of obesity in suburb area (odds ratio [OR]: 0.78; 95% confidence interval [CI]: 0.63, 0.96), in urban (OR: 0.71; 95% CI: 0.52, 0.99) and in whole population of both studies (OR: 0.75; 95% CI: 0.63, 0.90). Besides, more compliance of women to this diet in urban (OR: 0.64; 95% CI: 0.48, 0.85) and population of both studies (OR: 0.77; 95% CI: 0.62, 0.96) were associated with reduced odds of central obesity.

Considering this study limitations, the following can be mentioned: in this cross-sectional study, the causal relationship between DASH diet and obesity could not be assessed. Consequently, further prospective studies are required in this area. Second, although a valid food frequency questionnaire was used, but there was a measurement error and an error in the classification of people participating in the study. Moreover, we cannot reject the possibility of residual confounding bias because unknown or unmeasured confounders may exist that affected our results. Finally, our participants with odds of obesity might have been advised to reduce their fat intake, which led them to alter their dietary habits. However, such possibility cannot be resolved in a cross-sectional study.

DASH dietary pattern could decrease odds of obesity in both urban and suburb area and central obesity in urban area only. Further prospective studies are needed for causal conclusion.