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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

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is emerging as the most prevalent liver disease in overweight and obese children. While no cure exists, dietary and lifestyle modifications have been shown to improve the condition. This study investigates the relationship between fructose and fiber consumption, physical activity, and NAFLD in children. Methods A cross-sectional study was conducted on 378 overweight and obese children aged 6–13 years. NAFLD diagnosis was confirmed via ultrasound, and dietary intake was assessed using a 147-item food frequency questionnaire (FFQ). Physical activity was evaluated using the Modifiable Activity Questionnaire (MAQ). Multivariable logistic regression models were applied to determine the associations. Results After excluding 53 participants due to incomplete data, 325 were included in the final analysis. The mean age was 9.2 ± 1.7 years, and 35% had NAFLD. No significant association was found between fructose intake and NAFLD (OR: 0.67, 95% CI: 0.35–1.29, P = 0.221). However, higher intake of legume fiber (OR: 0.48, 95% CI: 0.26–0.90, P = 0.03) and nut fiber (OR: 0.52, 95% CI: 0.28–0.95, P = 0.04) was significantly associated with a reduced risk of NAFLD. Physical activity showed a trend towards reduced NAFLD risk but was not statistically significant after adjustments (OR: 0.53, 95% CI: 0.22–1.04, P = 0.07). Conclusions While fructose intake was not significantly linked to NAFLD in this population, fiber from legumes and nuts appeared protective. Further prospective studies are needed to confirm these findings and clarify the role of physical activity in NAFLD prevention.

Abstract Background/Aim Familial resemblance in dietary patterns has been a subject of interest, with both genetic and environmental factors playing crucial roles. This study aims to investigate trends in macronutrient intake correlations over a 9-year period among different familial pairs, including parent-offspring, siblings, and spouses, using data from the Tehran Lipid and Glucose Study (TLGS). Methods This longitudinal study, conducted within the framework of the TLGS, analyzed data from 1,814 families over a 9-year period. Dietary intakes were assessed using a validated 168-item food frequency questionnaire. Macronutrient intakes were calculated and adjusted for age. Familial correlations were estimated using intraclass correlation coefficients for various familial pairs (parent-offspring, siblings, and spouses) across four consecutive surveys. Changes in correlations were analyzed over 3-year, 6-year, and 9-year intervals, as well as across all four surveys, to determine overall trends in macronutrient intake correlations. Results The results revealed diverse trends in intake correlations for carbohydrates, proteins, fats, and specific fatty acids across familial relationships. Parent-offspring dyads exhibited varied patterns, with some nutrients showing regression to the mean. Sister-sister pairs demonstrated strengthening correlations for energy, carbohydrates, fats, and saturated fatty acids over time. Conversely, brother-sister pairs displayed weakening correlations for most macronutrients, particularly energy, proteins, cholesterol, and fiber. Spouse correlations tended towards regression to the mean for energy, carbohydrates, and fats, and fiber. Conclusions The present study illuminates the dynamic nature of familial dietary correlations over time. The contrasting trends between sister-sister and brother-sister dyads suggest a significant influence of gender on shared dietary patterns. These findings underscore the complex interplay of genetic and environmental factors in shaping family dietary behaviors and highlight the importance of considering both gender and relationship type when examining familial nutritional habits.

Abstract Background No study has investigated the association between ultra-processed food (UPF) and pre-diabetes development. Furthermore, prior investigations on the association between UPF and the risk of type 2 diabetes (T2D) were primarily conducted in Europe and America, and studies in other regions are lacking. We investigated the association between ultra-processed foods and the risk of pre-diabetes and T2D in a cohort of Iranians. Methods This prospective study, with a sample size of 1954 for pre-diabetes and 2457 for T2D, was conducted among adults’ participants (aged ≥ 18 years) from the Tehran Lipid and Glucose Study (TLGS). We defined UPF intake using NOVA calcification as a proportion of total energy, and calculated its average intake during the follow-ups. The hazard ratios (HR) and 95% confidence intervals (95% CI) for pre-diabetes/T2D across tertiles of total UPF and per 10% of its increment were examined using Cox proportional hazards models. We also investigated the possibility of non-linear association using a restricted cubic spline regression. Results We identified 766 and 256 cases of pre-diabetes and T2D, respectively, during a median follow-up of 7 years for pre-diabetes and 8.6 years for T2D. In the multivariable adjusted model, a 10% increase in total UPF intake was associated with a 12% higher risk of pre-diabetes (HR = 1.12; 95% 1.02, 1.23). The incidence of pre-diabetes was also higher in those in tertile 3 than those in tertile 1 (HR = 1.28; 95% CI = 1.07, 1.52). Following additional adjustment for diet quality, the results remained unchanged. Spline regression demonstrated a J-shaped association between UPF and the risk of pre-diabetes; the risk of pre-diabetes did not increase until UPF consumption exceeded about 24% of total energy intake. Of the individual UPF, hydrogenated fat/mayonnaise/ margarine group was related to an increased risk of pre-diabetes. The total UPF and its individual items were not associated with T2D. Conclusions This study found a positive, non-linear relationship between total UPF and the risk of pre-diabetes in Iranian adults. Our data could not show any significant association between UPF and T2D risk.

Abstract Background The possible role of the insulinemic potential of diet in the etiology of type 2 diabetes (T2D) has recently received significant attention in observational studies. This meta-analysis aimed to synthesize available evidence and quantify the potential association between the empirical dietary index for hyperinsulinemia (EDIH) score and T2D risk. Methods Various electronic databases, including Scopus, PubMed, and Web of Science, were comprehensively searched up to January 2024 using related keywords to identify relevant studies. The hazard ratios (HR) or odds ratios were extracted from eligible cohort studies, and a random-effects model with an inverse variance weighting method was used to calculate the pooled effect size, which was expressed as HR. Results The analysis included six cohort studies (four publications), with sample sizes ranging from 3,732 to 90,786 individuals aged 20 to 79 years. During follow-up periods of 5 to over 20 years, 31,284 T2D incidents were identified. The pooled results showed that a higher EDIH score was associated with an increased risk of T2D incidence (HR: 1.47; 95%CI 1.21–1.77; I2 = 91.3%). Significant publication bias was observed in the present meta-analysis (P = 0.020). Geographical region and follow-up period can be as sources of heterogeneity (Pheterogeneity

Abstract Background/aim In the current study, we aimed to assess the association of carbohydrate quality index (CQI) with the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults. Methods This case-control study was conducted on 225 newly diagnosed NAFLD patients and 450 controls, aged 20–60 years. A food frequency questionnaire was used to calculate the CQI and its components, including fiber intake, glycemic index, whole grains: total grains ratio, and solid carbohydrates: total carbohydrates ratio. Multivariable logistic regression was used to estimate the odds ratio (OR) of NAFLD across the tertile of CQI and its components. Results The participant’s mean ± SD of body mass index and age were 26.8 ± 4.3 kg/m2 and 38.1 ± 8.8 years, respectively. The median (interquartile) CQI score in participants of the case and control groups was 20 (15–25) and 23 (18–28), respectively. In the multivariable-adjusted model, the risk of NAFLD decreased significantly across the tertiles of the CQI [(OR: 0.20; %95CI: 0.11–0.39), Ptrend

Background : Various food quality indicators have been proposed as tools for predicting metabolic syndrome (MetS). This study investigated the association between global diet quality score (GDQS) and the risks of developing MetS and its components. Methods : In this secondary analysis, we included elective adult participants (n=4,548) from the Tehran Lipid and Glucose Study. Dietary data were collected by a valid and reliable semi-quantitative food frequency questionnaire. MetS was defined according to the Iranian modified National Cholesterol Education Program. Multivariable Cox proportional hazard regression models were used to estimate the incidence of MetS in association with GDQS. Results : This study involved 1,762 men and 2,786 women with a mean±standard deviation age of 38.6±14.3 and 35.9±11.8 years, respectively. A total of 1,279 subjects developed MetS during the mean follow-up of 6.23 years. Incidence of MetS was associated with GDQS (hazard ratio [HR], 1.00; 0.90 [95% confidence interval, CI, 0.82 to 0.98]; 0.84 [95% CI, 0.76 to 0.91]; 0.80 [95% CI, 0.73 to 0.89]; P for trend

Over the years, numerous evaluations of material attractiveness have been performed for conventional light water reactors to better understand the nature of the spent fuel material and its desirability for misuse at different points in the nuclear fuel cycle. However, availability of such assessments for newer, Generation IV reactors such as Molten Salt Reactors is rather limited. In the present study we address the gap in knowledge of material attractiveness for molten salt reactor systems and describe the nature of irradiated fuel salts which the nuclear safeguards community might be faced with in the near future as more and more such reactors enter commission and operation. Within the scope of the paper, we use a large database of simulated irradiated fuel salt isotopics (and other derived quantities such as gamma activity, decay heat, and neutron emission rates) developed specifically for a molten salt reactor concept in order to shed some light on possible weapons usability of uranium and plutonium present in the irradiated fuel salts. This has been achieved by proposing a new attractiveness metric that is better suited for quantifying attractiveness of irradiated salts from a model molten salt concept. The said metric has been computed using a database that has been created by simulating the irradiation of molten fuel salt in a concept core over a wide range of operational parameters (burnup, initial enrichment, and cooling time) using the Monte-Carlo particle transport code, Serpent. With the help of this attractiveness metric, the findings from this study have shown that in relative terms, molten salt spent fuel is more attractive than spent fuel produced by a conventional light water reactor. The findings also underscore the need for strengthened safeguards measures for such spent fuel. These results are expected to be useful in the future for regulatory authorities as well as for nuclear safeguards inspectors for designing a functional safeguards verification routine for irradiated fuel of such unique nature.

Abstract Background The association between macronutrient consumption and the risk of type 2 diabetes (T2D) remains equivocal. Here, we investigated whether the quantity and quality of macronutrient intake are associated with T2D incidence in a West Asian population. Methods T2D-free adults (n = 2457, mean age 38.5 ± 13.6 years, 54.2% women) who participated in the third examination cycle (2005–2008) of the Tehran Lipid and Glucose Study were followed for a median of 8.6 years. We estimated the macronutrient quality index (MQI), its individual sub-indices (carbohydrate quality index (CQI), fat quality index (FQI), and healthy plate protein quality index (HPPQI)), as well as the macronutrient quantity. The risk of T2D in relation to macronutrient quantity, quality, and their combined effects was examined using Cox proportional hazard models adjusted for known risk factors for T2D. Results During the study follow-up, 257 incident cases of T2D were documented. Individuals in the highest tertiles of MQI and CQI had a 27% (HR = 0.73, 95% CI = 0.54, 0.98) and 29% (HR = 0.71, 95% CI = 0.51–0.99) lower T2D risk than those in the lowest tertiles. The T2D incidence was 35% lower in the middle HPPQI tertile than in the lowest (HR = 0.65, 95% CI = 0.47, 0.89). The multivariable adjusted model showed that individuals in the middle and highest tertiles of carbohydrate intake had 32% (HR = 0.68, 95% CI = 0.49–0.95) and 26% (HR = 0.74, 95% CI = 0.55–1.00) lower risks of T2D than individuals in the lowest tertile. A high-quantity, high-quality carbohydrate diet (≥ 58.5% of energy from carbohydrate with a CQI ≥ 13) and a low-glycemic index (GI), high-fiber diet (GI

Abstract Background Food intakes 1–2 years following bariatric surgery depend more on patients than the surgery’s gastrointestinal tract changes. This study aimed to determine the major dietary patterns of patients after the first two years of sleeve gastrectomy and to investigate their associations with total weight loss (TWL) and the proportion of TWL as fat mass (FM) and fat-free mass (FFM) loss. Methods This cross-sectional study included 146 patients undergoing sleeve gastrectomy 2–4 years after surgery. Dietary patterns were determined using principal component analysis based on the 19 food groups. The percentage of FM loss relative to TWL (%FML) and FFM loss relative to TWL (%FFML) were calculated. A suboptimal clinical response was defined as a TWL of less than 25%. High FM loss and excessive FFM loss were defined based on the highest tertiles. Linear and logistic regression models were used to derive unstandardized (B) coefficients and odds ratios (OR), with dietary pattern scores serving as both a continuous and a binary variable (higher vs. lower adherence groups based on median). Results Two predominant dietary patterns were retained. Each 1-unit increase in the first dietary pattern score characterized by high intakes of fast foods, soft drinks, processed meats, sugar confectionary, salty snacks, grains, and organ meats was associated with higher %FFML (B = 1.99; 95% confidence interval (CI) 0.34, 3.66), lower %FML (B = − 1.84; 95% CI − 3.49, − 0.20), and higher odds of excessive FFM loss (OR = 1.84; 95% CI 1.09, 3.11). Participants with higher adherence to the first dietary pattern had lower %TWL, and greater odds of suboptimal clinical response and excessive FFM loss than those with lower adherence. Each 1-unit increase in score for the second dietary pattern characterized by a high intake of fruits, dairy, vegetables, legumes, eggs, nuts, red meats, poultry, and fish was associated with lower odds of suboptimal clinical response (OR = 0.51; 95% CI 0.31, 0.86). Conclusion Patients should be encouraged to modify their diet by reducing the consumption of ultra-processed foods and increasing their intake of high-quality protein sources, fruits, and vegetables to achieve the best postoperative outcome.

Abstract Backgrounds Dietary potassium can play an important role in decreasing inflammatory factors as a protective factor for cancers. In this case-control study, we aimed to assess the possible association between dietary potassium intake and the risk of breast cancer (BC) among Iranian adult women. Methods The present case-control study was conducted at Shohada and Imam Hossain hospitals, in Tehran. The study included 134 newly diagnosed cases of BC and 267 controls. A validated semi-quantitative 168-item food frequency questionnaire was used to compute the potassium intake. Logistic regression, adjusted for potential confounders, was used to estimate odds ratios(ORs) and 95% confidence intervals(CI) of BC according to tertiles of potassium intake. Results The mean(M) ± standard deviation(SD) of age and body mass index (BMI) were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m2, respectively. Also, the M ± SD of potassium intake for the control and case groups was 1616 ± 293 and 1542 ± 338 (mg/1000 Kcal), respectively. In the multivariable-adjusted model for potential confounders, the higher total potassium intake was associated with decreased odds of BC (OR: 0.35, 95%CI: 0.19–0.62, P for trend

Abstract Background This prospective cohort study aimed to investigate the association between ultra-processed food (UPF) and the risk of metabolic syndrome (MetS), as well as to assess whether fruit and vegetable intake and weight change modify this association. Methods We included 1915 healthy participants who participated in the Tehran Lipid and Glucose Study (TLGS), all of whom had complete demographic, anthropometric, and dietary measurements. A validated food frequency questionnaire was used to assess UPF consumption based on the NOVA classification system. MetS was defined according to the Joint Interim Statement. Multivariable adjusted Cox regression was used to estimate hazard ratios (HRs) for MetS events across tertiles of UPF. The effect of fruit and vegetable consumption and weight change on this association was assessed using joint classification by Cox regression. Results UFP consumption showed no association with MetS risk after adjusting for confounders. However, after adjustment for dietary fiber, fruits, and vegetables, the highest tertile of UPF consumption was positively linked to MetS risk, compared to the lowest tertile. There was a significant interaction between fruit, vegetable, and dietary fiber intake and UPF consumption concerning the risk of MetS (All P values

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.

Type 2 diabetes (T2D) significantly increases the risk of vascular complications (12-32 %), which are a major cause of death (over 50 %) in T2D patients. In T2D, both endothelial (ET) and vascular smooth muscle (VSM) cells are impaired, which act as independent risk factors for cardiovascular disease. Thus, the question of this systematic review and meta-analysis is: Do ET-dependent and -independent VSM relaxation impair in T2D? We systematically searched PubMed and Scopus databases until March 2024; 44 eligible clinical trial studies (68, 16, 30, and 50 study arms for acetylcholine (ACh), methacholine (MTH), sodium nitroprusside (SNP), and glyceryl trinitrate (GTN)) published were included. ET-dependent VSM relaxation in response to ACh (overall ES = -28.9 %, 95 % CI: -35.2, -22.7; p

Abstract Background In this prospective study, we aimed to examine the association between ultra-processed foods and health-related quality of life (HRQoL) and to evaluate the effect of lifestyle and socioeconomic factors on this association. Methods This study included 1766 adults (aged 18 to 78, 54.3% women), who took part in the Tehran Lipid and Glucose study. The Short-Form 12-Item Health Survey version 2 was used to determine HRQoL, which includes the physical component summary (PCS) and mental component summary (MCS) scores. Ultra-processed food consumption was assessed using a validated semi-quantitative food frequency questionnaire. Lifestyle (physical activity and smoking status) and socioeconomic factors (education level and employment status) were also determined. General linear models (GLM) were applied to estimate the mean (95% confidence interval) for MCS and PCS scores across the ultra-processed foods tertiles. Additionally, the effect of lifestyle and socioeconomic factors on the relationship between ultra-processed foods and HRQoL was examined using GLM. Results The median consumption of ultra-processed foods was 11.9% (IQR: 8.2 to 16.8) of total energy intake. There was a significant inverse association between ultra-processed foods consumption and PCS, but not MCS, after adjustment for confounding factors. Significant interactions were observed between ultra-processed food consumption, sex, and occupation on PCS score (all P values

Abstract This study aimed to examine the interaction between diet quality indices (DQIs) and smoking on the incidence of hypertension (HTN), stroke, cardiovascular diseases, and all-cause mortality. We prospectively followed 5720 participants and collected dietary data via a validated food frequency questionnaire to calculate DQI-international (DQI-I) and DQI-revised (DQI-R). Considering an interaction analysis, we classified participants based on diet quality (median: higher/lower) and smoking status. Over 9 years of follow-up, higher diet quality scores were associated with a lower risk of stroke and mortality. While current smokers had a higher risk of stroke and mortality but had a lower risk of developing HTN. Compared to the current smokers with lower diet quality, nonsmokers with higher diet quality according to the DQI-I [HR 0.24; 95% CI (0.08, 0.66)], and DQI-R [HR 0.20; 95% CI (0.07, 0.57)] had a lower risk of stroke. Moreover, the lower risk of mortality was more evident in nonsmokers with higher DQI-I [HR 0.40; 95% CI (0.22–0.75)] and DQI-R scores [HR 0.34; 95% CI (0.18–0.63)] compared to nonsmokers with lower diet quality. While higher DQI-I and DQI-R scores were associated with a lower risk of stroke and mortality, this beneficial effect may be negated by smoking.

Abstract Background Sirtuins have an important role in the regulation of metabolic and biological processess. Thus, we hypothesized that foods that could activate sirtuins, known as “sirtfood”, may improve health status. So, this study was aimed at investigating the association between the amount of sirtfood intake and the risk of major adverse cardiovascular events (MACE). Methods In this cohort study, 2918 adults who had no history of MACE at the start of the study (2006–2008) participated and were followed up on until 2018. The amount of sirtfoods intake (servings per week) was computed using a validated food frequency questionnaire. Each patient’s medical records were evaluated to detect MACE. The Cox proportional hazards model was applied to assess the association between the amount of sirtfood intake and the risk of MACE. Results The median duration of the study was 10.6 years. The hazard ratio (HR) for the risk of MACE was 0.70 for the second (95% CI: 0.50, 0.98) and 0.60 (95% CI: 0.42, 0.86) for the third tertile of sirtfoods intake compared with the first tertile. This association was nonlinear, and sirtfoods consumption of more than five servings per week did not result in a lower risk of MACE. In addition, there was a significant interaction between age (P-interaction

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/objectiveThe current study investigates the association between dietary insulinemic indices and Akt, PTEN, and PI3K gene expressions in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) among individuals undergoing abdominal surgery.Materials and methodsThis cross-sectional study was conducted on 176 individuals, aged 18–84 years, who had undergone abdominal surgery. The participants were classified based on body mass index (BMI) as normal (BMI

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

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

Abstract Background This study examines the potential long-term joint association between smoking and diet quality as modifiable risk factors concerning cardiovascular diseases (CVDs) incidence and all-cause mortality among current and former smokers. Methods The study followed 955 smokers from the third and fourth examinations of the Tehran Lipid and Glucose Study to March 2018. Dietary data was collected using a food frequency questionnaire. Three diet quality indices (DQIs) were computed at baseline: DQI-international (DQI-I), DQI-revised (DQI-R), and Mediterranean-DQI (Med-DQI). Cox proportional hazards regression models were used to determine the HR (95% CI) of the joint association between smoking and diet quality among heavy and light smokers, based on the number of cigarettes per day and pack-years, as well as between current and former smokers based on smoking habits. Results Over a follow-up period of almost eight years, 94 cases of CVDs (9.80%) and 40 cases of mortality (4.20%) were documented. The lower diet quality based on the Med-DQI was associated with a higher risk of mortality among current smokers (HR:3.45; 95%CI:1.12, 10.57). Light smokers with good diet quality, compared to heavy smokers with poor diet quality, had a lower risk of CVDs incident (HR:0.35; 95%CI: 0.15, 0.83) and all-cause mortality (HR:0.20; 95%CI:0.05, 0.77). Current smokers with good DQI had a lower risk of mortality compared to current smokers with poor DQI (HR:0.26; 95%CI:0.08, 0.80). However, this lower risk was more significant in former smokers with good DQI (HR:0.10; 95%CI:0.02, 0.45). Conclusions Light and former smokers had a lower risk of developing CVDs and experiencing mortality. However, when coupled with a high-quality diet, this protective effect is even more pronounced.

Abstract Background We assessed the possible effect of usual dairy consumption on pre-diabetes (Pre-DM) remission or progression to type 2 diabetes (T2D). Methods Pre-DM adults (n = 334, mean age of 49.4 years, and 51.5% men) were assessed for dairy intakes (2006–2008) and followed up to 9 years for incidence of T2D or normal glycemia (NG). All biochemical measurements were done at baseline and all subsequent examinations with 3-y follow-up intervals. Multinomial regression models with adjustment of confounding variables were used to estimate odds ratios (OR) and 95% confidence intervals (CIs) of incident T2D and NG for each serving/d dairy consumption. Results The odds of NG was significantly elevated by 69% (OR = 1.69, 95% CI = 1.00–2.86, P = 0.05) per 200 g/d increased high-fat dairy intake, while the amount of total dairy or low-fat dairy was not related to the outcomes. Higher intakes of yogurt were more likely to be associated with an increased odds of NG (OR = 1.82, 95% CI = 1.20–2.74, P = 0.01). Usual intakes of milk, cheese, or cream-butter were not associated to Pre-DM remission or progression to T2D. Conclusion Regular dairy consumption may increase the chance of Pre-DM regression to NG.

Abstract Background Cardiovascular disease (CVD) is a major cause of death worldwide, although limited data are currently available regarding the impact of consuming ultra-processed food (UPF) on its incidence. Given the increased consumption of UPF in Iran, we aimed to investigate the association between UPF intake and CVD risk. Methods Individuals without CVD (n = 2050) aged ≥ 30 years old were recruited from the Tehran Lipid and Glucose Study (TLGS). Dietary data were collected using a validated food frequency questionnaire (FFQ) and UPF intakes were assessed based on the Nova food classification. Multivariable Cox proportional hazard models adjusted for potential confounders were used to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for the risk of CVD across tertiles of UPF intake. Results A 10.1% incidence of CVD occurred over a median follow-up of 10.6 years, with a 22% increase in CVD risk per each 50 g/day UPF intake. Participants with the highest intake of UPF had a 68% greater incidence of CVD compared to those with the lowest intake (HR = 1.68, 95% CI=1.14–2.48) after controlling for potential confounders. Regarding sub-groups of UPF, participants in the 3rd tertile compared to the reference had a significantly increased risk of CVD (HR = 1.56, 95% CI=1.04–2.34). Nevertheless, intake of bread, fast food, sweetened beverages, sweets and desserts, high-fat dairy products, and other UPFs were not associated with greater CVD risk. Conclusion Our findings support the hypothesis that the incidence of CVD is enhanced with the higher consumption of UPF in a representative sample of the Iranian population.

Abstract Background/aim Evidence from recent studies suggested that the quality of dietary macronutrients can play a possible role in predicting the risk of metabolic disorders. In the current study, we aimed to assess the association of carbohydrate quality index (CQI) and protein score with the risk of metabolic syndrome (MetS) in Iranian adults. Methods This prospective study was conducted within the framework of the Tehran Lipid and Glucose Study on 1738 individuals aged between 40 and 70 years old, who were followed up for a mean of 6.1 years. A food frequency questionnaire was used to determine CQI and protein scores. The multivariable adjusted Cox regression model was used to calculate the hazard ratio (HR) of MetS across quartiles of protein score and CQI, and its components. Results The mean ± standard deviation (SD) age and body mass index of the study population (42.5% men) were 49.3 ± 7.5 years and 27.0 ± 4.0 kg/m2, respectively. Mean ± SD scores of CQI and protein for all participants were 12.6 ± 2.4 and 10.3 ± 3.5, respectively. During the study follow-up, 834(48.0%) new cases of MetS were ascertained. In the multivariable-adjusted model, the risk of MetS was decreased across quartiles of CQI (HR = 0.83;95%CI:0.69–1.00, Ptrend=0.025) and protein score (HR = 0.75; 95% CI:0.60–0.94, Ptrend=0.041). Also, Of CQI components, the whole grain/total grains ratio showed a significant inverse association with the risk of MetS (HR = 0.75;95%CI:0.60–0.94, Ptrend=0.012). Conclusion Our findings revealed that a dietary pattern with higher CQI and protein score may be related to a reduced risk of MetS in adults.

Abstract Background Evidence from recent studies suggested that variation in the quantity and quality of macronutrients in the diet may potentially play a role in predicting the risk of breast cancer (BC). In the current study, we aimed to assess the association of different high-protein diet scores and replacing fats and carbohydrate (CHO) with protein in the diet with the BC risk among Iranian women. Methods The current hospital-based case-control study was conducted on 401 participants, aged ≥ 30 years old, including 134 women in the case group who had been diagnosed with histologically confirmed BC and 267 women in the control group. Dietary intake data was collected using a validated food frequency questionnaire, and high protein diet scores were determined. Logistic regression models were used to determine the odds ratios (OR) and 95% confidence interval (CI) of BC across tertiles of high protein diet scores. Also, we assessed how substituting protein with other macronutrients affected BC odds while adjusting for the various confounding variables. Results Participants’ mean ± SD of age and body mass index were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m2, respectively. The scores of high-protein-low-CHO and fat diet, high-protein and CHO-low-fat diet, and high-protein and fat-low-CHO diet in participants were 16.5 ± 3.8, 16.5 ± 6.7, and 16.4 ± 5.9, respectively. In the multivariable model, individuals in the highest tertile of high-protein-low-CHO and fat diet score (OR:0.71;95%CI:0.56–0.90) and high-protein and CHO-low-fat diet (OR:0.76;95%CI:0.60–0.97) had lower odds of BC compared to those in the lowest tertile (P

ABSTRACT Aims/Introduction The aim was to examine the joint effect of metabolic syndrome (MetS) and insulin resistance (IR) with ideal cardiovascular health (iCVH) status on incident cardiovascular diseases (CVDs). Materials and Methods The study included 6,240 Iranian adults ≥30 years, free of prior cardiovascular disease. Ideal cardiovascular health was determined based on American Heart Association's Life Simple 7. Metabolic syndrome was defined according to the Joint Interim Statement Criteria, and insulin resistance was defined as HOMA‐IR ≥1.85 in women and ≥2.17 in men. Multivariable Cox proportional hazard ratios (HRs) were applied to examine the impact of metabolic syndrome, and insulin resistance at various levels of iCVH status. Results During the median follow‐up of 14.0 years, 909 cases of cardiovascular disease occurred. Metabolic syndrome and insulin resistance were significantly associated with incident cardiovascular disease events. In the poor and intermediate status, metabolic syndrome increased cardiovascular disease events with HRs of 1.83 and 1.57, respectively; the corresponding values for insulin resistance in the mentioned categories were 1.91 and 1.25, respectively (P values

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.