TNF and Insulin resistance: In their study, higher diet quality was associated with a lower BMI (p < 0.05), and WC (p < 0.001), as well as lower levels of tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6), and plasminogen activator inhibitor-1 (PAI-1) (p < 0.01), a lower white blood cell count (WBC) (p < 0.01) and reduced insulin resistance (p < 0.05).