Nutrition and diabetes, cardiovascular and chronic kidney diseases: findings from 20 years of the Tehran lipid and glucose study

Context: the high prevalence of chronic diseases can be prevented or managed by specific changes in lifestyle patterns of individuals of which dietary factors is emphasized. The objective of this study was to review all findings of the Tehran Lipid and Glucose Study regarding validity and reliability of food frequency questionnaire [FFQ], evaluating dietary quality and association of dietary factors in relation to diabetes, dysglycemia, cardiovascular [CVD] and chronic kidney disease [CKD]

Evidence Acquisition: related documents were searched through PubMed and Scopus databases, in English language from 2000 to 2017. Finally, 52 relevant documents were eligible for inclusion in this review

Results: the FFQ proved to be an acceptable tool for assessing nutrient and food group intakes and rank individuals accurately according to the levels of their dietary intakes. After 8 years of follow-up, the western dietary pattern [DP] was fairly stable but there was instability of traditional Iranian DP. DPs of over two-thirds of Tehranian populations were not in accordance with the dietary recommendations. Higher dietary scores of variety and healthy DPs were also associated with reduced odds of dysglycemia. The main dietary factor related to increased risk of CVDin our population was western DP. Patterns of amino acid intakesmaycontribute to the development of CVD. Higher intakes of several micronutrients and macronutrients, DPs and some vegetables decrease the risk of CKD. In conclusion DPs of most Tehranian adults need improvement

Conclusions: this review showed that higher adherence to healthy food choices was associated with reduced odds of dysglycemia and CVD. Dietary sources of renal-protective nutrients should be encouraged among the general population

Nutrition and cardio-metabolic risk factors: findings from 20 years of the Tehran lipid and glucose study

Context: genetic and environmental factors contribute to the incidence of metabolic syndrome [MetS]. This study aimed to review all findings of studies conducted in framework of the Tehran lipid and glucose study [TLGS] regarding the association of dietary factors with cardio-metabolic risk factors

Evidence Acquisition: all English-language studies were searched using PubMed and Scopus databases from 2000 to 2017. Finally, 105 relevant papers were included in this review

Results: whole grains, legumes, nuts and healthy dietary patterns [DPs] reduced risk of MetS, while white rice, salty/sweet snacks increased this. The western DP had a significant interaction with APOC3, APOA1 and MC4R polymorphisms in relation to MetS. After 6.5 years of follow-up, odds of reaching menarche

Conclusions: higher adherence to healthy food choices was associated with reduced odds of MetS, abdominal obesity, dyslipidemia and hypertension. The western DP accentuated the association of polymorphisms with MetS

Metabolic syndrome: findings from 20 years of the Tehran lipid and glucose study

Context: in recent decades, investigations have been focused on the definition, incidence and predictors of metabolic syndrome [MetS] in Iranians. This study aimed to review systematically investigations on MetS, conducted among the Tehran lipid and glucose study [TLGS] participants

Evidence Acquisition: literature on MetS documented by TLGS studies published from 2000 to 2017 were searched using Pubmed and Scopus database in English language with a combination of following keywords: Metabolic syndrome, TLGS

Results: the harmonized definition of MetS was confirmed, based on the estimated cut point of waist circumference [WC] >/= 95 cm for both genders in Iran. The incidence rate was 550.9/10000 person/years, lower among women [433.5/10000] than men [749.2/10000]. The prevalence of abdominal obesity, high triglycerides [TG], low high density lipoprotein cholesterol [HDL-C], high blood pressure [BP], and high fasting blood glucose [FBG] was 30, 46, 69, 34, and 12%, respectively. The prevalence of MetS in adolescents was 10.1% with no significant difference between boys and girls [10.3% in boys and 9.9% in girls]. A strong association of WC [OR: 2.32, CI: 2.06 - 2.59] and TGs [OR: 1.95, CI: 1.65 - 2.11] with development of MetS was found. In adolescent boys, WC had the highest OR for MetS risk. WHO-defined MetS was a significant predictor of total and cardiovascular mortality both in men [HR: 1.66, CI: 1.23 - 2.24; HR: 1.93, CI: 1.26 - 2.94] and women [HR: 2.01, CI: 1.39 - 2.88; HR: 2.71, CI: 1.44 - 5.09]

Conclusions: our results indicate high incidence of MetS in Tehranian adults and adolescents; high WC also appears to be a strong predictor of MetS. All definitions of MetS predicted cardiovascular disease

nitrate-nitrite-nitric oxide pathway: findings from 20 years of the Tehran lipid and glucose study

Context: we describe here the contributions of the Tehran lipid and glucose study [TLGS] to understanding different aspects of the nitrate [NO3]-nitrite [NO2]-nitric oxide [NO] pathway in health and disease

Evidence Acquisition: all English-language documents from the TLGS, focused on NO pathway were searched using the PubMed, Scopus, and Embase databases

Results: reference values of serum concentrations of NO metabolites [nitrate + nitrite or NOx] were 11.5 - 76.4, 10.1 - 65.6, and 10.3 - 66.8_mol/L in men, women, and the total population, respectively. Circulating NOx was affected by age, smoking habits, menopause status, thyroid hormones, and various pathologic conditions. Elevated serum NOx was related to increased incidence of metabolic syndrome [odds ratio [OR] = 1.75, 95% confidence interval [CI] = 1.19 - 2.59], hypertriglyceridemic-waist phenotype [OR = 1.39, 95% CI = 1.05 - 1.93], chronic kidney disease [OR = 1.86, 95% CI = 1.10 - 3.14] in women, and cardiovascular disease [hazard ratio [HR] = 1.35, 95% CI = 1.01 - 1.80] in the total population. In participants with low vitamin C intake, higher intakes of NO2 [ >/= 8.77 mg/d] were accompanied with increased risk of diabetes [HR = 2.43, 95% CI = 1.45 - 4.05]. A decreased risk of hypertension [OR = 0.58, 95% CI = 0.33 - 0.98] and chronic kidney disease [OR = 0.50, 95% CI = 0.24 - 0.89] was observed in response to higher intakes of NO2

Conclusions: circulating NOx is associated with and could predict the risk of metabolic disorders in a general population. Moreover, dietary NO3/NO2 exposure from usual diets seems to contribute to development of noncommunicable diseases

Congenital Malformations in Infants of Mothers Undergoing Assisted Reproductive Technologies: A Systematic Review and Meta-analysis Study / 예방의학회지

OBJECTIVES: This meta-analysis aimed to evaluate congenital malformations in infants conceived by assisted reproductive techniques (ART), compared with infants conceived spontaneously. METHODS: In this study, available resources searched to find relevant articles included PubMed, ScienceDirect, Scopus, Google Scholar, Cochrane, ProQuest, Iranmedex, Magiran, and Scientific Information Database. After extracting the necessary information from evaluated articles, meta-analysis on the articles’ data was performed using Stata version 11.2. RESULTS: In this study, from a total of 339 articles, extracted from the initial investigation, ultimately 30 articles were selected for meta-analysis that assessed the use of ART on the risk of congenital abnormalities and some birth complications on 5 470 181 infants (315 402 cases and 5 154 779 controls). The odds ratio (95% confidence interval [CI]) for low birth weight was 1.89 (95% CI, 1.36 to 2.62), preterm labor 1.79 (95% CI, 1.21 to 2.63), cardiac abnormalities 1.43 (95% CI, 1.27 to 1.62), central nervous system abnormalities 1.36 (95% CI, 1.10 to 1.70), urogenital system abnormalities 1.58 (95% CI, 1.28 to 1.94), musculoskeletal disorders 1.35 (95% CI, 1.12 to 1.64), and chromosomal abnormalities in infants conceived by ART was 1.14 (95% CI, 0.90 to 1.44), which were all statistically significant, except chromosomal abnormalities. CONCLUSIONS: The risk of congenital abnormalities and some birth complications were significantly higher in ART than normal conception, while chromosomal abnormalities were not; therefore, the application of ART should be selected individually for patients by detailed assessment to reduce such risks in the population.

effect of interactions of single nucleotide polymorphisms of APOA1/APOC3 with food group intakes on the risk of metabolic syndrome

Background: the aim of this study was to examine the interaction of dietary food groups and genetic variants of APOA1/APOC3, relative to Metabolic Syndrome [MetS] risk in adults

Methods: in this matched nested case-control study, 414 MetS subjects and 414 controls were selected from among participants of Tehran Lipid and Glucose Study. Dietary intake was assessed with the use of a valid and reliable semi-quantitative food frequency questionnaire. Single Nucleotide Polymorphisms [SNPs], APOA1 [rs670, -75G>A and rs5069,+83C>T/APOC3 rs5128 C3238>G] were genotyped by the conventional polymerase chain reaction and restriction fragment length polymorphism

Results: the mean [SD] of age was 40.7 [13] and 41.2 [13] years in male cases and controls versus 44.0 [11] and 44.0 [12] years in female case and controls. A significant interaction between intake quartiles of the sugar group and APOA1 combined group [GA+AA/CT+TT] SNPs was found; The ORs for these genotype carriers were [1, 0.44, 0.36, 0.23; P trend<0.001] in quartiles of intake, relative to other combined genotypes [P interaction=0.02]. MetS risk appeared to be increased significantly in higher quartiles of sweet beverages and fish intakes in the GA+AA/CT+TT/CC genotypes of APOA1/APOC3 SNPs, compared to other genotypes [P interaction=0.01]. The combined effect of genotypes of APOC3/APOA1 showed further decrease in MetS risk in higher quartiles of sugar group intakes [OR: 1, 0.24, 0.26, 0.14, P trend=0.001] relative to other combinations [P interaction=0.008]

Conclusion: results obtained demonstrate that some dietary food groups [sugar, fish, and sweet beverages] modulate the effect of APOA1/APOC3 SNPs in relation to MetS risk

narrative review of obesity and its associated complications in Iranian women

Context: Obesity is a major public health problem worldwide. This review aimed at providing an updated overview of obesity in Iranian women and its associated complications

Evidence Acquisition: In this narrative review study, related systematic reviews or meta-analysis studies of high ranking journals conducted from 2000 to 2016 were searched in the PubMed, Medline, and Scopus with the following keywords: "women OR female" AND "weight OR overweight OR obesity", "risk factors OR complications", "reproduction OR cancer OR cardiovascular disease OR diabetes OR gestational diabetes OR maternal obesity OR fertility OR pregnancy OR polycystic ovary syndrome" OR management

Results: In Iran, women have shown a constantly higher risk of obesity compared to men. After a 9- year follow-up, the age-standardized incidence rate [95% CI] of diabetes was 10.1 [7.24 - 13.9] in women. The increases in overweight and obesity in menopausal women have an important role in endometrial, colon, and breast cancer. Obesity increases the risk of endometrial cancer 2.4 to 4.5 folds compared to the normal weight women. Maternal obesity increases the risk of gestational hypertension 4.5 to 8.7 times compared to normal weight women. An increasing number of obese women becoming pregnant is associated with short- and long-term maternal and child outcomes. The prevalence of childhood obesity in children of obese women aged 3 to 5 years increases up to 25%; and these children have an almost 6- fold chance of being obese in young adulthood. Weight reduction of obese women is accompanied with lower incidence of obesity complications. The most effective interventions are multiple behavioral management activities

Conclusions: Considering the large population of young people in Iran and the lack of any effective preventive policy, the burden of obesity and its associated outcomes will be problematic in the near future

Low birth weight may increase body fat mass in adult women with polycystic ovarian syndrome

Background: Women engaged with polycystic ovarian syndrome [PCOS], as the commonest endocrine disorder, are known to have a specific type of adiposity. Birth weight is among different contributors reported to be responsible for this diversity

Objective: We aimed to compare the relation between birth weight and body fat mass [BFM]/ body lean mass [BLM] in PCOS and their age and body mass index [BMI] matched normal controls

Materials and Methods: In this case-control study, a total number of 70 reproductive aged women, diagnosed with PCOS and 70 age- BMI matched healthy women without hirsutism and/or ovulatory dysfunction were recruited., control group had no polycystic ovaries in ultrasonographic scans. A detailed history of birth weight was taken and was divided into the following categories: <2,500 [low birth weight, LBW] and 2,500-4,000 [normal birth weight; NBW]

Results: Results showed that LBW prevalence was higher in women with PCOS than in controls [19.3% [27] vs. 15.7% [22]]. Also body fat and lean mass [BFM, BLM] have increased in adult women with PCOS who were born underweight compared to their normal [19.8+/-9.05 vs. 12.9+/-4.5, p=0.001 and 48.9+/-6.9 vs. 43.2+/-5.8, p=0.004 respectively]

Conclusion: Fetal birth weight influences on the adulthood obesity, BFM and BLM. This impact is different among women with and without PCOS

Associations between Dietary Acid-Base Load and Cardiometabolic Risk Factors in Adults: The Tehran Lipid and Glucose Study

BACKGROUND: In this study we investigated the associations of dietary acid-base load, identified by potential renal acid load (PRAL) and protein to potassium (Pro:K) ratio, with cardiometabolic risk factors in Tehranian adults. METHODS: A cross-sectional study was conducted within the framework of the fourth phase of the Tehran Lipid and Glucose Study (2009 to 2011) on 5,620 men and women aged 19 to 70 years. Dietary data were collected by a trained dietitian using a validated, 147-food item, semi-quantitative food frequency questionnaire, and dietary PRAL and Pro:K ratio were calculated. Multiple linear regression models with adjustment for potential confounding variables were used to evaluate the associations of dietary acid-base load with anthropometric measures, blood pressure, serum triglycerides, high density lipoprotein cholesterol (HDL-C), serum creatinine, and fasting blood glucose. RESULTS: The mean+/-SD age of the participants was 39.8+/-12.8 years and 54% of participants were women. Mean+/-SD PRAL was -22.0+/-29.1; mean PRAL was -15.6 in men and -26.8 in women. Dietary PRAL was associated with weight (beta=0.098, P<0.001), waist circumference (beta=0.062, P<0.01), serum triglycerides (beta=0.143, P<0.01), HDL-C (beta=-0.11, P<0.01), diastolic blood pressure (beta=0.062, P<0.01), and serum creatinine (beta=0.142, P<0.001). Pro:K ratio was associated with weight (beta=0.055, P<0.001), waist circumference (beta=0.04, P<0.01), serum HDL-C (beta=-0.06, P<0.01), serum triglycerides (beta=0.03, P<0.05), diastolic blood pressure (beta=0.026, P<0.05), and serum creatinine (beta=0.07, P<0.01). CONCLUSION: A more acidic dietary acid-base load may be a risk factor for the development of metabolic disorders.

Helicobacter pylori Stool Antigen Levels and Serological Biomarkers of Gastric Inflammation are Associated with Cardio-Metabolic Risk Factors in Type 2 Diabetic Patients

BACKGROUND: Helicobacter pylori infection and subsequent gastric inflammation have been proposed as risk factors for the development of insulin resistance and cardiovascular disease. In this study we assessed the possible association of H. pylori bacterial load, and serum biomarker of gastric inflammation with cardiometabolic risk factors in diabetic patients. METHODS: In this cross-sectional study, 84 H. pylori-infected type 2 diabetic patients were assessed for anthropometrics, biochemical and clinical measurements. Pearson correlation test, linear, and logarithmic regression curve estimation models were used to assess the association of H. pylori stool antigen (HpSAg) levels, and pepsinogen I (PGI) to pepsinogen II (PGII) ratio with fasting serum glucose, insulin, serum lipid and lipoprotein parameters, malondialdehyde, high-sensitive C-reactive protein (hs-CRP), systolic and diastolic blood pressure, body weight, waist circumference and lipid accumulation product (LAP) index. RESULTS: The mean age of participants was 54+/-10 years, and 44% were men. Mean HpSAg levels and PGI/PGII ratio were 0.24+/-0.23 microg/mL and 9.9+/-9.0, respectively. Higher HpSAg as well as lower PGI/PGII was correlated with higher anthropometric measures and LAP. A significant negative correlation between PGI/PGII ratio and blood pressure (r=-0.21 and r=-0.22, systolic and diastolic, respectively, P<0.05), serum insulin (r=-0.17, P=0.05), and hs-CRP (r=-0.17, P=0.05) was observed. A significant linear association between PGI/PGII ratio with serum triglycerides (beta=-0.24, P<0.05), serum high density lipoprotein cholesterol (HDL-C; beta=0.43, P<0.01), and triglycerides/HDL-C ratio (beta=-0.28, P<0.05) were observed. CONCLUSION: Higher H. pylori bacterial load and lower PGI/PGII ratio was associated with higher levels of cardiometabolic risk factors in H. pylori infected type 2 diabetic patients.

Sugar-Sweetened Beverage Consumption Is Associated with Metabolic Syndrome in Iranian Adults: Tehran Lipid and Glucose Study

BACKGROUND: Metabolic syndrome (MetS), a cluster of multiple metabolic abnormalities, is one of the major public health challenges worldwide. The current study was conducted to evaluate the association between sugar-sweetened beverage (SSB) consumption and MetS and its components in Iranian adults. METHODS: This cross-sectional study was conducted among 5,852 men and women, aged 19 to 70 years, who participated in the fourth phase (2009 to 2011) of the Tehran Lipid and Glucose Study. Demographics, anthropometrics, biochemical measurements, and blood pressure (BP) were assessed and MetS was defined by National Cholesterol Education Program Adult Treatment Panel III definition. Frequency and quantity of SSB intakes including carbonated drinks and synthetic fruit juices were collected using a validated semiquantitative food frequency questionnaire. RESULTS: Mean age of participants (43%, men) was 40.6+/-12.9 years. Significant positive associations between SSBs and waist circumference, triglyceride level, systolic and diastolic BP in the third and fourth quartile of SSBs were observed, after adjustment for all potential confounding variables. The odds of MetS in the third and fourth quartiles compared to the first quartile category of SSBs was 1.21 (95% confidence interval [CI], 1.01 to 1.45) and 1.30 (95% CI, 1.06 to 1.58), respectively (P for trend=0.03). The odds of MetS, abdominal obesity, low high density lipoprotein cholesterol and elevated BP had increasing trends across increasing of SSB consumption (P for trend <0.05). CONCLUSION: Higher intake of SSBs was associated with the higher odds of MetS in adults. It is suggested that reducing consumption of SSBs could be a practical approach to prevent metabolic abnormalities.

[Comparison of energy-restricted high protein [HP] with standard-protein [SP] diets in women with polycystic ovary syndrome]

Some researchers administer a diet with a higher ratio of protein to carbohydrates [HP] in patients with polycystic ovary syndrome [PCOS], but there is a limited number of dietary interventions compared the effects of an HP diet with a standard protein [SP] diet. Therefore, the aim of this review was to compare the effects of energy-restricted HP diets with those of iso-calorically prescribed SP diets on anthropometric, metabolic, hormonal, and reproductive outcomes in women with PCOS. Searches for English-language studies published between 2000 and 2014 were conducted using PubMed, Science Direct, and Scopus databases to identify all randomized controlled trials that compared HP diet with SP diet. There was no difference in anthropometric outcomes between two different diets. There was no difference in reproductive outcomes between the two dietary treatments. Weight loss decreased testosterone, free testosterone, or FAI [Free Androgen Index] and increased SHBG, independent of prescribed diet. There was no difference in metabolic outcomes between the two dietary treatments. A standard-protein weight-loss diet reduced HDL- cholesterol, while no changes occurred for a high protein weight-loss diet. The high-protein diet reduced total cholesterol to HDL-C ratio. Weight loss, independent of diet composition, decreased fasting insulin, insulin resistance and Improvements in lipid profiles. High protein diet caused subtle and inconsistent changes in metabolic variables, and weight loss results in clinical benefit, regardless of diet composition, in women with PCOS

Lipid Accumulation Product Is Associated with Insulin Resistance, Lipid Peroxidation, and Systemic Inflammation in Type 2 Diabetic Patients

BACKGROUND: Lipid accumulation product (LAP) is a novel biomarker of central lipid accumulation related to risk of diabetes and cardiovascular disease. In this study, we assessed the association of LAP with glucose homeostasis, lipid and lipid peroxidation, and subclinical systemic inflammation in diabetic patients. METHODS: Thirty-nine male and 47 female type 2 diabetic patients were assessed for anthropometrics and biochemical measurements. LAP was calculated as [waist circumference (cm)-65]x[triglycerides (mmol/L)] in men, and [waist circumference (cm)-58]x[triglycerides (mmol/L)] in women. Associations of LAP with fasting glucose, insulin, insulin resistance index, lipid and lipoprotein levels, malondialdehyde, and high-sensitive C-reactive protein (hs-CRP) were assessed. RESULTS: Mean age and LAP index were 53.6+/-9.6 and 51.9+/-31.2 years, respectively. After adjustments for age, sex and body mass index status, a significant positive correlation was observed between LAP index and fasting glucose (r=0.39, P<0.001), and homeostasis model assessment of insulin resistance (r=0.31, P<0.05). After additional adjustment for fasting glucose levels, antidiabetic and antilipidemic drugs, the LAP index was also correlated to total cholesterol (r=0.45, P<0.001), high density lipoprotein cholesterol (HDL-C) levels (r=-0.29, P<0.05), triglycerides to HDL-C ratio (r=0.89, P<0.001), malondialdehyde (r=0.65, P<0.001), and hs-CRP levels (r=0.27, P<0.05). CONCLUSION: Higher central lipid accumulation in diabetic patients was related to higher insulin resistance, oxidative stress and systemic inflammation.

[ effect of consumption of unhealthy snacks on diet and the risk of metabolic syndrome in adults: Tehran lipid and glucose study, Iran]

Unhealthy snacks contain high amounts of calories, simple sugars, fat, cholesterol, salt, additives, and conservatives. Increased consumption of these unhealthy snacks is one of the underlying factors for the prevalence of overweight, obesity, and metabolic disorders. In this study, we investigated the effects of unhealthy snacks on diet and the risk of metabolic syndrome after 3-years of follow-up in Tehranian adults. This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study, between 2006-2008 and 2009-2011, on men and women in Tehran, Iran. Dietary intakes of participants were measured using a validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were assessed at baseline and 3 years later. Multiple logistic regression models with adjustment for confounding factors were used to estimate the occurrence of metabolic syndrome [MetS] in each quartile of unhealthy snacks. The mean age of participants was 37.8 +/- 12.3 years, and the mean of body mass index was 26.0 +/- 4.5 kg/m2. Moreover, 39% of the participants were male. Daily energy intake, dietary energy density, and total fat and sodium intake were higher in the fourth quartile of unhealthy snacks consumption. There was a significant decreasing trend in dietary intake of carbohydrate, calcium, zinc, selenium, and fiber parallel to increase in consumption of energy-dense snacks. Participants who were in the highest quartile of energy intake from unhealthy snacks consumed less whole grains, vegetables, and dairy products. After adjustment for potential confounders, the risk of metabolic syndrome had a significant positive association with salty snacks consumption, and a non-significant positive association with consumption of candies, chocolate, and soft drinks. Increased daily energy intake from unhealthy snacks could be a risk factor for the occurrence of metabolic syndrome

Association of Macro- and Micro-nutrients Intake with the Risk of Multiple Sclerosis: a Case Control Study

Multiple Sclerosis [MS] is the most prevalent autoimmune disease of the central nervous system, and it has been suggested that nutrition might play a role in the etiology of MS. This study was aimed to evaluate the relationship between MS risk and intake of some macro- and micro-nutrients in Tehran [Iran]. In this hospital based, case-control study, a total of 60 newly diagnosed patients with MS and 140 controls underwent face-to-face interviews. Information regarding the usual dietary intake of each individual in the past year was collected by using a valid and reliable 168-item semi-quantitative food frequency questionnaire. Multivariate logistic regression was used to estimate the odds ratios and 95% confidence intervals. Inverse significant associations were observed [P< 0.05] between the intake of protein [OR=0.19; 95% CI: 0.04- 0.76] and micro-nutrients such as vitamin B1 [OR=0.10; 95% CI: 0.02-0.53], vitamin B2 [OR=0.15; 95% CI: 0.04-0.50], cobalamin [OR=0.13; 95% CI: 0.04-0.38], vitamin C [OR=0.20; 95% CI: 0.07-0.58], vitamin A [OR=0.23; 95% CI: 0.09- 0.59], vitamin D [OR=0.28; 95% CI: 0.11-0.72], vitamin E [OR=0.15; 95% CI: 0.05-0.41], beta-carotene [OR=0.38; 95% CI: 0.15-0.97], zinc [OR=0.05; 95% CI: 0.01-0.27], magnesium [OR=0.12; 95% CI: 0.03-0.47] and calcium [OR=0.23; 95% CI: 0.08-0.67] and the risk of MS. The results suggest that intake of some macro- and micro-nutrients might be associated with reduced risk of MS. It seems promising that intake of nutrients at least in the dietary reference levels may decrease the risk of MS

Food Security Is Associated with Dietary Diversity: Tehran Lipid and Glucose Study

This study was undertaken to determine the relationship between food security and individual dietary diversity score [IDDS]. This population-based cross-sectional study was conducted on 200 non-diabetic individuals aged>/=40 years, selected randomly from the Tehran Lipid and Glucose Study. Household food security was measured using a validated United States Department of Agriculture [USDA] 18-item questionnaire and IDDS using a valid and reliable 147-item food frequency questionnaire based on five food groups of the Food Guide Pyramid. Overall, 48.5% of the study subjects had high, 36.0% had borderline, and 15.5% had low food security. Significant inverse correlations were observed between the scores for food security, diversity of fruits and vegetables, and total IDDS. Food secure group had significantly higher total IDDS [4.74 +/- 1.40 vs. 5.15 +/- 1.28, P = 0.033] and score for diversity of fruits [1.48 +/- 1.40 vs. 1.68 +/- 1.28, P = 0.030] as compared to the food insecure group. After adjusting for covariates, higher food security score was associated with lower total IDDS [regression coefficient for a 1-unit difference in diversity score = -0.130, P = 0.040], and score for diversity of fruits [regression coefficient for a 1-unit difference in diversity score = -0.182, P = 0.010]. The results showed an inverse relationship between food security score and dietary diversity score. Intake of different fruits is associated with higher food security

Association of metabolic syndrome with body fat percent, anthropometric indices in 10 to 18 year old adolescents

Background: Our aim was to evaluate the association of metabolic syndrome [MetS] and its components with body fat percentage [BFP] and anthropometric indicesin10 to 18year old adolescents

Methods: This was a cross-sectional study conducted on 134 Tehranian adolescents, aged 10 to 18 years [66 boys and 68 girls] in 2007. The MetS definition proposed by Cook et al. was used. Logistic regression was used to determine the relationship of MetS and its components with body mass index [BMI], waist circumference [WC], waist to height ratio [WHtR], and BFP. Using the areas under the receiver operating characteristic [ROC] curve, the discriminatory ability of anthropometric measurements and BFP was evaluated

Results: The mean+/-SD forage of boys and girls was14.5+/-2.3and13.0+/-2.9 years, respectively [P=0.001]; the prevalence of MetS in these groups was 32.3 and6.5%, respectively [P=0.001]. After adjusting for sex and physical activity, the highest odds ratios [95% CI] for MetS and hypertriglyceridemia were found for WC, 6.27 [2.63-14.94; P<0.05] and 3.14 [1.87-5.27; P<0.05], respectively, and those for low HDL-C and hypertension were found for BMI, 2.91 [1.73-4.90; P<0.05] and 2.26 [1.27-4.02; P=0.05], respectively. After adjusting for sex and physical activity, the highest area under ROC curve for MetS and hypertriglyceridemia was seen for WC [P=0.001], for hypertension it was seen for BMI [P=0.001], and for low HDL-C it was observed for both WC and BMI [P=0.001]

Conclusions: In adolescents, WC was the best predictor of MetS and hypertriglyceridemia, BMI was the best predictor of hypertension, and WC and BMI were the best predictors for low HDL-C

Nutritional approaches for prevantion and treatment of metabolic syndrome in adults

Metabolic syndrome, a clustering of components that reflect overnutrition, sedentary lifestyles, and excess adiposity, has become a major health problem worldwide. The increase in its prevalence could be the result of the increase in obesity and insulin resistance. It is suggested that modification of lifestyle including increasing exercise and improving dietary habits is an effective approach for management of the metabolic syndrome. No single diet is recommended for patients with metabolic syndrome. This paper will review the data and make an evidence-based recommendation for the optimal dietary patterns for reducing cardiometabolic risk

Do the other nutrients except calcium and vitamin D prevent the incidence of osteoporosis?

Osteoporosis as a skeletal disorder characterize by compromised bone strength predisposing a person to an increased risk of fracture. All people should be encouraged to take efforts to prevent bone loss and fractures. Nutrition is one of several factors that can be modified to reduce osteoporosis risk. The purpose of this review article is assessment the role of the other nutrients the exception of calcium and vitamin D on bone health and prevention of osteoporosis.The search was undertaken in three databases [PubMed, google scholar and science direct] for publications from 2005 onwards using key words as follows. Initial searches yielded approximately 2467 results. After considering additional exclusion criteria, 33 clinical trial and meta- analysis papers remained.According to investigations, high intake of dietary protein increase bone resorption and calcium excretion and low protein intake can prevent calcium absorption and decrease strength and bone mass. Omega-3 supplementation also can decrease bone resorption and alpha-linleic acid [for men and women] and arashidonic acid [in men] and isoflavones can significantly diminish the risk of hip fracture. Adequate intake of some nutrients like zinc, vitamin A, boron and manganese in bone formation and copper, fluoride and strontium in bone mineralization have positive effects. However, high intake of vitamin A and fluoride result in hip fracture incretion. Vitamin K [in form of K2] along with calcium and vitamin D induce bone fracture decrease. If intake of phosphate, iron and sodium be more than the recommended values, they may present negative effects on bone mineralization.In conclusion, risk of osteoporosis incidence may be diminished with an adequate and balanced diet containing variety of foods to meet needs and a healthy lifestyle. Nutrition education and training the other preventive factors should be carrying out in childhood to achieve the peak bone mass in youth and aging

Lifestyle interventions and risk of Type 2 diabetes

Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It is difficult to treat and expensive to manage. The development of type 2 diabetes is strongly related to lifestyle factors, thus it might be a preventable disease. Observational studies and intervention trials have shown that physical activity, weight loss and dietary intake including whole grain, dietary fiber and dietary fat are important in delaying and preventing type 2 diabetes. The aim of this review is to gather current information from epidemiologic and clinical trial studies on dietary and lifestyle practices for reducing the risk of type 2 diabetes. The review focuses on the macro and micronutrients, food items and dietary patterns which have been identified as significant in the prevention and management of type 2 diabetes. Also, the role of physical activity and weight loss are presented