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Background The present study aimed to determine whether total fibre or specific fibre food sources are associated with the incidence of the metabolic syndrome (MetS) after 3 years of follow-up in the Tehran Lipid and Glucose Study. Methods This population-based prospective study, conducted within the framework of the Tehran Lipid and Glucose Study, included 1582 adults, who were aged 19-84 years and free of MetS at baseline. Usual dietary fibre intake was assessed at baseline using a 168-item food frequency questionnaire. Anthropometrics, blood pressure, and fasting blood glucose and lipid profiles were measured at baseline and 3 years later. The MetS was defined according to the definition of the revised Adult treatment Panel III. Results During the 3-year follow-up, there was 15.2% incidence of MetS. Among sources of dietary fibre, fruit fibre was significantly and inversely associated with the occurrence of MetS, after adjustment for confounding factors, with a 21% lower risk [odds ratio ( OR) = 0.79, 95% confidence interval ( CI) = 0.60-0.97] in the highest tertile of intake compared to the lowest tertile. Subjects in the highest tertile of cereal fibre intake had lower odds of MetS compared to those in the lowest tertile ( OR = 0.73, 95% CI = 0.52- 0.97) and this association disappeared after adjustment for confounders. No significant association was found between intakes of vegetables, legumes and nut fibre with the incidence of MetS. Conclusions Among specific fibre food sources, fruit fibre had a protective effect against the risk of MetS. [ABSTRACT FROM AUTHOR]

Background/Objective:The objective of this study was to determine the effects of substitution of red meat with legumes in the Therapeutic Lifestyle Change (TLC) diet on cardiometabolic risk factors in type 2 diabetes patients based on dietary education.Subjects/Methods:This study was a randomized, controlled, cross-over trial. Thirty-one participants (24 women and 7 men; age: 58.1±6.0 years) with type 2 diabetes were randomly assigned to consume a control diet (legume-free TLC diet) and legume-based TLC diet for 8 weeks. Legume-based TLC diet was the same as the control diet, but the legume-based TLC group was advised to replace two servings of red meat with legumes, 3 days per week. After the interventional period, a washout period was conducted for 4 weeks. The groups were then advised to follow the alternate treatment for 8 weeks. Cardiometabolic risk factors were measured.Results:Compared with the legume-free TLC diet, the legume-based TLC diet significantly decreased fasting blood glucose (P=0.04), fasting insulin (P=0.04), triglyceride concentrations (P=0.04) and low-density lipoprotein cholesterol (P=0.02). Total cholesterol concentrations decreased after consumption of both TLC diet and legume TLC diet; however, the data did not differ significantly between the two diets. body mass index (BMI), waist circumference, systolic and diastolic blood pressures did not change significantly after consumption of either the legume-free TLC diet or the legume-based TLC diet.Conclusions:Dietary advice given for substitution of red meat with legume intakes within a TLC diet-improved lipid profiles and glycemic control among diabetes patients, which were independent from BMI change. This trial was registered in the Iranian Registry of Clinical Trials (http://www.irct.ir) as IRCT201202251640N7. [ABSTRACT FROM AUTHOR]

Background and Objective: Hypertension in long time can cause cardiovascular disorders and increase chance of stroke. This study was done to determine the association between some dietary factors and risk of hypertension. Methods: This cross-sectional study was conducted on the fourth phase (2008-11) of Tehran lipid and glucose study (TLGS). In this study 6089 subjects (2807 males and 3282 females), aged 19-70 years, were participated and dietary, demographic, anthropometric and blood pressure of each subject were collected. Dietary intake was assessed using a validated and reliable food frequency questionnaire with 147-items. Odds ratio for hypertension according to quartiles of dietary factors was determined using logistic regression with adjustment for confounder variables. Results: The rate of hypertension was 29.8%. Mean of weight, body mass index, waist circumference, prevalence of abdominal obesity and alliteration in the hypertensive subjects were significantly higher than normotensive subjects (P<0.05). There was a non significant direct relationship between energy density, total fat and saturated fat. Higher consumption of fiber was associated with lower risk of hypertension (OR: 0.62, 95% CI: 0.37-0.97). The risk of hypertension increased in the highest quartiles of dietary protein (OR: 1.20, 95% CI: 1.02-1.43). Odds ratio for hypertension was higher among subjects whom consumed lower fruits and nuts than those subjects with higher fruits consumption (OR: 1.33, 95% CI: 1.15-1.85) and nuts (OR: 1.21, 95% CI: 1.02-1.42). Conclusion: High consumption of fiber could protect against hypertension while some dietary factors such as high consumption of protein could increase risk of hypertension. [ABSTRACT FROM AUTHOR]

Background and Objective: Insulin resistance (IR) is one of the factors affecting dyslipidemia in type 2 diabetes which increases the risk of cardiovascular diseases. This study was done to determine the association of homeostasis model assessment of insulin resistance with lipid profiles in type 2 diabetes. Methods: This descriptive study was conducted on 72 patients with type 2 diabetes in Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran during 2011. Anthropometric indces, fasting serum glucose, serum insulin and lipid profiles were measured and IR index and atherogenic lipid parameters were calculated. The mean of lipid profiles and parameters were compared across the IR tertiles. The association of homeostasis model assessment and insulin resistance in each tertile with lipid profiles was determined. Results: The mean±SD of IR index was 0.9±0.3, 2.1±0.4 and 4.4±1.6 in the 1th, 2th and 3th tertiles, respectively. In the 3th tertile, serum triglyceride and atherogenic lipid parameters were significantly high and serum HDL-C level was non-significantly low than normal reference range. IR index in the 2th and 3th tertiles was significantly related to serum Triglyceride (P<0.05). IR index in level of >2.8, was inversely associated with HDL-C and directly associated with atherogenic lipid parameter. Conclusion: There is association between Insulin resistance with lipid metabolic abnormality in type 2 diabetic patients. [ABSTRACT FROM AUTHOR]

Background:There are growing concern globally regarding fast food consumption and its related cardiometabolic outcomes. In this study we investigated whether fast food consumption could affect the occurrence of metabolic syndrome (MetS) after 3-years of follow-up in adults.Methods:This longitudinal study was conducted in the framework of Tehran Lipid and Glucose Study on 1476 adults, aged 19-70 y. The usual intakes of participants were measured using a validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were assessed at baseline (2006-2008) and 3 years later (2009-2011). Multiple logistic regression models were used to estimate the occurrence of the MetS in each quartile of fast food consumption.Results:The mean age of participants was 37.8±12.3 y, and mean BMI was 26.0±4.5 kg/m2 at baseline. Participants in the highest quartile of fast food consumption were younger (33.7 vs 43.4 years, P<0.01). Higher consumption of fast food was accompanied with more increase in serum triglyceride levels and triglyceride to HDL-C ratio after the 3-year follow-up. After adjustment for all potential confounding variables, the risk of metabolic syndrome, in the highest quartile of fast foods compared with the lowest, was 1.85 (95% CI=1.17-2.95). The effects of fast food consumption on the occurrence of MetS were more pronounced in younger adults (<30 years), and participants who had greater wait to hip ratio, consumed less phytochemical-rich foods or had low-fiber diet (P<0.05).Conclusion:We demonstrated that higher consumption of fast foods had undesirable effects on metabolic syndrome after 3-years of follow-up in Iranian adults. [ABSTRACT FROM AUTHOR]

Objective: Middle Eastern and North African countries are undergoing nutrition transition, a transition which is associated with an increased burden of non-communicable diseases. This necessitates the evaluation of dietary patterns in these regions. The present study aimed to assess changes in dietary patterns in Middle Eastern and North African countries between 1961 and 2007.Design: Availability of energy and fifteen main food items during 1961-2007 was examined using FAO food balance sheets from the FAOSTAT database.Setting: Fifteen countries including nine in the Middle East and six in North Africa were selected and the average availability of total energy and different food items in these regions were compared.Results: Over the 47 years studied, energy and food availability (apart from animal fats and alcoholic beverages) has increased in the Middle East and North Africa. In both regions the proportion of energy derived from meat and vegetable oils has increased significantly while that from cereals decreased significantly. In addition, the proportion of energy from milk and dairy products and vegetables has shown an ascending trend in North Africa while the proportion of energy from fruits has shown a descending trend in the Middle East.Conclusions: The study results reveal an unfavourable trend towards a Westernized diet in the Middle East and, to a certain extent, in North Africa. Tailored nutritional education encouraging healthy eating for prevention of the burden of chronic diseases in these countries seems essential. [ABSTRACT FROM AUTHOR]

Background/Objectives:In vitro and animal studies have reported that young broccoli sprouts improve oxidative stress status in diabetic condition. The objective of this double-blind, placebo-controlled, randomized clinical trial was to investigate the effects of broccoli sprouts powder (BSP) on some oxidative stress parameters in type 2 diabetes patients.Subjects/Methods:A total of 81 patients with type 2 diabetes were randomly assigned to one of three treatment groups for 4 weeks. The groups received either 10 g/d BSP (n=27), 5 g/d BSP (n=29) or placebo (n=25). Serum total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), malondialdehyde (MDA) and oxidized low density lipoprotein (LDL) cholesterol were measured at baseline and at 4 weeks after treatment.Results:In all, 63 patients in three groups were included in the analysis: 10 g/d BSP (n=21), 5 g/d (n=22) and placebo (n=20). After 4 weeks, consumption of BSP resulted in significant decrease in MDA (P=0.001 for treatment effect), oxidized low density lipoprotein cholesterol (P=0.03 for treatment effect), OSI (P=0.001 for treatment effect) and significant increase in TAC (P=0.001 for treatment effect). No effects were found on TOS.Conclusion:BSP had favorable effects on oxidative stress status in type 2 diabetes patients. [ABSTRACT FROM AUTHOR]

Objectives: To establish the distribution of 10-year risk for coronary heart disease (CHD) and eligibility for therapeutic approaches among Tehranian adults within the framework of the Tehran Lipid and Glucose Study (TLGS). Study design: Cross-sectional study conducted on data from Phase III of the TLGS (12,521 people aged ≥3 years). Methods: The modified Framingham algorithm adopted by the National Cholesterol Education Program Adult Treatment Panel III was used to estimate participants' 10-year risk of developing CHD; only participants aged 20-79 years were included. Following the exclusion of subjects without full relevant data, 9483 participants (42.6% men) were enrolled in the final analysis. The distributions of the population needing therapeutic lifestyle changes (TLCs) and additional drug therapy were calculated. Results: Overall, the mean (standard deviation) age was 43.7 (15.4) years; 44.6 (15.9) for men and 43.0 (14.9) for women. Ten-year risk for CHD of <10%, 10-20% and >20% was observed in 86.0%, 12.0% and 2.0% of participants with at least two risk factors and without CHD or a CHD risk equivalent, respectively. For subjects with less than two risk factors and without CHD or a CHD risk equivalent, these values were 14.0%, 8.3% and 14.7%, respectively; 63.1% of subjects had less than two risk factors. The need for TLCs and additional drug therapy was observed in 12% and 12.5% of subjects, respectively. Conclusions: Regarding the estimated 10-year risk for CHD, about one-quarter of Tehranian adults are eligible for therapeutic approaches. [ABSTRACT FROM AUTHOR]

Background/Aim: Several epidemiologic studies have shown that many nutritional and non-nutritional risk factors for non-communicable diseases are modifiable. This study was conducted to determine the effectiveness of nutrition intervention on non-communicable disease risk factors among Tehranian urban adults. Methods: In the Tehran Lipid and Glucose Study (TLGS), 1,474 subjects, aged 3 years and over, were selected for dietary assessment; nutrition intervention was implemented for one third through pamphlets, posters, nutritional consultations, educational courses, and demonstration of films in the community health medical centers, schools, and other public places. After a 3.8-year follow-up period, data were collected for 578 subjects, aged 18–74 years, who participated in the second phase of the study; there were 356 subjects in the control group and 222 in the intervention group. Mean body mass index, energy intake, macronutrients, fibre, micronutrients, serum lipids, fasting blood sugar, and systolic and diastolic blood pressures were determined in both groups. Results: The mean fasting blood sugar concentrations increased significantly in the control group and decreased significantly in the intervention group. Mean diastolic blood pressure and total cholesterol and low-density lipoprotein cholesterol levels decreased in both groups. However, the body mass index showed a significant increase in both groups. Adjusted for age, sex, and baseline variables, the cholesterol intake (214 vs. 232 mg/day, p < 0.05) was significantly lower in the intervention as compared with the control group. Conclusions: The present study shows decreases in fasting blood sugar, total serum cholesterol, and daily cholesterol intake after nutrition interventions. Specific intervention measures, keeping in mind cultural and socio-economic factors, could modify dietary patterns and are effective in the primary pre- vention of non-communicable diseases. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study was conducted to assess the prevalence of metabolic syndrome (MetS) in Tehranian women during menopausal transition. Design: In this cross sectional study 2182 subjects, pre-menopausal (pre-M) n =537, menopausal (M) n =311 and post-menopausal (post-M) n =1334 were selected from 15005 participants of the TLGS and assessed for MetS risk factors. All MetS components were evaluated following age adjustment according to the ATPIII criteria. Results: The mean ages of post-M, M and pre-M women were 61.0±4.3, 53.0±4.0 and 47.0±1.9 years, respectively. The prevalence of MetS in subjects was 63% (53%, 54% and 69%) in pre-M, M and post-M women respectively. HDL-c levels was significantly higher in post-M women in comparison to pre-M women (p <0.001). TG levels, FPG and waist circumference was significantly higher in post-M women in comparison to pre-M women (p <0.05). The most frequent markers of MetS were low HDL-c and high diastolic blood pressure in post-M women. Conclusion: It is concluded that the frequency of MetS is significantly higher in post-M women as compared to pre-M women; low HDL-c and high diastolic blood pressure is the most frequent feature in comparison to other factors. [Copyright &y& Elsevier]

Aim: To evaluate the relationship between dietary diversity score (DDS) and cardiovascular risk factors in Tehranian adults.Methods: In this population-based cross-sectional study, a representative sample of 581 subjects (295 males and 286 females) aged over 18 years, residents of Tehran, participated. Hypercholesterolaemia, hypertriglyceridaemia and low high-density lipoprotein cholesterol were defined according to the Adult Treatment Panel III guidelines of the National Cholesterol Education Program. Diabetes was defined as fasting plasma glucose concentration > or = 126 mg dl(-1) or 2-h post challenge glucose concentration > or = 200 mg dl(-1). Hypertension was defined on the basis of the sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Dietary diversity was defined according to the Diet Quality Index revised.Results: Mean (+/- standard deviation) DDS was 6.15 +/- 1.02. The probability of having diabetes (odds ratio (OR) among quartiles: 1.45, 1.26, 1.11 and 1.00, respectively; P for trend = 0.04) and hypertriglyceridaemia (OR = 1.41, 1.23, 1.05 and 1.00, respectively; P for trend=0.04) decreased with increasing quartile of the diversity score for whole grains. The probability of having obesity (OR among quartiles: 1.39, 1.06, 1.03 and 1.00, respectively; P for trend = 0.03), hypercholesterolaemia (OR = 1.46, 1.28, 1.11 and 1.00, respectively; P for trend = 0.03), hypertension (OR = 1.32, 1.17, 1.13 and 1.00, respectively; P for trend = 0.03) and high low-density lipoprotein cholesterol (LDL-C) (OR = 1.25, 1.12, 1.07 and 1.00, respectively; P for trend = 0.04) decreased with increasing quartile of the diversity score for vegetables. The probability of having hypercholesterolaemia, high LDL-C, hypertension and diabetes decreased with quartile of the DDS. But the probability of being obese increased with quartile of the DDS (P for trend = 0.03).Conclusion: DDS was inversely associated with cardiovascular risk factors in this cross-sectional study. Increased diversity scores of diets, to increase the variety score for vegetables, may be emphasised in programmes attempting to bring about changes in lifestyle. [ABSTRACT FROM AUTHOR]

Objective: To compare the ability of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) to predict cardiovascular risk factors in an urban adult population of Tehranian women.Design: Population-based cross-sectional study.Setting: Tehran, the capital of Iran.Subjects: This study was conducted on 5073 women aged 18-74 years, participants of the Tehran Lipid and Glucose Study. Demographic data were collected. Anthropometric indices were measured according to standard protocols. Cut-off points of BMI, WC, WHR and WHtR were considered as 25 kg m(-2), 80 cm, 0.8 and 0.5, respectively. Blood pressure was measured and hypertension was defined based on the sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Biochemical analyses were conducted on fasting blood samples. Diabetes was defined as fasting plasma glucose > or = 126 mg dl(-1) or 2-hour plasma glucose > or = 200 mg dl(-1) and dyslipidaemia based on the third report of the National Cholesterol Education Program Expert Panel. The presence of 'at least one risk factor' from the three major cardiovascular risk factors (hypertension, dyslipidaemia and diabetes) was also evaluated.Results: Mean (+/-standard deviation) age of women was 39.9+/-14.6 years; mean BMI, WC, WHR and WHtR were 27.1+/-1.5 kg m(-2), 86.5+/-13.5 cm and 0.83+/-0.08 and 0.55+/-0.08, respectively. Of the four anthropometric measures, WC had the highest sensitivity and specificity to identify subjects with risk factors in both the 18-39 year and the 40-74 year age categories. WC was seen to have a higher percentage of correct prediction than BMI, WHR and WHtR.Conclusion: It is concluded that WC is the best screening measure for cardiovascular risk factors, compared with BMI, WHR and WHtR, in Tehranian adult women. [ABSTRACT FROM AUTHOR]

OBJECTIVE:Assessing overall diet instead of the effects of a single nutrient on diet–disease relations may be more informative. This study was conducted to evaluate the relationship between dietary diversity score (DDS) and metabolic syndrome in Tehranian adults.DESIGN:Cross-sectional study.SUBJECTS:A representative sample of 581 healthy subjects aged over 18 y selected randomly from among participants of the Tehran Lipid and Glucose Study.MEASUREMENTS:Usual dietary intake was assessed using a validated semi quantitative food frequency questionnaire. DDS was calculated based on scoring to the five-food group. The DDS range was 0–10. Weight and height were measured according to standard protocols and body mass index (BMI) was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Metabolic syndrome was defined according to ATPIII. Subjects were categorized based on quartile cut-points of DDS.RESULTS:Means (±s.d.) of age and BMI were 37±12 y and 25.7±4.3 kg/m2, respectively. Mean (±s.d.) of DDS was 6.15±1.02. The probability of having metabolic syndrome decreased with quartiles of DDS (odds ratios among quartiles: 1.00, 0.82, 0.76, 0.70, P<0.05, and odds ratios among quartiles after further adjustment for BMI: 1.00, 0.88, 0.80, 0.77, P<0.05). After controlling for confounders, a significantly decreasing trend was observed for the risk of having high blood pressure, impaired glucose homeostasis and high triglyceride levels.CONCLUSION:DDS had inverse association with metabolic syndrome and some of its features in this cross-sectional study. A higher dietary diversity, therefore, might be associated with lower possibility of having some metabolic disorders.International Journal of Obesity (2005) 29, 1361–1367. doi:10.1038/sj.ijo.0803029; published online 23 August 2005 [ABSTRACT FROM AUTHOR]

Objective:To examine the relationship between variety scores of food groups (between and within food groups) and the probability of nutrient adequacy in Tehranian men.Design:A cross-sectional study assessing food intake by two 24-h recall questionnaires. Dietary diversity was defined according to diet quality index revised, which was used by Haines et al in 1999. The mean probability of adequacy across 14 nutrients was calculated using the Dietary Reference Intakes.Setting:District 13 of Tehran, Iran.Subjects:A total of 295 males, aged 18 y and over.Results:Whole grain variety mostly correlated with protein and vitamin B2 (r=0.3, P<0.05). Fruit variety was correlated with vitamin C (r=0.4, P<0.05). Dairy variety was correlated with calcium intake (r=0.4, P<0.05). Meat variety was correlated with protein intake (r=0.3, P<0.05). Most subjects failed to meet vitamin B6, zinc, magnesium, calcium, copper, and vitamin B12 adequacy. Energy intake was a strong predictor of the mean probability of adequacy in models controlled for age, body mass index, education level and job status (model R2=0.48). Adding the number of servings from each of the food group to the models significantly improved the model fit (model R2=0.55). Adding the dietary variety improved the model fit significantly (model R2=0.61). Dairy variety and meat variety had the strongest association with improved nutrient adequacy.Conclusion:Variety of different food groups is a useful indicator of specific nutrient adequacy. Hence, to determine the adequacy of a specific nutrient, the variety scores of specific food groups should be taken into account.European Journal of Clinical Nutrition (2005) 59, 1233–1240. doi:10.1038/sj.ejcn.1602234; published online 13 July 2005 [ABSTRACT FROM AUTHOR]

BACKGROUND:: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, epidemiologic data regarding whole-grain intake association with metabolic syndrome are sparse. OBJECTIVE:: To evaluate the relationship between whole-grain intakes, metabolic syndrome and metabolic risk factors in Tehranian adults. DESIGN:: Population-based cross-sectional study. SETTING:: Tehran, the capital of Iran. SUBJECTS:: A representative sample of 827 subjects (357 men and 470 women) aged 18-74?y. METHODS:: Usual dietary intake was assessed using a food frequency questionnaire. The procedure developed by Jacobs et al was used to classify grain products into whole and refined grains. Weight and height were measured according to standard protocols and body mass index was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Hypertriglyceridemia, hypercholestrolemia, high LDL, low HDL and metabolic syndrome were defined according to ATP III guidelines and hypertension based on JNC VI. Diabetes was defined as fasting plasma glucose level of=126?mg/dl or 2-h postchallenge blood glucose level of=200?mg/dl. Subjects were categorized based on quartile cut-points of whole- and refined-grain intake. RESULTS:: Mean (±s.d.) consumptions of whole and refined grains were 93±29 and 201±57?g/day, respectively. Both men and women reported higher intakes of refined grain than of whole grains. Compared with subjects in the lower quartile category, those in the upper category of whole-grain intake had lower prevalence of metabolic risk factors. Conversely, those in the higher category of refined-grain intake had higher prevalence of metabolic risk factors, except for diabetes. After controlling for confounders, a significantly decreasing trend was observed for the risk of having hypertriglyceridemia (odds ratios among quartiles: 1.00, 0.89, 0.74, 0.61, respectively), hypertension (1.00, 0.99, 0.93, 0.84) and metabolic syndrome (1.00, 0.84, 0.76, 0.68). Higher consumption of refined grains was associated with higher odds of having hypercholestrolemia (1.00, 1.07, 1.19, 1.23), hypertriglyceridemia (1.00, 1.17, 1.49, 2.01), hypertension (1.00, 1.22, 1.48, 1.69) and metabolic syndrome (1.00, 1.68, 1.92, 2.25). CONCLUSION:: Whole-grain intake is inversely and refined-grain intake is positively associated with the risk of having metabolic syndrome. Recommendations to increase whole-grain intake may reduce this risk. SPONSORSHIP:: Endocrine Research Center, Shaheed Beheshti University of Medical Sciences.European Journal of Clinical Nutrition (2005) 59, 353-362. doi:10.1038/sj.ejcn.1602080 Published online 10 November 2004 [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To assess the relationship between consumption of dairy products and body mass index (BMI) in Tehranian adults. DESIGN:: Cross-sectional study. SUBJECTS:: A total of 462 healthy subjects (223 men and 239 women) aged over 16?y selected randomly from among participants of the Tehran Lipid and Glucose Study (TLGS). MEASUREMENTS:: Dietary data were collected by means of a food frequency questionnaire for 1?y and two 24-h dietary recalls. Height and weight were measured and BMI was calculated. Physical activity was assessed by the Lipid Research Clinic (LRC) questionnaire. RESULTS:: Consumption of dairy products was 3.7±1.0 and 2.9±1.2 servings per day in men and women, respectively. As the servings of dairy consumption increased per day, the proportion of normal-weight subjects rose and that of obese ones declined. As BMI increased, the proportion of subjects with lower consumption of dairy products increased, whereas that of those with higher consumption decreased. There was a significant inverse correlation between the servings of dairy consumption per day and BMI after controlling for the effect of age, physical activity, energy, carbohydrate, dietary fiber, protein and fat intake (r=-0.38, P<0.05). After adjustment for potential confounding variables, men and women in the top quartile of dairy consumption had lower chances for being overweight (OR=0.78, 95%CI=0.43-0.92 for men and OR=0.89, 95%CI=0.53-0.95 for women) and obese (OR=0.73, 95%CI=0.40-0.83 for men and OR=0.69, 95%CI=0.34-0.80 for women) compared to those in the first quartile. CONCLUSION:: The results suggest an inverse relationship between dairy consumption and BMI. It is recommended that further studies address this issue by focusing on the dairy components responsible for this effect.International Journal of Obesity (2005) 29, 115-121. doi:10.1038/sj.ijo.0802838 Published online 9 November 2004 [ABSTRACT FROM AUTHOR]

BACKGROUND: It is essential to identify the best anthropometric index in any population to predict chronic disease risk. OBJECTIVE: To compare the ability of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHpR) and waist- to-height ratio (WHtR) to predict cardiovascular risk factors in an urban adult population of Tehranian men. DESIGN: Population-based cross-sectional study. SUBJECTS: A representative sample of 4449 men aged 18–74y, participants of the Tehran Lipid and Glucose Study METHODS: Demographic data were collected; anthropometric indices and blood pressure were measured according to standard protocol. In the 18–34y age category, cutoff points for BMI, WHpR, WHtR and WC were 24kg/m2, 0.86, 0.47 and 81 cm, respectively. In the 35–54y age category these cut points were 26kg/m2, 0.91, 0.52 and 89cm, and in the 55–74y age category 26kg/m2, 0.95, 0.54 and 91 cm, respectively. Hypertension was defined based on JNC VI. Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as fasting plasma glucose ≥126mg/dl or 2hPG >200mg/dl and dyslipidemia based on ATP III. The presence of ‘at least one risk factor’ from the three major cardiovascular risk factors (hypertension, dyslipidemia and diabetes) was also evaluated. RESULTS: Mean age of men was 41.8±15.4y. Mean BMI, WHpR, WC and WHtR for subjects were 25.6±4.2kg/m2, 0.91 ±0.07, 87.7±11.7cm and 0.51 ±0.02, respectively. Dyslipidemia and ‘at least one risk factor’ are more prevalent risk categories. Although all anthropometric indicators had a significant association to cardiovascular risk factors, WHpR had the highest correlation coefficients compared to other anthropometric measures. For all risk factors in all age categories, the highest odds ratios were pertained to WHpR. Of the four individual indicators, WHpR had the highest sensitivity, specificity and accuracy to predict cardiovascular risk factors. Cutoff points for WHpR were seen to have a higher percentage of correct prediction than BMI, WC and WHtR in all age categories. CONCLUSION: It is concluded that WHpR is a better predictor for cardiovascular risk factors than BMI, WC and WHtR in Tehranian adult men. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To determine optimal cutoff points of anthropometric measures as cardiovascular indicators in an Iranian adult population. DESIGN:: Population-based cross-sectional study. SETTING:: Tehran, the capital of Iran. SUBJECTS:: A total of 10?522 subjects (4449 men and 6073 women) aged 18-74?y. METHODS:: Demographic data were collected and anthropometric indices were measured. Blood pressure was evaluated and hypertension was defined based on JNC VI. Biochemical measurements were done. Diabetes was considered as FBS=126?mg/dl (=7.0?mmol/l) and dyslipidemia was defined according to ATP II. Risk factors were considered as: hypertension, diabetes, dyslipidemia, ‘hypertension or diabetes’, ‘hypertension and diabetes’, ‘hypertension or dyslipidemia’, ‘hypertension and dyslipidemia’, ‘ diabetes or dyslipidemia’, ‘diabetes and dyslipidemia’, ‘at least one risk factor’ and ‘at least two risk factors’. ROC curve analysis was performed to determine optimal cutoff values-where the sensitivity approximates specificity. RESULTS:: Younger men (the age category of 18-34?y) had higher WC than women. Men had higher waist-to-hip ratio (WHpR) and lower waist-to-height ratio (WHtR) than women in all age categories. Dyslipidemia, ‘hypertension or dyslipidemia’, ‘diabetes or dyslipidemia’ and ‘at least one risk factor’ were more prevalent risk categories in both genders. Range of areas under ROC curves for BMI and WC was 0.55-0.94 and 0.56-0.93 for men and 0.41-0.94 and 0.53-0.92 for women in various age groups, respectively. Range of areas for WHpR and WHtR in men was between 0.58-0.87 and 0.56-0.94, respectively, and for women varied between 0.53-0.91 and 0.53-0.90 in various age groups, respectively. Cutoff points of BMI for various risk factors were between 24 and 29?kg/m2 in men and 25-31?kg/m2 in women. Range of WHpR was between 0.86 and 0.97 in men and between 0.78 and 0.92 in women. Cutoff points for WC and WHtR were between 80 and 93?cm and 0.47 and 0.56 for men and between 79 and 96?cm and 0.50 and 0.63 for women in different age groups to detect various risk factors, respectively. In general, values were lowest for the most prevalent risk factors and highest for less prevalent conditions. CONCLUSION:: The results suggested cutoff points of anthropometric measures as indicators of cardiovascular risk factors. It seems that these cut-points are higher for Iranians than for other Asian populations. SPONSORSHIP:: Endocrine Research Center, Shaheed Beheshti University of Medical SciencesEuropean Journal of Clinical Nutrition (2004) 58, 1110-1118. doi:10.1038/sj.ejcn.1601936 [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To clarify the hypothesis that parent's dietary intakes are associated with their offspring's body mass index. DESIGN:: Observational analytical cross-sectional survey among inhabitants of district 13 in the east of Tehran. SUBJECTS:: A total of 117 healthy families comprising 474 subjects including 240 offspring (3–25 y old). MEASUREMENTS:: Weight and height were measured by a standard protocol and body mass index (kg/m2) was calculated. Dietary intakes were assessed by means of a 2 day dietary recall questionnaire. RESULTS:: The prevalence of overweight was 11.8% in offspring of normal-weight parents, 19.0% in offspring of overweight fathers and normal-weight mothers, 25.4% in offspring of overweight mothers and normal-weight fathers and 40.8% in offspring with both parents overweight. The Offspring's overweight was significantly and independently associated with high-energy intake of both parents (odds ratio; 95% CI 2.7; 1.6–4.5). Adjusted for the sex of parents, the chances of offspring being overweight were higher in overweight (3.8; 1.5–9.2) and high-energy-intake mothers (2.6; 1.2–5.6) and high-energy-intake fathers (2.0; 1.1–3.9) as compared with children of normal-weight parents. High fat intake of husbands was an independent risk factor increasing the chances of their wives being overweight (2.1; 1.5–3.6) and vice versa (1.8; 1.2–2.8). CONCLUSION:: The observed familial obesity pattern was shown to be associated with the familial dietary intakes. Hence, familial intervention seems essential to stop the accelerated rise in the prevalence of overweight and obesity in our community.International Journal of Obesity (2002) 26, 1617–1622. doi:10.1038/si.ijo.0802120 [ABSTRACT FROM AUTHOR]

Summary: Background: Current evidence available on the association between Dietary Approach to Stop Hypertension (DASH) diet and cardiovascular risk in adolescents is controversial. Objective: The aim of the present study was to assess the association between DASH diet and cardiovascular risk factors after 3 years of follow‐up among Tehranian adolescents. Methods: A population‐based cohort study was conducted on 628 subjects, aged 10–18 years, selected from among participants of the Tehran Lipid and Glucose Study. The DASH score was determined on the basis of eight components using a valid and reliable food‐frequency questionnaire at baseline. Anthropometric and lipid profile data were measured at baseline and after a 3‐year follow‐up. Results: Mean (SD) age of the study population (46.6% men) was 14.1 (2.5) years. After adjustment for potential confounding variables, including sex, age, physical activity and total calorie intake, the risk of general obesity (OR = 0.26, 95%CI: 0.15–0.76) and central obesity (OR = 0.32, 95%CI: 0.14–0.84) in the highest quintile of DASH score were significantly lower than in subjects in the lowest quintile. However, DASH score was not associated with risk of incident dyslipidaemia in our study (OR = 0.81, 95%CI: 0.30–1.82). The higher DASH score was inversely associated with 3‐year changes in body mass index and waist circumference during the study period (P for trend <0.05). However, there was no significant association between the higher score of this diet with 3‐year changes in lipid profiles. Conclusion: Adherence to the DASH diet was associated with decreased risk of central and general obesity, whereas higher DASH diet score was not associated with risk of dyslipidaemia in adolescents. [ABSTRACT FROM AUTHOR]

Background/Objective:The epidemiological association of phytochemical-rich foods with the risk of hypertension is unclear. This study aimed to determine the association of dietary phytochemical index (PI) with the occurrence of hypertension (HTN) after 3 years of follow-up in Tehranian adults.Subjects/Methods:This prospective study was conducted on 1546 nonhypertensive subjects, aged 20-70 years. Dietary intake was collected by validated semiquantitative food frequency questionnaire (FFQ). Dietary PI was calculated as (dietary energy derived from phytochemical-rich foods (kcal)/total daily energy intake (kcal)) × 100. Blood pressure was measured at baseline and after 3 years of follow-up and HTN was defined by Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure criteria. The odds of HTN after 3 years in each quartile category of dietary PI were estimated by logistic regression model and adjusted for potential variables.Results:The mean age of participants was 38.0±12.0 years and 43% were male. The mean dietary PI was 29.1±11.8. After 3 years of follow-up, 265 (17.1%) new cases of HTN were identified. No significant changes were observed in the systolic and diastolic blood pressure across quartile categories of dietary PI. After adjustment for confounders, the odds (95% confidence interval) of HTN across quartiles of dietary PI were 1.00, 0.97 (0.62-1.38), 0.69 (0.45-1.07) and 0.52 (0.32-0.84) (P for trend=0.004).Conclusions:Consumption of phytochemical-rich foods may prevent the development of HTN. Further investigations are, however, recommended. [ABSTRACT FROM AUTHOR]

Background To determine the association between fatty acid intake and the prevalence of risk factors for the metabolic syndrome. Methods In this population-based cross-sectional study, a sample of 2750 Tehranian subjects (44% men and 56% women) aged 20-74 years, who completed a validated food frequency questionnaire, was studied. The metabolic syndrome ( Met S) was defined in accordance with the modified guidelines of the National Cholesterol Education Program Adults Treatment Panel III, and waist circumference was coded according to the newly-introduced cut-off points for Iranian adults (≥95 cm for both sexes). Metabolic risk factors across quartile categories of each type of dietary fat [total fat intake, total poly-unsaturated fatty acid ( PUFA) intake, total MUFA intake, total saturated fatty acid ( SFA) intake expressed as percentage of energy and quartiles of the ratio of polyunsaturated fat to saturated fat ( P : S)] were compared. Results The mean ( SD) ages of participants were 40.8 (14.6) and 38.6 (12.9) years, respectively, for men and women. The mean contribution of fat to energy intake was approximately 26% in men and women. A positive trend over successive quartiles of SFA intake with low-density lipoprotein-cholesterol ( LDL- C) and triglyceride, as well as P/ S ratio intake with high-density lipoprotein-cholesterol ( HDL- C), was found. An inverse association between HDL- C with SFA and PUFA intake and a positive association with MUFA and the P/ S ratio was found. A significant association of fatty acid consumption and risk of the Met S in this population was observed, except for total PUFA intake. Conclusions Special dietary fatty acids are associated with metabolic risk factors among the Iranian population. Because of the high prevalence of cardiovascular disease and Met S, national nutrition policies must be developed accordingly for the modification of dietary fatty acid intake with respect to causation and prevention. [ABSTRACT FROM AUTHOR]

Background Phytochemicals are natural non-nutritive bioactive compounds found in fruits, vegetables, whole grains, nuts and legumes, as well as other plant foods. In the present study, we assessed the dietary phytochemical index (PI) in relation to cardiometabolic risk factors among Iranian adults. Methods This cross-sectional study was conducted within the framework of third phase of Tehran Lipid and Glucose Study 2006-2008. For the present study, 2567 subjects aged 19-70 years (1129 men and 1438 women) were selected randomly. Dietary data were collected using a validated semi-quantitative food frequency questionnaire with 168 food items. The PI was calculated based on daily energy derived from phytochemical-rich foods. The odds ratios of abdominal obesity, impaired fasting glucose, hypertriglyceridaemia, low high-density lipoprotein-cholesterol and hypertension were assessed across PI quartile categories. Results The mean (SD) age of participants was 39.4 (13.2) years. Participants in the upper quartile of PI were older, and had a lower weight and waist circumference. The mean (SD) of the PI was 17.3 (5.6), 25.5 (6.4), 32.7 (8.3) and 42.8 (10.5) in the first, second, third and fourth quartiles, respectively. Compared with those in the lower quartile of PI, participants in the upper quartiles had a 66% lower risk of abdominal obesity [95% confidence interval ( CI) = 0.23-0.51] and a 36% lower risk of hypertriglyceridaemia (95% CI, 0.47-0.86), after adjustment for potential confounders. Conclusions Higher intakes of phytochemical-rich foods are associated with a lower risk of abdominal obesity and hypertriglyceridaemia as the main cardiometabolic risk factors. [ABSTRACT FROM AUTHOR]

Objective: To analyse dietary compliance with WHO/FAO nutritional objectives, identify food subgroups that contribute to discrepancies between dietary intakes and recommendations, and assess food patterns and risk factor profiles at common nutritional targets.Design: The study was a population-based, cross-sectional assessment of the dietary patterns of Tehranian adults. Usual dietary intake was assessed in relation to common nutritional targets of public health (fat, saturated fat, dietary fibre, fruit and vegetables) using a validated FFQ. Metabolic syndrome (MetS) risk factors were diagnosed based on the Iranian-modified diagnostic criteria of the National Cholesterol Education Program Adult Treatment Panel III.Setting: The Tehran Lipid and Glucose Study (2005-2008).Subjects: A total of 2510 individuals (1121 men and 1389 women), aged between 19 and 70 years.Results: Generally, 68·5 % of total grain ounce-equivalents were derived from refined grains, with rice making up 36·6 % of all grains consumed. Solid fat (61·1 %) contributed more to discretionary energy than did added sugars (38·9 %). There was a twofold difference in fruit and vegetable consumption between the lowest and highest quartile categories of dietary fibre intake. The probability of having MetS was significantly lower in the highest quartile of fibre intake v. the lowest (OR = 0·69, 95 % CI 0·58, 0·84 v. OR = 0·92, 95 % CI 0·80, 1·03; P -trend < 0·001), whereas it was higher in the highest quartile of SFA intake v. the lowest (OR = 0·92, 95 % CI 0·78, 0·98 v. OR = 0·71, 95 % CI 0·62, 0·89; P-trend = 0·01).Conclusions: Complying with common nutritional targets of public health is inversely associated with MetS risk factors in Tehranian adults. These results may initiate measures for future development of regional food-based dietary guidelines. [ABSTRACT FROM AUTHOR]

Background/Objectives:This cohort study was conducted to evaluate the effect of waist change on metabolic syndrome (MetS) status and its parameters in 5720 participants, aged 20 years, of the Tehran Lipid and Glucose Study who were followed up for a mean of 6.6 years.Subjects/Methods:We measured waist circumference (WC) and MetS parameters at baseline (phase I: 1999) and at follow-up (phase III: 2008), and assessed this relationship across five groups: waist loss (<−2.0 cm); waist stable (−2.0 to 2.9 cm); mild (3.0–5.9 cm); moderate (6.0–8.9 cm) and large (9.0 cm) waist gain. MetS was defined according to the International Diabetes Federation criteria.Results:In phase I, the mean (s.d.) waist gain was 88.8 cm (11.7). Between phases I and III, the mean (s.d.) waist gain was 5 cm (7.9). There was 16% (95% confidence interval (95% CI): 13.6–18.4) age-adjusted incident MetS and for every centimeter of WC gained over 6.6 years, the risk of MetS increased by 10% (odds ratio (OR) 1.10; 95% CI: 1.09–1.12). Compared with a stable WC in both genders, ORs for MetS for different waist gain groups were as follows: mild (OR 2.3, 95% CI: 1.7–3.2); moderate (OR 3.5, 95% CI: 2.6–4.7) and large (OR 5.8, 95% CI: 4.5–7.6). Waist loss had a protective effect on MetS (OR 0.6, 95% CI: 0.4–0.9). Waist gain showed a detrimental effect on all parameters of MetS in both genders, except for high-density lipoprotein cholesterol and fasting blood sugar in women.Conclusions:Waist gain, even mild, was a risk factor of the development of MetS and its parameters. Intervention for reducing WC could be an effective strategy to decrease incident MetS. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between dietary patterns and obesity indices (BMI, WC, WHR) among Tehranian adults in a 6-year follow-up study. Methods: Within frame of a cohort study in Tehran (mean follow up 6.6+/-0.9 years), 141 adults were recruited with: two 24 hour dietary recalls at the beginning, as well as obesity indices at the beginning and end of the study period. Dietary intakes were converted into grams of intakes of food items and categorized into 16 groups. Reduced rank regression analysis derived five patterns with total and polyunsaturated-to-saturated fat intake, cholesterol, fiber and calcium intake as response variables. Factors (dietary patterns) were generated retaining a corresponding factor loading >= |0.17| on the food groups. Changes in obesity indices were scrutinized within quintiles of factor scores. Results: There were high loadings on refined carbohydrates, whole grain, starchy vegetables, other vegetables, red and refined meat, saturated/trans fat, and egg for the first factor named 'traditional'. All obesity indices had increasing trend across quintiles of pattern score. The fifth pattern (namely egg pattern) had high loading for eggs, salty snacks, as well as fruits and dry fruits, and negative loadings for red and processed meat, saturated and trans fat, plant oils, and dairy products. This pattern showed increasing trends for WC and WHR after adjustment for potential confounders. Other patterns showed non-significant trends for obesity indices. Conclusions: The results were indicative of a traditional pattern which is dominated in the Tehran region and associated with increase in obesity indices. [ABSTRACT FROM AUTHOR]

Background and Aim: This study aimed to determine dietary patterns in district 13 of Tehrani adults and evaluate its association with socio-demographic and lifestyle factors Materials and Methods: This cross-sectional study was conducted on 343 male and 453 female aged 18-65 years who participated in Tehran Lipid and Glucose study. Usual dietary intakes were assessed with food frequency questionnaire. Dietary patterns were determined by factor analysis based on 24 food groups identified by similarity of nutrients. Three major dietary patterns were identified: healthy (HDP), western (WDP) and traditional (TDP). Lifestyle and socio-demographic characteristics gathered with pre-tested questionnaires. Multiple regression models separately for men and women were fitted to assess the relationships. Results: The mean age(SD) of men and women were 40(13) and 36(12) respectively. WDP characterized by a higher consumption of salty snacks, sauces, sweetened beverages, processed meats and refined grains, and the HDP characterized by greater intakes of vegetables, low fat meats, tea and coffee, legumes and nuts.WDP had the most variance among 3 dietary patterns. The mean factor score of HDP was higher in women than in men (P<0.05) after adjusting for age and total energy intake. Adherence to a WDP was higher among younger participants (men: β=-0.46, women:-0.34, P<0.001). The percent of married individuals were the most in fourth quartiles of HDP score among the other quartiles (P<0.01) and married men were less likely to follow WDP (β=-0.25, P<0.01). Conclusion:Three major dietary patterns were found with factor analysis: western, healthy and traditional. Younger and single individuals had more adherence to WDP and women had higher score in HDP. [ABSTRACT FROM AUTHOR]

Background: Northern rural areas of Tehran have been shown to have severe iodine deficiency in our previous studies. In 1989 the inhabitants of these villages received an injection of iodised oil, followed by iodised salt distribution in 1993. The aim of the present study was to evaluate the effect of the iodine supplementation on iodine-deficient schoolchildren with hypothyroidism in these villages.Methods: In total, 571 students aged 6-14 years were studied. Goitre was graded according to the World Health Organization classification. Serum concentrations of thyroid hormones (thyroxine (T4) and triiodothyronine (T3)) and thyroid-stimulating hormone (TSH) were determined using commercial kits, and urinary iodine was measured using a digestion method. The results were compared with data from our previous study in 1989.Results: Total goitre rate decreased by 42% in 1999 compared with that in 1989. A significant decrease in Grade 2 goitre concomitant with an increase in Grade 1 goitre was seen (P < 0.001). Values of the variables studied before (1989) and 10 years after iodine supplementation (1999) were: median urinary iodine excretion, 2.0 vs. 19.0 microg dl(-1) (P < 0.001); T4, 6.5 +/- 2.0 vs. 8.4 +/- 1.6 microg dl(-1) (P < 0.001); T3, 177 +/- 38.0 vs. 145 +/- 29.0 ng dl(-1) (P < 0.001); TSH, 10.8 +/- 15.1 vs. 1.8 +/- 0.8 microU ml(-1) (P < 0.001). No correlation was found between thyroid hormones and TSH on the one hand, and goitre and urinary iodine, on the other. Serum T4, T3 and TSH concentrations were within normal ranges in all schoolchildren in 1999.Conclusion: This study showed that euthyroidism induced by administration of iodised oil in iodine-deficient schoolchildren with hypothyroidism is sustained following the consumption of iodised salt. [ABSTRACT FROM AUTHOR]

Aim To perform a systematic review of the effect of interaction between Melanocortin-4 receptor ( MC4R) single nucleotide polymorphisms and diet on the development of obesity and Type 2 diabetes. Background Environmental factors, such as nutrient intakes or feeding behaviours, can modulate the association of polymorphism in the MC4R gene with obesity and Type 2 diabetes mellitus. Methods A systematic literature search was conducted in the PubMed, Scopus and Google Scholar databases, with a combination of the following keywords: Diet*, nutr*, melanocortin receptor, melanocortin 4 receptor and MC4R. To assess the quality of observational studies, we used a 12-item quality checklist, derived from the STREGA statement. Results A total of 14 articles were selected based on the inclusion and exclusion criteria. Consumption of highly salty foods and adherence to a Mediterranean dietary pattern can modulate the association between MC4R polymorphisms and the risk of obesity or Type 2 diabetes. Despite the highly contradictory results of intervention studies, after short-term lifestyle interventions, children with variant alleles of MC4R single nucleotide polymorphisms can lose more body weight, compared with non-carriers, although they may have difficulty in maintaining this weight loss in the long-term. To interpret the results of studies on adults, we need further studies. Conclusions The interaction between MC4R genes with dietary factors plays a significant role in the development of obesity or Type 2 diabetes phenotypes. Early detection of MC4R risk alleles in individuals and modification of their diet based on these results could be an efficient strategy to prevent obesity or diabetes in these subgroups. [ABSTRACT FROM AUTHOR]

What is already known about this subject Little is known about the predictive ability of anthropometric indices in adolescence for prediction of early adulthood metabolic syndrome ( MetS)., There are controversies about the predictive power of body mass index ( BMI) vs. waist circumference ( WC) for prediction of MetS in late adolescence; some of the studies did not support the need to measure WC in mid-adolescence, in addition to BMI; on the other hand, some other studies proposed either similar predictability or superiority of WC to identify MetS in late adolescence., What this study adds This is the first study to evaluate the adolescent anthropometric indices in relation to early adulthood MetS incidence one decade later in the Middle East region., There is an important sex difference regarding the incidence of MetS in Tehranian adolescents., It is interesting to know that all anthropometric indices in the pubertal age group (11-14 years) had better predictive ability compared to late-pubertal (15-18 years) adolescents., In addition, adolescent abdominal obesity surrogates, including WC and waist-to-height ratio, predicted adulthood MetS better than BMI in boys., It seems that WC had an independent role beyond BMI in identification of adulthood MetS in Tehranian boys (11-18 years old)., Background Little is known about the predictive ability of anthropometric indices in adolescence for prediction of early adulthood metabolic syndrome ( MetS). Objective Our purpose was to explore incidence of MetS and the optimal anthropometric indicator to predict early adulthood MetS in Tehranian adolescents. Methods Using data from the population-based, prospective, Tehran Lipid and Glucose Study, the utility of four anthropometric indices of adolescents in predicting early adulthood MetS (2009 Joint Scientific Statement definition) was examined among 1100 participants, aged 11-18 years, who were free of MetS at baseline, during a mean of 10.2 years of follow-up. Results The cumulative incidence of MetS was 25.5% (95% confidence interval [ CI]: 21.8-29.2%) for young men and 1.8% (95% CI: 0.6-3%) for young women. In boys, waist circumference ( WC) had the highest odds ratio ( OR) for the MetS risk, followed by waist-to-height ratio ( WHtR). Adjusting body mass index ( BMI) in addition to WC did not change the results in the 11-14-year age group ( OR for WC: 2.28 [1.64-3.16] without BMI adjustment vs. 1.98 [1.05-3.73] with BMI adjustment), suggesting that WC may predict MetS risk beyond BMI. None of the anthropometric indices were found to have significant associations with subsequent MetS risk in girls. Conclusions Measures of abdominal obesity including WHtR and WC predicted early adulthood MetS better than BMI in Tehranian male adolescents (11-18 years old). [ABSTRACT FROM AUTHOR]

Background and Objective: Limited studies on the relation between the cardiovascular diseases (CVDs) risk factors and dietary glycemic index (GI) and glycemic load (GL) are available. This study was done to determine the association between glycemic index, glycemic load and cardiovascular risk factors in adults. Materials and Methods: This descriptive study was carried out on 2284 subjects (1327 males, 957 females) with 19-84 age in Tehran, Iran during 2005-08. Dietary GI and GL were assessed using a validated semi quantitative food-frequency questionnaire. Blood pressure, Anthropometric, fasting blood of glucose and lipid profiles including total cholesterol, triglyceride, high density lipoprotein (HDL) and low density lipoprotein (LDL) as a CVDs risk factors were measured. The mean intake of nutrient, adjusted for energy production, gender, age, according to GI and GL, using general linear model analysis covariance test was measured. Data were analyzed using SPSS-15, one-way analysis variance, Chi-Square, partial correlation and Linear regression. Results: The mean intakes of glycemic index and glycemic load were 68.3 and 244.8, respectively. Dietary GI and GL was inversely associated with whole grain and positively associated with refined grained, fruits, dairy products and simple sugar. After adjustment for lifestyle and dietary variables, dietary GI was inversely associated with triglyceride and HDL cholesterol concentrations among obese subjects. Dietary GL was inversely associated with fasting and 2-h blood glucose among non-obese subjects after adjustment for confounders. Conclusion: GI in obese men associated with serum increase triglyceride and reduced HDL-C. Glycemic load in a non-obese man is correlated with reducing fasting blood glucose. [ABSTRACT FROM AUTHOR]

Background and Objective: Malnutrition in hospital increases the mortality of patients. The aim of this study was to investigate the prevalence of malnutrition and related risk factors in hospitalized patients. Materials and Methods: This descriptive study was carried out on 446 patients (217 males, 229 females) during 6 months, admitted to the Taleghani hospital in Tehran, Iran during 2005. Anthropometric measurements and previous admission to hospital in previous 6 months for each patient was recorded. Mild, moderate and severe malnutrition were considered as BMI=18-20 kg/m² and TSF, or MAMC<10th, or weight loss<5%; as BMI=16-18kg/m² and TSF, or MAMC<5th, or weight loss 5-10% and severe as BMI<16kg/m² and TSF, or MAMC<5th or weight loss>10% in previous 6 months respectively. Results: The prevalence rate of malnutrition as a general was 52% with following subdivision: 14%, 10% and 28% in mild, moderate and severe, respectively. The highest prevalence of malnutrition observed in gastrointestinal ward, males, those aged 18-29 year and patients with secondary and high school education. In malnourished patients, the prevalence of TSF, MAC and MAMC <5th were significantly more than of well-nourished subjects (P<0.05). Increase BMI per unit decreased the risk of malnutrition by 17% (OR: 0.83; CI: 0.79-0.87). Malnutrition was 64% higher in patients with 1⩾ gastrointestinal disturbances, compared with those without it and 2.1 higher in patients with 2⩾-hospitalized readmission, compared with subjects without readmission in previous 6 month. Odds ratio of at least one hospitalized admission in previous 6 month was 1.64 in patients with MAC <5th, compared with those with MAC 50-75th (P<0.017). Conclusion: This study showed that Malnutrition upon hospitalization is common in Tehran. BMI, gastrointestinal disturbances, and readmission were associated with malnutrition. [ABSTRACT FROM AUTHOR]

Summary Objective Delivery of iodine to the foetus depends not only on maternal dietary iodine intake but also on the presence of a functioning placental transport system. A role for the placenta as an iodine storage organ has been suggested, and this study compares the iodine content of placentas from women giving birth at term in Ireland and Iran, areas with median urinary iodine of 79 and 206 μg/l respectively. Design Placental cotyledon iodine was measured using an alkaline ashing technique with Sandell-Kolthoff kinetic colorimetry. Samples were taken from six sites from the centre and periphery of each cotyledon. Placentas (Ireland n = 58; Iran n = 45) were obtained from consecutive euthyroid women delivering at term. Results The median placental iodine (μg/g wet weight) was significantly higher in Iranian than in Irish women (187·2 μg/g vs 34·3 μg/g; P < 0·001). The distribution of individual placental iodine values showed that values >50 μg/g were found in 71·0% of Iranian and in only 21·0% of Irish samples. In Irish subjects, the relationship of placental iodine to pregnant population urinary iodine (UI) (ng/g:μg/l) was 1:2 (40:79), while in Iranians this ratio is closer to 1:1 (211:206). Conclusions These findings, by demonstrating an apparent ability of the placenta to store iodine in a concentration-dependent manner, suggest a hitherto undetected role for the placenta. Whether placental iodine has a role in protecting the foetus from inadequacies in maternal dietary iodine intake is as yet unknown. [ABSTRACT FROM AUTHOR]