Physical activity and body mass index in elderly Iranians in Sweden: a population-based study.

BACKGROUND/OBJECTIVES: To analyze whether elderly Iranians in Sweden have a higher mean body mass index (BMI) and are less physically active than elderly Swedes after adjustment for possible confounders. SUBJECTS/METHODS: A total of 402 men and women (167 Iranian-born and 235 Swedish-born) aged 60-84 years residing in Stockholm, Sweden, were included in this population-based survey. Iranian participants were weighed and their height was measured. BMI values from the Swedish participants were based on self-reported data adjusted for the known discrepancy between objectively measured and self-reported weight and height. The outcome variables, BMI and self-reported leisure-time physical activity, were analyzed by linear regression and unconditional logistic regression. RESULTS: Overall, Iranian women had the highest mean BMI (29.2) of all subgroups. The model that included an interaction between sex and length of time in Sweden showed that there was no significant difference in BMI between Swedish men (reference) and Swedish women or Iranian men. In contrast, Iranian women had significantly higher BMI than the reference group after adjustment for age, education and marital status. The largest difference in BMI compared to the reference group was found among Iranian women who immigrated to Sweden in 1989 or later (beta-coefficient=3.41, 95% CI=1.99-4.83). Iranians and Swedes had almost the same odds of >or= once-weekly leisure-time physical activity. CONCLUSIONS: Elderly Iranian immigrants and especially women who immigrated to Sweden in 1989 or later must be targeted in order to decrease their burden of risk factors for cardiovascular disease.

Effects of a short-term intervention with a paleolithic diet in healthy volunteers.

OBJECTIVES: Prevention of cardiovascular diseases by paleolithic or hunter-gatherer diets has been discussed during recent years. METHODS: Our aim was to assess the effect of a paleolithic diet in a pilot study on healthy volunteers during 3 weeks. The intention was to include 20 subjects, of whom 14 fulfilled the study. Complete dietary assessment was available for six subjects. RESULTS: Mean weight decreased by 2.3 kg (P<0.001), body mass index by 0.8 (P<0.001), waist circumference by 0.5 cm (P=0.001), systolic blood pressure by 3 mm Hg (P=0.03) and plasminogen activator inhibitor-1 by 72% (P=0.020). Regarding nutrient intake, intake of energy decreased by 36%, and other effects were also observed, both favourable (fat composition, antioxidants, potassium-sodium rate) and unfavourable (calcium). CONCLUSION: This short-term intervention showed some favourable effects by the diet, but further studies, including control group, are needed.

Foetal development and breastfeeding in early texts of the Islamic tradition.

BACKGROUND: Knowledge of some early Islamic teachings regarding foetal development and breastfeeding may be of interest to health workers in paediatric practice. The Koran describes the creation of human beings in verses 22:5, 23:12 and 39:6. Some descriptions are reminiscent of phrases in Genesis and Ecclesiastes of the Old Testament. Symbiosis between mother and child is implicit in Koranic verse 46:15, which defines this period as lasting for 30 mo. Accumulated knowledge from earlier periods on the beneficial effects of breastfeeding is reflected in verse 2:233, as a recommendation that infants be breastfed for 2 y. In early Islam it was a father's obligation to ensure that his child received human milk, if the biological mother was indisposed to provide it. Securing human milk was of vital importance for the survival of the child. The historical solution was to employ a wet nurse. Paying a good salary to wet nurses and giving them a status similar to that of a biological mother was a precaution for securing that babies received sufficient milk. During the period of Islamic expansion, the medieval physician Ibn Sina of Buckara (AD 980-1037) contributed to the significance of breastfeeding by describing breast milk as "white blood". CONCLUSION: The significance of breastfeeding was recognized in early texts of the Islamic tradition. These have inspired positive attitudes to breastfeeding in Muslim communities. Adherence may differ among contemporary groups, but it may be important to keep original teachings in mind when planning breastfeeding programmes in Muslim communities.

Thoughts about rates of breastfeeding.

Socio-economic and other factors which influence the duration of breastfeeding have been reviewed. We agree with the conclusion of WHO's multinational study that breastfeeding is a biological type of behaviour with deep roots in human societies, although there are great variations across settings.

The promotion of breastfeeding and maternal attitudes.

Research on infant feeding practices indicate distinct social class- and country-specific patterns for breastfeeding. In industrialized countries educated upper class women breastfeed more often than women from lower classes and discriminated ethnic minorities. The reverse is true for developing countries, with high rates among traditional groups and low rates among the educated upper class women. The reasons for these discrepancies need to be studied to find more effective promotional messages for these groups of mothers in which the current rate of breastfeeding is low. Possible reasons leading to different attitudes toward breastfeeding in different socioeconomical and cultural environments are discussed.

Advantages of breastfeeding according to Turkish mother's living in Istanbul and Stockholm.

As part of a cross-sectional study, carried out among Turkish mother-infant pairs, the mothers of 269 infants living in Istanbul and 30 living in Stockholm were asked their opinions as to the advantages and/or disadvantages of breastfeeding. The answers were categorized according to the attributes mentioned, quantified and related to the socio-economic status of the area of residence, maternal education, origin, current infant feeding practice and contraceptive method. In Istanbul, 63% of the responses stressed some advantage and 31% some disadvantage of breastfeeding. The contraceptive effect was considered the major advantage and the possibility of milk insufficiency the major disadvantage. In Stockholm, the nutritional value of breastfeeding was considered the most important advantage. No disadvantage was mentioned in Stockholm, despite the fact that breastfeeding durations among the immigrant group was shorter than that of the group in Istanbul. The implications of the responses are analyzed. It is hypothesized that mother-centered advantages, such as the birth-spacing effect of breastfeeding, may be more important motivators for continuing breastfeeding among women living under less-advantaged social conditions, and that, if this is true for some groups of mothers, the infant-centered emphasis in the breastfeeding promotional messages may need modification to include the interests of the mothers, as well.

Hospital practices and doctor's attitudes leading to early introduction of complements to infant diets in Istanbul.

Infant feeding pattern among 269 mothers living in three socio-economically distinct areas of Istanbul was ascertained by a cross-sectional study. In spite of a relatively high prevalence of breastfeeding, mothers displayed a marked tendency toward early introduction of complements. Early complementary feeding and weaning was positively associated with the mother's degree of urbanization, educational, and socio-economic status and hospital deliveries. A prospective study carried out among 24 mothers strived to identify the underlying reasons for early complementation in areas with low to middle socio-economic characterization. Direct advice from doctors was found to be responsible for mother's decisions to introduce complements in many of instances.

Events leading to the decision to introduce complementary feeding to the breast among a group of mothers in Istanbul.

A cross-sectional study carried out among 269 mother-infant pairs in Istanbul showed that the majority of infants began receiving regular complements or had been weaned before the age of three months. A prospective study carried out among 24 mothers beginning the last month of pregnancy and continuing until the time when regular complementation was instituted showed that the average duration of exclusive breastfeeding was 58 days. Infants began receiving complements on an irregular basis beginning the early postnatal days. Irregularly introduced complements often lead to gastro-intestinal reactions and weight loss. Mothers displayed sensitivity toward cues that suggested dissatisfaction in infants or other events that they conceived as threats to their milk yield in terms of quality and quantity. Mothers often discussed their decision to introduce complements with other people such as doctors and older female acquaintances who supported them toward complementation. Failure to gain sufficient weight with exclusive breastfeeding was seldom the cause of introducing complementary feeding.

Growth, nutritional status and infant mortality of Turkish immigrant preschool children.

Turkish preschool children in Stockholm, Sweden, 59 born 1979, 32 born 1976 and 43 siblings of preschool age have been studied as to nutritional status including anthropometric parameters, dental caries, haemoglobin level and bacteriological and parasitological findings in faeces and as to deaths of siblings in Turkey and Sweden. Growth was very close to that of the Swedish standard. Two of three children with slightly subnormal growth had had recent direct or indirect contact with the home country. There were no signs of nutritional deficiency but dental caries was common. There was little anaemia. One case of shigellosis was found. Mortality of infancy was significantly reduced after immigration. The group had made a successful nutritional adaptation in Sweden considering their origin in regions of Turkey with a high prevalence of growth failure. Health care in this group should aim at prevention of diarrhoeal disease on visits to Turkey as well as of dental caries.

Breastfeeding among Turkish mothers living in suburbs of Istanbul and Stockholm--a comparison.

The infant feeding pattern among 96 Turkish mothers living in a suburb of Istanbul and 30 living in a suburb of Stockholm, both with working class characteristics, was determined. The duration of breastfeeding among the Turkish immigrant group living in the Stockholm suburb was significantly reduced compared with the group with a similar social background but living in a native urban area. Infant feeding pattern among the Turkish immigrant mothers was more similar to that of Swedish populations. Attitudes to breastfeeding among the immigrant group had changed. Early weaning, reliance on commercially available infant foods and bottle feeding characterized their infant feeding practices. The majority of the infants of this group showed a tendency to overweight.

Consumption pattern of infant foods by Turkish immigrants.

Fifty-nine Turkish infants in metropolitan Stockholm and two adjacent communities have been studied regarding food consumption pattern. The infants were breastfed for a shorter period than expected in Turkey and shorter than in Swedish children. Illiterate mothers breastfed longer than those who had received some kind of education. Formula feeding was extensively used. Supplementary semisolid feeding was introduced, mainly at 4-6 months of age, much earlier than in Turkey but rather later than in Swedish families. Some problems were noted with the bottle feeding, most importantly with regard to hygienic practices, dangerous especially on summer visits to Turkey. Unsatisfactory handling of bottle feeding was linked to the mother's educational level. Further interest in nutrition education for this and other immigrant groups is important.