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Introduction: Previous research has shown that a healthy diet is important in preventing and developing Type 2 Diabetes. This study aims to investigate the association between the innovative index, the Global Diet Quality Score (GDQS), and the risk of Type 2 Diabetes. Methods: In this secondary analysis, we included elective adult participants (n=5948) from the Tehran Lipid and Glucose Study. Participants had an average follow-up of 6.65 years. Dietary data was collected by expert nutritionists by a semiquantitative food frequency questionnaire which was valid and reliable. Dietary scores were calculated for the GDQS. Biochemical and anthropometric characteristics were assessed during the first and follow-up surveys. Multivariable Cox proportional hazards regression models were used for estimating the progression of T2D in association with the GDQS. Results: This study was implemented on 2,688 men and 3,260 women, respectively with the mean(SD) age of 41.5(14.1) and 39.3(13.02) years. A total of 524 subjects were found with T2D incidence. The healthy component of GDQS was conversely associated with T2D incidence [HR: 1, 0.91 (0.84-0.98), 0.91 (0.84-0.98), 0.84 (0.77-0.92) P trend= <0.001] in an adjusted model. The total unhealthy component of GDQS were conversely related to T2D incidence in an adjusted model [HR: 1, 0.86 (0.80-0.92), 0.93 (0.86-1.01), 0.89 (0.81-0.98) P trend= 0.009). Conclusions: The results of this study suggested that higher adherence to healthy components of GDQS and lower intake of unhealthy in excessive amount components of GDQS are related to the lower risk of T2D incidence. [ABSTRACT FROM AUTHOR]

Background: The possible relationship between diet-related inflammation and the risk of gestational diabetes mellitus (GDM) requires further investigation, especially in non-Western populations. We examined the association between dietary inflammatory index (DII) scores and GDM in a case-control study conducted in Iran. Methods: This study included 122 GDM cases and 266 controls hospitalized for acute non-neoplastic diseases. Cases were pregnant women aged 18-40 years, who visited major general hospitals in different regions of Tehran. Pregnant women were screened for gestational diabetes between the 24th and 28th week of gestation with a 50-g, 1-hour glucose challenge test (GCT). Cases were diagnosed positive for GDM. Controls were pregnant women who had normal GCT test. DII scores were computed from dietary intake assessed by a previously validated 147-item food frequency questionnaire. Logistic regression models adjusted age, gestational age, energy, exercise, BMI, smoking exposure, family history of diabetes, and history of multivitamin intake were used to estimate odds ratios (ORs) and 95% confidence intervals (CI). Results: Subjects with higher DII scores (i.e. indicating a more proinflammatory diet) had a higher odd of GDM with the DII being used as both a continuous (OR = 1.20; 95% CI = 0.94-1.54) and as categorical (ORtertile 3vs1 = 2.10; 95% CI = 1.02-4.34, p-trend = .03). Conclusions: These results indicate that a proinflammatory diet, as evidenced by higher DII scores, is associated with increased odds of GDM among Iranian women. [ABSTRACT FROM AUTHOR]

Introduction: Rodent models and studies on women with galactosemia suggest the ovo-toxicity effect of galactose. However, the association between galactose intake from dietary sources and the ovarian function in women without galactosemia has not yet been described. Therefore, this study aimed to investigate the associations between both dietary galactose and lactose intake, and ovarian dysfunction as the odds of early menopause in women without galactosemia. Materials and methods: This cross-sectional study was conducted on 821 women without galactosemia, participants of the Tehran Lipid and Glucose Study (TLGS), who experienced natural menopause. Habitual dietary intakes of lactose and galactose during the past 12 month were assessed, using a food-frequency questionnaire (FFQ). In this study, early menopause was defined as natural menopause before the age of 45 years. Results: Mean- and menopausal age of women were reported as 59.3±7.94 and 48.6±4.81 years, respectively. No statistically significant linear association was observed between the daily intakes of lactose and galactose and the odds of early menopause. After adjusting for age, energy intake, and age at menarche, women in the middle tertiles of lactose (62%, 95%CI: 1.07, 2.46) and galactose (58%, 95% CI: 1.05, 2.39) intake had significantly higher odds of early menopause, than those in the first tertile. When the daily intake of lactose and galactose were expressed as the percentage of energy intake, the higher odds of early menopause among women in the middle tertile compared to those with the first tertile were reduced and became non-significant. Conclusion: No statistically significant linear associations were reported between the intake of lactose and galactose and age of menopause. However, the odds of early menopause in those women with the middle tertile of lactose and galactose intake were significantly higher than those women in the first tertile. [ABSTRACT FROM AUTHOR]

Background Despite their different cardiovascular consequences, little is known about predictors of metabolically healthy ( MHO) and metabolically unhealthy obesity ( MUHO). This cohort study was designed to address this question in participants of the Tehran Lipid and Glucose Study. Materials and methods Employing the Joint Interim Statement ( JIS) metabolic syndrome criteria to define MHO/ MUHO phenotypes, nonobese, otherwise healthy individuals, aged > 20 years ( n = 3489) were recruited and followed up for a median of 13·4 years. Results At the follow-up, MHO incidence rate in obese individuals was 36·6%. Comparing MHO vs. MUHO, female gender [odds ratio ( OR) = 3·28, 95% confidence interval ( CI) 1·27, 8·46)], increased body mass index ( BMI; OR = 1·32, 95% CI: 1·12, 1·60) and elevated high-density lipoprotein cholesterol ( HDL-C) levels ( OR = 1·04, 95% CI: 1·02, 1·07) were related to higher odds of incident MHO, while older age ( OR = 0·95, 95% CI: 0·92, 0·98), increased waist circumference ( WC; OR = 0·86, 95% CI: 0·81, 0·91), higher WC gain ( OR = 0·91, 95% CI: 0·87, 0·95) and increased diastolic blood pressure ( DBP; OR = 0·94, 95% CI: 0·91, 0·98) prevented progression towards MHO. Conclusions While baseline BMI and WC were detrimental for developing MHO vs. MUHO, gender was the strongest predictor of incident obesity phenotype in healthy nonobese individuals. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate possible effects of food fortification practices on vitamin D intake in adults.Design and Setting: This was designed as a cross-sectional, population-based study.Subjects: We investigated vitamin D intake in a population-based sample of 5224 adults, using a validated food frequency questionnaire. A theoretical model was conducted to evaluate the hypothetical effects of dairy product fortification.Results: Dairy had the highest mean of vitamin D intake among food groups. If all types of milk were fortified by vitamin D (42 IU/100 grams of milk), the mean intake of vitamin D would reach 132 ± 148 (92(180)) IU/day. If both milk and yogurt were fortified to 42 IU/100 g and 89 IU/100 g, respectively, the average mean vitamin D intake from foods in this population would increase from 84 ± 88 IU/day to 308 ± 240 IU/day. As the fortification level increased, the proportions of young people with more than the recommended daily allowance (RDA) of vitamin D increased from 1.1% to 77.4% in men and from 1.4% to 80% in women, but none of them achieved the tolerable upper intake level (UL) of vitamin D.Conclusion: The proposed fortification scenario would provide enough vitamin D intakes by RDA in a population aged between 18 and 50 years (about 80% of the population), with none of them achieving ULs. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the association between hydrogenated- (HVOs) and non-hydrogenated vegetable oils (non-HVOs) and butter and the metabolic syndrome (MetS) after 3-years of follow-up in adults.Methods: This study was conducted between 2006-2008 and 2009-2011 within the framework of the Tehran Lipid and Glucose Study, on 1582 adults, aged 19-84 years. Intakes of HVOs, non-HVOs and butter were assessed by a validated semi-quantitative food frequency questionnaire. Based on the consumption of food rich in fat including HVOs, non-HVOs and butter, participants were categorized to consumers and non-consumers.Results: Of 1582 participants during a 3-year follow-up, 15.2% developed MetS. Non-consumption of butter was associated with lower MetS risk compared with its consumption. Among consumers of food rich in fat, intake of HVOs and butter were associated with an increased risk of MetS; ORs in the final multivariate model were 2.70 (95% CI: 1.52-4.78) for HVOs and 2.03 (95% CI: 1.20-3.41) for butter, in the highest, compared to the lowest category of dietary intakes. Intake of non-HVOs was not associated with risk of MetS.Conclusions: Consumption of HVOs and butter were positively associated with an increase risk of MetS. [ABSTRACT FROM AUTHOR]

Background: As food insecurity has negative effects on health, the aim of this study was to determine the relationship between household food security and type 2 diabetes mellitus and its related risk factors. Methods: In this case-control study, 200 individuals with and 200 individuals without type 2 diabetes mellitus, aged over 40 years, were randomly selected from among participants of the Tehran Lipid and Glucose Study. The questionnaire on household food security proposed by the United States Department of Agriculture was completed for them by trained personnel. Logistic regression was used to determine the variable that had the most significant relationship with food security status. Results: The average of food security score was 2.38 ± 2.0 in non-diabetic and 2.25 ± 2.0 in diabetic individuals (P = 0.6). In both groups, the risk for food insecurity in women was more than in men. In the diabetic group, being single and having education levels below high school increased the risk of food insecurity. In the non-diabetic group, the risk of food insecurity in obese individuals was 3.3 times higher than normal individuals (odds ratio = 2.1, 95% confidence interval: 1.2-4.1). Conclusions: There were no significant differences in food security levels of diabetic and non-diabetic groups. However, some risk factors of type 2 diabetes including sex, marital status, educational level, and obesity were associated with food insecurity. [ABSTRACT FROM AUTHOR]

This study investigated the association between total and various types of dairy products and hypertension (HTN) among Tehranian adults. This cross-sectional study was conducted on 5616 adults within the framework of the Tehran lipid and glucose study. Multiple logistic regression models were conducted to assess association between HTN and dairy intakes. Consumption of high-fat dairy and non-fermented dairy in the highest quartile was inversely associated with HTN (OR: 0.76, 95% CI: 0.63–0.92 and OR: 0.70, 95% CI: 0.65–0.94, respectively). Among dairy products, milk intake (OR: 0.79, 95% CI: 0.66–0.96) was inversely and yoghurt intake (OR: 1.28, 95% CI: 1.06–1.55) and cheese intake (OR: 1.21, 95% CI: 1.01–1.46) were positively associated with HTN, findings indicating that higher intakes of high-fat dairy, non-fermented dairy and milk are associated with lower risk of HTN, whereas higher consumption of yoghurt and cheese associated with higher risk of HTN. However, further randomised clinical trials are recommended. [ABSTRACT FROM AUTHOR]

The prevalence of dyslipidaemia has been increasing in developing countries that are undergoing nutrition transition. However, the association of diet quality and lipid profile has not been well-understood in these countries. The aim of the current study was to compare the ability of three diet quality indices—the Mediterranean diet scale (MDS), healthy eating index-2005 (HEI-2005), and diet quality index-international (DQI-I) in relation to changes in lipid profile between baseline and 6.7 years of follow-up. Baseline data from two 24-hour dietary recalls provided by 469 adults with mean age of 38.7±12.3 years, who were participants of the Tehran Lipid and Glucose Study, were analyzed to describe dietary intakes. Data on anthropometry, sociodemography, physical activity, and other lifestyle variables were recorded, and a comparison of baseline and follow-up data revealed changes in the concentrations of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). A general linear model was used in assessing changes in lipid profile depending on adherence to diet quality indices at baseline, after adjustment for age, smoking status, waist-circumference, body mass index, physical activity, and energy intake. A significant interaction was observed between scores and sex, and upon stratification, males in the highest quartile score of the HEI-2005 had significantly lower TG changes than those in the lowest quartile, after adjusting for confounders (-8.8 vs 2.9, p=0.038). No association was apparent in females (-0.2 vs 11.2, p=0.297). In addition, a positive association was found between DQI-I and HDL-C (Q1=0.6 vs Q4=-2.0, p=0.044) in males. In both sexes, all these indices were weakly associated with TC while none was associated with LDL-C. It is concluded: adherence to the HEI-2005 recommendations was weakly associated with reduced TG concentration in an urban Iranian adult population. The MDS and DQI-I were not related to change in lipid profile. [ABSTRACT FROM AUTHOR]

Purpose: Studies indicate that milk intake is associated with insulin-like growth factor 1 (IGF-1) concentrations and height in childhood, whether milk and other dairy products promote puberty remains unclear. This study aimed to investigate influences of pre-pubertal intakes of milk, yogurt and cheese on menarcheal age in Tehranian girls. The associations of total dietary calcium (Ca), magnesium (Mg), and phosphorus (P) with menarcheal age were also examined. Methods: This prospective study was conducted on 134 pre-pubertal girls, aged 4-12 years at baseline, who participated in the Tehran Lipid and Glucose Study (TLGS), and were followed for a median of 6.5 years. Dietary intakes were determined at initiation of the study using two non-consecutive 24-h dietary recalls and the age of menarche was documented during the follow-up. Logistic regression was used to calculate the risk of reaching menarche ≤ 12 years according to pre-pubertal levels of dairy or mineral intakes. Results: The risk of earlier menarche was higher in girls with higher intakes of milk [OR: 2.28 (95% CI: 1.03–5.05)], Ca [OR: 3.20 (95%CI: 1.39–7.42)], Mg [OR: 2.43 (95% CI: 1.12–5.27)] and P [OR: 3.37 (95 % CI: 1.44–7.87) after controlling for energy and protein intake, interval between the age at study initiation and the age of menarche, and maternal age at menarche (Model 1). Girls in the middle tertile of cheese intakes had a lower risk of reaching menarche ≤ 12 years than those in the lowest tertile after controlling for covariates in model 1. These associations remained significant after further adjustment of BMI Z-score at baseline. The relationship of Ca, Mg, and P with menarche remained after further adjustment for height Z-score at baseline, whereas the association between milk and cheese intakes became non-significant. Conclusions: Pre-pubertal intake of milk, but not cheese and yogurt, may hasten age at menarche. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To evaluate the association between total dietary fiber and its types and sources with the risk of MetS. Methods: This population-based cross-sectional study was conducted on a representative sample of 2457 adults (1327 male and 1130 female), aged 19–84 years. Dietary intake was assessed using a validated semiquantitative food-frequency questionnaire. Anthropometrics, blood pressure, and fasting blood glucose and lipids were measured according to standard protocols. The MetS was defined according to definition by Adult Treatment Panel III. Results: Multivariate-adjusted odds ratio of MetS between highest and lowest quartiles was 0.53 (95% CI: 0.39–0.74; P for trend <0.05) for total dietary fiber, 0.60 (0.43–0.84; P for trend <0.05) for soluble fiber, and 0.51 (0.35–0.72; P for trend <0.05) for insoluble fiber. Among sources of dietary fiber, fruit fiber (OR: 0.51; 95% CI: 0.37–0.72), cereal fiber (0.74; 0.57–0.97), and legume fiber (0.73; 0.53–0.99) were inversely associated with the risk of MetS, after adjustment for confounding factors. Intake of vegetable fiber and nut fiber were unrelated to the risk of MetS. Conclusions: Total dietary fiber, soluble- and insoluble fiber, fruit fiber, cereal fiber and legume fiber were associated with a protective effect for the presence of MetS among this Tehranian population. [Copyright &y& Elsevier]

Objectives: The aim of this study was to assess leisure time physical activity and its determinants among adults in Tehran. Methods: This cross-sectional study comprised adults (n &equals; 7285), aged 20 years and older. The subjects were participants of the Tehran Lipid and Glucose Study between 2002 and 2004. Information on the number of days spent on different activities during a week and the time devoted to each activity on a typical day was recorded. In addition, each activity, weighted by its relative intensity, was referred to as a metabolic equivalent. Results: The prevalence of inactivity was 69.8% (95% CI: 68.7−70.8) in the whole population and 30.2% (95% CI: 27.2−33.1%) of men and 30.3% (95% CI: 27.7−32.8%) of women were considered as active. Leisure time physical activity less than 30 min/week was scored in 1590 (50.6%) men and 1803 (43.5%) women. The most frequent leisure time physical activity performed by men (96.1%) and women (95.2%) was walking. A negative association was observed in men between leisure time physical activity and increased work hours, older age, more cigarette smoking and higher body mass index (69.8% were overweight and 75.3% were obese; P < 0.05). Leisure time physical activity was more likely to be associated with high educational levels in men. In addition, there was a statistically significant relationship between physical inactivity and occupation in both men and women. Conclusions: The prevalence of physical inactivity among adults in Tehran was high. Leisure time physical inactivity was more likely to be associated with older age, more cigarette smoking, more working hours, and higher body mass index. Public health efforts are needed to improve people's participation in physical activities in Iran. [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:Production of iodized salt in Iran for household consumption began in 1990. Previous studies have reported sustainable elimination of iodine deficiency disorders in Iran. The aim of this study was to evaluate the iodine nutritional status in Tehran in 2009.Methods:In this cross-sectional study, 383 Tehranian households were enrolled through randomized cluster sampling and a total of 639 adult subjects (242 men and 397 women), aged 19 and over, participated. A 24-hour urine sample was collected for measurement of urinary iodine, sodium, and creatinine concentrations using the digestion method, flame photometry, and autoanalyzer assay, respectively. Salt intake was estimated and iodine content of household salt was measured by titration.Results:Median (interquartile range) iodine content of household salt and urinary iodine concentration (UIC) in Tehran were 21.2 (3.2–31.7) parts per million and 70.0 (34.0–131.2) μg/L, respectively. There was no statistically significant difference in 24-hour UICs between men and women. Median (interquartile range) daily salt intake was 7.6 (5.5–9.8) g, which was not different in the two genders. According to the WHO/ICCIDD/UNICEF classification, 11.2%, 25.9%, 26.7%, 25.1%, 8.0%, and 3.2% of participants had UIC <20, 20–49, 50–99, 100–199, 200–299, and >300 μg/L, respectively.Conclusions:Mild iodine deficiency has recurred in Tehranians. The results emphasize the need for continuous monitoring in all regions, even in a country with iodine sufficiency. [ABSTRACT FROM AUTHOR]

Seasonal aggregation and the monthly rate of neonatal transient hyperthyrotropinemia (THT) were assessed. From November 1998 to April 2005, neonates of gestational age ≥37 wks, birth weight 2500-4000 g, birth length 45-55 cm, and 1st min Apgar score >3, who had thyrotropin (TSH) ≥20 mU/L in their cord dried-blood specimen, but without congenital hypothyroidism, were enrolled in the study. The recall rate equals the rate of THT occurrence in this study. Of 47,945 neonates, 555 had THT (recall rate: 1.2%). The aggregated seasonal recall rate (recall for further assessment to rule out congenital hypothyroidism) was significantly higher in winter (January, February, and March) than the other seasons ( p < .0001). Winter had higher recall rate in each year as compared to other seasons, but the overall rate of recalls decreased in 2001 and 2002. Excluding the first 6 months (due to erratic variations), the remaining 72 months revealed a relatively sinusoidal pattern in monthly recall rates; indeed, there was an initial 11-month high recall rates (1.7%), followed by a 33-month decrease (0.7%), a 19-month increase (1.9%), and a final 9-month decrease (0.8%). The recall rate of each of these time intervals was significantly different from that of the next time interval ( p < .0001). The monthly recall rates were best fitted to cubic curve estimation and then autoregressive integrated moving average (ARIMA) (0, 1, 1) models. THT occurs significantly more in winter than in other seasons, and this suggests a possible role for time-varying factor(s) contributing to its seasonal preponderance. (Author correspondence: E-mail: ) [ABSTRACT FROM AUTHOR]

Abstract: Aim: To assess the utility of different definitions of the metabolic syndrome (MetS) in predicting adulthood MetS among Tehranian adolescents in a 6-year follow-up. Methods: A random sample of 2645 adolescents was selected from the Tehran Lipid and Glucose Study (TLGS) in 1999–2001; MetS was assessed based on five definitions for adolescents. In 2005–2007, 572 age 18 years and over were assessed for MetS by NCEP ATP III adults’ criteria. Sensitivity, specificity, and area under receiver operating curve for attaining adulthood MetS, obesity and overweight were calculated for each MetS definitions. Results: The prevalence of adolescence MetS varied from 0.7±0.2 to 15.1±0.8% by different definitions in adolescents and 4.0±0.9% among adults. The highest area under curve for prediction of adulthood MetS pertained to the de Ferranti''s definition (0.723), and for prediction of adulthood obesity and overweight were 0.723 and 0.606, respectively, for this definition. Kappa for agreement between these definitions was fair (0.195). Conclusions: Definition of MetS for adolescents showed a fair agreement with adult definition. Yet, a diagnosis of MetS in adolescents seems to be a good predictor of developing adulthood MetS within a short time. [Copyright &y& Elsevier]

Background/Aim: The high prevalence of non-communicable diseases and their risk factors among the general urban population of Tehran necessitates an urgent implementation of nutritional interventional programs to curtail these risk factors. This study aimed to provide preliminary data on the knowledge, attitude and practices of urban Tehranian adults regarding nutrition and their relation to major non-communicable disease risk factors and to assess the need for educational interventions. Methods: This cross-sectional study was performed within the framework of the second phase of the Tehran Lipid and Glucose Study (TLGS). Subjects were 826 individuals, 369 men and 457 women, aged 20–70 years old, selected randomly from among 15,005 participants in the TLGS. Knowledge, attitude and practices of subjects were assessed by a ‘knowledge, attitude and practice’ questionnaire; height, weight, waist and hip circumferences were measured, and BMI and waist to hip ratio were calculated. Biochemical data including fasting blood glucose, cholesterol, triglycerides and HDL-cholesterol were measured, based on standard protocols, and LDL-cholesterol was calculated. Associations between nutritional knowledge, attitude, practice, sex, age and educational level, and between knowledge, attitude and practice and BMI, waist to hip ratio and levels of lipid and lipoproteins, were determined. Results: For knowledge 26.5, 52.7 and 20.8%, for attitude, 27.6, 48.9 and 23.5% and for practice, 27.4, 51.7 and 20.9% of individuals had desirable, moderate and weak knowledge scores, respectively. With increases in educational levels, knowledge scores increased (p < 0.001). Attitudes of illiterate and poorly literate groups were weaker than those of other groups (p < 0.001). However, illiterate and poorly literate groups had higher practice scores as compared to middle school and high school graduates (p < 0.001). Mean practice scores of university graduates were higher than high school graduates (p < 0.05). Those aged 30–50 years had higher knowledge scores than older individuals (p < 0.001). LDL- and total cholesterol were correlated to practice scores (p < 0.001, r = 0.23). Subjects with borderline triglyceride levels had better practice scores than normal individuals (p < 0.001). Conclusions: The findings revealed that age, educational level and gender are factors that can influence knowledge, attitude and practices, regarding nutrition. It is vital to develop approaches and implement programs to improve the nutritional practices of the population. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aims: Familial aggregation of the metabolic syndrome has been reported in some nations. The aim of this study was to evaluate familial aggregation of the metabolic syndrome in Tehranian families. Methods: In a cross-sectional study, anthropometry, blood pressure and biochemical data were collected for 4,558 individuals in the Tehran Lipid and Glucose Study. Variables of the metabolic syndrome in offspring were correlated with those of their parents. Results: There were 1,274 fathers, 1,576 mothers, 802 sons and 906 daughters. Prevalence of metabolic syndrome was 24.4% for fathers, 39.7% for mothers, 9.0% for sons and 7.6% for daughters. Triglycerides and HDL-C of children whose fathers had metabolic syndrome, and BMI, triglycerides and HDL-C of those whose mothers had it were significantly different from those adolescents whose parents were free of metabolic syndrome. Compared with children whose parents did not have metabolic syndrome, the odds ratio (confidence interval) for children with both parents having metabolic syndrome was 4.53 (2.42–8.8) for metabolic syndrome, 2.22 (1.17–4.19) for abdominal obesity, 1.90 (1.15–3.13) for high blood pressure, 2.66 (1.77–4.00) for low HDL-C and 3.16 (2.10–4.75) for high triglyceride levels. Conclusion: This survey provides evidence suggesting that there is a familial aggregation of the metabolic syndrome among Iranian families. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study investigated the combined effect of saturated fat and cholesterol intake on serum lipids among Tehranian adults. Methods: In 443 subjects ≥18 y, dietary intake was assessed. Height and weight were measured and body mass index was calculated. Serum cholesterol, triacylglycerol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol levels were calculated. Cholesterol intakes ≥300 mg/d and saturated fat intakes ≥7% of total energy were defined as high intakes. Individuals were categorized into four groups based on cholesterol and saturated fat intakes. Results: Subjects'' mean age was 40.1 ± 14.6 y; those in whom cholesterol and saturated fat intake was normal had significantly less energy and fat intake than those with high cholesterol and saturated fat intakes (P < 0.01). Saturated fat intake had a significant effect on serum total and HDL-C levels. Subjects with a normal saturated fat intake had significantly less serum total and HDL-C than those who had high saturated fat intake (P < 0.01 and P < 0.05, respectively). Adjusting for age, sex, and body mass index, the main effect of cholesterol intake on HDL-C was significant (P = 0.05). Mean serum HDL-C was lower in subjects who had normal cholesterol intake than in those with high cholesterol intake. Conclusion: These results show that cholesterol and saturated fat intakes have no combined effect on serum low-density lipoprotein cholesterol level, whereas cholesterol intake per se affects serum HDL-C level. [Copyright &y& Elsevier]

Background: Considering the increasing trend of obesity reported in current data, this study was conducted to examine trends of obesity and abdominal obesity among Tehranian adults during a median follow-up of 6.6 years. Methods: Height and weight of 4402 adults, aged 20 years and over, participants of the Tehran Lipid and Glucose Study (TLGS), were measured in 1999-2001(phase I) and again in 2002- 2005(phase II) and 2006-2008 (phase III). Criteria used for obesity and abdominal obesity defined body mass index (BMI) ≥ 30 and waist circumference ≥ 94/80 cm for men/women respectively. Subjects were divided into10-year groups and the prevalence of obesity was compared across sex and age groups. Results: The prevalence of obesity was 15.8, 18.6 and 21% in men and 31.5, 37.7 and 38.6% in women in phases I, II and III respectively (p < 0.001). The prevalence of abdominal obesity in men was 36.5, 57.2 and 63.3% and in women was 76.7, 83.8 and 83.6% in the three periods mentioned (p < 0.001). Men aged between 20-29 years had highest increase rates of obesity and abdominal obesity in phase III in comparison with phase I (with a respective rates of 2.2- and 3.3-fold). In both sexes, an increased trend was observed between phases I and II, whereas between phases II and III, this trend was observed in men, but not in women. Conclusion: This study demonstrates alarming rises in the prevalences of both obesity and abdominal obesity in both sexes especially in young men, calling for urgent action to educate people in lifestyle modifications. [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]

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]

Objective To measure breast milk iodine (MI) and urinary iodine (UI) concentrations in healthy newborns and their nursing mothers from an iodine-sufficient region to determine adequacy and to relate these parameters to thyroid function tests in mothers and infants. Design Cross-sectional. Patients Forty-eight healthy neonates of 37 to 42 weeks’ gestation with normal cord blood TSH values and their mothers were recruited in Tehran, Iran. Measurements Serum thyroid function tests were performed, and maternal and infant urinary iodine excretion, and maternal MI concentration were measured. Results Neonatal age was 12·9 ± 3·9 (mean ± SD; range 7–30) days and maternal age was 25·8 ± 5 years. Median (range) UI in neonates was 271 µg/l (57–800) and in mothers was 107 µg/l (20–710). Median (range) MI was 148 µg/l (45–750). Neonatal and maternal UI did not correlate with serum thyroid function tests. UI < 150, 150–230, and > 230 µg/l was found in 20, 12·5, and 67·5% of neonates and 79·1, 14, and 7% of mothers, respectively. MI was < 150, 150–180, and > 180 µg/l in 52·4, 11·9, and 35·7% of mothers, respectively. Conclusions Among euthyroid neonates, UI was adequate despite low median maternal UI and MI concentrations. There were no significant correlations between UI or MI and thyroid function tests in the mothers and infants. [ABSTRACT FROM AUTHOR]

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 ≥126 mg dl−1 or 2-h post challenge glucose concentration ≥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]

Abstract: Objective : To evaluate the relationship between hip circumference and metabolic risk factors in an urban adult population of Tehranian men. Methods : In this population-based cross-sectional study, a representative sample of 4040 men aged 18–74 years was assessed in 1998. Demographic data were collected; anthropometric indices and blood pressure were measured according to standard protocol. Hypertension was defined based on Joint National Committee VI. Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as fasting plasma glucose ≥126 mg/dl or 2 h plasma glucose ≥200 mg/dl. Lipid disorders and components of metabolic syndrome were considered based on Adult Treatment Panel III. Results : Higher hip circumference was associated with lower levels of serum total cholesterol, serum triglyceride, fasting plasma glucose, and 2-h plasma glucose. Subjects in the top quintile of hip circumference had higher values of serum HDL-cholesterol concentration compared to those in the lower category. After adjustment for potential confounding variables, a significant decreasing trend was observed among hip circumference quintile categories for odds of having hypercholestrolemia (odds ratios among quintiles: 1.00, 0.83, 0.76, 0.66, 0.51, respectively, P for trend = 0.03), diabetes (1.00, 0.74, 0.55, 0.29, 0.20, P for trend = 0.01), and abnormal glucose homeostasis (1.00, 0.82, 0.68, 0.46, 0.36, P for trend = 0.01). Individuals in the upper category of hip circumference had lower odds of having low serum HDL-cholesterol (0.91 vs. 1.00) and high serum triglyceride levels (0.73 vs. 1.00) compared to those in the lowest category. Conclusion : Hip circumference is independently and negatively associated with metabolic risk factors. [Copyright &y& Elsevier]

Abstract: Background: It has been suggested that health professionals may discard measurement of hip circumference from public health screening efforts. Before discarding the hip circumference in epidemiological surveys, it is important to consider whether any important information is likely to be lost. Objective: To evaluate the relationship between hip circumference and metabolic risk factors in an urban adult population of Tehranian women. Design: In this population-based cross-sectional study, a representative sample of 5720 women aged 18–74 years, were included. Demographic data was collected; anthropometric indices and blood pressure were measured according to standard protocol. Hypertension was defined based on Joint National Committee VI (JNC VI). Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as fasting plasma glucose (FPG) ≥126 mg/dl or 2-h plasma glucose (2hPG) ≥200 mg/dl. Lipid disorders and components of metabolic syndrome were considered based on Adult Treatment Panel III (ATP III). Results: Mean age of women was 39.9±14.6 years. Mean body mass index, waist-to-hip ratio, waist and hip circumferences for subjects were 27.1±5.1 kg/m2, 0.83±0.08, 86.5±13.1 cm and 103.5±9.8 cm, respectively. Higher hip circumference was associated with lower levels of serum total- and LDL-cholesterol, serum triglyceride, fasting plasma glucose, 2-h plasma glucose, systolic and diastolic blood pressure. Subjects in the top quintile of hip circumference had higher values of serum HDL-cholesterol concentration compared to those in the lower category. After adjustment for potential confounding variables and anthropometric measures associated with higher hip circumference, a significant decreasing trend was observed for odds of having high LDL-cholesterol (odds ratios among quintiles: 1.00, 0.98, 0.97, 0.95, 0.84, respectively, P for trend=0.04), diabetes (1.00, 0.68, 0.58, 0.45, 0.42, P for trend=0.01), hypertension (1.00, 0.96, 0.82, 0.78, 0.70, P for trend 0.02), low serum HDL-cholesterol (1.00, 1.03, 0.86, 0.82, 0.56, P for trend=0.04), elevated blood pressure (1.00, 0.99, 0.82, 0.70, 0.61, P for trend=0.01) and abnormal glucose homeostasis (1.00, 0.69, 0.66, 0.54, 0.48, P for trend=0.01) among hip circumference quintile categories. Individuals in the upper category of hip circumference had lower odds of having hypercholestrolemia (0.86 vs. 1.00) and high serum triglyceride levels (0.74 vs. 1.00) compared to those in the lowest category. Conclusion: Hip circumference is independently and inversely associated with metabolic risk factors. This study underscores the importance of continuing to measure hip circumference in epidemiologic surveys in Tehranian adult women. [Copyright &y& Elsevier]

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 ≥126 mg dl−1 or 2-hour plasma glucose ≥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]

The healthy eating index (HEI) was developed to track the quality of diets in different societies. The aim of this study was to determine the HEI score of Tehranian adults. This study, conducted within the framework of Tehran Lipid and Glucose Study (TLGS), was a part of a dietary intake assessment carried out in 819 cases aged 19 and over. Dietary intake was assessed with two 24-hour recalls. HEI was calculated based on 9 components. The HEJ score was categorized into three groups: less than 45 (poor diet), between 45-72 (needs improvement) and more than 72 (good diet). The mean score of HEI was 65.8 ± 9.6 in men and 65.9 ± 8.6 in women. The results showed that the number of servings of food groups in those with good diet was significantly higher than the two other groups (P<0.05). The percentage of observations failing to meet the estimated average requirements (EAR) in the poor diet group (HEJ<45) was higher than the other diet groups for most of the nutrients. Diets were categorized into: needs improvement (74%); good (23%); and poor (3%). Since the majority of the sample needed to improve their diet, this suggests that nutrition intervention may be needed. [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]

The purpose of this study was to determine dietary diversity and its relation to dietary adequacy in 10-18 year-old adolescents of district 13 of Tehran during the period 1999-2001. After excluding for over and under reporters, dietary intake assessment was conducted on 304, 10-18 year old individuals, participants of Tehran Lipid and Glucose Study. A dietary diversity score was calculated as part of the pyramid serving database that is categorized into 23 broad food groups. Each of the 5 broad food categories received a maximum diversity score of 2 of the 10 possible score points. To be counted as a "consumer" for any of the food groups categories, a respondent needed to consume one-half serving, as defined by Food Guide Pyramid quantity criteria, at any time during a 2-day survey period. The nutrient adequacy ratio for a given nutrient is the ratio of a subject's intake to the current recommended allowance for the subject's sex and age category. Weight and height were measured and BMI was calculated. Student's t-test was used to compare the means. Those variables which had normal distribution were tested by Pearson correlation coefficient and the others were tested by the Spearman correlation coefficient. Mean ± SD of dietary diversity score (DDS) was 6.25 ± 1.08 (range 0-10). The maximum and minimum scores of dietary diversity were related to the fruit (1.46 ± 0.61) and bread-grain (0.95 ± 0.27) groups, respectively. Significant positive correlation was observed between DDS and the mean adequacy ratio (MAR) (r = 0.42, P <0.001). Fifty percent of people had DDS ≥ 6. In people with a DDS of six or over, BMI was higher (19.81 ± 4.08 vs 18.95 ± 3.30 Kg/m², p <0.01) than others. There was a significant and positive correlation between DDS and most of the nutrient adequacy ratios (NARs). It is concluded that DDS is an appropriate method to evaluate nutrient intake adequacy in this group of adolescents. [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 μg dl-1 (P<0.001); T4, 6.5±2.0 vs. 8.4±1.6 μg 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 μU 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]

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]

Background: The prevalence of obesity and its two important phenotypes, the metabolically healthy obese (MHO) and the metabolically unhealthy obese (MUO) are 10.9, 9.1, and 1.8%, respectively, among children and adolescents in Iran. Data on the link between diet quality indices and obesity phenotypes in children and adolescents is scarce. The present study aimed to assess the association of the Dietary Approaches to Stop Hypertension (DASH) score with MHO and MUO, as well as with cardiometabolic risk factors (RFs) in children and adolescents with excess weight.Methods: This cross-sectional study was conducted on 341 children and adolescents with excess weight aged 6-13 years, selected from primary schools of Tehran. The DASH score was determined based on eight components using a valid and reliable food frequency questionnaire. Anthropometric measures, insulin, fasting plasma glucose, lipid profile, and physical activity levels were collected. MUO was classified based on two definitions: having 2 or more cardiometabolic RFs, or being insulin resistant determined by a homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 3.16. Multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for MUO phenotypes and cardiometabolic RFs in each tertile of the DASH score after adjustment for confounders.Results: The mean ± SD for age and DASH score was 9.3 ± 1.7 years and 24.0 ± 4.9, respectively. The prevalence of MUO was 62.2% based on RFs, and 43.4% based on HOMA-IR. Participants in the highest tertile of the DASH score had significantly decreased odds for MUO based on HOMA-IR (OR = 0.49; 95% CI: 0.28-0.87) compared with those in the lowest tertile, after adjustment for confounders. However, there were no associations between the DASH score and any of cardiometabolic RFs, or MUO based on RFs (OR = 0.68; 95% CI: 0.38-1.20).Conclusion: The DASH score was inversely associated with MUO based on HOMA-IR, but not associated with MUO based on cardiometabolic RFs in this sample of children and adolescents. A DASH-style diet may have favourable effects on insulin sensitivity among children and adolescents with excess weight. Universal definitions for MHO/MUO are required, and longitudinal studies recommended to shed light upon this subject. [ABSTRACT FROM AUTHOR]

This study aims to assess the effects of a community-based lifestyle intervention program on the incidence of type 2 diabetes (T2D). For this purpose, three communities in Tehran were chosen; one community received a face-to-face educational session embedded in a long-term community-wide lifestyle intervention aimed at supporting lifestyle changes. We followed up 9,204 participants (control: 5,739, intervention: 3,465) triennially from 1999 to 2015 (Waves 1–5). After a median follow-up of 3.5 years (wave 2), the risk of T2D was 30% lower in the intervention community as compared with two control communities by (Hazard-ratio: 0.70 [95% CI 0.53; 0.91]); however, the difference was not statistically significant in the following waves. After a median follow-up of 11.9 years (wave 5), there was a non-significant 6% reduction in the incidence of T2D in the intervention group as compared to the control group (Hazard-ratio: 0.94 [0.81, 1.08]). Moreover, after 11.9 years of follow-up, the intervention significantly improved the diet quality measured by the Dietary Approaches to Stop Hypertension concordance (DASH) score. Mean difference in DASH score in the intervention group versus control group was 0.2 [95% CI 0.1; 0.3]. In conclusion, the intervention prevented T2D by 30% in the short-term (3.5 years) but not long-term; however, effects on improvement of the diet maintained in the long-term. Registration: This study is registered at IRCT, a WHO primary registry (https://irct.ir). The registration date 39 is 2008-10-29 and the IRCT registration number is IRCT138705301058N1. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between dietary patterns and obesity indices (BM1, 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]