Evaluation of Iranian household's diet in terms of calcium and iron density in the seven provinces of Iran

Background: Imbalanced diet, as it may cause micronutrient malnutrition has been known as a causal factor for several chronic diseases. Several studies in Iran have shown that some micro-nutrient deficiencies are prevalent and of high concern. Minerals such as calcium and iron can supply physical and mental health as well as survival, and growth development. In this study, Nutrient density analysis was used to display Iranian households' diet quality

Methods: In this descriptive-analytical study, the diet quality of seven provinces, namely Eastern Azarbaijan, Isfahan, Tehran, Khorasan, Khouzestan, Sistan Balochestan and Fars was assessed in terms of calcium and iron. To do so, the data were obtained through national household food consumption survey conducted by National Nutrition and Food Technology Research Institute, 2000-02, in Iran

Results: Generally, 80% of households' calcium density was less than the standard value and this rate was 40-70% for iron. Index of nutrition quality [INQ] for calcium and iron were respectively almost 1/2 and 1/3 of requirements in all provinces

Conclusions: There were significant differences in calcium intake density between the rural and urban households however; there were no differences between the selective provinces and all over the country

Nutritional assessment for primary school children in Tehran: an evaluation of dietary pattern with emphasis on snacks and meals consumption

In order to provide better advice for prevention of obesity and eating disorders among children, there is a need to have more knowledge of their dietary patterns. This study examined meal and snacking patterns of primary school children in Tehran. A total of 761 male and female primary school children from all educational areas in Tehran were recruited in a cross sectional survey. The data was collected by interviewing the students and their mothers or caregivers. Information on food consumption patterns was collected by one 24-h-recall and one snack-oriented food frequency questionnaire which covered a period of 1 month. Means, standard deviations, frequencies, percentages, energy and nutrient analyzes and nutrient densities were reported. All of the students snacked at least once on the day of the survey. Snacks provided 38% of total energy intake by the students. Fruits and sweet snacks were consumed by almost all of the students during a week. Energy and most nutrient intakes from meals were greater than those consumed from snacks. Snacks had a higher density of fiber, carbohydrate, calcium, iron, vitamin C, riboflavin and thiamin and had a lower density of protein, fat and niacin, compared with main meals. Salty snacks such as extruded cheese curls [Cheetos] and chips were not consumed so often. Results provide detailed information about dietary patterns, which in turn enable development of targeted messages and/or interventions to improve nutritional status of school children

Oral zinc supplementation positively affects linear growth, but not weight, in children 6-24 months of age

Childhood zinc deficiency is a common problem in many developing countries where people rely mainly on plant based diets with low zinc contents. Zinc supplementation is one of strategies to combat zinc deficiency and its consequences in children. The aim of this community trial was to examine the effect of zinc supplementation on the linear growth of children 6-24 months of age and to examine the feasibility of its implementation in the context of primary health care [PHC]. Rural community health centers providing maternal and child care in two areas with moderate rates of malnutrition were randomly assigned to intervention and control groups, including 393 and 445 children 6-24 months of age, respectively. Children in both groups received routine iron and multivitamin or vitamin A and D supplements through PHC services. Mothers of children in the intervention group were asked to give a single dose of 5 ml/day zinc sulfate syrup [containing 5 mg elemental zinc] to their children for 3 months while children in the control group did not receive the supplement. Anthropometric measurements were performed at baseline and on a monthly basis in both groups. We found a 0.5 cm difference in the height increment in the intervention group as compared with the control [P< 0.001]. Zinc supplementation had no effect on weight increment of children. Oral zinc supplementation was found to be both practical and effective in increasing linear growth rate of children less than 2 years of age through PHC

[Validity of telephone versus face-to-face interviews in the assessment of bread consumption pattern]

There are different methods to assess dietary intake in the community. Accurate and appropriate methods, rather than costly and time-consuming ones, are good alternatives to assess dietary intake. The aim of this study was to analyze the validity of telephone and face-to-face interviews, in determination of bread-consumption pattern. A randomized and stratified multi-stage sampling method was used to select 2312 participating households within the Tehran metropolitan area. The study [research] was carried out in two individual and household levels, using 24 hours recall and purchase frequency questionnaire. The same 24 hour recall and purchase frequency questionnaires were used at both individual and household level. At household and individual level, the correlation coefficients between the two methods were 0.64 and 0.60, respectively [p<0.001]. Mean difference of intake of bread between the methods at individual level was 16-21 g/day and at household level was 3-4 g/person/day, statistically not significant. Our findings suggest that a telephone survey can provide a reliable estimation of actual bread intake at both individual and household level. This method is important considering its cost and needed time

[Association of body mass index and food intake with renal cell carcinoma]

Renal Cell Carcinoma [RCC] accounts for approximately 90% of kidney cancer cases and its incidence rates have increased over recent years. Many studies have shown that high Body Mass Index [BMI] is positively associated with RCC. However the role of diet in etiology of RCC is controversial. The aim of this study was to identify the association of BMI and food intake with RCC. Forty four patients with pathological confirmation of RCC and 84 controls matched with cases by sex, age [5-year age group] and smoking status, were recruited in this case-control study. General characteristics [including socioeconomic and health status, self-reported weight and height], physical activity and food frequency questionnaires were completed. The food items were classified into 29 groups. Statistical analyzing was done with SPSS-21. No association was found between BMI and RCC. The mean daily intake of egg differed significantly in two groups [30.7, 21.6 gram per day in cases and controls, respectively]. When we analyzed the association of food groups with RCC, there was also a significant positive association between egg consumption and RCC [OR= 1.093, 95% CI=1.004-1.190]. The mean daily intake of other food items, including cheese, cream, potato and sugar, was significantly higher. Whilst the mean daily intake of tomato, lentil and split peas was lower in cases than controls. Our data shows that there is no significant association between BMI and RCC. A higher intake of egg, cheese, cream, milk, potato and sugar and lower intake of tomato, lentil, and split peas may increase the risk of RCC

Mothers' Views on Food Security and Complementary Feeding: a Qualitative Study in Urban Iran

Food insecurity may be associated with poor nutrition, which in turn can increase the risk of adverse nutrition and health outcomes among infants and toddlers. This study was undertaken in 2008 to gain an insight of mothers' views on complementary feeding practices and food security. In this qualitative study, data were collected through 10 Focus Group Discussions [FGDs] with groups of mothers who had under two-year-old children in the urban areas of Damavand [7 FGDs; n=51] and Varamin [3 FGDs; n=29]. Each FGD was held in the presence of a moderator, two note takers, and an observer. All notes were collected, and the emerging themes were reported. In the study, nine general themes were identified: 1] The mothers viewed adequate food as a food, which is useful for health in both quality and quantity; 2] Households have limited access to adequate food because they cannot afford it; 3] In hard situations, household's strategies are: changing the type and amount of food, and buying cheaper foods; 4] In case of poverty, mothers abstain from eating to save food for their children; 5] The mothers viewed complementary feeding as soft, simple and light foods, which are especially made for children; 6] The best time for introducing complementary feeding was 6 months of age; 7] There were no complementary local foods in the region; 8] For under one-year-old children, a different type of food was separately prepared; 9] Home-made complementary food was preferred over the readymade type. Despite mothers' sufficient knowledge about the advantages of complementary feeding, the majority of them had not good performance. This qualitative study provides a foundation and valuable information for future studies on the nutritional health of children in food insecure households

Socio-economic Differences in Dietary Intakes: the Comprehensive Study on Household Food Consumption Patterns and Nutritional Status of I.R. Iran

An association between socioeconomic status [SES] and poor health has been recognized. Inequalities in nutrition have been associated with inequalities in health. This study aimed to identify the social variability in the food and nutrient intake of Iranian households. This study was conducted in the framework of the Comprehensive Study on Household Food Consumption Patterns and Nutritional Status of I.R. Iran during 2001-2003. Households were selected by cluster systematic sampling method in urban and rural areas. SES was assessed through in-depth interviews. Assessment of food and nutrient intake was done using three consecutive 24-hour diet recalls completed by trained nutritionists. Some of the socio-economic variables were extracted by factor analysis as indicators of SES. Among the 7158 studied households, 2496 [34.9%] were rural and 4662 [65.1%] were urban dwellers. Consumption of the food groups, including bread and cereals, vegetables, fruits, meats, eggs, milk and dairy products, sugar and sweets, was significantly different by the level of education, occupation [P<0.001] and living conditions [P<0.05]. These factors explained 70% of variance in SES. In higher quintile of SES, consumption of bread and cereals, as well as sugar and sweets significantly decreased and meats, vegetables and fruits was increased. Intake of protein, calcium, vitamin C, riboflavin and retinol was higher in the third quintile of SES as compared to the first quintile [P<0.05]. Based on our findings, an unhealthier dietary intake may exist among the households belonging to lower socio-economic level in Iran. This calls for appropriate policy making and intervention[s]

Perceptions of Local Parents and School Staff on Childhood Obesity Prevention Interventions in Iran

Childhood obesity is an increasing public health problem in Iran, and there is no evidence for effective prevention strategies to date. The aim of this qualitative study was to identify and prioritise perceived potential interventions by parents and school staff to help inform the development of an obesity prevention intervention for Iranian school children. Focus groups were held with the parents of primary school aged children and school staff working in primary schools in Tehran city. Additionally, three interviews were held with two physical education teachers and one school nurse. The participants were asked about the causes of obesity and what activities they believed would help children to maintain healthy weight. Then they were asked to prioritise the activities that would have the greatest impact on children to maintain their healthy weight. Thematic analysis was used to analyse the data. Parents were selected from a range of socio-economic backgrounds to include two groups from each of high, medium, and low socio-economic districts of Tehran. Eleven focus groups were held with a total of 85 participants. Public policy interventions included the provision of valid nutrition information, physical activity promotion, and accessibility to healthy foods. School-based interventions included improving physical education, providing organised physical activity, provision of good quality education for children, parents and school staff, improving school shops, and using rewards and competitions. The findings suggest that close liaison should be established between the school, the family, and the broader community. This study provided important contextual data on where the emphasis should be placed in developing the childhood obesity prevention interventions for the school children in Tehran. The findings further highlight the importance of involving a wide range of stakeholders, and including multiple components to maximise the chances of success

Is household food insecurity associated with overweight/obesity in women?

Despite reports on association between overweight/obesity among women and household food insecurity [FI] in developed countries, such association is not evident in developing countries. This study aimed to assess the association between household FI and weight status in adult females in Tehran, Iran. In this cross-sectional study, 418 households were selected through systematic cluster sampling from 6 districts of Tehran. Height and weight were measured and body mass index [BMI] was calculated. Socio-economic status of the household was assessed by a questionnaire. Three consecutive 24-hour diet recalls were completed. FI was measured using adapted Household Food Insecurity Access Scale. Logistic regression was used to test the effects of SES and food security on weight status, simultaneously. Using Structural Equation Modeling [SEM] potential causal relationships between FI and weight status was explored. Only 1.0% of women were underweight, while 40.3% were overweight and 33% were obese, respectively. Severe, moderate, and mild food insecurity was observed in 11.5, 14.7, and 17.8%, respectively. Among women in moderately food insecure households, the possibility of overweight was lower than those of food secure households [OR 0.41; CI95%:0.17-0.99], while in severely food insecure households, the risk of abdominal obesity for women was 2.82 times higher than food secures [CI95%:1.12-7.08] [P<0.05]. SEM detected no causal relationship between FI and weight status. Association of severe food insecurity with abdominal obesity in adult females of households may indicate their vulnerability and the need for tailoring programs to prevent further health problems in this group

nutrition knowledge level of physicians, nurses and nutritionists in some educational hospitals

Nutritional care is an important part of medical care of patients and plays a key role in improvement, prevention and control of malnutrition in hospitals. The current study aimed to determine the nutrition knowledge level of doctors, nurses and nutritionists in some teaching hospitals in Tehran in 2008. In a cross-sectional study a total of 198 samples including 28 nutritionists, 81 nurses and 89 physicians were selected using simple random sampling. The current study was conducted in 9 hospitals affiliated with the Shahid Beheshti University of Medical Sciences [SBMU] in Tehran. A self-administered multiple choice questionnaire about different aspects of basic and clinical nutrition was completed. Then nutrition knowledge levels of each individual was determined by calculating correct knowledge, perceived knowledge and accuracy of knowledge scores. The median knowledge score of the nutritionists, physicians, and nurses was 85%,77%, and 75%, respectively. The median perceived knowledge of all the groups was above 90%. The mean accuracy score in the 3 groups of nutritionists, physicians and nurses was 87%,79%, and 76%, respectively. The results indicated that all groups have a poor knowledge, especially in clinical nutrition topics. Based on the current results, knowledge level of clinical staff is an effective factor in not paying attention to the importance of nutritional care as a part of medical care of the patients. Enhancing awareness level of all groups especially physicians and nutritionists in clinical division plays an important role in enhancing clinical nutrition care and treatment regime

Parental determinants of overweight and obesity in Iranian adolescents: a national study

Overweight among adolescents is not only an important public health problem but also a problem affecting economic growth in developing countries. The aim of this study was to investigate the parental determinants of overweight and obesity in Iranian adolescents at national level. This cross sectional study was conducted within the framework of the Comprehensive Study on Household Food Consumption Patterns and Nutritional Status of IR Iran during 2001-2003. In adolescents, anthropometric indices were defined based on the CDC 2000 cut-off points for age and gender-specific body mass index [BMI]. Parental characteristics were collected by questionnaire. Among the 7158 participating households, data on 7908 adolescents aged 11-19 years [3750 girls and 4158 boys] was analyzed. The prevalence of overweight [85-94th percentile] in boys and girls was 6.2%, and 8.7%, respectively. The prevalence of obesity [>/= 95th percentile] among boys and girls was similar [3.3%]. Parents' weight status, father's job and parents' education showed significant association with weight status in adolescents. Logistic regression analysis showed that parental overweight and obesity, parental education and father's job were the main parental determinants of overweight and obesity in Iranian adolescents. Parental overweight and obesity, parental education and father's job seem to be the major parental determinants of overweight in Iranian adolescents. Future prevention programs must take these risk factors into account

Trauma care system in Iran / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to describe the current status of trauma system regarding the components and function.</p><p><b>METHODS</b>The current status of trauma system in all components of a trauma system was described through expert panels and semi-structured interviews with trauma specialists and policy makers.</p><p><b>RESULTS</b>Currently, various organizations are involved in prevention, management and rehabilitation of injuries, but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of public education through media, traffic regulation reinforcement, hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training standards of the front line medical team and continuing education and evaluation are yet to be addressed. Trauma registry has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance, financial resources), it is not yet established in our system of trauma care.</p><p><b>CONCLUSIONS</b>It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system.</p>