Nutritional assessment for primary school children in Tehran: an evaluation of dietary pattern with emphasis on snacks and meals consumption

In order to provide better advice for prevention of obesity and eating disorders among children, there is a need to have more knowledge of their dietary patterns. This study examined meal and snacking patterns of primary school children in Tehran. A total of 761 male and female primary school children from all educational areas in Tehran were recruited in a cross sectional survey. The data was collected by interviewing the students and their mothers or caregivers. Information on food consumption patterns was collected by one 24-h-recall and one snack-oriented food frequency questionnaire which covered a period of 1 month. Means, standard deviations, frequencies, percentages, energy and nutrient analyzes and nutrient densities were reported. All of the students snacked at least once on the day of the survey. Snacks provided 38% of total energy intake by the students. Fruits and sweet snacks were consumed by almost all of the students during a week. Energy and most nutrient intakes from meals were greater than those consumed from snacks. Snacks had a higher density of fiber, carbohydrate, calcium, iron, vitamin C, riboflavin and thiamin and had a lower density of protein, fat and niacin, compared with main meals. Salty snacks such as extruded cheese curls [Cheetos] and chips were not consumed so often. Results provide detailed information about dietary patterns, which in turn enable development of targeted messages and/or interventions to improve nutritional status of school children

[Validity of telephone versus face-to-face interviews in the assessment of bread consumption pattern]

There are different methods to assess dietary intake in the community. Accurate and appropriate methods, rather than costly and time-consuming ones, are good alternatives to assess dietary intake. The aim of this study was to analyze the validity of telephone and face-to-face interviews, in determination of bread-consumption pattern. A randomized and stratified multi-stage sampling method was used to select 2312 participating households within the Tehran metropolitan area. The study [research] was carried out in two individual and household levels, using 24 hours recall and purchase frequency questionnaire. The same 24 hour recall and purchase frequency questionnaires were used at both individual and household level. At household and individual level, the correlation coefficients between the two methods were 0.64 and 0.60, respectively [p<0.001]. Mean difference of intake of bread between the methods at individual level was 16-21 g/day and at household level was 3-4 g/person/day, statistically not significant. Our findings suggest that a telephone survey can provide a reliable estimation of actual bread intake at both individual and household level. This method is important considering its cost and needed time

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]

Development and Validation of a Food Frequency Questionnaire for Assessing Dietary Calcium in Children

This study aimed to develop and validate a food frequency questionnaire [FFQ] for measuring calcium intake in 9-13 years old children in Tehran, Iran. A 56-item FFQ containing main contributors of calcium in Iranian diet was designed. Criterion validity of the calcium specific FFQ was evaluated through comparing its result with five 24-h recalls as the reference method. Reproducibility was measured by twice administration of FFQ, one month apart. The study was performed in the selected primary and middle schools of Tehran city. Subjects included 184 children aged 9-13 years [90 girls and 94 boys], who were recruited through two-stage systematic cluster sampling from 20 primary and middle schools. Mean calcium intake was 922.8 +/- 322.3 and 876.0 +/- 491.8 mg/d for the 24-h recalls and FFQ, respectively, indicating a mean difference of 46.7 +/- 458.7 mg/d [P<0.001]. Corrected Pearson's correlation was 0.57. Cross-classification analysis of the FFQ and 24-h recalls classified 80% of the subjects in the same or adjacent category, and 6% in the extreme quartiles. The FFQ correctly identified 85% of the children consuming less calcium than the age-specific Recommended Dietary Allowance [RDA] [1300 mg/d]. Pearson's correlation for repeated administrations was 0.65. Cross-classification analysis of the repeated administration of FFQ classified 81% of the subjects in the same or adjacent quartiles, and 3.3% in the extreme categories. The FFQ underestimates mean calcium intake of a group, and has limited use to estimate calcium intake for individuals. However, it has acceptable validity and reproducibility for epidemiologic studies to assess a group's mean calcium intake

Can current supply figures support the nutritional recommendation of fish consumption in Iran? a case-study of the challenges in front of a nutrition policy

Fish consumption twice per week" recommendation has been adopted in many countries, including Iran, by Nutrition experts. Data derived from food balance sheets [FBSs] and national household food consumption surveys [NHFCSs] show that fish consumption has been increased in the last 20 years in Iran. The gap between supply and recommendation figures in order to analyze the feasibility of this policy however needs to be determined. In this study, we took current figures of fish supply and consumption in Iran and calculated the amount of fish needed to support the recommendation of fish consumption. Data obtained from FAOSTAT-FBSs in 1980-82, 1990-92 and 2000-02, and NHFCS reports in 1992-95 and 2001-03. Fish supplies needed to fulfill the nutritional policy were calculated based on 120 and 180 gr/caput/wk scenarios. Sharp increase happened in the average fish supply from 1980s to 1990s, but slowed down afterwards. In early 2000, fish availability and intake were 4.73 and 4.43 kg [as raw-whole fish]/capita/year, respectively. The amount of fish required to fulfill the recommendation were however calculated as 10.97 and 16.43 kg/caput/yr based on the two scenarios, respectively. This study reveals that the gap between present fish consumption and the amounts for nutritional goal is still big. Whether bridging this gap in terms of feasibility, ecological, environmental and logistical burdens is attainable, needs more evaluation. Nutrition educators should be aware of the effects of their campaigns on the nationwide food policy as well as on issues such as consumer demand, prices, and environment

nutrition knowledge level of physicians, nurses and nutritionists in some educational hospitals

Nutritional care is an important part of medical care of patients and plays a key role in improvement, prevention and control of malnutrition in hospitals. The current study aimed to determine the nutrition knowledge level of doctors, nurses and nutritionists in some teaching hospitals in Tehran in 2008. In a cross-sectional study a total of 198 samples including 28 nutritionists, 81 nurses and 89 physicians were selected using simple random sampling. The current study was conducted in 9 hospitals affiliated with the Shahid Beheshti University of Medical Sciences [SBMU] in Tehran. A self-administered multiple choice questionnaire about different aspects of basic and clinical nutrition was completed. Then nutrition knowledge levels of each individual was determined by calculating correct knowledge, perceived knowledge and accuracy of knowledge scores. The median knowledge score of the nutritionists, physicians, and nurses was 85%,77%, and 75%, respectively. The median perceived knowledge of all the groups was above 90%. The mean accuracy score in the 3 groups of nutritionists, physicians and nurses was 87%,79%, and 76%, respectively. The results indicated that all groups have a poor knowledge, especially in clinical nutrition topics. Based on the current results, knowledge level of clinical staff is an effective factor in not paying attention to the importance of nutritional care as a part of medical care of the patients. Enhancing awareness level of all groups especially physicians and nutritionists in clinical division plays an important role in enhancing clinical nutrition care and treatment regime

Parental determinants of overweight and obesity in Iranian adolescents: a national study

Overweight among adolescents is not only an important public health problem but also a problem affecting economic growth in developing countries. The aim of this study was to investigate the parental determinants of overweight and obesity in Iranian adolescents at national level. This cross sectional study was conducted within the framework of the Comprehensive Study on Household Food Consumption Patterns and Nutritional Status of IR Iran during 2001-2003. In adolescents, anthropometric indices were defined based on the CDC 2000 cut-off points for age and gender-specific body mass index [BMI]. Parental characteristics were collected by questionnaire. Among the 7158 participating households, data on 7908 adolescents aged 11-19 years [3750 girls and 4158 boys] was analyzed. The prevalence of overweight [85-94th percentile] in boys and girls was 6.2%, and 8.7%, respectively. The prevalence of obesity [>/= 95th percentile] among boys and girls was similar [3.3%]. Parents' weight status, father's job and parents' education showed significant association with weight status in adolescents. Logistic regression analysis showed that parental overweight and obesity, parental education and father's job were the main parental determinants of overweight and obesity in Iranian adolescents. Parental overweight and obesity, parental education and father's job seem to be the major parental determinants of overweight in Iranian adolescents. Future prevention programs must take these risk factors into account