Objective: No studies have examined the contribution of major dietary patterns to MUH phenotypes in obese and overweight people based on Karelis criteria. This study was conducted to evaluate the association of major dietary patterns with MUHOW/O and MHOW/O phenotypes. Methods: This cross-sectional study was conducted on 290 overweight and obese women aged 18-50 (BMI >= 25 kg/m(2)). Anthropometric measurements were assessed in all participants. The MH phenotype was defined according to the Karelis criteria. Major dietary patterns were determined using factor analysis of 21 foods groups using a valid and reliable FFQ containing 147 items. Participants' body composition was assessed by BIA. Serum HDL, LDL, TG, insulin, and hs-CRP levels were quantified by ELISA. Results: By the use of factor analysis, 3 major dietary patterns were extracted: healthy dietary pattern (HDP), western dietary pattern (WDP) and unhealthy dietary pattern (UNHDP). Binary logistic analysis showed that participants in the in the upper category of WDP had greater odds of MUH phenotype (OR = 2.33, 95% CI = 1.11-4.91, P = 0.02), after confounder factor control. Individuals with high adherence to the UNHDP score had high odds of MUH phenotype (OR = 1.75, 95% CI = 0.98-3.10, P = 0.05), after adjustment for BMI, age, and total EI, compared to those with low adherence. A positive relation was observed between WDP and levels of hs-CRP, HOMA-IR (OR = 1.94, 95% CI = 0.91-4.10, P = 0.05 and OR = 2.53, 95% CI = 1.26-5.11, P = 0.009) as well as a positive association between UHDP and plasma level of LDL (OR = 1.90, 95% CI = 1.04-3.47, P = 0.03), but an inverse association between HDP and hs-CRP level (OR = 0.56, 95% CI = 0.29-0.92, P = 0.03). Conclusions: The present evidence indicates various significant associations among major dietary patterns and MUHOW/O phenotypes. (c) 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.