Women's behaviors and views on home food safety in Tehran: a qualitative study

Background and Objectives: The aim of this study was to explore the food safety knowledge and behavior of housewives in the city of Tehran, Iran in 2015

Materials and Methods: In this qualitative study 12 Focus Group Discussions by directed content analysis method [n= 96], were conducted among the women who were responsible for food handling in their households in 10 health centers. Each session was held with 7-10 participants, and their voices were recorded. The final transcripts were read to obtain categories until developing themes by using constant comparison method

Results: Three categories in nine themes were emerged as follows: 1] Personal hygiene and poisoning [Washing hands as priority in personal hygiene]; 2] Food safety, preparation and storage [Inadequate knowledge about proper time for boiling raw milk, Lack of awareness about temperature of refrigerator, Incorrect storage of food in the refrigerator, Storage of unwashed and unpacked eggs, fresh fruits and vegetables in the refrigerator, Thawing frozen raw meat and chicken at room temperature, Incorrect separation and sanitization of cutting boards for fresh vegetables, raw meat, chicken, and Inappropriate washing of fresh leafy vegetables]; and 3] Safety of cooked foods [Improper reheating of leftover foods]

Conclusions: The findings of this study illustrated that there was lack of knowledge about food safety. It was evident that the majority of the participants were not familiar with appropriate practices to prevent cross contamination and food handling. Therefore, home food safety education should be conducted for housewives

Manganese intake and risk of esophageal cancer in golestan cohort study

Background: Infections attributed to Helicobacter pylori [H. pylori] involve almost half of the world's population. One of the effects is auto-antibody induction and cross-reaction with numerous proteins in the body. As a result of its widespread prevalence and importance, this study evaluates the associations between H. pylori and thyroid auto-antibodies

Materials and Methods: This study enrolled 100 patients who were candidates for gastroesophageal endoscopy that referred to the Yazd Gastrointestinal Clinic. Patients underwent the following laboratory analyses: urease test, anti-H. pylori [IgG], TSH, T4, T3 and thyroid auto-antibodies [anti-thyroglobulin, anti-thyroid peroxides] Patients were divided into two groups of H. pylori positive and negative according to the results of the anti-H. pylori IgG and urease tests. The level of thyroid auto-antibodies and thyroid function tests were compared between groups. Data were analyzed with chi-square and t-tests. SPSS software version 17 was used for data analysis

Results: Overall, 61 % of patients were H. pylori positive. The mean anti-Thyroid peroxidase level in the H. pylori positive group was significantly more than the negative group [p<0.01]. In addition, 19.7% of H, pylori positive patients and 5.1% of H. pylori negative patients had positive anti-TPO levels, which the difference between both groups was significant [p<0.04]. There was no significant difference in thyroid fimction between the two groups

Conclusion: Although no significant difference in thyroid function was seen in the two groups more patients tested positive for anti-TPO levels in the H. pylori positive group, which was suggestive of thyroid auto-antibody induction by H. pylori

Household milk consumption and its socio-economic associates in West Azarbayejan province, North-west Iran

Background and Objectives: according to the available evidence, consumption of milk and other dairy products among Iranians is far less than recommendations. The share of different milks [i.e., traditionally vs. industrially processed] and its associated variables are, however, neither consistent nor fully known in different Provinces

Materials and Methods: this cross-sectional study was conducted to determine household milk consumption and its association with selected socio-demographic factors in West Azerbaijan Province, North-west Iran. A total of 650 households were selected from urban and rural areas in three major Azeri and Kurdish districts [i.e. Urmia, Khoy and Mahabad] using a multi-stage cluster sampling method. Data were collected using socioeconomic and milk frequency questionnaires

Results: the findings indicated that traditionally-processed milk [bulk] was the most common milk consumed at household level [62.5%]. Mean of bulk milk consumption in urban and rural areas was 479+/-23 and 730+/-64 ml/wk per capita, respectively. It was also shown that establishment of the new food subsidization policy has decreased the mean of household milk consumption by approximately 3 l/wk in urban areas. Factor analysis detected a significant decrease in the higher tertiles of family size/ethnicity score consumption of both bulk and pasteurized milk, which resulted in decreased consumption of total milk

Conclusions: designing and implementation of alternative approaches, such as targeted milk subsidies for poor households or vulnerable age-groups should be considered

Impact of body mass index on pregnancy outcome

Pre-pregnancy obesity is considered as a significant predictor for neonatal and maternal morbidity and mortality. Several studies have indicated conflicting associations between body mass index [BMI] and pregnancy outcomes. This study aimed to evaluate the effects of pre-pregnancy BMI on adverse pregnancy outcomes. This cohort study was conducted from 2010 to 2013 in Qazvin province, Iran. BMI was measured in a total of 1376 pregnant women before their 12th week of pregnancy. The subjects were followed-up until the termination of their pregnancy and childbirth. Data collection was performed through checklists prepared by the researchers, which consisted of three parts: demographic features, obstetric history, and subsequent pregnancy outcome. For data analysis, Chi-square, ANOVA and Mann- Whitney tests were performed, using SPSS version 16. In addition, adjusted odds ratio [OR] and 95% confidence interval [CI] were measured. The risk of preeclampsia [OR: 5.36, CI: 2.505-11.49], gestational diabetes mellitus [OR: 5.092, CI: 1.67-15.46], cesarean section [OR: 1.959, CI: 1.37-2.79], and large for gestational age [OR: 4.735, CI: 1.402-15.98] was higher in overweight [2530 kg/m2], compared to women with below-normal and average weight. Pre-pregnancy obesity is strongly associated with certain pregnancy complications and perinatal conditions. Therefore, these complications implicate the need for pre-pregnancy counseling and weight loss in this group of women

Systematic review of zinc biomarkers and esophageal cancer risk

It is hypothesized that poor zinc nutritional status is associated with an increased risk of esophageal cancer [EC], but current evidence is contradictory. Since some factors may influence zinc absorption, its status may be better evaluated thorough biomarkers. The objectives of this study were to perform a systematic review on the association of zinc biomarkers with EC in observational studies and to evaluate the efficacy of zinc supplements in preventing EC in randomized trials. The MEDLINE database was searched in December 2013 for studies written in English with relevant keywords. Articles which met inclusion criteria were included in this study. Eleven observational studies that measured zinc biomarkers and eight randomized trials which evaluated supplements containing zinc, met our inclusion criteria. The majority of studies suggested that higher zinc status was inversely associated with EC risk. Most of the evidence for this hypothesis comes from case-control studies, which may introduce bias. Cohort studies are needed to establish whether poor zinc status is associated with increased risk for EC. Findings from trials are inconclusive as there is no data from single agent trials. However, the evidence is not still strong enough to conclude a protective role of zinc in EC

[Diet therapy in irritable bowel syndrome; a review]

Irritable Bowel Syndrome [IBS] has the most common functional gastrointestinal disease and has among the most common reasons for outpatients doctor visit both in primary and specialty clinics. Patients suffer from lifelong chronic abdominal pain, diarrhea, constipation, bloating and flatus often associated with anxiety depression which significant opposing effect on the quality of life and have to use the patients to use the healthcare system and induce a huge cost for health care system. It has also result in abstinence from work and its economic consequences. Treatment of irritable bowel syndrome has symptom base which were most challenging aspect of clinical practice. Recently there was accumulating evidence in favor of dietary therapy as one of the cheapest and most effective therapy for IBS. However, there was need for a review which concludes these results. Purpose of this study was to look at the recent literatures about the role of diet in controlling IBS symptoms. Studies published in recent 5 years in Pub Med and SID databases were searched with relevant keywords. Human studies, English or Persian and original articles were included. Studies which were not relevant to medical nutrition therapy were excluded. From 81 studies, 31 studies were included. Foods containing gluten, lactose, fructose, galactane, sorbitol, fructane and allergen foods should be limited or omitted. Patients should be advised to use fibers, prebiotics and probiotics more often. Medical nutrition therapy is a useful method for controlling symptoms of these patients and should be advised

[ role of aerobic training and Pistacia atlantica extract on the levels of protein carbonyl, heat shock protein 70, and glycogen in the liver tissue of diabetic rats]

Background and Aim: The use of medicinal herbs is taken as a healthy and effective alternative treatment for hyperglycemia and liver toxicity. Therefore, due to the positive effects of exercise training on diabetic patients, the objective of the present study was to investigate the effect of a 6 week period of aerobic training together with Pistacia atlantica extract taking on protein carbonyl [PC], heat shock protein 70 [HSP70], and glycogen levels in the liver tissues of diabetic rats

Materials and Methods: In this experimental research, 40 male Wistar rats were randomly divided into 5 groups: 1] healthy control, 2] diabetic control, 3] diabetic under aerobic training, 4] diabetics receiving Pistacia atlantica extract and 5] diabetics under aerobic training and receiving the extract. The six week period exercise program included aerobic training on a treadmill [5 sessions per week, 40 minutes per each session, with a speed of 20m/min and 5% incline]. Pistacia atlantica extract was fed 5 days per week [25mg/kg]. The rats were anesthetized.48 hours after the last training session, and their livers were isolated. Then, the level of their PC, HSP70, and hepatic glycogen were assessed by means of ELISA and chemical colorometry

Results: Mean level of PC in the diabetic group under aerobic training, diabetic group receiving pistacia extract, and the group under aerobic training together with receiving pistacia extract was significantly lower than that of the control diabetic group [P was 0.002, 0.006 and 0.002, respectively] but, mean level of PC was not significantly different in the three case groups. Mean level of HSP70 and glycogen in the three groups was not significantly different either [P was 0.21 and 0.59, respectively]

Conclusion: It was found that aerobic training and Pistacia atlantica extract consumption, either alone or together, led to a significant reduction in PC levels in the liver tissues of diabetic rats. Thus, Pistacia atlantica extract and aerobic training can be good remedies in reducing liver complications resulting from diabetes

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]

Family-based intervention for controlling childhood obesity: an experience among Iranian children

Treatment of childhood obesity is difficult, and successful management may differ in various areas with different cultural backgrounds. The present study was conducted to assess the effect of lifestyle modification family-based intervention in young Iranian children. This field trial study was conducted in 2011 among 156 obese children in Tehran, Iran. They were randomly assigned to intervention and control groups. At baseline, anthropometric measurements and biochemical analysis were performed. The second and third phases consisted of training sessions for parents of the intervention group. At the fourth phase, there was no training program. In all four phases, questionnaires on demographic characteristics, lifestyle and food frequency were completed by interviewing with mothers, and biochemical analysis was repeated at the end of the study. During the second and third phases of the study, weight and height increased significantly in both groups, although weight increased more slowly, and waist and hip circumferences was decreased in the intervention group. Serum triglycerides and cholesterol decreased significantly in the intervention group [P < 0.05]. Analysis of food group consumption showed that in the intervention group, not only consumption of milk, dairy and nuts group increased significantly but also the corresponding figure decreased for bread and cereals, sugar and confectionery ingredients; moreover, the family's oil and fat consumption decreased significantly [P < 0.05]. Watching TV and playing on the computer decreased significantly in the intervention group; however, walking time increased significantly in both groups [P < 0.05]. The family-based lifestyle program had limited but desirable effects on anthropometric and metabolic outcomes of the obese children. We suggest that a longer period of intervention may have more favorable results

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

Schools' cafeteria status: does it affect snack patterns? a qualitative study

The aim of this study was to evaluate patterns of students' snacks habits regarding to their schools' cafeteria status in Tehran by focus group discussion [FGD] technique. Participants were 240 students [12-15. years old], selected from 12 middle-schools in Tehran. The field study consisted of 24 FGDs sessions; involving 8-10 participants. Collected data were coded, categorized and analyzed using constant comparative method. Over half of the students believed that snack consumption is necessary. Although, majority of students believed that their schools' cafeterias are not acceptable, they noted them as one of the necessary parts of school. Nearly half of the children were complaining of unvaried and expensive food items. The most purchased items were: Cookies, sandwiches with mayonnaise and ketchup, soft drinks and chocolate milk. Most of the students were interested in having roles in their cafeterias. Schools' cafeteria are significant sources of supplying adolescents' snacks, so developing hygienic stores containing healthy and nutritious food items is a key element to affect their snack selection positively. Reaching this goal requires a multi disciplinary approach through participation of students, school staff, parents, and the support of community and media

Determinants of stunting in school-aged children of Tehran, Iran

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

Dietary predictors of childhood obesity in a representative sample of children in north east of Iran / 中国当代儿科杂志

<p><b>OBJECTIVE</b>The prevalence of obesity is increasing in Iranian youngsters. This study aimed to assess some dietary determinants of obesity in a representative sample of children in Neishabour, a city in northeastern, Iran.</p><p><b>METHODS</b>This case-control study was conducted among 114 school students, aged 6-12 years, with a body mass index (BMI) ≥95th (based on percentile of Iranian children) as the case group and 102 age- and gender-matched controls, who were selected from their non-obese classmates. Nutrient intake data were collected by trained nutritionists by using two 24-hour-dietary recalls through maternal interviews in the presence of their child. A food frequency questionnaire was used for detecting the snack consumption patterns. Statistical analysis was done using univariate and multivariate logistic regression (MLR) by SPSS version 16.</p><p><b>RESULTS</b>In univariate logistic regression, total energy, protein, carbohydrate, fat (including saturated, mono- and poly-unsaturated fat), and dietary fiber were the positive predictors of obesity in studied children. The estimated crude ORs for frequency of corn-based extruded snacks, carbonated beverages, potato chips, fast foods, and chocolate consumption were statistically significant. After MLR analysis, the association of obesity remained significant with energy intake (OR = 2.489, 95%CI: 1.667-3.716), frequency of corn-based extruded snacks (OR = 1.122, 95%CI: 1.007-1.250), and potato chips (OR = 1.143, 95%CI:1.024-1.276). The MLR analysis showed that dietary fiber (OR = 0.601, 95%CI: 0.368-0.983) and natural fruit juice intake (OR = 0.909, 95%CI: 0.835-0.988) were protective factors against obesity.</p><p><b>CONCLUSIONS</b>The findings serve to confirm the role of an unhealthy diet, notably calorie-dense snacks, in childhood obesity. Healthy dietary habits, such as the consumption of high-fiber foods, should be encouraged among children.</p>

[Some determinants of Stunting in children of Tehran]

Stunting indicates longWterm effects of inadequate nutrition and/or health. This study aimed to investigate the factors influencing stunting among first grade primary school children in Tehran, Iran 2008. This is a case-control study. The subjects were selected from 3147 Children whose height was measured using standard protocols. 86 stunned children [Case group] and 308 children with normal height recruited for the study, using a cluster sampling method in 5 districts of Tehran. Stunting was defined as the height for age below the 5th percentile of CDC2000 standard. The tool for data collection was a questionnaire including questions about children's birth weight and height, duration of breast feeding and demographic characteristics. Data were analyzed by SPSS14 and using Chi-square, student t-test and multivariate logistic regression. The prevalence of stunting was%3.7 among children. Means for birth weight and duration of breast feeding were 2.9 +/- 0.6 kg, 17.4 +/- 8.7 months, respectively among stunted children which were significantly lower than non stunted children [3.2 +/- 0.5 kg 20 +/- 7.7 months, respectively] [P<0.05].The parents of stunted children had lower education [P<0.05]. Logistic regression analysis showed that odds ratio of stunting among children is 4.6 for children with "birth weight of lower than 3Kg" compared to children with "birth weight higher than 3Kg" [CI= 95%; OR:1.4-14.7]. Odds ratio of stunning was also 3.3 [CI= 95%; OR: 1.1-9.2] among children with "breast feeding less than 3months" compared to "breast feeding more than 3 months". It was also 6.7 [CI= 95%; OR: 1. 1-9.2]. This study showed that the prevalence of stunting is relatively low in Tehran. Primary health care during pregnancy and breast feeding in first 3 month of life were shown as the most important factors influencing stunting.

Pulmonary tuberculosis in household contact of patients with active tuberculosis in Ahwaz, Iran [2003-2005]

To determine the prevalence of tuberculosis [TB] among the household contacts. It is a retrospective descriptive study conducted in Ahwaz a city in the southwest of Iran, between October and February 2007. Medical files and epidemiological forms of documented TB cases and their contacts in Ahwaz Health Center over the three years period from 2003 to 2005 were reviewed. An index case[IC] was defined as the first TB case identified in the household. A household contact [HC] was defined as an individual who had resided in the household for at least thirty days prior to the diagnosis of tuberculosis in the index case. Secondary cases were defined as TB cases among contacts of the IC. We found 69 patients as IC of TB. Secondary TB in HC and community contacts [CC] was 64 and 15 cases respectively. The studied contact population of 1293 individuals included 352 HC and 941 CC. The prevalence rate of TB for HC and CC was 18.2% and 1.5% respectively [p<0.05]. The prevalence rate of TB from IC with smear positive pulmonary tuberculosis [SPPTB] and smear negative pulmonary tuberculosis [SNPTB] for HC and CC was 23.1%, 11.7% and 2.3%, 0.8% respectively [p<0.05]. More than 95% of patients with TB in HC were middle aged or elderly. HIV seropositivity and history of IDU addiction was detected in 18.7% of HC with tuberculosis [p<0.05]. Tuberculosis is common among household contacts of index cases in Ahvaz [Iran], especially among middle aged and elderly,HIV-infected and IDU addict contacts