Dietary Patterns in 1125 Iranian Women: Adequacy of Energy and Micronutrient Intakes and Weight Statuses.

Background: Women's nutrition status includes significant effects on their children and household health. The purpose of this study was to assess energy and micronutrient intake adequacy in Iranian women. Methods: This study was a part of the Urban HEART Study, which has jointly been developed by the World Health Organization (WHO) Centre for Health Development, Kobe, Japan. In total, anthropometric and dietary intake data were collected from 1125 women in southern Tehran municipality districts. A 24-h recall questionnaire was completed by the expert nutritionists and the participants' anthropometric statuses were assessed. Food intakes were calculated in grams per capita per day. Micronutrients and energy requirements were adapted from WHO/Food and Agriculture Organization (FAO) tables and Iran National Food Consumption Survey, respectively. Results: Nearly 71.5% of the women were overweight or obese [body mass index (BMI) ≥25 kg/m2]. Furthermore, 1.2% of the women were underweight (BMI <18.5 kg/m2), while 27.3% had normal weight (BMI = 18.5--24.9 kg/m2). The mean bread/cereal and vegetable intakes were significantly higher in obese group, compared to that in normal/under/overweight group (375.6 g/day ± 151.4, P = 0.05; and 331.4 g/day ± 227.5, P = 0.02), respectively]. Women in the lean group significantly consumed higher quantities of cakes/pastries and had the lowest calcium and iron adequacy ratios, compared to other groups (p = 0.001, P = 0.03, and P = 0.05, respectively). Conclusions: These findings suggest that Iranian women, especially those who reside in the southern areas of Tehran, need to change their dietary habits to maintain their health. Moreover, being under/normal weight does not necessarily mean following healthy diets.

Dietary patterns derived using principal component analysis and associations with sociodemographic characteristics and overweight and obesity: A cross-sectional analysis of Iranian adults.

Introduction: This study examined the cross-sectional association between household dietary patterns and sociodemographic characteristics and BMI in a nationally representative sample of Iranian adults. Methods: Data on 6,833 households (n = 17,824 adults) from the National Comprehensive Study on Household Food Consumption Pattern and Nutritional Status 2001-2003 were used. Principal component analysis (PCA) was used to extract dietary patterns from three household 24-h dietary recalls. Linear regression analyses were used to examine associations between dietary patterns and sociodemographic characteristics and BMI. Results: Three dietary patterns were identified: the first was characterized by high citrus fruit intake, the second by high hydrogenated fats intake and the third by high non-leafy vegetables intake. The first and third patterns were associated with household heads with higher education and living in urban areas, while the second was associated with household heads with lower education and living in rural areas. All dietary patterns were positively associated with BMI. The strongest association was found with the first dietary pattern (ß: 0.49, 95% CI: 0.43, 0.55). Discussion: While all three dietary patterns were positively associated with BMI, the sociodemographic characteristics of Iranian adults who consumed them differed. These findings inform the design of population-level dietary interventions to address rising obesity rates in Iran.

Socioeconomic determinants of nutritional behaviors of households in Fars Province, Iran, 2018.

Introduction: Households' dietary habits are affected by their environment and socioeconomic status (SES). This study aims to investigate eating behaviors and determine the factors affecting nutritional status in households in Fars Province in 2018. Method: In this cross-sectional study, urban and rural households were selected using the multistage sampling method. A questionnaire was employed to interview the mother or householder to record the demographic, SES, and dietary habits of the family for major food items commonly used. A logistic regression model was used to analyze the data. The p-value less than 0.05 was considered significant. Results: In total, 6,429 households participated in the study. The majority of households use traditional flatbread, low-fat milk, and liquid/cooking oil. Frying was the most prevalent method of cooking. Parents' level of education and SES were associated with type of consumed bread, milk and dairy, methods of food preparation, adding salt at the table, eating out, and fast-food usage. Parents' higher level of education was significantly associated with salt storage in optimal conditions and not using salt before tasting the meal. Conclusion: Most of the households had healthy practices, especially in consumption of certain oils and methods of preparing their food as well as keeping salt in an optimal condition and using iodized salt. The most important unhealthy nutritional behavior was high consumption of fast food and outdoor food, especially in urban regions. Unhealthy dietary habits were more prevalent in households with low household and regional SES. Both households and regions with higher SES had better dietary habits.

The association between obesity with serum levels of liver enzymes, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and gamma-glutamyl transferase in adult women.

BACKGROUND: Obesity-induced inflammation may independently disturb the function of critical organs such as liver. This study aimed to investigate the association of obesity with serum levels of biomarkers of liver function including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) in adult women. METHODS: This cross-sectional study was carried out on 360 adult women in the summer of 2020 in Tehran, Iran. The participants were categorized into two groups based on their body mass index (BMI≤29.9 and BMI > 30). The serum levels of ALT, AST, ALP and GGT were measured. Logistic regression method was used to assess the association between BMI and liver enzymes after adjusting for the confounders. RESULTS: The mean BMI in non-obese and obese groups was 26.32 ± 2.61 and 33.40 ± 2.80 kg/m2 , respectively (p = .01). A significant association was found between BMI with ALT (ß = .16, p = .002) and GGT (ß = .19, p = .01) enzymes after adjustment for age. The association between BMI and GGT remained significant after further adjustments for smoking, alcohol use, physical activity and educational status. There was no significant association between BMI and liver enzymes after adjustment for dietary intake. CONCLUSIONS: Obesity was associated with the level of serum liver enzymes. However, adjustment for dietary intake disappeared the significant results. Further studies are needed to determine the independent effects of obesity on the liver function.

Narrative-focused Group Counseling Improves Intervention Outcomes in Women With Obesity.

OBJECTIVE: To investigate the effects of narrative group counseling combined with diet modification and exercise plans on weight loss in Iranian women with obesity. DESIGN: Parallel 2-arm clinical trial. PARTICIPANTS: Fifty-six Iranian women with obesity (aged 18-50 years). INTERVENTION: The intervention group included weekly diet, exercise, and narrative-focused group counseling, whereas the comparison group included dietary modification and exercise sessions for 8 months (32 sessions). MAIN OUTCOME MEASURE: Anthropometric and body composition parameters, blood biochemical parameters (high-density lipoproteins, low-density lipoproteins, triglycerides, fasting blood sugar, ghrelin, obestatin), physical activities, and appetite scores. ANALYSIS: McNemar test was used for the variables that were not normally distributed and for scaling. Furthermore, t tests were used to compare quantitative variables with normal distributions. The original P (0.05) was adjusted to P = 0.0031 using the Bonferroni correction. RESULTS: Weight, body mass index, body fat proportion, and hip circumference decreased significantly in the intervention vs comparison group. Serum low-density lipoproteins, triglycerides, total cholesterol, fasting blood sugar, appetite score, and ghrelin decreased, whereas obestatin increased significantly in the intervention vs comparison group. CONCLUSIONS AND IMPLICATIONS: Narrative-focused group counseling combined with traditional strategies was effective in achieving significant changes in weight, body mass index, and appetite. Future studies with a more diverse audience and a longer follow-up are warranted.

The significance and potential of functional food ingredients for control appetite and food intake.

Dramatically rising global levels of obesity have raised consumers' commercial and public health interest in foods that may help control appetite and weight. The satiety cascade consists of sensory, cognitive, physical, and hormonal events following food intake, preventing overeating, and the desire to eat for a long time. Functional foods can be one of the most influential factors in reducing appetite as long as effective ingredients, such as fiber and protein, are used to design these products. Also, functional foods should be designed to reduce appetite at different levels of oral processing, stomach, small intestine, and large intestine by various mechanisms. Therefore, the satiety power of functional foods depends on the type of ingredients and their amount. Because each compound has a different mechanism of action, it is recommended to use different compounds to influence satiety in functional foods.

Associations between diet quality and obesity in a nationally representative sample of Iranian households: A cross-sectional study.

OBJECTIVE: Research examining associations between diet quality and obesity in Iranian adults is limited by small and non-representative samples. This study examined associations between two diet quality indices and obesity risk in a nationally representative sample of Iranian adults and interactions by sex and area of residence. METHODS: Data on 18,307 adults (mean age 37 [SD 15.2] years) were used from the Iranian National Survey 2001-2003. Two diet quality indices (Healthy Eating Index 2015, HEI-2015, and Diet Quality Index International, DQI-I) were calculated from household 24-h dietary recalls. Multi-level regression analyses were used to examine the association between household diet quality and individual-level obesity risk, with interaction terms for sex and area of residence. RESULTS: Higher household HEI-2015 and DQI-I were associated with higher risk of obesity (HEI-2015: relative risk ratio: 1.04, 95% CI: 1.03, 1.05; DQI-I: relative risk ratio: 1.02, 95% CI: 1.01, 1.02), with stronger effect sizes in adults living in rural areas. CONCLUSIONS: Higher diet quality (HEI-2015 and DQI-I) was associated with higher obesity risk, which was stronger in adults living in rural areas. Due to the complexity of examining these associations in a Middle Eastern country undergoing a nutrition transition, longitudinal research is needed to confirm these findings.

Dietary and Socio-Economic Predictors of Obesity Among 2-5-Year Old in Northwest Iran.

BACKGROUND: As a rising epidemic in developing countries, childhood obesity and overweight need particular attention. METHODS: The sample (n = 2432) was randomly selected among children aged 24-59 months living in West Azerbaijan Province whose information was recorded in SIB software. The survey questionnaire is derived from the Demographic and Health Survey and the Multiple Indicator Cluster Survey questionnaires designed by the WHO 2017 and UNICEF 2017, respectively. RESULTS: The prevalence of obesity defined as BMIz (body mass index z-score)> +2 was 1.4% among children. Dietary diversity score (DDS) was high in 59.3% of children, moderate in 36.1%, and low in 4.6%. Socio-economic status (SES) of children families was high, moderate, and low in 34%, 28.9%, and 37.1% of families, respectively. Physical activity hours were over 3 in 85.9% of children. The girls were more likely to be obese than the boys (OR = 0.43, P = 0.016). Those with high and moderate DDS were less likely to be obese than those with low DDS (OR = 0.250 and OR = 0.180, respectively). The likelihood of obesity among children with high and moderate SES were 2.6 and 1.6 times more compared to children with low SES, respectively. CONCLUSIONS: According to the results, DDS and physical activity levels are related to obesity in children aged 24-59 months. Therefore, establishing proper nutritional behavior and promoting a healthy lifestyle are essential for preventing obesity and non-communicable diseases in this age group.

A comparison of diet quality indices in a nationally representative cross-sectional study of Iranian households.

BACKGROUND: Iranian diet quality has been evaluated using indices that have not been created based on Iranian dietary guidelines. This study aimed to examine the applicability of two diet quality indices by examining their associations with nutrient adequacy, nutrient intakes and sociodemographics. METHODS: Dietary data were collected using three 24-h dietary recalls from Iranian households. Nutrient adequacy was assessed using World Health Organization/Food and Agriculture Organization 2002 (WHO/FAO) cut points. Household diet quality was calculated using the Healthy Eating Index (HEI) and Diet Quality Index-International (DQI-I). Sociodemographics of the household members were assessed. Regression analyses were used to examine associations between diet quality and nutrient adequacy, and between sociodemographics and diet quality. RESULTS: A total of 6935 households were included in the analysis. Higher household diet quality was associated with adequate intake of calcium (HEI: OR 1.11, 95% CI: 1.10, 1.13; DQI-I: OR 1.14, 95% CI: 1.13, 1.16), vitamin C (HEI: OR 1.19, 95% CI: 1.17, 1.20; DQI-I: OR 1.12, 95% CI: 1.11, 1.12) and protein (HEI: OR 1.01, 95% CI: 1.00, 1.02; DQI-I: OR 1.09, 95% CI: 1.08, 1.09). Higher household diet quality was associated with household heads who were older (> 56 years old) (HEI: ß 2.06, 95% CI: 1.63, 2.50; DQI-I ß 2.90, 95% CI: 2.34, 3.45), higher educated (college/university completed) (HEI: ß 4.54, 95% CI: 4.02, 5.06; DQI-I: ß 2.11, 95% CI: 1.45, 2.77) and living in urban areas (HEI: ß 2.85, 95% CI: 2.54, 3.16; DQI-I: ß 0.72, 95% CI: 0.32, 1.12). CONCLUSIONS: Based on associations with nutrient adequacy and sociodemographics, the applicability of two diet quality indices for assessing the diet quality of Iranian households was demonstrated. Results also indicated DQI-I may be more applicable than HEI for evaluating Iranian nutrient adequacy. Findings have implications for the design and assessment of diet quality in Iranian populations. Future research should examine the link between these diet quality indices and health outcomes.

Zinc supplementation is an effective and feasible strategy to prevent growth retardation in 6 to 24 month children: A pragmatic double blind, randomized trial.

BACKGROUND: Zinc is an essential nutrient that is naturally available in most foods. Deficiency of this micronutrient in particular can cause a number of health complications. Zinc deficiency during infancy is more troublesome as rapid growth and nutrient relied development takes place in this period. Most severe outcomes of zinc deficiency during infancy are considered to be, impaired immunity, growth retardation and impaired neurodevelopment. The aim of this pragmatic study is to determine whether zinc supplementation strategy is feasible and effective for reducing growth retardation at national level. METHODS: A randomized, multicenter, double-blind, parallel group effectiveness trial that evaluated the effect of zinc supplementation in infant development. Children aged 6-24 months were recruited from healthcare centers of Damavand, Pishva and Varamin in the beginning of the study (n = 682). The Subjects were then randomly allocated in two groups of intervention (n = 272), and control (n = 308), where a daily dose of zinc sulfate (5ml) suspension containing 5mg elemental zinc and placebo were administered for the period of 6 month. Investigators, care givers and the parents of the children were blinded to the nature of the intervention. Anthropometric measures were evaluated at the beginning and after the six month intervention period. The primary outcome measured was linear growth and length difference, serum zinc and ferritin concentrations were the secondary outcomes. FINDINGS: Following the intervention, compared with the placebo, zinc supplementation was associated with significant difference in the average length increment (primary outcome) (placebo 5·23 ± 2·19 vs. intervention 5·79 ± 2·18 cm, p = 0·02). No significant difference was observed in concentrations of serum zinc and ferritin. After the intervention the prevalence of zinc deficiency was significantly lower in the intervention group compared to the placebo group. No complications and adverse effects were reported and the compliance was very good (7 children out of 344 didn't comply with the intake of syrup). INTERPRETATION: Zinc supplementation for six month among children (6-24 months) had beneficial outcomes on growth and average length increment, therefore we propose it is a feasible strategy for preventing growth retardation.

Contamination of foods with arsenic and mercury in Iran: a comprehensive review.

Human and animals are exposed to heavy metals such as arsenic (As) and mercury (Hg) through atmospheric depositions, industrial effluents, chemical pesticides and fertilizers, erosion of geological beds, and mining wastes which can result in the contamination of food chains. The aim of the current study was to review the available papers reporting contamination levels of As and Hg in commonly consumed foods in Iran. A descriptive search was carried out with specific keywords and entry criteria in databases of Science-Direct, PubMed, Scopus, Google Scholar, and Scientific Iranian Database (SID) published from January 2000 to July 2018. All articles were assessed by two reviewers, and final decision was made through discussions or a third reviewer arbitration. The articles were categorized based on the type of food groups including rice, fruit, vegetable, fish, seafood, drinking water, tea, and miscellanies. Of 221 identified articles on As and Hg contaminations in foods, 92 articles were selected using defined criteria. Published articles were reviewed to report contamination (mean and rate) of each food group in Iran. Results showed that rice and fish included the highest contamination rates of As and Hg, respectively. In general, As and Hg contents in Iranian foods cause serious health concerns due to the consumption quantities of the main foods. Further risk-based surveillance studies must be carried out to decrease exposure to As and Hg from dietary and non-dietary sources.

Association Among Sources Exposure of Cadmium in the Adult Non-smoking General Population of Tehran.

Acute and chronic exposure to cadmium can cause numerous health effects including poisoning, as well as, bone, liver, and kidney diseases. Cadmium competes with iron absorption in blood and can induce anemia. Cadmium body burden can be measured through urine and blood samples. Urine reflects chronic and blood indicates recent and cumulative exposures to cadmium. Dietary is considered as the main source of exposure to cadmium in non-smoking general population. The study was conducted to determine cadmium level in blood, urine, and in diet of 120 non-smoking adults in Tehran. Dietary components and consumption pattern of participants estimated by a food frequency questionnaire. Next, the correlation investigated between them. Moreover, serum ferritin measured as a marker of iron storage in blood to determine its association with cadmium. The prediction of cadmium fate in the body is determined by toxicokinetic models. This study tried to evaluate one of these models' validity which is developed to predict urinary cadmium from dietary. Afterwards, the predicted urinary compared with the measured urinary cadmium. The correlation coefficient between dietary and blood cadmium equaled 0.66 which was statically significant, but the correlation between dietary and urinary cadmium was minimal and not statically significant (p > 0.05). An inverse and negative correlation was found between serum ferritin and blood cadmium. The mean predicted urinary cadmium calculated by the model was 2.5-fold higher than the measured value in the total population. Results of the present study revealed that blood cadmium reflected mainly acute exposure. There was no correlation between chronic and acute exposures to cadmium. The low serum ferritin level increased cadmium amount in blood. Moreover, the mean predicted urinary cadmium by the model was greater than the measured value. It can because of characteristics of populations and type of dietary exposure. Thus, it is suggested that the model coefficients are determined in each society based on their characteristics.

What do we know about exposure of Iranians to cadmium? Findings from a systematic review.

Cadmium is an important environmental contaminant. High consumption of chemical fertilizers and industrial activities in recent decades has caused people to be worried about exposure to cadmium. There is no policy for environmental and biological monitoring of exposure to cadmium in the general population in Iran. This study was aimed to review cadmium content in consuming foods and biological samples in Iran, systematically. We developed a comprehensive search strategy and used it to search on Web of Science, Scopus, Science Direct, and Scientific Information Database until 28 December 2016. The totals of 285 articles were identified and finally 31 original papers were selected. Cadmium contamination was found in Iranian food groups such as rice, cereal and legumes, canned tuna fish, vegetables, fruit juice, and egg. This study showed that cadmium amount in 75% of the consumed rice samples (domestic and imported) was higher than the maximum limits approved by institute of standards and industrial research of Iran. Lettuce samples in Yazd were recorded the highest concentration of cadmium compared to other studies. In addition, high amount of cadmium was observed in the blood of the general population. Regarding the cadmium contamination in food and blood samples in Iran, policies must be adopted to reduce exposure to cadmium through different matrices as much as possible.

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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Regular consumption of both vitamin D- and calcium- and vitamin D-fortified yogurt drink is equally accompanied by lowered blood lipoprotein (a) and elevated apoprotein A1 in subjects with type 2 diabetes: a randomized clinical trial.

OBJECTIVE: Cardiovascular disease (CVD) is the major morbidity and cause of death in diabetic subjects. Observational studies have shown the association of low vitamin D status with poor glycemic control, atherogenic lipid profile, and CVD. However, the possible link between circulating 25-hydroxycholecalciferol and apoproteins (Apo A1 and B) and the atherogenic lipoprotein (a) [Lp(a)] has not been documented to date. METHODS: Ninety subjects with type 2 diabetes (T2D) aged 30-60 years from both sexes were randomly allocated to one of the 3 groups to receive 2 bottles a day of either (1) plain doogh (PD; containing 150 mg calcium and no detectable vitamin D/250 mL); (2) vitamin D-fortified doogh (DD; containing 150 mg calcium and 500 IU vitamin D/250 mL); or (3) calcium- and vitamin D-fortified doogh (CDD; containing 250 mg calcium and 500 IU vitamin D/250 mL) for 12 weeks. Anthropometric, dietary, and laboratory assessments, including Apo A1, Apo B, and Lp(a), were done. RESULTS: Improvement of vitamin D status in DD and CDD groups, compared to PD, resulted in a significant increase in Apo A1 (mean changes 0.22 ± 0.38, 0.20 ± 0.27 and 0.01 ± 0.35 g/L, respectively, p = 0.047) and a significant decrease in serum Lp(a) (mean changes -0.08 ± 0.30, -0.08 ± 0.31, and 0.14 ± 0.25 µmol/L, respectively, p = 0.011). There was no significant difference between DD and CDD groups. Serum Apo B did not change significantly in any of the groups. CONCLUSIONS: Significant amelioration of serum Apo A1 and Lp(a) following improvement of vitamin D status in T2D subjects may have preventive implications against long-term diabetic complications, notably CVD. This trial was registered at ClinicalTrials.gov as NTC01229891.

Vitamin D Receptor Fok-I polymorphism modulates diabetic host response to vitamin D intake: need for a nutrigenetic approach.

OBJECTIVE: Interpopulation as well as interindividual variations in response to vitamin D intake commonly observed in subjects with type 2 diabetes may be related to genetic makeup. One of the candidate genes potentially responsible for this diversity is vitamin D receptor (VDR). This study aimed to investigate the interactive effect of VDR Fok-I polymorphism and vitamin D intake on diverse aspects of diabetic host response. RESEARCH DESIGN AND METHODS: Glycemic status, lipid profiles, inflammatory biomarkers, and VDR Fok-I genotypes were determined in diabetic subjects (n = 140) who participated in a randomized controlled trial. Participants consumed two 250-mL bottles per day of yogurt drink (doogh) fortified with 500 IU vitamin D/250 mL for 12 weeks. RESULTS: Mean serum 25(OH)D increased by ~30 nmol/L (P < 0.001). The time × intervention effect was significant for 25(OH)D (P = 0.030), HDL (P = 0.011), high-sensitivity C-reactive protein (hsCRP) (P < 0.001), interleukin (IL)-4 (P = 0.008), and IL-6 (P = 0.017) among the genotypic groups. The alleles were defined as ''F'' or ''f'' depending on the absence or presence of the restriction site, respectively. The least increment in 25(OH)D was in ff (23.0 ± 3.8 nmol/L) compared with Ff (31.2 ± 3.4 nmol/L) and FF (35.6 ± 2.7 nmol/L) (P for trend = 0.009), but only the difference between ff and FF was significant (P = 0.023). FF group had the largest decrement of both hsCRP and IL-6 compared with Ff (P < 0.001 and P = 0.038) and ff (P = 0.010 and P = 0.048), respectively. CONCLUSIONS: We concluded that those of VDR ff genotype may be regarded as "low responders" to vitamin D intake in terms of response of circulating 25(OH)D and certain inflammatory biomarkers. A nutrigenetic approach may, therefore, be needed to protect diabetic patients from vitamin D deficiency.

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

OBJECTIVE: 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. METHODS: 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. FINDINGS: 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. CONCLUSION: 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.

Improvement of vitamin D status resulted in amelioration of biomarkers of systemic inflammation in the subjects with type 2 diabetes.

BACKGROUND: Both vitamin D deficiency and inflammation have been linked to cardiovascular disease, the major cause of death in diabetes. In this study, the effects of daily intake of vitamin D-fortified yoghourt drink (doogh) on systemic inflammatory biomarkers in subjects with type 2 diabetes (T2D) were investigated. SUBJECTS AND METHODS: In this 12-week randomized controlled trial, T2D subjects received either plain doogh (PD; containing 170 mg calcium and no detectable vitamin D/250 mL, n(1) = 50) or vitamin D3-fortified doogh (FD; containing 170 mg calcium and 500 IU/250 mL, n(2) = 50) twice a day. Glycemic status, body fat mass and systemic inflammatory biomarkers including serum highly sensitive C-reactive protein (hsCRP), serum amyloid A (SAA), interleukin(IL)-2, IL-6, IL-10 and tumour necrosis factor (TNF)-α were evaluated at the beginning and after the intervention. Data were expressed as either mean ± SD or median (interquartile range) whenever they had either normal or non-normal distribution, respectively. RESULTS: In the patients receiving the vitamin D fortified drink, compared with those receiving the unfortified drink, a significant increase in serum 25(OH)D was accompanied by significant changes in TNF-α (-57.9 (-264.6) versus +106.3 (683.2), p = 0.044), IL-6 (-6.3 (-69.2), p = 0.002), hsCRP (-0.39 (-1.50) versus +0.8 (1.52), p < 0.001), SAA (-14.2 ± 44.5 versus +5.6 ± 37.5 mg/L, p = 0.022) and IL-10 (+38.7 ± 157.0 versus -51.9 ± 165.2 ng/L, p = 0.013). The between-group differences of hsCRP, SAA and IL-6 changes remained significant even after controlling for changes quantitative insulin check index (p < 0.001, p < 0.001 and p = 0.009, respectively). CONCLUSIONS: Improvement of vitamin D status of T2D subjects resulted in amelioration of the systemic inflammatory markers. This may have preventive implications against cardiovascular disease and other diabetic complications.

Comparison of the effects of canola oil versus sunflower oil on the biochemical markers of bone metabolism in osteoporosis.

BACKGROUND: Recently, omega-3 fatty acids are in the center of attention for their potent anti-inflammatory effects. Osteoporosis as a chronic senile disease is associated with inflammation, and the role of inflammatory mediators has been demonstrated in the recent years. The beneficial effects of n-3 fatty acids on bone were proven in many animal studies, while to date, no conclusive data is available in human. The aim of this study was to evaluate the impact of n-3 fatty acids on bone biomarkers in osteoporotic women. MATERIAL AND METHODS: Forty osteoporotic post-menopausal women were recruited in the study and randomized in receiving either 40 g canola oil or the same amount sunflower oil per day as their dietary oil for 3 months. Serum levels of osteocalcin, bone alkaline phosphatase (BALP), N telo peptide collagen (NTX) and 25- hydroxy vitamin D3 were measured at baseline and at the end of the third month in both groups. RESULTS: In the canola oil group, BALP and NTX were increased after 3 months while Osteocalcin decreased in both groups slightly; however,none of these changes were significant. In both groups, serum vitamin D3 was increased significantly; however, this change between groups was not significant. CONCLUSION: Canola oil did not affect bone formation and resorption significantly after 3 months consumption. Further investigations with longer follow up are recommended.

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.