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

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

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: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]

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

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

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

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