Low food and nutrition literacy (FNLIT): a barrier to dietary diversity and nutrient adequacy in school age children.

OBJECTIVE: This study aims to assess the relationship between Food and Nutrition Literacy (FNLIT) and dietary diversity score (DDS); FNLIT and nutrient adequacy (NAR%, MAR%) in school-age children in Iran. RESULTS: This cross-sectional study was undertaken on 803 primary school students in Tehran, Iran. Socio-economic, as well as three 24-h dietary recalls were collected through interviewing students and their mothers/caregivers. FNLIT was measured by a self-administered locally designed and validated questionnaire. Low level of FFNL was significantly associated with higher odds of low DDS (OR = 2.19, 95% CI 1.32-3.62), the first tertile of fruit diversity score (OR = 3.88, 95% CI 2.14-6.99), and the first tertile of dairy diversity score (OR = 9.60, 95% CI 2.07-44.58). Low level of IFNL was significantly associated with probability of lower meat diversity score (OR = 1.73, 95% CI 1.07-2.81). Low level of FLL was also significantly associated with probability of lower DDS (OR = 1.81, 95% CI 1.11-2.94), dairy diversity score (OR = 2.01, 95% CI 1.02-3.98), and meat diversity score (OR = 2.14, 95% CI 1.32-3.45).Low FNLIT and its subscales were associated with higher odds of low level of NAR of protein, calcium, vitamin B3, B6, B9, as well as the probability of lower level of MAR.

Calcium Intake, Major Dietary Sources and Bone Health Indicators in Iranian Primary School Children.

BACKGROUND: Adequate calcium intake may have a crucial role with regards to prevention of many chronic diseases, including hypertension, hypercholesterolemia, different types of cancer, obesity and osteoporosis. In children, sufficient calcium intake is especially important to support the accelerated growth spurt during the preteen and teenage years and to increase bone mineral mass to lay the foundation for older age. OBJECTIVES: This study aimed to assess daily calcium intake in school-age children to ensure whether they fulfill the FGP dairy serving recommendations, the recommended levels of daily calcium intake and to assess the relationship between dietary calcium intake and major bone health indicators. PATIENTS AND METHODS: A total of 501 Iranian school-age children were randomly selected. Calcium intake was assessed using a semi-quantitative food frequency questionnaire. Bone health indicators were also assessed. RESULTS: Dairy products contributed to 69.3% of the total calcium intake of the children. Daily adequate intake of calcium was achieved by 17.8% of children. Only 29.8% met the Food guide pyramid recommendations for dairy intake. Dietary calcium intake was not significantly correlated with serum calcium and other selected biochemical indicators of bone health. CONCLUSIONS: The need for planning appropriate nutrition strategies for overcoming inadequate calcium intake in school age children in the city of Tehran is inevitable.

High prevalence of vitamin D deficiency in school-age children in Tehran, 2008: a red alert.

OBJECTIVE: To assess the vitamin D status of 9-12-year-old primary-school children in Tehran during autumn and winter 2007-2008. DESIGN: A descriptive cross-sectional study. SETTING: Primary schools of Tehran city, Iran. SUBJECTS: A total of 1111 children aged 9-12 years (573 boys and 538 girls) from sixty primary schools were enrolled in the study. Weight, height, BMI and serum levels of Ca, P, Mg, 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone (iPTH), osteocalcin and bone-specific alkaline phosphatase of all the participants were assessed. Dietary Ca intake was also evaluated using a quantitative FFQ for a subsample of the study population (n 503). Vitamin D sufficiency was defined on the basis of serum levels of 25(OH)D as either ≥37 nmol/l (criterion 1) or ≥50 nmol/l (criterion 2). RESULTS: Daily intake of Ca did not differ significantly between boys and girls (929·6 (sd 436·7) mg and 909·5 (sd 465·5) mg, respectively). However, on the basis of the first criterion, approximately 86 % of the children had vitamin D deficiency, with 38·3 % being severely deficient (25(OH)D < 12·5 nmol/l). According to the second criterion, prevalence of vitamin D deficiency rose to 91·7 %. Prevalence of vitamin D deficiency was higher in girls than in boys by either criterion. Serum levels of 25(OH)D inversely correlated with iPTH (r = -0·154, P < 0·001) and BMI (r = -0·092, P = 0·002) but directly correlated with duration of sun exposure (r = 0·115, P < 0·001). CONCLUSIONS: The high prevalence of vitamin D deficiency among schoolchildren (especially among girls) warrants immediate interventions for proper nutritional support.

Regular consumption of vitamin D-fortified yogurt drink (Doogh) improved endothelial biomarkers in subjects with type 2 diabetes: a randomized double-blind clinical trial.

BACKGROUND: Endothelial dysfunction has been proposed as the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease, the major cause of death in diabetes. We recently demonstrated the ameliorating effect of regular vitamin D intake on the glycemic status of patients with type 2 diabetes (T2D). In this study, the effects of improvement of vitamin D status on glycemic status, lipid profile and endothelial biomarkers in T2D subjects were investigated. METHODS: Subjects with T2D were randomly allocated to one of the two groups to receive either plain yogurt drink (PYD; containing 170 mg calcium and no vitamin D/250 mL, n1 = 50) or vitamin D3-fortified yogurt drink (FYD; containing 170 mg calcium and 500 IU/250 mL, n2 = 50) twice a day for 12 weeks. Anthropometric measures, glycemic status, lipid profile, body fat mass (FM) and endothelial biomarkers including serum endothelin-1, E-selectin and matrix metalloproteinase (MMP)-9 were evaluated at the beginning and after the 12-week intervention period. RESULTS: The intervention resulted in a significant improvement in fasting glucose, the Quantitative Insulin Check Index (QUICKI), glycated hemoglobin (HbA1c), triacylglycerols, high-density lipoprotein cholesterol (HDL-C), endothelin-1, E-selectin and MMP-9 in FYD compared to PYD (P < 0.05, for all). Interestingly, difference in changes of endothelin-1, E-selectin and MMP-9 concentrations in FYD compared to PYD (-0.35 ± 0.63 versus -0.03 ± 0.55, P = 0.028; -3.8 ± 7.3 versus 0.95 ± 8.3, P = 0.003 and -2.3 ± 3.7 versus 0.44 ± 7.1 ng/mL, respectively, P < 0.05 for all), even after controlling for changes of QUICKI, FM and waist circumference, remained significant for endothelin-1 and MMP-9 (P = 0.009 and P = 0.005, respectively) but disappeared for E-selectin (P = 0.092). On the contrary, after controlling for serum 25(OH)D, the differences disappeared for endothelin-1(P = 0.066) and MMP-9 (P = 0.277) but still remained significant for E-selectin (P = 0.011). CONCLUSIONS: Ameliorated vitamin D status was accompanied by improved glycemic status, lipid profile and endothelial biomarkers in T2D subjects. Our findings suggest both direct and indirect ameliorating effects of vitamin D on the endothelial biomarkers. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01236846.

Determination of the actual height predictors in Iranian healthy children.

Height measurement is an important part of nutritional assessment especially in children. However, in such cases as hospitalized or certain kinds of malformations or disabilities, height cannot be measured accurately. We aimed to determine appropriate height predictors in Iranian healthy children for further use in disabled and/or hospitalized children. A total of 730 apparently healthy children aged 7-11 years old from both sexes from Tehran, Meshed and Rasht were enrolled in a cross sectional study. Height, demispan (DS), halfspan (HS), arm length (AL) and tibia length (TL) were all measured using a measuring tape. Linear regression models were established between height, DS, HS, AL and TL. For boys AL (R2=0.783) and TL (R2=0.837) and for girls AL (R2=0.720), TL (R2=0.765), HS (R2=0.771) and age (R2=0.775), respectively, entered the linear regression model. When height predictors were evaluated individually for each city, only in Tehran DS also entered the regression model. Concordance of different percentiles of height estimates based on AL with those of actual height proposed this measure as a reliable height proxy for this age group in clinical as well as field practice.

Regular daily intake of black tea improves oxidative stress biomarkers and decreases serum C-reactive protein levels in type 2 diabetic patients.

BACKGROUND: This study was undertaken to evaluate the possible effects of different daily doses of black tea intake on certain oxidative stress, inflammatory and metabolic biomarkers in patients with type 2 diabetes mellitus (T2DM). METHODS: Forty-six patients with known T2DM were randomly assigned either to the test (n = 23, 57.0 +/- 7.9 years) or the control (n = 23, 55.4 +/- 8.3 years) group. Following a one-week 'run-in' period, the test group received 150, 300, 450 and 600 ml of black tea extract (BTE) during the weeks 1, 2, 3 and 4, respectively. The control group received 150 ml BTE a day throughout the intervention period. Dietary, anthropometric and biochemical assessments were performed at the end of each week. FINDINGS: Serum total antioxidant capacity was enhanced similarly in both test and control groups. However, daily intake of 2 cups of BTE by the test group showed a suppressing effect on serum malondialdehyde. Serum C-reactive protein significantly decreased and glutathione levels increased following the intake of 4 cups (600 ml) of BTE a day. CONCLUSION: Regular intake of BTE had anti-oxidative and anti-inflammatory effects in patients with T2DM. These findings may, to some extent, explain the mechanisms underlying the protective effects of drinking tea against cardiovascular disease.