What do we Need to Start a Multimedia Salt Reduction Campaign?

As reports of the first national study reveal, Iranian salt intake reaches 9.52 g/day (two times more than recommended by World Health Organization). Meanwhile ignoring the consequences of high salt intake has led to an increased rate of cardiovascular diseases (CVD), stroke, stomach cancer, osteoporosis, obesity, etc., To tackle these threatening issues, a nationwide intervention campaign could be an effective solution based on global experiences. A review of previous work in Iran shows that despite numerous efforts conducted in the prevention of CVDs, they were not well reflected in worldwide sources. Furthermore, a comprehensive campaign was not implemented particularly concerning the salt reduction in Iran. As a result, we first reviewed the major successful initiatives conducted in reducing salt intake around the world and Iran. Then we introduced the components of a comprehensive social marketing campaign along with customized actions related to Iranian nutrition habits, their attitude, and behavior toward salt consumption. These employed components were SWOT analysis, identifying target group, determining communication goals and objectives based on models and theories, planning executive plan, designing communication messages and materials, media planning and promotional actions, and determining campaign budget plus monitoring and evaluation.

The effect of vitamin D supplementation on body composition in nursing mothers with overweight or obesity: a randomized double-blind placebo-controlled clinical trial.

BACKGROUND: This study aimed to evaluate the effect of vitamin D3 supplementation on body composition and anthropometric measures of nursing mothers. METHODS: In a double-blind, randomized clinical trial, 90 nursing mothers with overweight or obesity were randomized into three groups for 12 weeks: two groups of vitamin D3 supplementation (2000 IU/d (VD1), n = 32 and 4000 IU/d (VD2), n = 29) and placebo (PL) group (n = 29). The information on body composition was obtained using the body impedance analysis (BIA) method. Serum 25-Hydroxy vitamin D (25(OH) D), Intact Parathyroid Hormone (iPTH), calcium, and phosphorus were measured before and after the intervention. Data were analyzed based on the intention-to-treat (ITT) method. Two-way repeated measure ANOVA (mixed ANOVA) was applied to assess whether the mean changes in the results from baseline to 12 weeks differ in the three groups. RESULTS: There was a significant increase in the serum 25(OH) D concentration in the VD2 group compared to VD1 and PL groups (mean change (MC), 12.3 ng/ml; 95% CI, 9.4/15.0, p-value < 0.001). In addition, fat mass (MC, - 4.3 kg; 95% CI, - 7.0/- 1.1, p-value < 0.007), fat mass index (MC, - 1.6; 95% CI, - 2.6/- 0.5, p-value < 0.006) and body fat percentage (MC, - 8.1; 95% CI, - 12.0/- 4.2, p-value < 0.007) reduced in VD2 group as compared with VD1 and PL groups. CONCLUSION: The intake of 4000 IU/d vitamins D3 supplementation would elevate circulating 25(OH) D concentrations in nursing mothers with overweight or obesity and improve some indices of body composition. TRIAL REGISTRATION: Iranian Registry of Clinical Trials ( http://www.irct.ir : IRCT20140413017254N6) registered on 11-04-2018. The graphical abstract of this clinical trial, is a figure that explains the final results of the manuscript in a clear and attractive way.

Plant and animal protein intake and its association with depression, anxiety, and stress among Iranian women.

BACKGROUND: Mental disorders are conditions that affect the usual function of the brain, causing a huge burden on societies. The causes are often unclear, but previous research has pointed out, as is the case with many other diseases, that nutrition could have a major role in it. Amino acids, the building blocks of proteins, are the main precursor of neurotransmitters (the chemical messengers in the brain) malfunction of which is heavily associated with a wide range of brain disorders. METHODS: We assumed different sources of dietary protein could have different impacts on mental well-being. Hence, we decided to collect the nutritional data (with a validated and reliable semi-quantitative food-frequency questionnaire) from a sample of 489 Iranian women and investigate the association between animal and plant protein sources and the risk of depression, anxiety, and stress. Symptoms of these mental disorders were assessed using a validated Depression, Anxiety, and Stress Scales (DASS) questionnaire with 21 items. RESULTS: After multivariable adjustment, it was shown that women in the highest tertile of animal protein intake were more likely to show symptoms of depression (OR: 2.63; 95% CI: 1.45, 4.71; P = 0.001), anxiety (OR: 1.83; 95% CI: 1.04, 3.22; P = 0.03), and stress (OR: 3.66; 95% CI: 2.06, 6.50; p < 0.001). While no significant association was seen between plant protein and any of the studied mental disorders. CONCLUSION: Overall, our findings suggest that a diet high in animal protein could predispose individuals to mental illnesses.

Carbohydrate quality index: Its relationship to menopausal symptoms in postmenopausal women.

OBJECTIVE: The aim of this study was to determine the relationship between carbohydrate quality intake and menopausal symptoms. STUDY DESIGN: This is a cross-sectional study of 393 postmenopausal women attending municipality health houses and health centers in the south of Tehran, Iran, from September 2016 to January 2017. MAIN OUTCOME MEASURES: The dietary intake and menopausal symptoms of the participants were assessed with a validated food frequency questionnaire and a menopause rating scale (MRS) carbohydrate quality index (CQI) was calculated using three indices: dietary fiber, glycemic index, and the ratio of solid carbohydrates to total carbohydrates. Linear and logistic regressions were used to assess the relationship between CQI and menopausal symptoms. RESULTS: After adjustment for age, education, time passed since menopause, body mass index, physical activity and energy intake, an inverse association was found between CQI and total MRS score (TMRSS) (ß -0.61; p <0.001), somatic score (SS) (ß -0.27; p <0.001) and psychological score (PS) (ß -0.37; p <0.001) in multivariable linear regression. In addition, logistic regression analysis revealed that compared with the lowest quartile of CQI, participants in the highest quartile of CQI had a lower TMRSS (odds ratio (OR) 0.36, 95% confidence interval (CI) 0.19-0.68). Moreover, CQI was inversely related to SS (OR 0.34; 95% CI 0.17-0.68) and PS (OR 0.32; 95% CI 0.16-0.61). However, there was no significant association between CQI and urogenital score (US). CONCLUSIONS: Higher-quality carbohydrate intake was found to be associated with lower somatic and psychological symptoms of menopause. These findings suggest that CQI may be an important basis for developing an effective dietary modification for reducing menopausal symptoms.

Healthy Dietary Pattern is Related to Blood Lipids in Patients with Type 1 Diabetes Mellitus: A Cross-sectional Study from a Developing Country.

BACKGROUND: The association between dietary patterns and cardiovascular disease (CVD) risk factors has been investigated in very limited studies in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to determine the relationship between the major dietary patterns and CVD risk factors in these patients. METHODS: A cross-sectional study was performed on 169 females of 18--35 years who were diagnosed with T1DM attending Iranian Diabetes Association in Tehran. Anthropometric measures, blood glucose, and lipid levels of all participants were measured. Dietary data was collected using a food frequency questionnaire. Dietary patterns were determined by factor analysis. Using the analysis of covariance (ANCOVA), mean value of the biochemical factors across the tertiles of dietary patterns was compared. RESULTS: Three major dietary patterns were identified: the grain, legume and nut (GLN), the fruits and vegetables (FV), and the high calorie foods, salty snacks, sweet and dessert (HSD). After adjustment for age, body mass index and energy intake, subjects who were in the highest tertile of FV pattern had significantly lower levels of LDL-c (P = 0.01), triglyceride (TG) (P = 0.02), and total cholesterol (P = 0.01). GLN and HSD patterns had no significant relationship with blood glucose and lipids. CONCLUSIONS: This study demonstrates that a dietary pattern rich in vegetables and fruits may be inversely associated with dyslipidemia in patients with T1DM. The results can be used for developing interventions that aim to promote healthy eating for the prevention of CVD in these patients.

Dietary phytochemical index associated with cardiovascular risk factor in patients with type 1 diabetes mellitus.

BACKGROUND: Dietary phytochemical index (DPI) is useful and inexpensive method to identify the role of phytochemicals on cardiovascular disease (CVD) risk factors. This study aimed to assess the relationship between DPI and CVD risk factors in patients with type1 diabetes mellitus. METHODS: A total of 261 participants aged 18-35 years with T1DM were enrolled in this cross-sectional study to assess the relationship between DPI and CVD risk factors. Anthropometric measurements, blood lipids, glucose, and antioxidant level were measured. Food intakes were determined using a food frequency questionnaire to calculate DPI. Logistic regression was used. RESULTS: The mean age of participants was 25 years. After adjustment for potential confounders, participants in the highest tertile of DPI had 88 % lower chance of hyperglycemia (P for trend = 0.020), 81 % lower chance of low high-density lipoprotein cholesterol (HDL-C) (P for trend = 0.030) and 98 % lower chance of high low-density lipoprotein cholesterol to HDL-C ratio (P for tend = 0.040). There were no relationships between DPI and other CVD risk factors. CONCLUSIONS: Although higher intake of phytochemical-rich foods had a beneficial effect on some risk factors of CVD, more studies more studies are warranted to corroborate the present findings.

Relationship between dietary diversity score and general health in female students.

BACKGROUND: Adolescence is a critical period with respect to mental and psychological issues. The role of nutrients is well known in health condition in adolescents, but little emphasis is placed on total diet quality. Dietary diversity score (DDS) is often used to assess diet quality. The objective of this study was to investigate the relationship between DDS and general health in girl students. METHODS: The present research is a cross-sectional study which used descriptive-analytical approach. A total of 384 high-school female students selected using proportional stratified sampling. Physical activity level, diet and general health information collected using International Physical Activity Questionnaire (IPAQ), Dietary Diversity Questionnaire (FAO-2013) and 28-item self-reported general health questionnaire (GHQ-28), respectively. In addition, weight, height and waist circumference (WC) measured. Data analyzed using Chi-Square test, one-way ANOVA and Multinomial Logistic Regression. RESULTS: Mean DDS was 4.43±1.09. After adjustment for confounders of age, body mass index, physical activity, socioeconomic status and nutritional supplement intake, students with higher DDS were less prone to general health disorders (P≤0.05). CONCLUSIONS: These finding implicate higher DDS in adolescents may associate with better general health.

Relationship between dietary carbohydrate quality index and metabolic syndrome among type 2 diabetes mellitus subjects: a case-control study from Ghana.

BACKGROUND: Dietary carbohydrate quality may play an important role in disease development. We evaluated the association between carbohydrate quality index (CQI) and the odds of metabolic syndrome (MetS) in type 2 diabetes mellitus (T2DM) subjects in Ghana. METHODS: In this case-control study, we analyzed data using 124 T2DM subjects. We obtained dietary information using 2-day 24-h dietary recalls. We calculated CQI from dietary fiber, glycemic index, whole grains/total grains ratio, and solid carbohydrates/total carbohydrates ratio. Serum lipid profiles were measured after an overnight fast of 8-12 h. RESULTS: Upon adjustments for the effects of covariates, the CQI showed a positive association with high-density lipoprotein cholesterol concentration (beta coefficient (ß) = 0.24; standard error (SE) = 0.20; P for trend = 0.01), and an inverse relationship with waist circumference (ß = - 17.29; SE = 4.00; P for trend < 0.001), systolic blood pressure (ß = - 15.74; SE = 4.69; P for trend < 0.001), diastolic blood pressure (ß = - 7.23; SE = 2.97; P for trend = 0.02), and triglyceride concentrations (ß = - 0.43; SE = 0.11; P for trend < 0.001). Overall, the CQI had an inverse relationship with the odds of MetS (Odds ratio tertile 3 vs.1 0.05; 95% Confidence interval: 0.01-0.23; p-trend < 0.001). Also, a positive correlation was found between the CQI and fiber, but the CQI showed a negative relationship with dietary glycemic index. CONCLUSIONS: The present results suggest an inverse association between the CQI of a diet and the odds of MetS. The CQI approach of dietary recommendation may be a useful strategy for dietary carbohydrate selection for the prevention of MetS.

The association of serum levels of zinc and vitamin D with wasting among Iranian pre-school children.

PURPOSE: Wasting is a main indicator of Child's undernutrition that is associated with several non-communicable diseases and child mortality. This is the first population-based study which evaluated the association of serum zinc and vitamin D levels with wasting in a Middle East region. We also reported the prevalence of vitamin D and zinc deficiencies among Iranian pre-school children aged 6 years. METHODS: This was a multicenter cross-sectional study that included 425 children aged between 5 and 7 years (on average 6 years) with BMI-for-age Z-scores of < - 1 SD resident in urban and rural areas of Iran in the spring of 2012 as part of the National Integrated Micronutrient Survey 2 (NIMS-2). Anthropometric measurements and blood sampling were obtained. The prevalence of vitamin D and zinc deficiencies together with the correlations of these variables with the increase of BMI-for-age Z-scores were evaluated. RESULTS: The prevalence of vitamin D and zinc deficiencies was 18.8% and 12.7%, respectively. In addition, 31.1% of children were wasted. Children in the second tertile of 25(OH)D levels were less likely to have wasting compared with those in the first tertile in both crude and adjusted models (OR 0.47, 95% CI 0.27-0.83). A significant inverse association was found between serum levels of zinc and wasting (OR 0.57, 95% CI 0.34-0.96); such that after adjusting for confounders, children in the highest tertile of serum zinc had 47% less odds of wasting compared with those in the first tertile (OR 0.53, 95% CI 0.31-0.91). CONCLUSION: The prevalence of vitamin D and zinc deficiencies among Iranian pre-school children aged 6 years was 18.8 and 12.7%, respectively. Serum levels of vitamin D and zinc were inversely associated with wasting either before or after controlling for confounders. LEVEL OF EVIDENCE: Level III, case-control analytic studies.

Dietary insulin index and insulin load in relation to glioma: findings from a case-control study.

BACKGROUND: Although hyperinsulinemia is assumed to be involved in brain carcinogenesis, data on the link between dietary insulin index (DII) and dietary insulin load (DIL) and risk of glioma are lacking. OBJECTIVE: The current study aimed to investigate the relation between DII and DIL and risk of glioma in a case-control study among Iranian adults. METHODS: In this hospital-based case-control study, 128 pathologically confirmed cases of glioma and 256 age and sex-matched controls were enrolled. Dietary intakes of study participants were assessed using a validated Block-format 123-item semi-quantitative FFQ. DII and DIL were computed using a published food insulin index (FII) data. RESULTS: A significant positive association was found between DIL and glioma (OR: 3.56; 95% CI: 1.85-6.58, P < 0.001); such that after controlling for potential confounders, participants in the highest quartile of DIL had 2.95 times greater odds of glioma than those in the lowest quartile (OR: 2.95; 95% CI: 1.40-6.24, Ptrend = 0.006). Furthermore, we observed a significant positive association between DII and glioma (OR: 2.65; 95% CI: 1.43-4.93, Ptrend = 0.001). This association remained significant even after considering energy intake (OR: 2.66; 95% CI: 1.43-4.95, Ptrend = 0.001). However, when further potential confounders were taken into account, this relationship became non-significant (OR: 1.87; 95% CI: 0.92-3.80, Ptrend = 0.03), despite a significant trend of increased odds ratios (P = 0.03). CONCLUSIONS: In conclusion, we found a significant positive association between DIL and odds of glioma. DII was not significantly associated with odds of glioma after controlling for confounders.

Dietary Fat Quality and Pre-diabetes: A Case-control Study.

BACKGROUND: The relationship between dietary fat quality (DFQ) indices and pre-diabetes has not been well studied. This study aimed to determine the association of DFQ indices and fatty acid intake with pre-diabetes. METHODS: This case-control study included 150 subjects with normal fasting blood glucose (FBG) and 147 pre-diabetic subjects. Dietary intake was assessed by a validated food-frequency questionnaire. DFQ indices including atherogenicity (AI) and thrombogenicity (TI), the ratios of hypo- and hypercholesterolemic (h:H), polyunsaturated:saturated (P:S) and n-3:n-6 polyunsaturated fatty acids were calculated. FBG test and 2-hour oral glucose tolerance test (OGTT) were measured. RESULTS: After adjustment for some confounding variables, a positive association was found between intake of total saturated fatty acids (SFA), myristic acid, palmitic acid, and pre-diabetes, and a negative association was observed among n-3 polyunsaturated fatty acids, eicosapentaenoic, docosahexaenoic and arachidonic acids intake and pre-diabetes. AI was found to be positively associated with pre-diabetes (OR 6.68, 95% CI 2.57-17.34). An inverse relationship was observed between n-3:n-6 (OR 0.37, 95% CI 0.14-0.93) and h:H (OR 0.20, 95% CI 0.07-0.52) ratios with pre-diabetes. CONCLUSIONS: Higher intake of dietary n-3 fatty acids was adversely, whereas SFA intake was positively related to pre-diabetes morbidity. DFQ indices may be a useful measure to investigate fat intakes and blood glucose disturbances.

The association of food quality index with mental health in women: a cross-sectional study.

OBJECTIVE: Diet is a fundamental modifiable risk factor for the development of depression and anxiety. However, no evidence currently exists regarding the association of food quality score (FQS) and mental health in Iranian women. This study investigated the relationship between food quality score, depression, anxiety and stress in Iranian women. RESULTS: Results showed that 35%, 41% and 42% of participants had depression, anxiety and stress, respectively. The average age of participants was 31.40 ± 7.47 years. A significant association was indicated between FQS and symptoms of depression (OR: 0.36; 95% CI 0.21, 0.63), anxiety (OR: 0.31; 95% CI 0.18, 0.53), and stress (OR: 0.39; 95% CI 0.23, 0.66) in both crude and adjusted models.

Association of dietary acid-base load and psychological disorders among Iranian women: A cross-sectional study.

Metabolic acidosis, which can be affected by dietary acid-base load, seems to be associated with psychological disorders through different pathways. Given limited evidence on dietary acid-base load, we aimed to examine the association of dietary acid-base load with psychological disorders in Iranian women. This cross-sectional study was performed on 447 female subjects (20-50 years old). Dietary intake was assessed using a valid food frequency questionnaire for Iran. Dietary acid-base load was calculated through different indices including potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL). To assess psychological disorders, an Iranian validated version of depression, anxiety, and stress scale (DASS-21) was used. The mean value of PRAL, NEAP, and DAL were -8.87mEq/da, 37.94mEq/day, and 30.77mEq/day, respectively. Considering a wide range of confounding variables, compared with the first tertile, a significant positive association was observed between dietary acid-base load and depression (ORPRAL: 3.63; 95 %CI:1.97, 6.71; Ptrend = 0.0001) (ORNEAP:3.42; 95 %CI: 1.87, 6.23; Ptrend = 0.0001) (ORDAL: 3.02; 95 %CI: 1.64, 5.58; Ptrend = 0.0001). Women in the high dietary acid-base load category had higher anxiety (ORPRAL: 3.31; 95 %CI: 1.81, 6.06; Ptrend = 0.0001) (ORNEAP:3.47; 95 %CI: 1.90, 6.33; Ptrend = 0.0001) (ORDAL: 3.25; 95 %CI: 1.76, 5.98; Ptrend = 0.0001). Moreover, there was a strong positive relationship between dietary acid-base load and psychologicaldistress (ORPRAL: 3.79; 95 %CI: 2.09, 6.90; Ptrend = 0.0001) (ORNEAP: 3.67; 95 %CI: 2.04, 6.58; Ptrend = 0.0001) (ORDAL: 3.00; 95 %CI: 1.66, 5.43; Ptrend = 0.0001). Women with higher dietary acid-base load score had greater odds for depression, anxiety, and psychological distress compared to lower ones.

The effects of green cardamom supplementation on blood pressure and endothelium function in type 2 diabetic patients: A study protocol for a randomized controlled clinical trial.

INTRODUCTION: Cardamom possesses antioxidant, anti-inflammation, and blood pressure lowering properties, which might improve endothelial function in type 2 diabetic patients. However, no study has examined the effect of cardamom on diabetic patients. The present study aimed to examine the effects of 10-week green cardamom intake on blood pressure, concentrations of inflammatory and endothelial function biomarkers in type 2 diabetes mellitus patients, and its potential mechanisms. METHODS AND ANALYSIS DESIGN: Eighty overweight or obese patients with type 2 diabetes mellitus (aged 30-60 years) will be recruited into the trial and will assign to receive either cardamom (3 g/day, 6 capsules) or placebo (rusk powder, 6 capsules) for a period of 10 weeks. Systolic blood pressure and diastolic blood pressure, asymmetric dimethylarginine, and nitric oxide will be measured. Serum inflammatory markers namely interleukin 6, tumor necrosis factor-α, high-sensitivity C-reactive protein, and factors related to endothelial function including intercellular adhesion molecule-1, vascular cell adhesion molecule 1, CD62 antigen-like family member E, and cluster of differentiation 163 will be measured at baseline and at the end of the trial. Sociodemographic, International Physical Activity Questionnaire, and three 24-hour dietary recall questionnaires will be collected for each participant. ETHICS AND DISSEMINATION: The study has been approved by The Ethics Committee of Tehran University of Medical Sciences (IR.TUMS.REC.1395.2700). Each participant will sign a written informed consent at the beginning of the study. At the end of the study, results will be published timely manner. TRIAL REGISTRATION NUMBER: (http://www.irct.ir, identifier: IRCT-2016042717254N5) Date of registration: 2016-11-23.

Dietary fat quantity and quality in relation to general and abdominal obesity in women: a cross-sectional study from Ghana.

BACKGROUND: Although relationships between obesity and total fat and fat types have been widely examined, the associations between the relative proportions of fatty acids calculated in the form of indices and obesity/overweight are lacking. The objective of this study was to assess associations between dietary fat quality indices and odds of obesity/overweight in women from Ghana. METHODS: In this cross-sectional study, dietary information was obtained using 24-h dietary recall. The odds of obesity were evaluated across quintiles of specific DFQ indices [atherogenicity index (AI), thrombogenic index (TI), hypo- and hypercholesterolemic fatty acids ratio (h/H), omega-3 to omega-6 polyunsaturated fatty acids ratio (∑ω-3/∑ω-6), polyunsaturated fatty acids/saturated fatty acids ratio (PSR), dietary lipophilic index (LI) and percentage of energy from total fat (TF)]. RESULTS: After adjustment for covariates, general obesity and overweight were inversely associated with ∑ω-3/∑ω-6 ratio (OR: 0.63; 95% CI: 0.24-1.63; P for trend (P) = 0.005) and positively with TI (4.14; 95% CI: 1.78-9.66; P = 0.01) and LI (2.49; 95% CI: 1.14-5.43; P = 0.01). The odds of abdominal obesity based on waist circumference (WC) were significantly higher among participants in the fifth quintile (Q) compared with those in the first Q of AI (1.24; 95% CI: 0.56-2.74; P = 0.01), TI (4.14; 95% CI: 1.78-9.66; P = 0.009), LI (2.11; 95% CI: 0.98-4.55; P = 0.02) and TF (1.59; 95% CI: (0.73-3.46; P = 0.003). Similarly, waist to height ratio (WHtR) was positively associated with AI (2.89; 95% CI: 1.32-6.31; P = 0.04), TI (2.65; 95% CI: 1.22-5.76; P = 0.03), LI (3.32; 95% CI: 1.52-7.28; P = 0.007) and TF (1.83; 95% CI: 0.85-3.93; P = 0.009). CONCLUSION: There was an inverse association between ∑ω-3/∑ω-6 ratio and general obesity and WC. We also found positive associations between abdominal obesity and AI and TF. Furthermore, TI and LI showed positive relationships with both general and abdominal obesity. Therefore, intake of dietary fatty acids in favor of higher ratios of ∑ω-3/∑ω-6 may be important in obesity prevention.

Higher dietary fat quality is associated with lower anxiety score in women: a cross-sectional study.

BACKGROUND: The relationship between anxiety and dietary fat quality (DFQ) has not been well studied. The aim of this study was to investigate the relationship between anxiety disorder and fatty acids' intake in women. METHODS: This cross-sectional study included 300 women aged 18-49 attending healthcare centers. Dietary exposure was measured by a 168-item semi-quantitative food frequency questionnaire (FFQ). To determine the status of anxiety, the Depression, Anxiety, and Stress Scale (DASS) questionnaire was used. Based on the total score of anxiety, the participants were divided into two groups of without anxiety (< 8) and with anxiety (≥ 8). The relationship between fatty acids intake and odd ratio (OR) for anxiety was analyzed by simple logistic regression. RESULTS: About 37.7% of individuals reported anxiety. After adjustment for covariates, an increase in the OR for anxiety was observed across the quintuples of saturated fatty acids (SFAs) (OR 3.17; 95% CI 1.43-7.00; p-trend = 0.005). In addition, higher intakes of monounsaturated fatty acids (MUFAs) (OR 0.15; 95% CI 0.05-0.44; p-trend = 0.001), oleic acid (OR 0.25; 95% CI 0.09-0.67; p-trend = 0.002), alpha-linolenic acid (ALA) (OR 0.07; 95% CI 0.02-0.23; p-trend < 0.001), and n-3:n-6 poly unsaturated fatty acids (PUFAs) (OR 0.56; 95% CI 0.24-1.03; p-trend = 0.02) were found to be related with lower OR of anxiety. CONCLUSION: Intake of SFAs was positively related to anxiety disorder, whereas MUFAs, oleic acid, ALA, and n-3: n-6 PUFAs intake were inversely related to anxiety score. For investigating the association of fat intake and anxiety disorder, DFQ may be a useful measure.

Higher intakes of fruits and vegetables are related to fewer menopausal symptoms: a cross-sectional study.

OBJECTIVES: The aim of this study was to explore the associations between fruit and vegetable (FV) intake, and its subgroups and menopausal symptoms along with its subtypes in postmenopausal women. METHODS: This cross-sectional study included 393 postmenopausal women in municipality health centers in the south of Tehran, Iran. Sociodemographic data, dietary intakes, and anthropometric measures were obtained from individuals. Menopause rating scale (MRS) questionnaire was employed to measure menopausal symptoms. The total MRS score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score (US). Participants were divided into low and high total MRS and its domain scores. RESULTS: After adjustment for confounding variables, an inverse relationship was found between total FV with TMRSS (odds ratio [OR] 0.23, 95% confidence interval [CI] 0.06-0.81) and SS (OR 0.30, 95% CI 0.11-0.82). In addition, the consumption of total fruits was significantly related to lower SS (OR 0.27, 95% CI 0.10-0.71). Only intake of citrus fruits was inversely associated with TMRSS (OR 0.23, 95% CI 0.07-0.71) and SS (OR 0.28, 95% CI 0.11-0.70). Likewise, intakes of total FV (OR 2.46, 95% CI 1.37-4.41), total vegetables (OR 2.54, 95% CI 1.10-5.88), green leafy vegetables (OR 3.59, 95% CI 1.47-8.75), dark yellow vegetables (OR 2.28, 95% CI 1.00-5.18), other vegetables (OR 5.23, 95% CI 1.17-15.39), and citrus fruits were linked to higher US (OR 4.35, 95% CI 1.77-10.71). CONCLUSION: The results of the present study showed that some FV subgroups had inverse associations with climacteric symptoms, whereas higher intake of some subgroups of FV appeared to be associated with more urogenital symptoms in postmenopausal women.

Dietary inflammatory index and dietary energy density are associated with menopausal symptoms in postmenopausal women: a cross-sectional study.

OBJECTIVES: No previous study has evaluated the association of the dietary inflammatory index (DII) and dietary energy density (DED) with menopausal symptoms and its subclasses in postmenopausal women. The aim of this study was to evaluate the association of DII score and DED with menopausal symptoms and its subtypes in Iranian postmenopausal women. METHODS: This cross-sectional study was conducted on 393 postmenopausal women who attended health centers in the south of Tehran, Iran. The DII score was calculated using dietary factors obtained by a validated food frequency questionnaire. DED was defined as average daily energy intake (kcal) per gram of food. The Menopause Rating Scale questionnaire was used to evaluate the menopausal symptoms. The total Menopause Rating Scale score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score. Linear regression analysis was used to assess the association of the DII score and DED with menopausal symptoms. RESULTS: After adjusting for covariates, participants in the highest tertile of DII score had greater SS compared to those in the lowest tertile (ßDIIt3vs1= 0.032, 95% confidence interval (CI): 0.004-0.068, P = 0.04). No significant relationship was found between DII score and PS, urogenital score or TMRSS. Furthermore, higher DED was associated with greater SS (ßDIIt3vs1 = 0.071, 95% CI: 0.028-0.115, P = 0.001), PS (ßDIIt3vs1 = 0.065, 95% CI: 0.012-0.121, P = 0.01) and TMRSS (ßDIIt3vs1 = 0.053, 95% CI: 0.017-0.088, P = 0.004). CONCLUSION: A proinflammatory diet was associated with higher menopause-specific somatic symptoms and higher DED was positively associated with menopausal symptoms.

Association of plant-based dietary patterns with psychological profile and obesity in Iranian women.

BACKGROUND: A bidirectional association exists between psychological disorders and obesity. Also, diet could impact on both of these disorders. The aim of this study was to evaluate the association between plant-based dietary patterns and psychological profile and obesity. METHODS: This cross-sectional study was performed in a sample of 435 Iranian women. A validated and reliable semi-quantitative food-frequency questionnaire was used to collect dietary data. Three dietary indices including an overall plant-based diet (PDI), healthful plant-based diet (hPDI), and unhealthful plant-based diet (uPDI) were determined. Body mass index (BMI) and waist circumference (WC) were used to define general and abdominal obesity, respectively. Psychological profile status was determined from the DASS-21 questionnaire. RESULTS: We found that higher uPDI scores increased the odds of overall (PDI: 2.62; 95% CI 1.28-5.35, Ptrend = 0.01) and abdominal (PDI: 2.36; 95% CI 1.11-5.02, Ptrend = 0.03) obesity in comparison with lower scores. Moreover, an inverse association was observed between higher PDI and hPDI scores and depression (PDI: 0.41; 95% CI 0.23-0.71, Ptrend = 0.001, hPDI: 0.44; 95% CI 0.25-0.76, Ptrend = 0.003), anxiety (PDI: 0.56; 95% CI 0.33-0.94, Ptrend = 0.03, hPDI: 0.55; 95% CI 0.33-0.94, Ptrend = 0.03), and psychological distress (PDI: 0.44; 95% CI 0.26-0.75, Ptrend = 0.003, hPDI: 0.49; 95% CI 0.29-0.82, Ptrend = 0.009). For uPDI, higher scores were associated with depression (uPDI: 1.91; 95% CI 1.03-3.55, Ptrend = 0.03). CONCLUSIONS: A plant-based diet, particularly healthful-rich plant foods were inversely associated with psychological disorders. Furthermore, unhealthy plant foods were associated with increased risk of obesity as well as depression.

Beneficial effects of nano-curcumin supplement on depression and anxiety in diabetic patients with peripheral neuropathy: A randomized, double-blind, placebo-controlled clinical trial.

Depression in patients with diabetes is associated with poor glycemic control and linked to an increased risk for diabetes complications such as neuropathy. Curcumin has shown potential antidepressant-like activities in some studies. The present study is the first randomized controlled trial to test the efficacy of nano-curcumin supplementation on depression, anxiety, and stress in patients with diabetic polyneuropathy. Eighty patients with diabetes were enrolled in this parallel, double-blind, randomized, placebo-controlled clinical trial. The participants were allocated randomly to the intervention (n = 40) and control (n = 40) groups. They received 80 mg of nano-curcumin or placebo capsules daily for 8 weeks. At baseline and end of study, anthropometric measurements, dietary intake, physical activity, glycemic indices, and severity of neuropathy were assessed. The depression, anxiety, and stress level were measured by Depression, Anxiety, Stress Scale (DASS-21-items) questionnaire before and after the intervention. After intervention, there was a significant reduction in the mean score of depression in the nano-curcumin group (from 16.7 [3.1] to 15.3 [2.6]) compared with placebo group (17.5 [3.2] to 17.3 [3.1]; p = .02). In addition, a significant fall was found in the mean score of anxiety in the nano-curcumin group (from 22.4 [4.03] to 20.6 [3.4]) compared with the placebo group (21.9 [3.5] to 21.2 [3.5]; p = .009). Changes in stress score were not statistically significant between the two groups. These findings suggested that nano-curcumin supplementation for 8 weeks was effective in reducing depression and anxiety scores in patients with diabetic polyneuropathy.