The relationship between adherence to a Dietary Approach to Stop Hypertension (DASH) dietary pattern and insomnia.

BACKGROUND: Adherence to a DASH- style diet has been reported to be associated with several health-related outcomes. A limited number of reports suggest that diet is an important behavioral determinant of insomnia. The current study aimed to explore the relationship between adherence to a DASH diet and the prevalence of insomnia in adolescent girls. METHODS: A total of 488 adolescent girls aged 12-18 years old were recruited from different regions of Khorasan Razavi in northeastern of Iran, using a random cluster sampling method. DASH scores were determined according to the method of Fung et al. A validated Iranian version of the Insomnia Severity Index questionnaire was used to assess sleep insomnia. To assess the association between the DASH dietary pattern and insomnia, we applied logistic regression analysis in crude and adjusted models. RESULTS: As may be expected, participants in the upper quintile of the DASH diet had significantly higher intakes of fruits, vegetables, low fat dairy products, fish and nuts and lower consumption of refined grains, red and processed meat, sugar-sweetened beverages and sweets. We found that a high adherence to a DASH-style diet was associated with a lower odds of insomnia (OR: 0.51; 95% CI 0.26-1.00) compared with those with lowest adherence. Similar results were found after adjustment for potential confounders. CONCLUSIONS: There is an inverse association between adherence to DASH dietary patterns and insomnia. Further prospective studies are required to demonstrate these findings.

A variant in CYP2R1 predicts circulating vitamin D levels after supplementation with high-dose of vitamin D in healthy adolescent girls.

AIM: The determinants of serum vitamin D seems to be the environmental factors (dietary and supplementary intake and exposure to ultraviolet light) and genetic factors. We aimed to study the relationship between a vitamin D-associated genetic polymorphism and serum 25(OH)D concentrations in healthy adolescent girls in Iran, and its effects on a high-dose supplement of vitamin D. MATERIAL AND METHOD: A total of 616 healthy adolescent girls with mean age 15 received 50,000 IU of vitamin D3 weekly over 9 weeks. Serum vitamin D levels and other metabolic factors were measured at baseline and after the intervention. The genotyping of the CYP2R1 variant (rs10741657) was performed by TaqMan genotyping assays. RESULTS: Regardless of the genetic background, at baseline, 87% of adolescent girls were vitamin D deficient (serum 25(OH)D level < 50 nmol/l). High-dose supplementation with VitD reduced the proportion of girls who were deficient substantially to about 24%. The genetic analysis revealed that although at baseline there was not a gene-vitamin D association ( p trend = 0.1), the response to supplementation appeared to be modulated by this variant ( p trend < 0.001). However, other anthropometric and biochemical measures were not affected by this intervention, over this short period. Serum 25(OH)D was increased in all participants although the carriers of the minor A allele seemed to be better responders so that the percentages of the change serum vitamin D in the holder of AA and AG genotypes were 539.4 ± 443.1 and 443.7 ± 384.6, respectively, compared with those with common GG genotype (363.3 ± 354.0). Our regression analysis revealed that the probability of an increase in serum 25(OH)D in a participant with AA genotype was 2.5-fold greater than those with a GG genotype (OR = 2.5 (1.4-4.4); p value = 0.002). CONCLUSION: Based on our findings, it appears that the rs10741657 variant of the CYP2R1 gene modulates the response to high-dose of vitamin D supplementation.

Associations of vitamin D binding protein variants with the vitamin D-induced increase in serum 25-hydroxyvitamin D.

BACKGROUND: Vitamin D deficiency is a global problem that may be improved by vitamin D supplementation; however, the individual's response to the intervention varies. We aimed to investigate possible genetic factors that may modify the impact of environmental exposure on vitamin D status. The candidate gene variant we investigated was the Gc gene-rs4588 polymorphism at the vitamin D receptor (DBP) locus. METHODS: A total of 619 healthy adolescent Iranian girls received 50000 IU of vitamin D3 weekly for 9 weeks. Serum 25(OH) D concentrations, metabolic profiles and dietary intake were measured at baseline and after 9 weeks of supplementation. The genotypes of the DBP variant (rs4588) were analyzed using the TaqMan genotyping assay. RESULTS: Our results revealed that the rs4588 polymorphism might be associated with serum 25-hydroxy vitamin D both at baseline (p value = 0.03) and after intervention (p value = 0.008). It seemed that the outcome of the intervention was gene-related so that the subjects with common AA genotype were a better responder to vitamin D supplementation (Changes (%) 469.5 (427.1) in AA carriers vs. 335.8 (530) in GG holders), and carriers of the less common GG genotype experienced a rise in fasting blood glucose after 9 weeks (Changes (%) 0 (1.5)). Our findings also showed that the statistical interaction between this variant and supplementation was statistically significant (intervention effect p-value<0.001 and p-value SNP effect = 0.03). The regression model also revealed that after adjusted for potential confounders, likelihood of affecting serum 25(OH)D in individuals who were homozygous for the uncommon allele G was less than those homozygous for the more common AA genotype (OR = 4.407 (1.82-8.89); p = 0.001). CONCLUSION: Serum vitamin 25(OH) D following vitamin 25(OH) D3 supplementation appears to be modified by genetic background. The Gc genetic variant, rs4588 encoding the vitamin D receptor seems to influence the response to vitamin D supplementation.

Dietary behaviors in relation to prevalence of irritable bowel syndrome in adolescent girls.

BACKGROUNDS AND AIMS: There is limited evidence regarding the relationship between dietary behaviors and irritable bowel syndrome (IBS). This study aimed to explore the association between diet-related practices and prevalence of IBS. METHODS: The study was conducted among 988 adolescent girls living in Iran. Dietary behaviors were pre-defined and assessed in nine domains using a pre-tested questionnaire. To investigate the association between diet-related practices and the presence of IBS, this study used logistic regression analysis in crude and adjusted models. RESULTS: The prevalence of IBS was 16.9% in this population. Compared with individuals who did not consume fluid with their meal, those who always consumed fluid with meals had a greater chance of IBS (odds ratio [OR]: 2.91; P: 0.01). This study found a direct relationship between a greater intake of spicy food and IBS prevalence (OR: 5.28; P: 0.02). The individuals who ate fried foods every day also had a greater risk of IBS compared with those who did not consume fried foods (OR: 1.65; P: 0.01). The subjects who had lost ≥ 5 teeth had 2.23 times greater odds for IBS than the individual who had lost ≤ 1 tooth (OR: 2.23; P: 0.01) was a significant inverse relationship between the chewing sufficiency and the risk of IBS (OR: 4.04; P: 0.02). These associations remained significant after controlling for potential confounder. CONCLUSIONS: Intra-meal fluid intake, chewing insufficiency, higher tooth loss, and the consumption of spicy and fried food were associated with increased risk of IBS. Prospective studies are needed to confirm these findings.

Adherence to a Dash-style diet in relation to depression and aggression in adolescent girls.

The aim of this study was to assess adherence to the Dietary Approach to Stop Hypertension (DASH) dietary pattern in relation to depression and aggression in adolescent girls. The study was carried out among 580 girls aged between 12 and 18 years of age. DASH scores were determined according to the method of Fung et al. A Persian version of the Beck Depression Inventory and Buss-Perry questionnaire were used for the assessment of depression and aggression. We analysed our data using crude and adjusted models. Adjustments were made for age, energy intake, mother's job status, passive smoking, start of menstruation, parental death, parental divorce, physical activity level and body mass index, using three different models. A high adherence to a Dash-style diet (for individuals in the upper quartile) was associated with a lower odds of depression compared with subjects with lower adherence (those in the lowest quartile) (OR 0.47; 95% CI 0.26-0.84, P-value = 0.009); these associations remained significant after adjustments. However, we did not obtain any significant relationship between a DASH-style diet and aggression. We observed a significant inverse relationship between greater adherence to a DASH diet and lower odds of depression. Further prospective studies are needed to confirm these findings.

Neuropsychological function in relation to dysmenorrhea in adolescents.

OBJECTIVE: Hormonal variations during the menstrual cycle may affect emotional regulation. We aimed to investigate the association between dysmenorrhea (the severe abdominal pain and cramps associated with menstruation) and cognitive abilities, emotional function and sleep patterns in adolescent girls. Moreover, we evaluated the frequency of premenstrual syndrome (PMS) in our population and then divided them into 4 groups: subjects with only PMS; subjects with only dysmenorrhea; individuals with both PMS and dysmenorrhea and normal subjects. STUDY DESIGN: In this cross sectional study, 897 adolescent girls who had entered menarche were recruited. Of these, 35.9% had only dysmenorrhea, 14.9% had only PMS, 32.7% had both PMS and dysmenorrhea while 16.5% had no PMS and/or dysmenorrhea (Normal). We assessed the tests for cognitive, emotional function and sleep patterns were compared for these groups. RESULTS: Individuals in the dysmenorrhea group had significantly higher depression, aggression, insomnia, daytime sleepiness and sleep apnea scores compared to normal controls and the PMS group, but did not have significantly different cognitive ability (P value <0.05). These differences were strongly correlated to pain intensity (P<0.001). However, there were no significant differences between those with only PMS and control subjects with regard to cognitive ability, emotional function and sleep pattern tests. CONCLUSIONS: Dysmenorrhea is highly prevalent among adolescents and appears to be associated with depressive mood, a tendency to aggressive behavior and sleep disorders among adolescent girls.