INS and obesity due to melanocortin 4 receptor deficiency: By adjusting variables included; energy intake, age, plasma insulin levels, marital status, education, economic status and familial obesity history, we observed that with increasing DII, the odds of having the EWNT (OR = 2.85, 95% CI 0.77 to 0.86, P for trend = 0.04), NWET (OR = 5.85, 95% CI 0.56 to 0.72, P for trend = 0.03) and EWET (OR = 3.13, 95% CI 0.86 to 0.98, P for trend = 0.05) phenotypes were significantly increased compared to NWNT phenotype among participants Table 3, Additional file 3: Table S3.