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

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

[Association between macronutrients and metabolic syndrome among adults]

The association between macronutrients and metabolic syndrome is inconsistent. The aim of this study was to investigate the association between macronutrients, and metabolic syndrome in adults referring to the outpatient clinics of the Taleghani hospital in 2009. This case control study was conducted on adults; aged 25-55 y. 80 subjects with metabolic syndrome as cases and 160 subjects without metabolic syndrome as controls participated and were matched by age [ +/- 5 year] and gender. The metabolic syndrome was defined based on Adult Treatment Panel three. Anthropometric and biochemical profiles were documented. Dietary data were collected using a valid and reliable food frequency questionnair. Intake of energy, carbohydrate, protein, fat, saturated fatty acid, monounsaturated fatty acid and polyunsaturated fatty acid was higher in metabolic syndrome compared with subject without metabolic syndroem. Subjects in the higher intake of carbohydrate [more than 55% of total energy intake] had a higher odds of metabolic syndrome compared with those with lower intake [lower than 55% of total energy intake]. Intake of carbohydrate was positively associated with metabolic syndrome. Future studies using clinical trial data are needed to clarify the effects of macronutrients on the metabolic syndrome.

Legume intake is inversely associated with metabolic syndrome in adults

Studies on the association between legume intake and metabolic syndrome [MetS] are sparse. The objective of this study is to evaluate the association between legume intake, MetS, and its components. This study was conducted on 80 subjects [48% female] with MetS as cases and 160 age and gender-matched healthy controls. Anthropometric measures, blood pressure, fasting blood glucose, and lipid profiles were evaluated by standard methods. Dietary data were collected using a food frequency questionnaire [FFQ] and legume intake was determined. MetS was defined according to the definition of - Adult Treatment Panel III. The mean [SD] intake of legumes was 1.4 [0.9] servings/week for cases and 2.3 [1.1] servings/week for control subjects [P < 35]. After adjustment for potential confounders, decreases in mean systolic blood pressure, fasting blood glucose, and increase in HDL cholesterol levels were observed across increasing quartile categories of legume intake. After adjustments for life style and food groups, subjects in the highest quartile of legume intake had lower odds of having MetS compared with those in the lowest quartile [odds ratio [OR]: 0.25: 95% Cl: 0.11-0.64, P < 0.05], an association that weakened after adjustment for body mass index [BMI], but remained significant OR: 0.28: 95% Cl: 0.12-0.81, P < 0.05]. Legume intake is inversely associated with the risk of having MetS and some of its components