Identification and prioritization of food insecurity and vulnerability indices in iran.

BACKGROUND: Food security is a multi-dimensional phenomenon. The objective of this study was to identify and prioritize major indices for determining food insecurity in Iran. METHODS: Descriptive study using the Delphi method was conducted through an email-delivered questionnaire. Forty-three senior experts at national or provincial level were selected based on their work experience and educational background through study panel consultation and snowballing from Tehran and other cities of Iran. During two rounds of Delphi, participants were asked to identify priority indicators for food security at provincial level in Iran. RESULTS: Sixty five percent of Delphi panel participated in the first round and eighty-nine percent of them participated in the second round of Delphi. Initially, 243 indices were identified through review of literature; after excluding indictors, which was not available or measurable at provincial level in Iran, 103 indictors remained. The results of study showed that experts identified "percentage of individuals receiving less than 70% of daily energy requirement" with a median score of 90, as the most influential index for determining food insecurity. "Food expenses as a proportion of the overall expenses of the family", "per capita of dietary energy supply", and "provision of micro-nutrient supply requirement per capita" with median of 80 were in the second rank of food security priority indicators. CONCLUSION: Out of 243 identified indicators for food security, 38 indicators were selected as the most priority indicators for food security at provincial level in Iran.

Validity of energy intake reports in relation to dietary patterns.

The role of under- and overreporting of energy intake in determining the dietary patterns is yet unclear, especially in the Middle Eastern countries. This study identifies the prevalence of misreporting among Tehranian women aged 18-45 years and to compare the dietary intake patterns of plausible and all energy reporters. Dietary intakes and anthropometric data were collected. FitMate metabolic analyzer and Goldberg equation were used in determining the under/overreporting of energy intake. Underreporters were more likely to be overweight and older compared to plausible reporters. Three dietary patterns emerged for all reporters, and two were identified for plausible reporters. Using only plausible reporters to determine dietary patterns was not similar to using all reporters. The proportion of underreporters was 59.3% in the mixture cluster, 30.4% in the unhealthy cluster, and 35.3% in the healthy cluster (p < 0.05). Underreporting of energy intake is not uniformly distributed among dietary pattern clusters and tends to be less severe among subjects in the unhealthy cluster. Our data suggested that misreporting of energy intake might affect the dietary pattern analysis.

Accuracy of energy intake reporting: comparison of energy intake and resting metabolic rate and their relation to anthropometric and sociodemographic factors among Iranian women.

BACKGROUND: This study assesses the accuracy of energy intake (EI) reporting and its relation to anthropometric characteristics and sociodemographic factors. In addition, we attempt to identify foods for which under- or over-reporting is more prevalent. METHODS: EI was assessed for 187 women using a semi-quantitative 168-item food frequency questionnaire (FFQ). Resting metabolic rate (RMR) was measured with an indirect calorimeter. We calculated the EI/RMR ratio to assess the accuracy of EI reporting. This study defined under-reporters as those with an EI/RMR of ≤ 1.34 and over-reporters as those with an EI/RMR of ≥ 2.4. We measured anthropometric characteristics and collected sociodemographic information. The chi-square test, ANOVA and multiple linear regressions were used for statistical analyses. RESULTS: Among participants, the under-reporting rate was 35.5% and the over-reporting rate was 7.5%. The EI/RMR ratio was significantly higher for younger women compared to older women (P < 0.04). Under-reporters had higher weight, waist circumference (WC), body mass index (BMI) and resting metabolism compared to accurate reporters (P < 0.05). Resting metabolism was significantly lower among over-reporters than accurate reporters. After adjusting for energy, the consumption of fish, high-fat dairy products, hydrogenated oil, sweets and coffee was lower, whereas consumption of unsaturated oils, tea, salt and yellow vegetables was higher among under-reporters compared to accurate reporters. CONCLUSION: Under-reporting of EI is more frequent than over-reporting among Iranian women. Among various factors that may affect the accuracy of EI reporting, age and anthropometric characteristics might have a significant effect.

Validity of predictive equations for resting energy expenditure among Iranian women.

OBJECTIVES: To determine the resting metabolic rate (RMR) in a sample of Iranian women, and to evaluate the validity of predictive equations for estimating RMR in normal and obese subjects. METHODS: This cross-sectional study was conducted on a total of 187 healthy women aged 18-45 years. Anthropometric data were collected and subjects' RMR was measured by indirect calorimetry for 15 minutes following an overnight fast. RMR was also predicted using various types of formulas based on subjects' height, age, weight or fat-free mass. Body composition was estimated by bioelectric impedance analysis (BIA). RESULTS: Measured RMR (mean ± SD) was found to be 1473 ± 296 kcal/day. The abbreviation formula overestimated RMR, while other formulas underestimated it. Harris-Benedict formula was valid among all BMI categories (normal weight, overweight, obese and morbidly obese). Two Schofield formulas were valid in normal weight, overweight and morbidly obese subjects; and Cunningham formula was valid only among overweight and obese women. Overweight and obese Iranian women had higher RMR in comparison with normal weight subjects (p<0.01); although after age and weight adjustment, the differences were not significant in any of the BMI categories. CONCLUSIONS: The Harris-Benedict for mula provides a valid estimation of RMR at the group level in a range of normal-weight to morbidly obese Iranians. However, at the individual level, errors might be so high that using a measured value has to be preferred over an estimated value.