Cheese consumption in relation to cardiovascular risk factors among Iranian adults- IHHP Study

BACKGROUND/OBJECTIVE: It is expected that dairy products such as cheeses, which are the main source of cholesterol and saturated fat, may lead to the development or increase the risk of cardiovascular and metabolic diseases; however, the results of different studies are inconsistent. This study was conducted to assess the association between cheese consumption and cardiovascular risk factors in an Iranian adult population. SUBJECTS/METHODS: Information from the Isfahan Healthy Heart Program (IHHP) was used for this cross-sectional study with a total of 1,752 participants (782 men and 970 women). Weight, height, waist and hip circumference measurement, as well as fasting blood samples were gathered and biochemical assessments were done. To evaluate the dietary intakes of participants a validated food frequency questionnaire, consists of 49 items, was completed by expert technicians. Consumption of cheese was classified as less than 7 times per week and 7-14 times per week. RESULTS: Higher consumption of cheese was associated with higher C-Reactive Protein (CRP), apolipoprotein A and high density lipoprotein cholesterol (HDL-C) level but not with fasting blood sugar (FBS), total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and apolipoprotein B. Higher consumption of cheese was positively associated with consumption of liquid and solid oil, grain, pulses, fruit, vegetable, meat and dairy, and negatively associated with Global Dietary Index. After control for other potential confounders the association between cheese intake and metabolic syndrome (OR: 0.81; 96%CI: 0.71-0.94), low HDL-C level (OR: 0.87; 96%CI: 0.79-0.96) and dyslipidemia (OR: 0.88; 96%CI: 0.79-0.98) became negatively significant. CONCLUSION: This study found an inverse association between the frequency of cheese intake and cardiovascular risk factors; however, further prospective studies are required to confirm the present results and to illustrate its mechanisms.

Outcomes of a comprehensive healthy lifestyle program on cardiometabolic risk factors in a developing country: the Isfahan healthy heart program

This study evaluated the outcome of a comprehensive, community-based healthy lifestyle program on cardiometabolic risk factors. The Isfahan Healthy Heart Program [IHHP] was a comprehensive action-oriented, multi-component intervention with a quasi-experimental design and reference area. IHHP targeted the population-at-large [n = 2,180,000] in three districts in central Iran. Data from independent sample surveys before [2000 - 2001] and after [2007] this program were used to compare differences in the intervention area and reference area over time after controlling for age, education level and income. The samples in 2000 - 2001 and 2007 included 6175 and 4719 participants in intervention area, and 6339 and 4853 in reference area, respectively. Multiple interventional activities were performed based on the four main strategies of healthy nutrition, increased physical activity, tobacco control and coping with stress. The prevalence of abdominal obesity, hypertension, hypercholesterolemia, hypertriglyceridemia and high LDL-C decreased significantly in the intervention area versus the reference area in both sexes. However the reduction in overweight and obesity was significant only in females [P < 0.05 for all]. There were no significant changes in the prevalence of diabetes mellitus. In the intervention area, the prevalence of hypercholesterolemia decreased from 23.5% to 12.5% among females without any changes in females in the reference area [p < 0.0001]. In males, hypercholesterolemia decreased significantly in both intervention area [18.5% to 9.6%] and reference area [14.4% to 9.8%; p = 0.005]. Mean triglyceride levels had a significant decrease in the intervention area and a non-significant decrease in the reference area [p < 0.0001]. A comprehensive healthy lifestyle program comprising preventive and promotional activities that considers both population and high risk approaches can be effective in controlling cardiometabolic risk factors in a middle-income country

association between hypertriglyceridemic waist phenotype, menopause, and cardiovascular risk factors

Background: the incidence of cardiovascular disease [CVD] and its risk factors increase after menopause, thus realizing that the effect of menopause on women’s 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

Barriers and facilitators of weight management in overweight and obese people: qualitative findings of tabassom project

Since weight management is affected by various factors, including social and behavioral ones, this study aimed to explore the peoples' experience of barriers and facilitators of weight management. This qualitative content analysis was conducted as the initial step of TABASSOM Study. Participants, who tried to reduce their weight at least once, were selected by purposeful sampling method from aerobic fitness clubs, parks, and public offices in Isfahan in 2010. Data saturation was reached after indepth unstructured interviews with 11 participants. Data analysis was done by conventional content analysis method. The participants have intermittently followed weight loss program. Barriers such as physical problems, lack of motivation, lack of work and family support and lack of time have resulted in their failures and outages. The main facilitator to start or restart after stopping such programs for a while was positive psychologic effect. Findings showed that many problems could prevent weight loss. It is important to identify obstacles that hinder weight management and regimen programs and to discuss them with people before planning for their weight management.

Antioxidant effects of L-serine against fatty streak formation in hypercholesterolemic animals

Peroxidation of blood lipoproteins is regarded as a key event in the development of atherosclerosis. Evidence suggests that oxidative modification of amino acids in low-density lipoprotein [LDL] particles leads to its convert into an atherogenic form, which is taken up by macrophages. Therefore the reduction of oxidative modification of lipoproteins by increasing plasma antioxidant capacity may prevent cardiovascular disease. In this study, the antioxidant and anti-fatty streak effects of L-serine were investigated in hypercholesterolemic rabbits. Rabbits were randomly divided into three groups which were fed high-cholesterol diet [hypercholesterolemic control group], high-cholesterol + L-serine diet [treatment group], and normal diet [control] for twelve weeks and then blood samples were obtained to measure plasma cholesterol, triglyceride [TG], high-density lipoprotein [HDL], low-density lipoprotein [LDL], antioxidant capacity [AC], malondialdehyde [MDA], and conjugated dienes [CDS]. Right and left coronary arteries were also obtained for histological evaluation. No significant difference was observed in plasma cholesterol, TG, HDL, LDL and CDS levels between treatment and hypercholesterolemic control groups [P>0.05]. The levels of plasma MDA and AC were 0.29% micro M and 56%, respectively in the treatment group which showed a significant change in comparison with hypercholesterolemic control groups [P<0.05]. The mean size of produced fatty streak also showed significant reduction in the treatment group compared to the hypercholesterolemic group [P<0.05]. The results showed that L-serine has antioxidant and anti-fatty streak effects without any influence on plasma lipid levels in hypercholesterolemic rabbits