Search

Zohreh Esfandiar,1 Firoozeh Hosseini-Esfahani,1 Parvin Mirmiran,1 Emad Yuzbashian,1 Fereidoun Azizi2 1Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranCorrespondence: Parvin MirmiranNutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranTel +98 21 22432500Fax +98 21 22402463Email mirmiran@endocrine.ac.irFiroozeh Hosseini-EsfahaniNutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranEmail f.hosseini@sbmu.ac.irPurpose: The current study aimed to investigate the relationship between daily consumption of total polyphenol and its subclasses and the incidence of diabetes.Materials and Methods: Eligible adults (n=6,547) were chosen from among participants of the Tehran Lipid and Glucose Study (TLGS) with an average follow-up of 3.0± 1.6 years. Dietary intakes were evaluated using a valid and reliable semi-quantitative food frequency questionnaire. Biochemical variables and anthropometrics were evaluated at baseline and follow-up examinations. Multivariate Cox proportional hazard regression models were used to estimate the development of type 2 diabetes mellitus (T2DM) in relation to total intake of polyphenol and its subclasses (flavonoids, phenolic acids, stilbenes, and lignans).Results: This study was conducted on 2,882 men and 3,665 women, aged 41.3± 14.6 and 39.0± 13.4 years, respectively. The number of participants with the new-onset T2DM was 253. Mean intake of total polyphenol was 346± 245 mg/1000 kcal. Risk of type 2 diabetes decreased from quartiles 1 to 4 for total polyphenols (HR: 1.00, 0.37, 0.61, 0.50, Ptrend< 0.01), phenolic acids (HR: 1.00, 0.57, 0.49, 0.45, Ptrend< 0.01), and lignans (HR: 1.00, 0.67, 0.61, 0.60, Ptrend< 0.01), whereas non-significant results were found for flavonoids and stilbenes. This study suggests an inverse association between total intake of polyphenols, phenolic acids, and lignin, and the risk of T2DM.Conclusion: These results emphasize the potential protective role of polyphenol rich food groups (especially fruits and vegetables) in the prevention of T2DM.Keywords: polyphenols, flavonoids, phenolic acids, stilbenes, lignans, diabetes

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

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 (P2.8, 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.

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.

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 MAMC10% 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

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Diabetes and dysglycemia have a high prevalence in Iranian population but the information about their impact on the cardiovascular disease (CVD) risk is scarce in this population. This study aimed to determine the risk of CVD according to glucose tolerance status."n"nMethods: We ascertained cases with incident CVD in a population of 1752 men and 2273 women, 40 years old and over and free of CVD at the beginning of study, during a follow up with a median of 7.6 years. To calculate hazard ratio (HR) for CVD, we controlled traditional risk factors, including age, body mass index, waist, total cholesterol, HDL-cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, education, smoking, hypertension medication, lipid lowering medication and family history of premature CVD and diabetes."n"nResults: Cardiovascular events occurred in 197 men and 143 women. Its incidence density was 11.8 per 1000 person-years (95% confidence interval: 10.6 to 13.1) totally. Multiple adjusted HR in women with known diabetes was 3.88 (95%CI: 2.40 to 6.27) and with newly diagnosed was 2.34 (95%CI: 1.39 to 3.95) and the corresponding values for men were 1.72 (95%CI: 1.00- 2.95) and 1.52 (95%CI: 1.01- 2.31) respectively. Impaired fasting glucose and impaired glucose tolerance increased 56% the risk of CVD in women (HR: 1.56 with 95% CI, 1.00 to 2.45), just in the age adjusted model."n"nConclusion: All diabetic patients should receive primary prevention for CVD intensively, regardless of whether they are newly diagnosed or are known cases; specially, females who have abnormal glucose metabolism.

"nBackground: Although metabolic syndrome (METs) is receiving attention from physicians, data on the syndrome's association with coronary heart disease (CHD) in the Iranian population are limited. This study was designed to determine the association of different definitions of METs and its components with CHD. "nMethods: Logistic regression analysis was used to analyze data from 5981 subjects aged ≥30 years. METs definitions by the International Diabetes Federation (IDF), the Adult Treatment Panel (ATP III) and the WHO for CHD were used in three models: model 1 an age adjusted model, model 2 adjusted for age, smoking status, premature history of CHD and LDL-cholesterol and model 3 adjusted for the mentioned variables plus the METs components. "nResults: METs as delineated by all three definitions was associated with CHD in models 1 and 2. In model 2, METs was most closely associated with CHD in men, as defined by the WHO [2.3 (1.8-3)] and in women by the ATP III definition [1.6 (1.3-2)]. In model 3, METs lost its association with CHD. However, in men high fasting plasma glucose and high blood pressure plus obesity (by the WHO definition) and in women high blood pressure plus high waist circumference (by the ATP III definition), obesity and glucose domain (by the WHO definition) remained associated with CHD. "nConclusions: In Iranian men and women, all three definitions of METs were associated with CHD when considering the conventional risk factors. After further adjustments for the components of METs, none of these definitions showed an association with CHD and only high blood pressure correlated with CHD in both sexes for all definitions.

Background: Rapid tissue growth and development during puberty increases the need for energy and nutrients. On the other hand, the prevalence of obesity is accelerating among adolescents. Controversies exist regarding meal frequency, obesity and adequacy of nutrients; in particular, a more frequent snacking pattern has been associated with overconsumption of calories in children and adolescents and also with greater body weight. We investigated the meal frequency of adolescents in relation to meeting nutrient requirements.Methods: This cross-sectional study, in the framework of the Tehran Lipid and Glucose Study (TLGS), included 367 boys and girls aged 10-19 years that were randomly selected. Dietary recalls for 48 hours were gathered and participants divided to three groups according to meal frequency; group 1, 2 and 3 with

Background: The NCEP step II diet produced a desirable lipoprotein response in hypercholesterolemia. A relation between plasma concentrations of small dense LDL and cardiovascular risk factors has also been mentioned in children. This study was conducted to determine the effects of the National Cholesterol Education Program (NCEP) step 2 diets on the low density and high density lipoprotein particle size in dyslipidemic adolescents. Methods: Forty- four dyslipidemic adolescents, aged 10-18 years, participated in this case-control study. The control group was not given a diet prescription and was simply instructed to “eat as usual”. Their eating patterns reflected the consumption of macronutrients, fruit, vegetables and dairy products, typical of what many Tehranian eat. NCEP step 2 diets was a diet with 30% of calories as total fat, less than 7% saturated fat, less than 200 mg cholesterol, less than 15% of calories as monounsaturated fat and less than 10% as polyunsaturated fat per day. Lipoprotein particle size was the major outcome variables, which was measured after 3 months of intervention. Lipoprotein particle size was estimated by nondenaturing polyacrylamide gradient gel electrophoresis using Krauss and Burke methodtion. Results: The mean body mass index was 26.3±4.2 kg/m2. Baseline characteristics of these adolescents did not differ significantly across the NCEP step 2 and control diet groups. The NCEP diet resulted in higher reduction in total cholesterol (-13±4 vs –2±0.3 mg/dl, p

Background: Stenotic coronary arteryIt is essential to identify the best simple anthropometric index in any population to predict chronic disease risk. This study was designed to compare the ability of waist circumference (WC), body mass index (BMI) and waist-to-hip ratio (WHR) to predict cardiovascular risk factors in an urban adult population of Tehranian men. Materials and Methods: This population-based cross-sectional study was conducted on 4449 men aged 18-74 years, participants of Tehran Lipid and Glucose Study (TLGS). Demographic data was collected. Anthropometric indices were measured according to standard protocol. Blood pressure was measured and hypertension was defined based on JNC VI. Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as FBS≥126 mg/dl and dyslipidemia based on ATP II. The presence of “at least one” and “at least two” risk factors from the four major cardiovascular risk factors (hypertension, dyslipidemia, diabetes and smoking) was also evaluated. Results: Mean age of men was 41.8±15.4. Mean BMI, WHR and waist circumference was 25.6±4.2 kg/m2, 0.91±0.07 and 87.7±11.7 cm, respectively. Of the three individual indicators, WHR had the highest sensitivity for all risk factors. No combination of indicators had higher average sensitivity + specificity than WHR alone. WHR had a higher percentage of correct prediction than BMI and waist circumference for all risk factors. No combination of measures was significantly more accurate than WHR alone, except for combinations where another indicator has been combined with WHR by “or”. Conclusion: It is concluded that WHR is the best predictor of cardiovascular risk factors compared to BMI and WC in Tehranian adult men residing in district-13.

Objective(s): To compare 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 women living in Tehran. Methods: This population-based cross-sectional study was conducted on 5073 women aged 18-74 years, participants of Tehran Lipid and Glucose Study (TLGS). Demographic data was collected. Anthropometric indices were measured according to standard protocol. Cut-points of BMI, WC, WHpR and WHtR were considered as 25 kg/rrrchr('39'), 80cm, 0.8 and 0.5, respectively. Blood pressure was measured and hypertension was defined based on JNC VI. Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as FBS2:126 mg/di or 2liBG>= 200 mg/di and dyslipidemia based on ATP II. The presence of "at least one risk factor" from the four major cardiovascular risk factors (hypertension, dyslipidemia, diabetes and smoking) was also evaluated. Results: The mean age of women was 39.9±14.6. The mean BMI, WC, WHpR and WHtR were 27.1±1.5 kg/rrrchr('39'), 86.5±13.5 cm and 0.83±0.08 and 0.55±0.08, respectively. Of the four anthropometric measures, subjects with abnormal WC had the highest odds for cardiovascular disease. Waist circumference had the highest sensitivity and specificity to identify subjects with risk factors in both 18-39 years and 40-74 years age categories. No combination of indicators had higher average sensitivity+ specificity than WC. Waist circumference had the highest area under the ROC and a higher percentage of correct prediction than BMI, WHpR and WHtR. Conclusion: It is concluded that WC is the best screening measure for cardiovascular risk factors compared to BMI, WHpR and WHtR in adult women.

The aim of the present investigation was to determine the prevalence of metabolic syndrome."nMaterials and Methods: Metabolic syndrome was defined by the presence of three or more of the following components: abdominal obesity, hypertriglyceridemia, low HDL-C, high blood pressure, and high fasting glucose."nResults: In this study, 10368 of the adults (4397 men and 5971 women) aged 20 years and over, participated in Tehran Lipid and Glucose study. The unadjusted prevalence of metabolic syndrome in the study population was 30.1% (CI 95%: 29.2-31.0), and age-standardized prevalence was 33.7% (CI 95%: 32.8-34.6). The prevalence increased with age in both sexes. Metabolic syndrome was more commonly seen in women than men (42% vs. 24%, p< 0.001). Low HDL-C was the most common metabolic abnormality in both sexes. Except for high FPG, all abnormalities were more common in women than in men (p< 0.001). Most of those with metabolic syndrome had 3 components of the syndrome (58%), 33% had four, and 9% had five"ncomponents."nConclusion: This first report on metabolic syndrome from Iran shows a high"nprevalence of this disorder, imposing serious impacts on health care system. Efforts"non promoting healthy diets, physical activity, and blood pressure control must be"nundertaken.

In this case-control study, 58 transfusion-dependent Thalassemic patients compared with 46 normal healthy persons on study of their thyroid size & function. In this study, thalassemia patients divided in two groups: Group one 31 patients with (Ferritin1500) and 3rd one was named control group (46 healthy persons). These groups were compared to achieve the best possible results and conclusion out of 31 patients. From first group 26 people had normal thyroid function test only 5 patients (16%) had goiter. From 27 patients in second group, 5 people (19%) had normal thyroid and 22 patients had goiter, in 3rd group 29% had normal thyroid, the difference between second and third groups were significant (P1500) are high.

Background: No evidence exists regarding the prevalence of the hypertriglyceridemic waist phenotype in adolescents. We aimed to evaluate the prevalence of this phenotype in a representative sample of Tehranian adolescents. Materials and Methods: Anthropometry and biochemical measurement were assessed in a population-based cross-sectional study of 3036 Tehranian adolescents (1413 male and 1623 female) aged 10-19 years. Hypertriglyceridemic waist phenotype was defined as concurrently having serum triglyceride concentration ≥110 mg/dl and waist circumference ≥90th percentile for age and sex. Overweight (≥95th percentile) and at risk for overweight (≥85th-

Objective(s): To investigate the relationship between the presence of risk factors for non-communicable diseases and occupation and marital status in Tehran women. Methods: The sample was composed of 566 working women (216 single, 350 married) and 561 age-matched non-working subjects (151 single, 410 married), selected randomly from among 15005 participants in the Tehran Lipid and Glucose Study (TLGS). Questionnaires were used to obtain demographic information. In addition, we recorded height, weight, waist circumference, systolic and diastolic blood pressures, body mass index (BMI), and waist to hip ratio (WHR). Serum total cholesterol, triglycerides (TG), and high-density lipoprotein (HDL) levels were measured and oral glucose tolerance test (GTT) performed. Low-density lipoprotein (LDL) levels were calculated using the Friedwald formula. We used Studentchr('39')s t test and one-way analysis of variance (ANOVA) to compare working and non-working women. Variables entered in the model included occupation, marital status, and education. Results: The mean± SD age in single and married subjects in the working group was 34.3±8.4 and 34.7±9.0 years, respectively. The same values for single and married subjects in the non-working group were 34.4±8.0 and 35.0±9.0 years. There were significant associations between marital status and the prevalence of all non-communicable disease risk factors (P

Objective(s): To study the association between the frequency of meals and the levels of non-communicable diseases (NCD) risk factors. Methods: The sample comprised 592 people (275 men, 317 women) aged 19-50 years, selected randomly from the pool of participants in the Tehran Lipid and Glucose Study. Eating patterns were assessed and the number of meals in a day recorded using two-day 24-hour recall questionnaires. We divided the sample into four subgroups: Group l comprised subjects taking less than 6 meals per day. Group 2 included those taking 6-7 meals per day, the third had 8-9 meals per day, and Group 4 took more than 9 meals per day. Blood lipids were measured after 12-14 hours of fasting; anthropometric indices and blood pressure were also recorded. Results: The four groups were composed of 190, 135, 185, and 82 individuals respectively. The risk of having high total cholesterol, triglycerides and LDL-cholesterol was found to decrease with greater meal frequency. No significant difference was observed in the intake of macronutrients. The intake of fibers was greater in the fourth group (P

Objective (s): To determine the pattern of waterpipe (ghalyan) use and the relevant indicators among adolescent students in Tehran, Iran. Methods: A cross-sectional study was conducted on 4361 schoolchildren (2219 boys and 2142 girls) selected by two-stage cluster random sampling from intermediate (orientation) and high schools (including vocational schools) in Tehranchr('39')s Municipal District 13. We determined the pattern for waterpipe smoking through a self·administered, anonymous questionnaire. Results: Overall, the prevalence of lifetime waterpipe smoking was 56.90/o and most adolescents (28.8%) had tried waterpipe between the ages of 12 and 13 for the first time (60.6% in boys vs. 53.1% in girls, P

BACKGROUND/OBJECTIVES: We aimed to investigate the associations of colors of fruit and vegetable (FV) subgroups, with 3-year changes of cardiometabolic risk factors. SUBJECTS/METHODS: This longitudinal study was conducted in the framework of Tehran Lipid and Glucose Study, between 20062008 and 2009-2011, on 1272 adults. Total intake of FV and their subgroups have been assessed by a validated semi-quantitative food frequency questionnaire at baseline (2006-2008) and again at the second examination (2009-2011). Demographics, anthropometrics and biochemical measures were evaluated at baseline and 3 years later. The associations of anthropometric and lipid profile changes with FV subgroups were estimated. RESULTS: The mean age of men and women at baseline was 39.8 [+ or -] 12.7 and 37.3 [+ or -] 12.1 years, respectively. Mean total intake of FV, red/purple, yellow, green, orange and white FV was 706 [+ or -]337,185 [+ or -]95, 141 [+ or -]91, 152 [+ or -]77, 141 [+ or -]87 and 22 [+ or -] 18 g/day, respectively. In men, 3-year changes of weight ([beta] = -0.13, P = 0.01) and waist circumference ([beta] = -0.14, P = 0.01) were related to intake of red/ purple FV; the yellow group was inversely associated with 3-year changes of total cholesterol ([beta] = -0.09, P = 0.03) and High-density lipoprotein cholesterol ([beta] = -0.11, P = 0.03). Consumption of green and white FV was inversely related to abdominal fat gain, and atherogenic lipid parameters in men (P < 0.05). In women, higher intake of red/purple FV was associated to lower weight and abdominal fat gain, fasting serum glucose and total cholesterol (P < 0.05);yellow FV was also related to 3-year weight gain ([beta] = -0.11, P = 0.01). CONCLUSIONS: Various colors of FV subgroups had different effects on cardiometabolic risk factors;higher intake of red/purple FV may be related to lower weight and abdominal fat gain, and yellow, green and white FV may be related to lipid parameters. European Journal of Clinical Nutrition (2015) 69, 1215-1219; doi: 10.1038/ejcn.2015.49; published online 8 April 2015, INTRODUCTION Protective effects of regular consumption of fruits and vegetables (FV) against chronic disease development, especially cardiovascular disease, have been well documented. (1-3) Higher contents of dietary fiber and other [...]

BACKGROUND: There is a paucity of data about the impact of changes in anthropometric measurements on the risk of mortality events, especially in men. METHODS: The study sample consists of 1805 Iranian men, aged ≥ 30 years, free from cardiovascular disease at baseline; they had undergone health examinations in both phases I (1999-2001) and II (2001-2003) and were followed up until March 2010. Participants were categorized by changes in anthropometric measurements into four groups: Group 1, change percentage < - 5%; Group 2, - 5% ≤ change percentages < +5%; Group 3, 5% ≤ change percentage < 10%; and Group 4, change percentage ≥ 10%. Cox proportional hazard regression was performed to assess the hazard ratios (HRs) of the anthropometric changes for all-cause mortality, given group 2 as the reference. RESULTS: During 6.6 years of follow-up, 88 cases of mortality events occurred. The confounder-adjusted multivariate HRs for the first, third and fourth groups of hip circumference (HC) changes were 3.13(1.28-7.64), 0.75(0.43-1.31) and 0.82(0.23- 2.99); the corresponding values for waist to hip ratio (WHR) change were 1.80(0.75-4.33), 1.21(0.70-2.1) and 2.32(1.25-4.3). After further adjustment for mediator covariates, results did not change. The equivalent values for body mass index and waist circumference did not reach statistical significance. CONCLUSIONS: In Middle Eastern Caucasian men, increase in WHR was associated with incident mortality, which was more prominent in those with ≥ 10% increase in the ratio. Moreover, decrease in HC was highly associated with excess risk of mortality. European Journal of Clinical Nutrition (2015) 69, 927-932; doi: 10.1038/ejcn.2014.235; published online 5 November 2014, INTRODUCTION Before the 1990s, obesity was mainly a public health problem, only in Western countries. But over recent decades, it has escalated to a global issue referred to as the [...]

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 [+ or -]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. European Journal of Clinical Nutrition (2015) 69, 592-597; doi: 10.1038/ejcn.2014.228; published online 29 October 2014, INTRODUCTION Cardiometabolic risk factors are the most frequent problems among type 2 diabetes patients; (1) consequently, interventions that decrease these cardiometabolic risk factors are considered beneficial to health. In previous [...]

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))x 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 [+ or -] 12.0 years and 43% were male. The mean dietary PI was 29.1 [+ or -] 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. European Journal of Clinical Nutrition (2015) 69, 392-398;doi: 10.1038/ejcn.2014.233; published online 12 November 2014, INTRODUCTION Hypertension (HTN), a chronic disease, is one of the underlying causes of cardiovascular disease and renal disease. (1) The global burden of HTN in adults was ~40% (1 billion) [...]

BACKGROUND/OBJECTIVES: To examine the association between the different definitions of metabolic syndrome (MetS) and the prediction of incident cardiovascular disease (CVD) and mortality events and to determine whether the concept of MetS adds to traditional risk factors among elderly Iranians. SUBJECTS/METHODS: The association between MetS and outcomes was examined in 922 adults aged ≥ 65 years, free of CVD at baseline, using multivariate Cox proportional hazards models. To examine whether MetS could enhance prediction of outcomes beyond that achieved by risk factors; the net reclassification improvement index was used. RESULTS: During a median follow-up of 9.9 years, 207 CVD events and 193 deaths (82 CVD deaths) occurred. World health organization (WHO) and the joint interim statement (JIS) definitions were shown to be the strongest predictors of CVD events. The WHO definition predicted CVD and all-cause mortality events (hazard ratio (HR) = 1.55 (95% confidence interval (CI) = 1.15-2.09) and 2.08 (95% CI = 1.23-3.51), respectively) and the JIS definition showed a risk for CVD mortality (HR=1.65 (95% CI = 1.03-2.65)). Different definitions of MetS did not add to traditional risk factors in the prediction of different outcomes. CONCLUSIONS: The WHO definition was the strongest predictor of CVD and mortality outcomes; however, none of the MetS definitions provided added value to traditional risk factors. European Journal of Clinical Nutrition (2014) 68, 853-858;doi: 10.1038/ejcn.2014.91; published online 28 May 2014, INTRODUCTION Metabolic syndrome (MetS) refers to a clustering of subclinical metabolic abnormalities including central obesity, elevated blood pressure (BP), hyperglycemia, and dyslipidemia, which its association with increased risk of cardiovascular [...]

BACKGROUND: Iodine as a micronutrient is mandatory for thyroid hormone production and inadequate iodine intakes during pregnancy may result in varying degrees of hypothyroidism affecting pregnancy outcomes adversely. The aim of this study was to evaluate nutritional status and its effects on thyroid function in pregnant women during all trimesters of pregnancy. SUBJECTS/METHODS: In this cohort study, we assessed a total of 203 pregnant women in the first trimester of pregnancy and followed them in the second and third trimesters. They were divided into two groups, group I with urinary iodine excretion (UIE) < 150 µg/l, and group II with UIE ≥ 150 mg/l. Serum samples from women were assayed for levels of total T4, T3, FT4I and thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) only once in each trimester. Urinary iodine concentration was measured three times and the median was considered as UIE in the first trimester, but it was measured only once in the second and third trimesters. RESULTS: The median inter quartile ranges of urinary iodine were 218 (150-276) mg/l, 160 (106-260) mg/l and 145 (88-225) µg/l in the three trimesters of pregnancy, respectively; UIE< 150 was observed in 48 (24.1%), 90 (44.8%) and 103 (52.3%) of pregnant women in the three trimesters of pregnancy, respectively. The median (range) of TSH was 1.7 (0.9-2.7) mIU/l, 1.9(1.2-2.7) mIU/l and 1.8 (1.1-2.8) mIU/l in the three trimesters of pregnancy, respectively. There was no correlation between UIE, TSH, TT4, FT4I, T3 and TPOAb in the first and second trimesters, but there was a weak correlation between UIE, TSH, T3 and TgAb in the third trimester. CONCLUSION: In our cohort of pregnant women the iodine intakes were sufficient, and no correlation between urinary iodine concentration and thyroid function tests was found. European Journal of Clinical Nutrition (2014) 68, 397-400;doi: 10.1038/ejcn.2013.273; published online 8 January 2014 Keywords: iodine; thyroid function; pregnancy, INTRODUCTION Iodine as a micronutrient is mandatory for thyroid hormone production during pregnancy. Inadequate iodine intake may result in either varying degrees of hypothyroidism that affects the pregnancy outcomes seriously [...]

BACKGROUND/OBJECTIVE: There is limited data from long-term prospective studies on the natural course of metabolic syndrome (MetS) incidence in healthy obese phenotypes. The aim of this study was to determine the incidence and predictors of the MetS in healthy obese subjects without the MetS at baseline after a decade of follow-up. SUBJECTS/METHODS: In this prospective cohort study, 438 obese subjects free from MetS at baseline, aged ≥ 20 years, were selected from among the participants of the Tehran Lipid and Glucose Study and followed up for 10 years for development of MetS. Based on national data, central obesity was defined as waist circumference cutoff point of 89cm for men and 91 cm for women. RESULTS: Initially, subjects had a mean age of 41.1 ± 11.8 years and a body mass index of 32.7 ± 2.7 kg/[m.sup.2]. At the end of follow-up, the cumulative incidence (95% confidence interval) of MetS was 44.0 (36.8-51.1)%. In the multivariable analysis, the adjusted odds ratios of hypertension, hypertriglyceridemia, low high- density lipoprotein cholesterol (HDL-C) and insulin resistance for the development of MetS were 3.08 (1.39-6.79), 2.84 (1.26-6.42), 6.49 (3.18-13.25) and 2.87 (1.55-5.32), respectively. The area under receiver operating characteristic curve of all the components was significantly higher than various combinations of MetS components, except for the two models including combinations of three components, that is, triglycerides (TGs), HDL-C and fasting blood sugar, as well as, TGs, HDL-C and systolic blood pressure. CONCLUSIONS: Our findings demonstrate that MetS developed in nearly half of the individuals during the 10 years of follow-up. Predictors of MetS in healthy obese subjects may differ from the general population, and waist circumference does not have an independent role. European Journal of Clinical Nutrition (2014) 68, 295-299;doi:10.1038/ejcn.2013.142; published online 21 August 2013 Keywords: metabolic syndrome; incident; obesity; adults, INTRODUCTION Obesity, one of the most significant and rapidly increasing public health burdens worldwide, is accompanied with various risks of metabolic and cardiovascular complications. (1) With a recent upward trend [...]

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/[m.sup.2] at baseline. Participants in the highest quartile of fast food consumption were younger (33.7 vs 43.4 years, P CONCLUSION: We demonstrated that higher consumption of fast foods had undesirable effects on metabolic syndrome after 3-years of follow-up in Iranian adults. European Journal of Clinical Nutrition (2013) 67, 1303-1309; doi: 10.1038/ejcn.2013.217; published online 6 November 2013 Keywords: metabolic syndrome; fast foods; abdominal obesity; insulin resistance; dyslipidemia; hypertension, INTRODUCTION Metabolic syndrome (MetS) is a common multi-factorial disorder including insulin resistance, abdominal obesity, dyslipidemia and hypertension, all of which directly promote the development of diabetes and cardiovascular disease. (1,2) [...]