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Background/Aims@#Accumulating evidence based on a few studies suggests a relationship between depression and functional constipation. This study examined whether depression is associated with a higher risk of functional constipation and whether it is gender specific. @*Methods@#This cross-sectional study was carried out on 3,362 adults aged 18-55 years. In this study, functional gastrointestinal symptoms were determined using an Iranian reliable and valid version of the modified Rome III questionnaire. The Iranian validated version of the hospital anxiety and depression scale was used to evaluate the psychological health. Scores of eight or more on the depression subscale in the questionnaire were considered the presence of depression. Simple and multiple binary logistic regression were used for data analysis. @*Results@#The mean±SD age of participants was 36.29±7.87 years, and 58.5% were female. The prevalence of depression and constipation in the study sample was 28.6% and 23.9%, respectively. In the full adjusted model, in the total sample, depressed people showed a significantly higher risk of constipation; adjusted OR (AOR), 1.69 (95% CI, 1.37-2.09). Although a significant association was observed between depression and constipation in both genders, the association was stronger in men than women (AOR, 2.28; 95% CI, 1.50, 3.63 vs. AOR, 1.55; 95% CI, 1.21, 1.99). @*Conclusions@#These study findings showed that depressed people are at a significantly higher risk of being affected by constipation. The current study findings justify the importance of mental health evaluations in all patients with functional gastrointestinal disorders, particularly among constipated individuals.
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Background/Aims@#Despite huge evidence on the link between adherence to dietary approaches to stop hypertension (DASH) eating pattern and several metabolic abnormalities, the association of this diet with irritable bowel syndrome (IBS) has not been investigated so far. We aim to examine the association between adherence to the DASH diet and prevalence of IBS symptoms and subtypes in adults. @*Methods@#This cross-sectional study was done among 3362 adult people in Isfahan, Iran. Usual dietary intakes were assessed using a validated 106-item dish-based semi-quantitative food frequency questionnaire. To investigate participants’ adherence to DASH-style diet, we created DASH score based on 8 main foods and nutrients emphasized or minimized in the DASH diet. Participants were classified into 3 categories according to their DASH-style diet scores. A validated modified Persian version of the Rome III questionnaire was applied for assessment of IBS. @*Results@#Totally, 22.2% of study participants were affected by IBS. After adjustment for potential confounding factors, we found that participants in the highest tertile of DASH score had lower odds of IBS (OR, 0.65; 95% CI, 0.50-0.83) compared with those in the lowest tertile. The same findings were also reached for IBS with constipation (OR for the highest vs the lowest tertile of DASH-style diet = 0.56; 95% CI, 0.38-0.85). No significant association was seen between adherence to DASH-style diet and IBS with diarrhea (OR, 1.31; 95% CI, 0.83-2.06). @*Conclusions@#We found a significant inverse association between adherence to DASH dietary pattern and odds of IBS and IBS with constipation.Further prospective studies are required to confirm these findings.
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Introduction and Aims: Data on the association of adherence to DASH-style and glioma are scarce. This hospital-based case-control study examined the association between adherence to DASH-style diet and glioma in a group of Iranian adults
Materials and Methods: Cases of glioma [n=128] and their age- and sex-matched healthy controls [n=256] were recruited from hospital. Participants' dietary intakes were assessed using a validate food frequency questionnaire. Adherence to DASH diet was evaluated
Results: After controlling for potential confounders, individuals with the greatest adherence to the DASH diet were less likely to have glioma compared with those with the lowest adherence [Odds ratio for the highest vs. the lowest tertile: 0.26; 95% CI: 0.13-0.54]. Additional controlling for BMI did not influence the association significantly [0.28; 0.13-0.57]. A diverse association was also seen between consumption of fruits [0.31; 0.14-0.68], legumes and nuts [0.23; 0.10-0.53] and risk of glioma. We found a significant positive association between red and processed meat intake and risk of glioma [2.60; 1.16-5.81]. Individuals in the highest tertile of salt intake were 2.87 times more likely to have glioma than those in the bottom tertile after taking all potential confounders into account [2.87; 1.30-6.34]
Conclusion: We found that adherence to the DASH style dietary pattern was inversely associated with glioma. In addition, some components of DASH diet, including red meats and salt intake was positively associated with glioma. Consumption of nuts and legumes as well as fruits was inversely associated with glioma
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OBJECTIVE: Major depressive disorder is the leading cause of disability around the world. The relationship between depression and dietary patterns has been reported in a few studies but with controversial results. This study aimed to investigate this relationship in an Iranian population. METHODS: In our study, 330 depressed patients (cases) and healthy people (controls) (1:2) were individually matched according to age, sex and area of residence. New cases of depression were recruited from two psychiatric clinics in Tehran. Interviewers went to each patient's residential area, and invited qualified individuals to participate in the study as controls. Food intake over the past year was collected using a validated semi quantitative food frequency questionnaire. Dietary patterns were determined by the principal components method. Binary logistic regression was used to test the effect of dietary patterns on depression. RESULTS: We identified two major dietary patterns by using factor analysis: the healthy and unhealthy dietary patterns. We categorized the scores of these patterns to quartiles. After adjusting for non-depression drug use, job, marital status, children number, and body mass index, the relations of depression and quartiles of two dietary patterns are significant (p=0.04 & p=0.01, respectively). Compared with participants in the lowest quartile, those in the highest quartile had significantly lower odds ratio (OR) for depression in healthy dietary pattern, and higher OR for depression in unhealthy dietary pattern. CONCLUSION: This study indicates that healthy and unhealthy dietary patterns may be associated with the risk of depression. The results can be used for developing interventions that aim to promote healthy eating for the prevention of depression.
Subject(s)
Child , Humans , Body Mass Index , Case-Control Studies , Depression , Depressive Disorder, Major , Eating , Epidemiology , Logistic Models , Marital Status , Odds RatioABSTRACT
Earlier forms of food frequency questionnaire [FFQ] used in Iran have extensive lists of foods, traditional categories and food-based design, mostly with the interviewer-administered approach. The aim of the current paper is to describe the development of a dish-based, machine-readable, semi-quantitative food frequency questionnaire [DFQ]. Within the framework of the Study on the Epidemiology of Psychological, Alimentary Health and Nutrition project, we created a novel FFQ using Harvard FFQ as a model. The following steps were taken to develop the questionnaire: Construction of a list of commonly consumed Iranian foods, definition of portion sizes, design of response options for consumption frequency of each food item and finally a pilot test of the preliminary DFQ. From a comprehensive list of foods and mixed dishes, we included those that were nutrient-rich, consumed reasonably often or contributed to between-person variations. We focused on mixed dishes, rather than their ingredients, along with foods. To shorten the list, the related food items or mixed dishes were categorized together in one food group. These exclusions resulted in a list of 106 foods or dishes in the questionnaire. The portion sizes used in the FFQ were obtained from our earlier studies that used dietary recalls and food records. The frequency response options for the food list varied from 6-9 choices from "never or less than once a month" to "12 or more times per day". The DFQ could be a reasonable dietary assessment tool for future epidemiological studies in the country. Validation studies are required to assess the validity and reliability of this newly developed questionnaire
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Increased requirement and decreased dietary intakes of micronutrients during pregnancy might affect maternal health and pregnancy outcomes. This study was aimed to examine the effects of two types of multiple micronutrient supplementations on pregnancy outcomes in Kashan, Iran. In a randomized single-blind controlled clinical trial, 104 primigravid singleton pregnant women aged 18-30 years were randomly assigned to receive either a multivitamin [n - 51] or a multivitamin-mineral [n - 53] supplements for 20 weeks. Participants consumed supplements once a day at week 16 of gestation. Maternal anthropometric data as well as newborn's weight, height, head circumference and 5-min Apgar score were also determined. Independent samples /-test was used for comparing between-group means. Multivariate linear regression analysis was used to identify determinants of newborn's weight, height and head circumference. Women taking multivitamin-mineral supplements gained marginally less weight until week 28 than those taking multivitamin supplements [weight at week 28 of gestation: 67.5 +/- 11.4 vs. 71.6 +/- 10.3 kg, P = 0.06]. Mean body mass index at week 28 [25.8 +/- 4.0 vs. 28.4 +/- 3.7 kg/m[2], P = 0.001] as well as at delivery [28.0 +/- 3.9 vs. 30.1 +/- 3.8 kg/m[2], P = 0.006] was lower among women taking multivitamin-mineral supplements than those taking multivitamin supplements. Although no significant difference was seen in newborns7 height and Apgar score between the two groups, mean birth weight [3.3 +/- 0.4 vs. 3.1 +/- 0.4 kg, P = 0.04] and head circumference [35 +/- 1.4 vs. 34 +/- 1.3cm, P< 0.0001] of the infants whose mothers receiving multivitamin-mineral supplements were higher than those whose mothers received multivitamins. Multivitamin-mineral use by pregnant women was a significant predictor of infants' weight [P =0.191, P = 0.03] and head circumference [p =0.907, P = 0.005]. In conclusion, we found that birth weight and head circumference was increased in infants whose mothers received multivitamin-mineral supplements for 5 months during pregnancy compared with infants whose mothers received multivitamin supplements
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Although several studies have assessed the influence of the glycemic index on body weight and blood pressure among adults, limited evidence exists for the pediatric age population. In the current study, we compared the effects of low glycemic index (LGI) diet to the healthy nutritional recommendation (HNR)-based diet on obesity and blood pressure among adolescent girls in pubertal ages. This 10-week parallel randomized clinical trial comprised of 50 overweight or obese and sexually mature girls less than 18 years of age years, who were randomly assigned to LGI or HNR-based diet. Macronutrient distribution was equivalently prescribed in both groups. Blood pressure, weight and waist circumference were measured at baseline and after intervention. Of the 50 participants, 41 subjects (include 82%) completed the study. The GI of the diet in the LGI group was 42.67 +/- 0.067. A within-group analysis illustrated that in comparison to the baseline values, the body weight and body mass index (not waist circumference and blood pressure) decreased significantly after the intervention in both groups (P = 0.0001). The percent changes of the body weight status, waist circumference and blood pressure were compared between the two groups and the findings did not show any difference between the LGI diet consumers and those in the HNR group. In comparison to the HNR, LGI diet could not change the weight and blood pressure following a 10-week intervention. Further longitudinal studies with a long-term follow up should be conducted in this regard.
Subject(s)
Adolescent , Adult , Humans , Blood Pressure , Body Mass Index , Body Weight , Diet , Follow-Up Studies , Glycemic Index , Longitudinal Studies , Obesity , Overweight , Waist CircumferenceABSTRACT
Background: the incidence of cardiovascular disease [CVD] and its risk factors increase after menopause, thus realizing that the effect of menopause on womens health is becoming ever more vital
Objective: the aim of this study was to investigate the menopausal effect on cardiovascular risk factors in elevated triglycerides [TG] and waist circumference [WC] phenotype, and to compare this phenotype among pre- and postmenopausal women
Method: a total of 4146 women were randomly selected for this study from three districts of Isfahan, Arak, and Najafabad in Isfahan Healthy Heart Program [IHHP]. Anthropometric, physical, and biochemical factors were assessed using standard methods. All variables were studied based on the menopause status and the levels of TG and WC
Results: twenty-five point three percent of the postmenopausal women and 9.5% of the pre-menopausal women were hyper-TG/WC phenotype; however, the highest percent [77.1%] belonged to high-WC women in the postmenopausal group. In comparison with the postmenopausal women, the premenopausal women were more physically active, with higher education level, but lower BMI, WC, waist to hip ratio, and less likely to be smoker. In postmenopausal women, biochemical factors including fasting blood sugar and lipid profiles were significantly higher than the premenopausal women. There was no significant difference for multivariate-adjusted means of cardiovascular risk factors for menopause in different phenotypes of the WC and TG groups after adjustment for age and BMI
Conclusion: hyper- TG/WC phenotype was more prevalent in postmenopausal women and menopause is not independently associated with CVD risk factors
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Background: potato, a high- glycemic index [GI] food, is one of the most widely used starchy foods worldwide. Previous studies on the association of dietary intakes with stroke have mostly focused on the dietary GI and there is no information regarding the association between potato consumption and risk of stroke. This case-control study was conducted to evaluate the association between potato consumption and risk of stroke in an Iranian adult population
Methods: in this case-control study, 195 patients with stroke, hospitalized in the Neurology Ward of Alzahra University Hospital and 195 controls from other wards of the hospital with convenience non-random sampling method were enrolled. To assess participants' dietary intakes, a validated food frequency questionnaire was used. Information on socioeconomic and demographic variables, physical activity pattern, and smoking were collected by the use of questionnaires. Logistic regression method in different models was applied to explore the associations between potato intake and stroke. First quartile of potato intake was used as a reference in all models. Mantel-Haenszel extension chi-square test was used to assess the overall trend across quartiles of potato consumption
Results: individuals with stroke were more likely to be male [60% vs. 46% , P < 0.05] and older [68.0 +/- 1.0 vs. 61.5 +/- 0.8 y, P < 0.001] as compared with controls. They had lower body mass index [BMI] [25.2 +/- 0.3 vs. 28.5 +/- 1.0 kg/m2, P < 0.05], and were less likely to be obese [11.3% vs. 29.2% , P < 0.001] compared with controls. The mean potato consumption was 31.1 +/- 3.4 and 23.4 +/- 1.3 g/d for cases and controls, respectively. Participants with the highest potato consumption were younger and more likely to be physically active. High potato consumption was associated with higher intakes of energy, fruits, vegetables, pulses, and grains. After adjustment for age, sex, and total energy intake, we found that individuals with the highest potato consumption were more likely to have stroke as compared with those with the lowest consumption [OR: 1.9; 95% CI: 1.0 3.6]. The correlation between physical activity and potato consumption was 0.03, P = 0.54 and that of smoking and potato intake was -0.004, P = 0.94. Even after additional control for smoking and physical activity, the association remained significant [OR: 1.9; 95% CI: 1.0 3.6]. Further adjustment for dietary intakes made the associations non significant [OR: 1.1; 95% CI: 0.5 2.5]. However, when BMI was taken into account in the final model, we found that individuals in the third quartile of potato consumption were significantly more likely to have stroke [OR: 2.2; 95% CI: 1.0 4.7]
Conclusion: we found evidence indicating that there is a marginally significant independent association between potato consumption and risk of stroke. Prospective studies are required to confirm this finding
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Obesity and overweight are the major health problems in Iran. The aim of this study was to determine the prevalence of overweight and obesity among adolescents living in Zabol settled in Sistan va Baluchistan, one of economically underprivileged provinces in South Eastern of Iran, based on four different definitions. This cross sectional study was accomplished among a sample of 837 Zaboli adolescents [483 males; 354 females] aged 11-15 years. Anthropometric measurements including weight and height were measured and body mass index [BMI] was calculated. Sex-specific BMI-for-age reference data of the Iranian national data, Centers for Disease Control data [CDC 2000], International Obesity Task Force data [IOTF] and recent World Health Organization [WHO] data was used to define overweight and obesity. Mean age of the studied population was 13.14 year. Underweight was prevalent among almost 18.7% and 18.4% of adolescents by the use of WHO 2007 and CDC 2000 cut-off points. The prevalence rates reached 25.8% and 27.2% by IOTF and Iranian national criteria, respectively. The highest prevalence of overweight was obtained by IOTF cut-points [10.8%] followed by CDC 2000 criteria [9.4%], WHO 2007 [8.8%] while national Iranian cut-points resulted in the lowest prevalence [2.4%]. 7.5% of the studied population were found to be obese by WHO 2007 definition, while this rate was 2.2%, 3.4% and 1.5% by IOTF, CDC 2000 and national Iranian cut-points. Almost all definitions revealed coexistence of underweight, overweight, and obesity among Zaboli adolescents. Huge differences exist between different criteria. To understand the best appropriate criteria for Iranian adolescents, future studies should focus on the predictability of obesity-related co-morbidities by these criteria
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Humans , Female , Male , Overweight/epidemiology , Thinness/epidemiology , Body Mass Index , Cross-Sectional Studies , AdolescentABSTRACT
Central obesity is one of the major public health problems. Recent studies have indicated that body fat distribution would be important in general health. The present study is a review of several studies which discuss the contributing factors of abdominal obesity, particulary in Iran. This study reviews 34 crosssectional and interventional studies, which have been comducted during 1995-2012 and issued in English language. PubMed search engine and the related keywords were used to search the papers. Breakfast skipping and also the sleep duration as well as the quality of diet are also associated with central adiposity. Dietary diversity score among Iranians can be related to abdominal adiposity. Fastfood consumption can increase the risk of central adiposity among young Iranian population. Red meat intake and food source of trans fat can increase the risk of central adiposity. Low quality diet with low amount of nutrients can increase the risk of central adiposity. Some behaviours such as sleep duration and eating breakfast can be associated with central adiposity among Iranians. Diet quality and dietary diversity score is also associated with this problem among Iranians
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To reach fetal appropriate growth during the third trimester, the requirements for dietary calcium and iron intakes during the pregnancy increases. This study was carried out to determine the effects of daily consumption of probiotic yoghurt on serum calcium and iron levels and liver enzymes among Iranian healthy pregnant women. In this controlled clinical trial, 70 primigravida pregnant women carrying singleton pregnancy at their third trimester were participated. Participants were randomly divided into two groups of consuming 200 g/d of conventional [n = 33] or probiotic yogurts [n = 37] for 9 weeks. The probiotic yogurt contained Lactobacillus acidophilus and Bifidobacterium lactis with a total of min 1 x 10[7] CFU. To measure serum calcium, iron, aspartate aminotransferase [AST] and alanine aminotransferase [ALT] levels, blood samples were drawn in a fasting state at baseline and after 9 weeks intervention. Consumption of probiotic yogurt resulted in maintaining serum calcium levels compared with the conventional yogurt [P = 0.01]. Within group differences in the conventional yogurt group revealed a significant reduction of serum calcium levels [-1.7 mg/dL, P < 0.0001].No significant differences were found between the two yogurts in terms of their effects on serum iron, AST and ALT levels. Consumption of probiotic yogurt among pregnant women resulted in maintaining serum calcium levels compared with the conventional yogurt; however, it could not affect serum iron, ALT and AST levels
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Limited data are available indicating associates of stunting among Iranian children. This study was conducted to investigate determinants of stunting in first grade primary school children of Tehran in 2007. In this case-control study, 3147 school children were selected by multistage cluster random sampling method from 5 districts of Tehran. Anthropometric measurements were done and stunting was defined as height for age less than the 5[th] percentile of CDC2000 cut-off points. Eighty six stunted children were identified and considered as case group. After matching for age, sex and residence area, 308 non-stunted children were randomly selected as control group. Required data were collected by trained nutritionists using questionnaires. Stunting was prevalent among 3.7% of the study population [girls 4.4% vs. boys 2.8%, P < 0.05]. Mean age of the studied children was 82.3 month. Children with a birth weight of >3000 g were less likely to be stunted [OR: 0.25: 95% CI: 0.11-0.54] compared with those with a birth weight of <3000 g. Being born to older mothers [>35 years] was associated with greater odds of being stunted [3.01; 1.19-7.60] compared with being born to younger mothers [<35 years]. Those with fathers' height of >160 cm were less likely to be stunted [0.04; 0.005-0.37] than those whose fathers' height was less than 160 cm. We found that birth weight, maternal age and fathers' height are the major contributing factors to stunting in this group of Iranian children. Taking into account the determinants of stunting might help policy makers designing appropriate interventions
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Humans , Female , Male , Schools , Child , Population , Breast Feeding , Case-Control Studies , Maternal AgeABSTRACT
Although individuals with food insecurity might be expected to have reduced food intake, and thus reduced body fat and less likelihood of being overweight, these associations have not been adequately studied. This study aimed to examine the relationship between household food insecurity and childhood obesity among school-age children in an Iranian population [Farokhshahr city]. In this cross-sectional study, 314 school children aged 6-12 years were selected by the use of a multi-stage cluster random sampling method. Food insecurity was assessed by the use of a validated Radimer-Cornell questionnaire. Participants were categorized separately by sex as "food secure", "having household food insecurity", "Adult food insecurity", and "child hunger". Underweight, overweight and obesity were defined based on four available cut-points [IOTF, CDC, WHO and National]. The associations were looked for in different models adjusting for confounders. Anthropometric measures and food insecurity data were assessed in 310 participants of the study. No significant associations were found between food insecurity and obesity, either before or after control for confounding variables. This was the case for all definitions of overweight and obesity. Food insecurity was not associated with weight status in this sample of students. Additional research with more samples is needed to explore this relationship
Subject(s)
Humans , Cardiovascular Diseases , Risk Factors , Diet , Cholesterol, HDL , TriglyceridesABSTRACT
Dietary habits play an important role in the prevention of chronic disease; however, few studies have assessed the major dietary patterns in Middle Eastern countries. This study identifies major dietary patterns among Iranian people with abnormal glucose homeostasis. This cross-sectional study was conducted at the Diabetes Research Center, Isfahan, Iran among 425 subjects with abnormal glucose homeostasis. Patients were of ages 35 - 55 years and had family histories of diabetes. We assessed dietary intake by the use of a food frequency questionnaire [FFQ] that contained 39 food items. General obesity was defined as a BMI > 30 kg/m[2] and central obesity was defined as waist circumference [WC] > 88 in women and WC > 102 in men. Five major dietary patterns were revealed by factor analysis: 'western', 'healthy', Vegetarian', 'high-fat dairy', and 'chicken and plants'. Those in the top tertile of the 'western pattern' had greater odds for general [OR = 1.73; 95% Cl = 1.07 - 2.78] and central obesity [OR = 2, 95% Cl = 1.24 - 3.22], however these associations were not significant after adjustment for confounding variables. The 'high-fat dairy pattern' was associated with greater odds of general obesity only after adjusting for confounding variables [OR = 1.73; 95%CI = 1.01 -2.96]. The dietary pattern characterized by high intake of hydrogenated fat and sugar was shown to be positively associated with a risk of general and central obesity, however further prospective studies are required to confirm our findings
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Little experience exists on valid and reliable tools for assessment of the determinants of underweight and overweight in children and adolescents living in the Middle-East and North Africa [MENA]. This study aimed to develop a valid and wide-ranging questionnaire for assessment of these parameters in a nationwide sample of Iranian children and adolescents. This national study was conducted in 31 provinces in Iran. The first phase consisted of focus group discussion with 275 children and adolescents and their parents. After a qualitative content analysis, the initial items were extracted. In the next step, the face validity was assessed by expert panelists using the quantitative method of the Impact Score. To assess the content validity, the content validity rate [CVR] and the content validity index [CVI] were determined. The internal consistency was examined by Cronbach alpha, and its test-retest reliability was determined. The socio-demographic variables, perinatal factors, lifestyle factors, family history, knowledge and attitude were assessed. Dietary intakes were assessed using a validated 168-item semi-quantitative food frequency questionnaire. A validated questionnaire for quality of life was filled in anonymously. A team of expert researchers conducted the data analysis of 576 interviews by using qualitative content analysis method. The analysis process began by determining the semantic units associated with the understanding of participants about the concepts studied. The initial questionnaire was developed in four domains by including Likert scale questions. In the face validity step, all questions of the primary questionnaire obtained a score of more than 1.5. In the phase of CVR assessment, 6 questions obtained a score of less than 0.62, and were omitted. The rest of questions were assessed for CVI, and got a score of more than 0.75. Cronbach's alpha coefficient of the whole questionnaire was 0.97, and the Pearson correlation coefficient of the test-retest phase was 0.94. The developed questionnaire is a valid and reliable tool for assessment of the determinants of weight disorders in a nationally representative sample of children and adolescents in the MENA