Glycemic index, glycemic load, dietary inflammatory index, and risk of infertility in women.

The dietary glycemic load (GL) indicates the quantity and quality of carbohydrates, which can affect ovulation and fertility by controlling insulin sensitivity. Also, past studies confirm the role of the dietary inflammatory index (DII) in many diseases, including metabolic syndrome and cardiovascular disorders, so it may be related to reproductive health. This case-control study aims to study the association between glycemic index (GI), GL, and DII with infertility in women. This study was conducted on 300 infertile women in the case group and 300 fertile women in the control group in Kermanshah, Iran. Food intake was evaluated using FFQ, and using NUTRITIONIST IV software programs, GI and GL values were determined. DII was computed as well using FFQ data. Physical activity was assessed using IPAQ-SF. The association between GI, GL, and DII with infertility was evaluated using a logistic regression test, using STATA version 14 software. The results showed that the DII, GI, and GL were higher in the case group compared to the control group ([p = .009], [p = .0001], and [p = .0007], respectively). The increase in GI, GL, and DII caused an increase in infertility factors, and consequently enhanced chance of infertility ((adjusted odd ratio [OR] 2; 95% confidence interval [CI], 1.16, 3.45), (OR 3.68; 95% CI, 1.99, 6.82), and (OR 1.7; 95% CI, 0.97, 2.95), respectively). The present study indicated that the chance of infertility is higher in women who follow a diet with high GI, GL, and DII. Therefore, a positive association may be present between GI, GL, and DII with infertility.

The relationship of dietary inflammatory index and dietary patterns with premenstrual syndrome among women in Kermanshah: An analytical cross-sectional study.

Premenstrual syndrome (PMS) is a common psychological condition that occurs continuously during the luteal phase of the menstrual cycle. Potential factors in this syndrome comprise the central nervous system, hormones, genetic background, and nutritional indicators. Little is known about foods or eating patterns that may be associated with this syndrome, yet nutritional factors can be considered in strategies for the management of PMS. The current study purposed to investigate the relationship between PMS and dietary inflammation index as well as PMS and food patterns. The present cross-sectional study was conducted on 125 women and girls aged 20-46 years who experienced symptoms of PMS. The inclusion criteria included cooperation and consent to enter the study, a body mass index of 18.5-25 kg/m2, no underlying disease, no use of contraceptives or antidepressants, and no use of multivitamin or mineral supplements. In the first stage of this study, participants' height, weight, waist circumference, and hip circumference were measured. In the second stage, eating habits were examined using a semiquantitative Food Frequency Questionnaire. This study found a significant correlation between glycemic load quintiles as well as between energy and macronutrient intake and the dietary inflammatory index; however, it revealed a direct correlation between PMS and both Western-mixed dietary and high-salt-high-sugar dietary patterns. Moreover, the Western food pattern was found to have a direct correlation with dietary inflammatory index, and the healthy food pattern had an inverse correlation with this index. This study showed that PMS symptoms are more severe with the consumption of high-salt-high-sugar or a Western-mixed food dietary pattern. It seems that an imbalance in hormones and neurotransmitters can affect the metabolism of proteins, carbohydrates, and fats. Also, some foods, such as vegetables, and low-fat and high-fiber diets reduce plasma estrogen levels and the duration of PMS symptoms.

Combination of the effect of ginger and anti-inflammatory diet on children with obesity with nonalcoholic fatty liver disease: A randomized clinical trial.

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in children. Following earlier reports on an increase in the prevalence of childhood obesity, NAFLD is now becoming increasingly common in children. Although no definitive cure exists, early management, early diagnosis, and treatment can reduce its complications. This study aims to determine the effectiveness of the combination of ginger and an anti-inflammatory diet (AID) in children with obesity on fatty liver management. This randomized clinical trial was conducted on 160 children with obesity aged 8-11 years, with a mean (SD) weight of 65.01 (9.67) kg, mean (SD) height of 139.87 (7.37) cm, and mean (SD) body mass index of 33.40 (5.59) kg/m2. The study duration was 12 weeks. Children were divided into four groups: ginger (G), AID, ginger plus an AID (GPA), and control. Ginger capsules comprised 1000 mg of ginger, whereas the AID comprised fruits and vegetables, fish, turkey, and chicken (without skin) with lean meat, omega-3 sources, nuts, legumes, probiotic products, and elimination of inflammatory food. Following the intervention, serum fasting blood sugar and high-sensitivity C-reactive protein levels were significantly decreased in the AID (p = .006 and .002, respectively), G (p = .04 and <.001, respectively), and GPA (p <.001 in both cases, respectively) groups. Further, in the G and GPA groups, there was a significant decrease in body mass index (p = .04 in both cases, respectively), waist circumference (p = .009 and .003, respectively), waist-to-height ratio (p = .02 and .005, respectively), alanine aminotransferase (p = .004 and <.001, respectively), total cholesterol (p = .0002 and .0001, respectively) and low-density lipoprotein-cholesterol (p < .001 and <.001, respectively). Eventually, serum aspartate aminotransferase was decreased (p < .001) and high-density lipoprotein-cholesterol (p = .03) was increased significantly in the GPA group. As a main finding of this study, hepatic steatosis significantly decreased in the G and GPA groups. Ginger supplementation can effectively improve NAFLD in children, and its effectiveness was further increased when combined with an AID.

The relationship between major dietary patterns and disease activity of rheumatoid arthritis.

AIM: Rheumatoid arthritis is an inflammatory illness characterized by persistent and systemic inflammation. There is just a little amount of research on nutrition and RA progression. The goal of this research is to see whether there's a link between main eating trends and RA activity. METHODS: In Kermanshah, Iran, 183 individuals with RA were studied in cross-sectional research. The American College of Rheumatology's 2010 criteria were used to diagnose RA. The disease activity score 28 and nutritional information from a reliable 147-item food frequency questionnaire were used to assess RA activity. Factor analysis was used to extract dietary patterns. RESULTS: The researchers discovered three main eating trends, which they named. Individuals in the highest tertile of a high protein anti-inflammatory dietary pattern that emphasizes consumption of dairy products, red meats, white meats, vegetables oils, condiments, vegetables and fruits as well as low in salts and refined grain had lower DAS-28 scores than those in the first tertiles (T3 = 2.09 ± 0.14 vs. T1 = 3.75 ± 0.13; P-value = 0.001) after controlling for potential confounders. Patients in the top tertile of the low fiber dietary pattern had higher DAS-28 scores than those in the bottom tertile (T3 = 3.40 ± 0.15 vs. T1 = 2.95 ± 0.15; P-value = 0.036) than those in the bottom tertile. CONCLUSION: This research found an inverse connection between RA activity and adopting a high-protein anti-inflammatory dietary pattern. Furthermore, adopting a low-fiber dietary pattern may be linked to increased RA disease activity. To confirm such a relationship, further research is needed in the future.

Optimal cut-off points of fat mass index and visceral adiposity index associated with type 2 diabetes mellitus.

Background: Indices, based on anthropometrics with or without non-anthropometric components, are predictive of cardio-metabolic outcomes. Fat mass index (FMI) is similar to BMI except measured fat mass replaces body weight. The visceral adiposity index (VAI) combines anthropometric measures with lipid measurements TG/HDL. The relationship of these indices to incident type 2 diabetes (T2DM) has not been established. Therefore, we have evaluated the predictive power and optimal cut-off points of FMI, and VAI with T2DM in a cross-sectional population study. Methods: These population-based cross-sectional study comprised 8411 adults aged 35-65 years using data from the Ravansar Non-Communicable Diseases (RaNCD) cohort. VAI and FMI were defined as previously published. Optimal cut-off points for association with incident T2DM were determined from receiver-operating curves (ROC). Results: The optimal cut-off point for VAI was 4.86 (AUC: 0.673; 95% CI: 0.65-0.69) and FMI 9.3 (AUC: 0.57; 95% CI: 0.55-0.59), and for T2DM in our study population. The odds ratios (OR) for T2DM were nearly identical, for VAI 1.098 (95% CI: 1.08-1.11) and for FMI 1.08 (95% CI: 1.05-1.10). Conclusions: In the current population study, VAI and FMI were weakly associated with T2DM. Therefore, it seems that anthropometric measures are unlikely to be strong mediators of T2DM compared to historical and other factors in the population studied.

A systematic review and meta-analysis of preclinical and clinical studies on the efficacy of ginger for the treatment of fatty liver disease.

Fatty liver disease (FLD) is the most common chronic liver disease worldwide. The pathogenesis of this disease is closely related to obesity and insulin resistance. Ginger has hypolipidemic and antioxidant effects and acts as an insulin sensitizer. This study aims to evaluate the effect of ginger supplementation on the fatty liver. A comprehensive search of Medline/PubMed, Embase, Scopus, Web of Science/ISI, and Cochrane databases was conducted without time or language restrictions. Eighteen eligible studies were identified, including 17 in-vivo experiments in quantitative analysis and 3 clinical trials in qualitative analysis. The present study provides comprehensive evidence of the efficacy of ginger to improve the liver levels of cholesterol (-5.60 mg/g), triglycerides (TG, -4.28 mg/g), malondialdehyde (-3.16 nmol/mg), catalase (CAT) (3.35 nmol/mg), superoxide dismutase (SOD, 3.01 U/mg), serum levels of alanine aminotransferase (ALT, -2.85 U/L), aspartate aminotransferase (AST, -0.98 U/L), TG (-4.98 mg/dL), low-density lipoprotein (LDL, -3.94 mg/dL), total cholesterol (TC, -3.45 mg/dL), high-density lipoprotein (HDL, 1.27 mg/dL), and fasting blood sugar (FBS, -2.54 mg/dL). Ginger administration may reduce many clinical aspects of FLD by several mechanisms, including insulin-sensitive effects, stimulating the expression of antioxidant enzymes, reducing the generation of reactive oxygen species (ROS), having antidyslipidemic activities, and reducing hepatic fat content. However, future clinical trials are essential to investigate the clinical application of ginger in this area.

Major dietary patterns in relation to muscle strength status among middle-aged people: A cross-sectional study within the RaNCD cohort.

Grip strength in midlife can predict physical disability in senior years. Recent evidence shows the critical role of nutritional status on muscle function. We aimed to elucidate whether adherence to a particular dietary pattern would be associated with abnormal muscle strength among middle-aged people. In this cross-sectional study, a semiquantitative Food Frequency Questionnaire was used to assess the dietary intake of 2781 participants in the Ravansar Non-Communicable Chronic Disease (RaNCD) cohort. Major dietary patterns from 28 main food groups were extracted using principal component analysis. Binary logistic regression was used to determine the association between the tertiles of the major dietary patterns and muscle strength status. Two major dietary patterns were identified: the "mixed dietary pattern" that heavily loaded with fruits, vegetables, nuts, dairies, sweets, legumes, dried fruits, fish, red meat, butter, whole grains, natural juices, poultry, pickles, olive, industrial juice, egg, processed meat, and snacks and "unhealthy dietary pattern" that heavily loaded by fats, sugar, refined grains, soft drink, salt, organ meat, tea, and coffee. Adherence to the mixed dietary pattern (OR = 1.03, 95% CI = 0.8-1.33, P for trend = 0.77) and the unhealthy dietary pattern (OR = 1.01, 95% CI = 0.79-0.13, P for trend = 0.89) did not associate with abnormal muscle strength. This study suggests that the dietary pattern involving the consumption of healthy and unhealthy food does not have an effect on muscle strength in middle-aged adults.

Effects of almond consumption on lipid profile in patients with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials.

The aim of this meta-analysis was to assess the effects of almond consumption on the lipid profiles of type 2 diabetes mellitus (T2DM) patients. Eligible trials were searched from four electronic databases until Jan 2020. Five eligible articles were included in the final quantitative analysis. Overall, meta-analysis could not show any beneficial effect of almond consumption on total cholesterol (TC) weighted mean difference (WMD: 0.65 mg/dL, 95% CI: -7.52-8.82, p = .87), triglyceride (TG; WMD: 1.59 mg/dL, 95% CI: -21.77-24.96, p = .89), low-density lipoprotein cholesterol (LDL-C; WMD: -5.40 mg/dL, 95% CI: -13.30-2.50, p = .18), and high-density lipoprotein cholesterol (HDL-C; WMD: 1.57 mg/dL, 95% CI: -0.95-4.10, p = .22). However, subgroup analyses showed that serum LDL-C levels were significantly reduced in trials administered > 50 g/d almond. The data suggest that consumption of almond could not improve lipid profile in patients with T2DM.

The effect of sumac (Rhus coriaria L.) supplementation on glycemic indices: A systematic review and meta-analysis of controlled clinical trials.

BACKGROUND & AIMS: Rhus coriaria L. (Sumac) is a popular spice/herb with several biological functions owing to its antioxidant and insulin-like activities. Many clinical trials have indicated the potent anti-diabetic property of sumac but the results on few glycemic indices were inconclusive. Hence, this systematic review and meta-analysis were aimed to investigate sumac supplementation effect on glycemic indices. METHODS: Systematically searched was performed by two independent reviewers using online databases including: PubMed, Scopus, web of science, EMBASE from inception until November 2020. Data were pooled using a random-effects model and weighted mean difference (WMD) with 95 % confidence intervals (CI). RESULTS: A total of 6 potentially relevant clinical trials met the inclusion criteria with total of 278 participants. Random-effects meta-analysis suggested no significant effects on the levels of fasting blood glucose [-7.08 mg/dl, 95 % CI: -14.85 to 0.70,P = 0.07, I2 = 59.8 %], glycosylated hemoglobin (HbA1c) [-0.48 %, 95 % CI: -1.01 to -0.04, P = 0.07, I2 = 0.0 %], homeostatic model assessment for insulin resistance (HOMA-IR) [-0.97, 95 % CI: -1.96 to 0.02, P = 0.05, I2 = 83.8 %], and insulin [-2.94 Hedges' g, 95 % CI: -6.67 to 0.80, P = 0.12, I2 = 83.1 %] following supplementation with sumac powder. CONCLUSION: This meta-analysis showed no significant effects on any glycemic indices following supplementation with sumac powder.

Association of Dietary Inflammatory Index with cardiovascular disease in Kurdish adults: results of a prospective study on Ravansar non-communicable diseases.

BACKGROUND: Various diets and dietary compounds, through their inflammatory properties, are involved in the pathogenesis of chronic diseases including Cardiovascular Diseases (CVDs). Dietary Inflammatory Index (DII) can evaluate the inflammatory properties of diet. The purpose of this study was to determine the association between DII and CVDs in participants of the Ravansar Non-Communicable Diseases (RaNCD) cohort study, Kermanshah, Iran. MATERIALS: The present cross-sectional study was conducted using the recruitment phase data of the RaNCD cohort study on 6369 participants aged 35 to 65 years. The Food Frequency Questionnaire (FFQ) was used to assess diet. The DII scores were calculated using FFQ data. Participants with a history of myocardial infarction, stroke and coronary artery disease, and/or taking medications for the CVDs were considered as the CVDs patients. RESULTS: Of the 6369 studied participants, 9% (n = 579) had CVDs history. The mean DII score in this study was - 0.84 ± 1.6. Odds ratio (OR) of CVDs in women was 1.6 times higher than in men (CI 95% = 1.3-1.9), which this association was remained after adjusting for confounding variables (OR = 1.5, CI% = 1.2-1.9). The risk of CVDs in the fourth quartile of DII was 1.4 times higher than the first quartile of DII (OR: 1.4, CI 95% = 1.1-1.8). We found that higher adhere to DII was associated with risk of CVDs. CONCLUSION: According to current documents, given the role of diet through inflammatory properties on the risk of CVDs, it is recommended to use DII as an appropriate index to measure the effect of diet on CVDs in Iranian population. In addition, a diet with lower DII may be healthier diet for cardiovascular health.

Adherence to healthy diet is related to better linear growth with open growth plate in adolescent girls.

Nutritional status can affect the linear growth of bones during puberty by affecting growth plate (GP) chondrocytes. We hypothesized that there is a relationship between dietary patterns and bone age on girls who have experienced height loss. This cross-sectional study was conducted on 350 girls aged 12-13 years with open GP, and major dietary patterns were determined using the factor analysis method. Dual-energy x-ray absorptiometry measurement of participant's wrist was performed to determine GP openness and bone age. In the present study, 70.3% of participants had bone age below chronological age. Three major dietary patterns-healthy, high sugar and salt, and Western diet-were identified using findings of dietary intake. Adherence to the healthy diet led to significant increase in height, weight, body mass index, and other components of body composition such as lean body mass (P < .001). Among these dietary patterns, we found only a significant association between healthy diet and difference between bone and chronological age (B = -0.106). In the present study, adherence to a healthy diet was associated with increase in bone age (P = .02). Healthy dietary pattern with an emphasis on enough intake of plant protein and white meat was associated with better linear growth.

Adherence to Healthy Diet Can Delay Alzheimer's Diseases Development: A Systematic Review and Meta-Analysis.

A healthy diet has long been indicated to be protective against Alzheimer's diseases (AD). We carried out a systematic review and meta-analysis of published observational studies to explore the relationship between healthy and unhealthy diets and risk of ADs. We screened PubMed, Scopus, Web of Sciences, Google Scholar, Science Direct, and Embase, and screened manually to identify relevant articles published in English and non-English until Jun 2020. We classified the studied dietary patterns into two groups: healthy and unhealthy diets. The pooled weighted mean difference and 95% confidence interval (95% CI) was used to analyze the data using a random-effects model. The data were extracted manually and the preferred reporting items for systematic review and meta-analysis checklist was used to appraise the risk of bias and quality of data. Of the 1,813 articles identified, 21 met the inclusion criteria and were included in the quantitative analysis. A healthy diet was related to a lower risk of AD [odds ratio (OR): 0.45, 95% CI: 0.23 to 0.86, I2=99.7%; n=17 studies]. Moreover, high adherence to an unhealthy diet was not associated with increased risk of AD (OR: 0.99, 95% CI: 0.98 to 0.99, I2=0.0%; n=6 studies). However, the etiology of AD is uncertain and it is difficult draw conclusions about dietary healthy patterns. We concluded that adherence to a healthy diet is associated with a lower risk of AD, but were unable to find evidence that an unhealthy diet increases the risk of AD.

Effects of coenzyme Q10 supplementation on matrix metalloproteinases and DAS-28 in patients with rheumatoid arthritis: a randomized, double-blind, placebo-controlled clinical trial.

OBJECTIVES: This study aimed to assess the effect of CoQ10 supplementation on serum matrix metalloproteinases (MMPs) and clinical parameters in rheumatoid arthritis (RA) patients. METHOD: In this randomized, double-blind, placebo-controlled trial, 54 RA patients who fulfilled the eligibility criteria (18-56 years, diagnosed at least 6 months ago, with DAS-28 > 3.2) were randomly assigned into two groups to receive 100 mg/day CoQ10 (n = 27) or placebo (n = 27) for 2 months. Serum MMP-1 and MMP-3 levels and clinical status using disease activity score in 28 joints (DAS-28) were assessed before and after supplementation. Data were analyzed using χ2, independent sample t test, paired t test, Wilcoxon, Mann-Whitney, and analysis of covariance. RESULTS: A significant reduction was observed in both CoQ10 and placebo groups in the medians of serum MMP-1 (0.2 to 0.16, P < 0.001), (0.18 to 0.15, P = 0.001); swollen joint count (2 to 0, P < 0.001), (2 to 0, P = 0.009); and the means of DAS-28 (5.01 ± 1.21 to 2.34 ± 0.68, P < 0.001), (4.88 ± 0.96 to 4.04 ± 1.36, P = 0.009) respectively. Serum MMP-3 level increased significantly in placebo group (2.26 to 2.57, P = 0.020), and the MMP-3 changes between groups were significant (P = 0.027). Furthermore, significant reductions were only observed in ESR, pain score, and tender joint count in CoQ10 group compared with baseline (P = 0.001, P < 0.001, and P < 0.001, respectively). Significant differences were observed between two groups in DAS-28, pain score, and swollen and tender joint count after the intervention (P < 0.001, P < 0.001, and P = 0.012 and P < 0.001, respectively). CONCLUSIONS: It seems that CoQ10 may provide a new complementary approach for RA patients.Key Points• CoQ10 supplementation in RA patients attenuated serum MMP-3 level.• CoQ10 supplementation in RA patients improved clinical outcomes and ameliorated disease severity.• CoQ10 may provide a new complementary approach for patients with RA.

Dietary pattern in relation to the risk of Alzheimer's disease: a systematic review.

Alzheimer's disease (AD) is a progressive neurodegenerative disease leading to a gradual and irreversible loss of memory, linguistic skills, and perception of time and space, thinking, and behavior. Dietary pattern has been presented as a contributor to the incidence of Alzheimer's. This study aimed at reviewing the evidence on the relation between dietary pattern and AD. This systematic search was performed on the articles available in PubMed, Scopus, and Web of Sciences databases until May 2019 using keywords, including (diet, food, dietary pattern, food pattern) and (Alzheimer's disease) among observational studies. After excluding duplicated, and irrelevant studies, 26 studies were eligible for this review study. We categorized the studied dietary patterns into two groups: healthy and unhealthy diet. This study reviewed two case-control, five cross-sectional, and 19 prospective studies. Eight studies assessed unhealthy diet (high-fat diet, high-glycemic diet, sweetened sugary beverage, etc.) and the risk of AD. In addition, the other studies considered the effect of healthy diet such as Mediterranean diet, dietary approaches to stop hypertension (DASH), Mediterranean-DASH intervention for neurodegenerative delay, and seafood-rich diet on AD. This literature review indicated that adherence to a healthy dietary pattern has neuroprotective effects on AD prevention, while unhealthy diet can cause neurodegenerative effects in AD etiology. In conclusion, our findings showed that adherence to healthy diet can decrease oxidative stress and inflammation and accumulation of amyloid-ß and consequently can decrease the risk of AD.

Nutritional Care in Iranian Intensive Care Units.

Intensive care units (ICUs) provides intensive treatment medicine to avoid complications such as malnutrition, infection and even death. As very little is currently known about the nutritional practices in Iranian ICUs, this study attempted to assess the various aspects of current nutrition support practices in Iranian ICUs. We conducted a cross-sectional study on 150 critically ill patients at 18 ICUs in 12 hospitals located in 2 provinces of Iran from February 2015 to March 2016. Data were collected through interview with supervisors of ICUs, medical record reviews and direct observation of patients during feeding. Our study showed that hospital-prepared enteral tube feeding formulas are the main formulas used in Iranian hospitals. None of the dietitians worked exclusively an ICU and only 30% of patients received diet counselling. Regular monitoring of nutritional status, daily energy and protein intake were not recorded in any of the participating ICUs. Patients were not monitored for anthropometric measurements such as mid-arm circumference (MAC) and electrolyte status. The nasogastric tube was not switched to percutaneous endoscopic gastrostomy or jejunostomy (PEG/PEGJ) in approximately 85% of patients receiving long-term enteral nutrition (EN) support. Our findings demonstrated that the quality of nutritional care was inappropriate in Iranian ICUs and improvement of nutritional care services within Iranian ICUs is necessary.

Energy restriction combined with green coffee bean extract affects serum adipocytokines and the body composition in obese women.

BACKGROUND AND OBJECTIVES: Obesity has become a public health problem and is a cause of some preventable illnesses. Among several methods for treating obesity, the use of food supplements is highly common. A commonly used food supplement is green coffee bean extract. The objective of this study was to evaluate the efficacy of green coffee bean extract combined with an energy-restricted diet on the body composition and serum adipocytokines in obese women. METHODS AND STUDY DESIGN: In this randomised clinical trial, 64 obese women aged 20-45 years were selected and divided into two groups: an intervention group (receiving 400 mg green coffee bean extract for 8 weeks) and control group (receiving placebo). All participants were on an energy-restricted diet. The body composition, leptin, adiponectin, lipid profile, free fatty acids (FFAs), and fasting blood sugar were compared between the two groups. RESULTS: We observed significant reductions in the body weight, body mass and fat mass indices, and waist-to-hip circumference ratio in both groups; however, the decrease was higher in the intervention group. Moreover, serum total cholesterol, low-density lipoprotein, leptin, and plasma free fatty acids significantly decreased in the intervention group (p<0.05) after adjustment for energy and fibre intake. The serum adiponectin concentration significantly increased in the intervention group (p<0.05). CONCLUSIONS: Green coffee bean extract combined with an energy-restricted diet affects fat accumulation and lipid metabolism and is thus an inexpensive method for weight control in obese people.

Intake of Dietary Supplements and Malnutrition in Patients in Intensive Care Unit.

BACKGROUND: Malnutrition is prevalent among patients hospitalized in Intensive Care Units (ICUs) and causes various complications. Dietary supplementation to provide appropriate nutritional support may reduce the malnutrition and complications through improvement in nutritional status. This study was carried out to assess the association between dietary supplementation and malnutrition among patients in ICUs. METHODS: A case-control study was conducted on 180 male patients aged 20-60 years in the ICUs of the hospitals in Ahvaz, Iran in 2013. Data of two groups including 83 patients (cases) who had consumed regular hospital meals and dietary supplements and 97 patients (controls) who had received regular hospital meals were compared. Anthropometric measurements, laboratory values, and dietary intakes were extracted from medical records, and Maastricht index (MI) was calculated. Data were analyzed using the IBM SPSS Statistics 21. T-test and paired-sample t-test were used to determine the difference between groups. RESULTS: Taking supplements increased daily energy intake, carbohydrate, and protein in case group (n = 83) significantly (P < 0.05). MI changed to 3.1 ± 3.8 and 4.3 ± 4.2 in case (n = 83) and control (n = 97) groups, respectively. Although the MI fell in both groups, it showed a greater reduction in case group (from 6.3 ± 5.3 to 3.1 ± 3.8). CONCLUSIONS: Since consuming dietary supplements besides the regular hospital meals increased intake of energy and macronutrients and reduced the MI significantly, it was concluded that it helped supply nutritional requirements more effectively and improved the malnutrition in ICU.

Relation between Lifestyle and Socio-Demographic Factors and Body Composition among the Elderly.

BACKGROUND: Aging is accompanied by various changes that can cause changes in diet and body composition resulting sometimes in malnutrition and disability in the elderly. Changes in body composition among the elderly are mainly the result of physical inactivity and nutrition. This study was designed to examine the relationship between lifestyle and socio-demographic factors and body composition. METHOD: A cross-sectional study was carried out with 380 elderly people aged 60 and over in district 5 of Tehran, Iran. Their body composition was measured by Bioelectrical Impedance Analysis and the Actigraph device was used for assessing physical activity patterns. A three-day food recall was conducted to measure their intake of energy and macronutrients. Lifestyle and socio-demographic information were collected by interview using a pretested questionnaire. RESULTS: Overweight, obesity and central obesity were more prevalent in women than in men (p<0.001). Moreover, 57.1% and 18.7% of participants had high and very high fat mass index, respectively. High fat mass index was seen in 47% of men and 37.5% of women who had normal body mass index (BMI). Meanwhile, age, gender, physical activity, energy intake, the percentage of energy from fat and protein, educational level, job, television watching time, smoking, chronic diseases, and taking medicine were significantly associated with anthropometric measurements (p<0.05). CONCLUSION: Overweight, obesity and high body fat percentage were common among the aged. Considering the factors that are significantly associated with body composition, programs that can increase their awareness about the dietary balance and suitable physical activity should be organized to address these problems.

Sensitivity and specificity of body mass index in determining obesity in children.

BACKGROUND: The purpose of this study is to determine sensitivity and specificity of body mass index (BMI) based on Center for Disease Control 2000 (CDC) percentiles compared to fat mass index (FMI) as an indicator of being really obese in children. Obesity was compared based on these two indexes among children under study. MATERIALS AND METHODS: This cross-sectional study was conducted on 410 primary school girls aged 8-10 years, in the city of Esfahan. Weight and height were measured and BMI was calculated based on weight divided by height squared. Fat mass was measured by body composition analyzer (BCA) and FMI was calculated by dividing fat mass by height squared. FMI at or above the 90(th) percentile and FMI less than 90(th) percentile of reference data were considered as criterion for defining real obesity and normal adiposity, respectively. Receiver operating characteristic (ROC) curve was used to assess the performance of BMI in detecting obesity on the basis of FMI. Furthermore, the rate of agreement between two indices was calculated using Kappa coefficient P number. RESULTS: Mean and standard deviation of FMI and BMI in all children were 6 ± 2.1 (kg/m(2)) and 19.4 ± 3 (kg/m(2)), respectively. The area under the ROC curve for obesity was 0.75. The cutoff point, sensitivity, and specificity of BMI to classify children as obese compared to FMI were 21.2 kg/m(2), 79%, and 73%, respectively. In this cutoff point for BMI (21.2 kg/m(2)), the agreement rate between BMI and FMI for determining obesity status was 0.5 (P < 0.001). CONCLUSION: Our results indicated 79% of children who were recognized as obese based on FMI, were also classified as obese according to BMI. Twenty-seven percent of children, who were non-obese, were identified as obese based on BMI. It appears that FMI compared to BMI is more accurate in determining obesity, but further studies are required.

Dietary calcium intake and risk of obesity in school girls aged 8-10 years.

BACKGROUND: Some studies have demonstrated the role of calcium in reducing body mass index (BMI) or fat mass. Though, BMI does not provide very valid information about changes in body fat mass, Fat Mass Index (FMI) relates body fat mass to height and allows comparing body fat mass of individuals at different heights. This study investigated the possible association between dietary calcium intake (CI) and other nutritional factors and weight status of girls aged 8-10 years. MATERIALS AND METHODS: In this case-control study, 110 girls aged 8-10 with FMI at or above 7.2 kg/m(2) as cases and 307 girls with FMI less than 7.2 kg/m(2) as controls were recruited through multistage cluster random sampling. FMI at or above 7.2 kg/m(2) was considered as the cutoff point for obesity. Body fat mass was assessed by a stand on bio impedance analyzer. In order to assess CI, participants were asked to complete a validated food frequency questionnaire. RESULTS: Mean and standard deviation of CI in the case group was significantly lower than the control group 649 ± 103 and 951 ± 152 mg/d, respectively (P < 0.01). After Adjustment for total energy intake, the percentage of energy from fat, carbohydrate and protein in quartiles of physical activity, inverse association between CI and obesity was significant and in the highest quartile of physical activity the association was weaker. By further adjustment for the effect of fruits and vegetable intake inverse association between CI and obesity became weaker but yet was significant. CONCLUSION: The inverse relationship between CI and FMI remained significant even after controlling for confounding factors. FMI may be more accurate, compared to BMI, in showing the association between CI and obesity.