[Policy priorities of the I.R of IRAN for childhood obesity prevention]

Introduction: Childhood obesity is an important risk factor for adult obesity and its consequences, its prevention and control are hence vital; considering the limited health resources, the most appropriate policies should be implemented

Materials and Methods: After reviewing literature, taking into account national health policies and priorities, of other countries, international organization and guidelines of authorized officials, eight priority criteria and twenty policies for prevention of childhood obesity were extracted and submitted to selected stakeholders as questionnaires to determine policy priorities using the Delphi technique

Results: The three highest score priority criteria were efficacy, feasibility and inequality, Five high priority policies were: 1- Improving public health education in particular for healthy foods; 2- Adding obesity prevention and healthy diet disciplines/lessons to school teaching curriculum for mothers and kindergarten training courses; 3-Improving community and school physical activities and sports by revising management strategies; 4-Controling media regarding food and drink advertising and 5- Encouraging participation in physical activities by implementing revised policies for public transportation

Conclusion: The prioritised policis in addition to other stakeholder opinions can be used for selecting most appropriate strategies and action plans to combat childhood obesity

Comparison of glycemic control indicators in patients with type ii diabetes in two alexithymiac and non-alexithymia groups

Diabetes is a multi-factorial chronic disease that has no absolute cure and requires continuous self-care. Emotional disorders such as alexithymia have been considered as one of the major barriers to self-care behaviors in diabetes control. This study aimed to compare glycemic control indicators in patients with type II diabetes in two alexithymic and non-alexithymic groups. This was a cross-sectional study with a study sample of 80 [47 females and 33 males, aged 40 to 60 years] type 2 diabetic out-patients who referred to clinics of the Labbafinejad hospital in 2012. Data collected, using 3 questionnaires included information on demographic, anthropometric and clinical characteristics, a summary of Diabetes Self-Care Activities, and the Toronto Alexithymia Scales. Blood tests were performed to obtain HbA1c. Pearson's correlation coefficients showed alexithymia has a significant negative association with self-care activities [-0.49] and a significant positive association with HbA1c levels [0.44]. Results of t-test indicated that self-care activities in alexithymic group were significantly lesser than the non-alexithymic one and their glycated haemoglobin was higher than this group. Alexithymia in patients with type II diabetes limits their ability in their self-care activities, resulting in higher levels of glycated haemoglobin in these patients, compared to the non-alexithymic group, results which could initiate related research on potential emotional problems in patients with type 2 diabetes and enhance their diabetes control

[Iodine intake knowledge, attitude and practice in pregnant women and its relation to iodine status during pregnancy]

Introduction: Previous research shows that pregnant women, due to their increased need for iodine, are among the high risk groups for iodine deficiency. This study hence aimed to evaluate the status of women's knowledge, attitude and practice [KAP] regarding iodine and iodized salt intake and its association with iodine nutrition levels

Materials and Methods: In this observational analytical study, 100 pregnant women, residents of southern Tehran were randomly selected from five health care centers. Data collected included the general information and demographic characteristics and KAP questionnaires regarding iodized salt intake. Urine assessments of pregnant women and household salt samples were collected and evaluated

Results: Mean age of participants was 27.16 +/- 5.58 years, and their mean +/- SD knowledge, attitude and prachie scores were 62.5 +/- 20.8, 85.2 +/- 12.3, 64.7 +/- 14.3, respectively. Median urinary iodine concentrations and salt iodine content were 25.9[20.6-29.6] ppm and 109[60-160] micro g/L, respectively with 74% of women consuming salt containing 20-40 ppm iodine and 29% had urine iodine concentrations >/= 150 8g/L. Urine iodine concentration was significantly associated with practice score as well as with iodine content of salt

Conclusion: Although women suffered from iodine deficiency, their KAP scores regarding iodine and iodized salt consumption were adequate. Further assessment of other personal and social factors which could affect iodine nutrition status of pregnant women is recommended

[ association between self-care and control of blood sugar and health-related quality of life in type II diabetes patients]

Diabetes is a complex and chronic disease associated with patients' quality of life. Previous studies have considered self-care as an important and necessary parameter for changing personal lifestyle and influencing the control of diabetes. The purpose of present study was to examine the relationship between self care activities of type 2 diabetic patients' and glycated hemoglobin levels [HbA1c] as well as their perceived diabetes-related quality of life. This is a cross-sectional study 100 [60 females and 40 males, aged 40 to 70 years] type 2 diabetic out-patients visiting the Labbafinejad hospital in 2012. Measures of data collection included demographic, anthropometric and clinical questionnaires, the short scale for self-care activities and the diabetes-related quality of life. Blood tests were performed to obtain HbA1c levels and other laboratory measures related to the study. Pearson's correlation coefficients showed a significant association between better reported self-care activities and lower HbA1c levels along with better perceived diabetes-dependent quality of life. Results of regression analyses, after control of age indicated that self-care activities explained 40% of HbA1c variance and 58% of quality of life. Based on the present data, diabetes-related self care predicted HbA1c levels and diabetes-dependent perceived quality of life in patients with type 2 diabetes, results that draw attention to the psychological factors effective in the prevention of diabetes complications and hence help in the conceptualization, planning and design of treatment policies for more effective control of type 2 diabetes

[Inefficient education and process of obesity in Tehranian adolescents: a qualitative study]

This study aimed to determine inefficiencies in current educational programs for promoting of healthy lifestyles and prevention of obesity from the perspective of adolescents and mothers. This was a qualitative study conducted based on a grounded theory approach. To collect data, 23 personal interviews and 12 semi-structured focus group discussions were conducted with overweight/obese adolescents and mothers who had at least one overweight/obese child. To maximize the variation of participants' experiences with different socio-economic backgrounds, two demographically diverse areas from the north and south of Tehran were selected and followed with theoretical sampling. All the interviews and focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously, using the Strauss and Corbin analysis method. In the current study, inefficient education was explored using two main themes including "Single dimensional curriculum of schools" and "Inefficient public education". The single dimensional curriculum of schools was found to be characterized by "lesson-based curriculum" and "burdensome educational programs" and the inefficient public education was characterized by "inappropriate content", "lack of comprehensive educational program", "inappropriate ways of messaging" and "contradictory messages". Based on the findings of this study, "single dimensional curriculum of schools" and "Inefficient public education" were the main correlates of inefficient education in our society, which led to obesity-related behaviors and consequently excessive weight gain in Tehranian adolescents. The results of this study may be effective in prioritizing and designing health promotion programs aimed at promoting healthy lifestyles and prevention of obesity in children and adolescents

[Mothers' perceptions on familial correlates of overweight and obesity related behaviors in adolescents: a qualitative study]

There is convincing evidence that family environment plays an important role in influencing the obesity related-behaviors in adolescents. Considering the necessity of understanding the familial correlates of obesity in adolescents, and the lack of related studies in Iran, this study aimed to explore mothers' perceptions and experiences regarding these associated factors of overweight and obesity related behaviors in adolescents. A grounded theory approach was used for analyzing the participants' experiences, and their perceptions. To collect data, 6 semi-structured focus group discussions were conducted with 25 mothers who had at least one overweight or obese child. Based on open sampling, with the aim of maximal variation of the participants' experiences, two demographically diverse areas from the north and south of Tehran were selected and then followed with theoretical sampling. All the focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously using the Strauss and Corbin analysis method. Five main familial correlates of overweight and obesity in adolescents emerged from data: 1] Parents with inadequate knowledge, 2] Parents' modeling of unhealthy behaviors, 3] Dissimilarity of members, 4] Maternal employment and 5] Children's studies being the top priority for parents. Conclusion: Findings demonstrate familial correlates of overweight and obesity in adolescents as perceived by mothers, correlates that must be addressed by effective interventions for tackling overweight and obesity in adolescents

Personal barriers to life style modification in overweight/obese adolescents: a qualitative study

Existing data show a rising prevalence of overweight and obesity among Iranian adolescents. Considering the lack of related studies from Iran, the current study investigates personal barriers to life style Modification among overweight/obese adolescents. This is a qualitative study, conducted according to the grounded theory approach. Participants were 35 school children [19 girls and 16 boys], aged 15-17 years, who were either overweight or obese. To collect data, 5 semi-structured focus group discussions and 10 in-depth interviews were conducted. To obtain views across a range of socioeconomic backgrounds, two demographically diverse areas in Tehran were selected, and in each area, participants were recruited from schools. All interviews and focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously according to the Strauss and Corbin analysis method. Based on data analysis, positive perception of conditions, priority of studying, lack of willingness, negative experiences, low self-esteem, and perceived lack of control were the major personal barriers to adolescents' healthy lifestyles. Study results demonstrated the main personal barriers for a healthy life style as perceived by adolescents, barriers that any effective interventions require to address for tackling overweight and obesity in adolescents

Association between the severity of angiographic coronary artery disease and paraoxonase-1 promoter gene polymorphism T[-107] C in Iranian population

The oxidation of low-density lipoproteins and cell membrane lipids is believed to play an integral role in the development of fatty streak lesions, an initial step in coronary artery disease [CAD]. Paraoxonase-1 [PON1] is an enzyme associated with the high-density lipoprotein [HDL] particle. PON1 protects LDL from oxidative modification by hydrolyzing lipid peroxides, suggestive of a role for PON1 in the development of CAD. The present study tested the hypothesis that Paraoxonase-1 promoter polymorphism T[-107]C could be a risk factor for severity of CAD in Iranian population. Paraoxonase-1 promoter genotypes were determined in 300 consecutive subjects [> 40 years old] who underwent coronary angiography [150 subjects with >50% stenosis served as cases [CAD+] and 150 subjects with < 20% stenosis served as controls [CAD-]]. PON1 promoter genotypes were determined by PCR and BSTU1 restriction enzyme digestion. CAD+ Subjects did not show any significant differences in the distribution of PON1 promoter genotypes as compared to CAD- Subjects [P = 0.075]. However the analysis of PON1 promoter genotypes distribution showed a higher percentage of [-107] TT among CAD+ compared with CAD- [P = 0.027]. After controlling for other risk factors, the T[- 107]C polymorphism had interaction with age [P = 0.012], but did not show any interaction with other risk factors such as BMI, gender, smoking, diabetes, level of HDL-C, LDL-C, triglyceride and Total cholesterol. These data suggest that the TT genotype may represent a genetic risk factor for Coronary artery disease in Iranian population

[Study of the general mental health status in an area of Tehran: Tehran lipid and glucose study [TLGS]]

There are significant correlations between the mental health status of individuals and non-communicable mental or physical diseases. Epidemiological data regarding mental health indices plays an important part in the planning and designing of mental health programs. This study was conducted to evaluate the general mental health status of inhabitants in an area of Tehran as part of the TLGS. Materials and Method: In this cross-sectional study, 927 residents [20 years and older] of a specific area were randomly selected. Subjects completed the demographic data forms alongwith the General Health Questionnaires [GHQ], validated for the Iranian population. A cut off of 6 and above was used as threshold to identify the group suspected of having psychiatric disorders. To compare the scores of total GHQ and subscales between different demographic variables, the Chi square, Mann whitney and Kruskal wallis test were used. Logistic regression was used to identify variables related to the group that scored above threshold. The total sample studied consisted of 927 adults, of whom 401 [43.3%] were males and 526 [56.7%] females. Among them 489 [52.8%] were suspected of having psychiatric disorders. Mean score of total GHQ was 7.0 +/- 5.4 and regarding the subscales of the questionnaire including physical symptoms, anxiety and sleep disorders, social dysfunction and depression, mean scores were 1.2 +/- 1.7, 1.7 +/- 2.0, 3.4 +/- 2.0, 0.75 +/- 1.4 respectively and the median of mentioned subscales were 0, 1, 3 and 0 respectively. Frequency of women suspected of mental disorders was significantly higher than that of men [59.7% vs. 43.6%, p<0.001]. Taking into consideration the sample group and the method of gathering data, the frequency of those suspected of having psychiatric disorders in our study was higher as compared to other studies. Since mental health plays an important role in health promotion and community development, as well as the financial and psychological burden of illnesses, inplementation of policies in regard to implementation of related programs for prevention especially in women, seems vital