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Background: The food frequency questionnaire (FFQ), as a way to assess the dietary intake in comparison with other methods, is easier to analyze and takes less time and is less costly. Our aim in this study was to develop and validate an FFQ for estimating the intakes of selected antioxidants in elderly Iranian people. Materials and Methods: A total of 185 elderly people were randomly selected. Three-day food records were completed by the subjects and collected every 2 months and dietary intake levels of zinc, selenium, carotenes and vitamins C and E were estimated. Based on the food records data, geographic location, and age, an FFQ was designed to estimate antioxidant intakes during 1 year. In addition, for controlling energy intake, 2-day food records were also collected with the food frequency questionnaire. To assess the reliability, 40 individuals were asked to complete the FFQ twice with an interval of 3 months in between. Results: Intraclass correlation coefficient (ICC) between the two FFQs for antioxidant C, antioxidant E, carotene, selenium, and zinc were 0.62, 0.47, 0.51, 0.54, and 0.58, respectively (P < 0.05). In addition, Pearson correlation coefficients between the FFQ and the food records, after controlling energy for vitamin C, vitamin E, carotene, selenium, and zinc, were 0.46, 0.48, 0.38, 0.55, and 0.47 respectively (P < 0.001). Conclusion: According to the results of this study, considering the fact that the FFQ was designed for the elderly and the special conditions (patience, memory, etc.) and vulnerability of this age group, the questionnaire is relatively valid and reliable to use. [ABSTRACT FROM AUTHOR]

Effectiveness of school-based interventions to prevent or control overweight and obesity among school children was reviewed for a 11-year period (January 2001 to December 2011). All English systematic reviews, meta-analyses, reviews of reviews, policy briefs and reports targeting children and adolescents which included interventional studies with a control group and aimed to prevent or control overweight and/or obesity in a school setting were searched. Four systematic reviews and four meta-analyses met the eligibility criteria and were included in the review. Results of the review indicated that implementation of multi-component interventions did not necessarily improve the anthropometric outcomes. Although intervention duration is a crucial determinant of effectiveness, studies to assess the length of time required are lacking. Due to existing differences between girls and boys in responding to the elements of the programs in tailoring of school-based interventions, the differences should be taken into consideration. While nontargeted interventions may have an impact on a large population, intervention specifically aiming at children will be more effective for at-risk ones. Intervention programs for children were required to report any unwanted psychological or physical adverse effects originating from the intervention. Body mass index was the most popular indicator used for evaluating the childhood obesity prevention or treatment trials; nonetheless, relying on it as the only indicator for adiposity outcomes could be misleading. Few studies mentioned the psychological theories of behavior change they applied. Recommendations for further studies on school-based interventions to prevent or control overweight/obesity are made at the end of this review. [ABSTRACT FROM AUTHOR]

Background: Little information about the effects of conjugated linoleic acids (CLAs) on inflammation and immune function in humans is available. This study investigated the effects of CLAs, with and without Vitamin E on immunity and inflammatory parameters in adults with active rheumatoid arthritis (RA). Methods: In a double-blind clinical trial, 78 patients were randomly divided into four groups, each group receiving one of the following daily supplement for 3 months; group C: 2.5 g CLAs, group E: 400 mg Vitamin E, group CE: CLAs plus Vitamin E, group P: Placebo. Cytokines, matrix metalloproteinase 3 (MMP-3) and citrullinated antibody (CCP-A) were measured by ELISA method and Vitamin E by high-performance liquid chromatography. Results: Consider statistical methods there were no significant differences between groups in cytokines interleukin-2 (IL-2), IL-4, tumor necrosis factor-α(TNF-α), IL-1γ, IL-2/IL-4, CCP-A white blood cells and neutrophils, lymphocyte, monocytes, and eosinophils numbers. TNF-αdecreased in all groups, but its reduction was significant in group CE. IL-1βincreased in groups P (P = 0.004) and E (P = 0.041) but the difference between group P and CE was significant. IL-4 decreased in groups C, CE and E (P = 0.03, P = 0.03, P = 0.07 respectively). IL2 did not change significantly within groups. CCP-A increased in groups P (P = 0.035) and E (P = 0.05), while it decreased in groups CE (P = 0.034). CCP-A and MMP-3 decrease were significant between groups P and CE. MMP-3 reduction was significant in group CE. Conclusions: Co-supplementation CLAs and Vitamin E may be effective in the level of inflammatory markers in RA patients. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is a world-wide health problem and development of interventions to prevent or control it is a priority. Obesity is prevalent and on the increase among school-students in Iran, too. As the first step for development of an intervention, the current study was designed to complete our understanding of ideas, attitudes, beliefs, and preferences of primary school children in Tehran, Iran. Methods: Twenty-seven primary school-students (11 boys, 16 girls) in grade-five, most of whom were overweight or obese, participated in four focus-group discussions (FGDs). All FGD notes were analyzed to find the main themes. Results: Nine themes in three main categories emerged after analysis. The themes in the category of barriers of losing weight included environmental, psychological and physiological barriers. Category of intervention components included nutrition improvement, physical activity promotion, social support and education. Setting and deliverer of the intervention were included in the intervention conditions category. The children proposed a multi-component approach for development of an intervention. They mentioned nutrition and physical activity improvement, social support and education as the main elements of an effective intervention. Conclusions: The findings indicate that obese children need to be supported against different barriers of losing weight, mainly social barriers, especially humiliation by the community. [ABSTRACT FROM AUTHOR]

Background: Brewer's yeast may have beneficial effects on insulin receptors because of itsglucose tolerance factor in diabetic patients. This study was conducted to investigate the effects of brewer's yeast supplementation on glycemic indices in patients with type 2 diabetes mellitus. Methods: In a randomized double blind controlled clinical trial, 84 adults (21 men and 63 women) aged 46.3 ± 6.1 years old with type 2 diabetes mellitus were recruited and divided randomly into two groups: Supplement group receiving brewer's yeast (six 300mg tablets/day, total 1800 mg) and control group receiving placebo (six 300mg tablets/day) for 12 weeks. Body weight, height, body mass index, food consumption (based on 24h food record), fasting blood sugar (FBS), glycosylated hemoglobin, insulin sensitivity, and insulin resistance were measured before and after the intervention. Data analysis was performed using the Statistical Package for Social Sciences (version 18.0). Results: The changes in FBS, glycosylated hemoglobin, and insulin sensitivity were significantly different between the two groups during the study (respectively P < 0.001, P < 0.001, P = 0.02 independent sample t test). There was a significant difference in FBS, glycosylated hemoglobin, and insulin sensitivity at the end of the study between the two groups after removing the effects of baseline values (respectively P = 0.002, P < 0.001, P = 0.02, analysis of covariance). Changes in body mass index, 24h food record, insulin resistance were not significant. Conclusions: Dietary supplementation with brewe>s yeast besides the usual treatment of diabetes can ameliorate blood glucose variables in type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

The article reports a study which compares the therapeutic effectiveness of vitamin D3 plus fluoxetine, with that of fluoxetine alone, in patients with major depressive disorder. The results revealed that after a 8-week trial, vitamin D + fluoxetine combination proved to be more effective and better than fluoxetine alone in controlling symptoms of depression in patients.

Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with difficulties in learning, behaviour and psychosocial adjustment that persist into adulthood. Decreased omega-3 fatty acids and increased inflammation or oxidative stress may contribute to neuro-developmental and psychiatric disorders such as ADHD. The aim of this study was to determine the effect of n- 3 supplementation on hyperactivity, oxidative stress and inflammatory mediators in children with ADHD. Methods: In this double blind study, 103 children (6-12 years) with ADHD receiving maintenance therapy were assigned randomly into two groups. The n-3 group received n-3 fatty acids (635 mg eicosapentaenoic acid (EPA), 195 mg docosahexaenoic acid (DHA)), and the placebo group received olive oil capsules which were visually similar to the n-3 capsules. The duration of supplementation was 8 weeks. Plasma C-reactive protein (CRP), interleukin- 6 (IL-6) and the activity of glutathione reductase (GR), catalase (CAT) and superoxide dismutase (SOD) were determined before and after the intervention. Likewise the Conners' Abbreviated Questionnaires (ASQ-P) was applied. Results: After 8-week intervention, a significant reduction was observed in the levels of CRP ( P<0.05, 95% CI = 0.72-2.02) and IL-6 (P<0.001, 95% CI = 1.93-24.33) in the n-3 group. There was also a significant increase in activity of SOD and GR (P<0.001). A significant improvement was seen in the ASQ-P scores in the n-3 group (P<005). Conclusion: Eight weeks of EPA and DHA supplementation decreased plasma inflammatory mediators and oxidative stress in the children with ADHD. These results suggest that n-3 fatty acid supplementation may offer a safe and efficacious treatment for children with ADHD. [ABSTRACT FROM AUTHOR]

BACKGROUND: Diabetes mellitus is a heterogeneous metabolic disorder characterized by hyperglycemia. Studies showed paraoxonase activity, and vitamin C and A levels are decreased in diabetes. The effect of omega-3 fatty acids on serum paraoxonase activity and vitamins A, E, C in patients with type 2 diabetes is not fully understood. This study aimed to determine the effect of omega-3 fatty acids on paraoxonase activity, vitamins C, A and E levels in type 2 diabetic patients. METHODS: In a double-blind, placebo controlled trial, 80 type 2 diabetic patients were randomly enrolled into the study. Study subjects received daily 2714 mg of omega-3 fatty acids or placebo for 8 weeks. Ten milliliter fasting blood was collected before and after treatments. Serum paraoxonase activity and vitamin C levels were measured by spectrophotometry. Vitamin A and vitamin E were measured using high performance liquid chromatography. Nutrient intake was estimated using 24-hours dietary recall questionnaire (for 2 days) before and after treatments. Dietary data were analyzed using FPII. To compare the means of variables between the two groups, independent t-test was employed. Differences between variables before and after interventions were calculated using paired t-test. RESULTS: Serum levels of paraoxonase activity were significantly increased after omega-3 intake (126.47 IU/ml vs. 180.13 IU/ml). However, omega-3 intake caused no significant change in serum vitamin A, C, and E. [ABSTRACT FROM AUTHOR]

BACKGROUND: School feeding programs are important interventions for improving the nutritional status of students. Therefore, this study was conducted to evaluate the effects of milk supplementation on physical, mental and school performance of students. METHODS: This case-control population-based intervention was conducted on 469 students from 4 schools in a medium socio-economic status region in Tehran. The schools were chosen by Iranian ministry of education and training and they were allocated in case and control groups randomly. All the students in the first to third classes in the intervention schools were daily consumed sterilized and homogenized milk for three months (250 ml each). Anthropometric measurements were done according to the standard methods. For evaluating the mental function, the Raven's Coloured Progressive Matrices (CPM) and Wechsler Intelligence Scale for children (verbal, non-verbal, total Intelligent Quotient) were conducted on students. School performance was assessed by grade-point averages of each student. RESULTS: The weight of children was significantly different between control and intervention group at the end of the study among girls (23.0 ± 3.8 vs. 23.8 ± 4.3 kg; p < 0.05). Psychological tests' scores were significantly different between the control and the intervention groups (p < 0.05) at the end of the trial among boys. The grade-point average was significantly different at the end of the trial between the intervention and the control group among girls (p < 0.05). CONCLUSIONS: School feeding programs focus on milk supplementation had beneficial effects on the physical function and school performances specifically among girls in Iran. [ABSTRACT FROM AUTHOR]

Background: Some studies have indicated impaired metabolism of Insulin-like growth factor-1 (IGF-1) and zinc in type-1 diabetic patients. However, no results have been reported to date on the relationship between IGF-1 and serum zinc levels in children and adolescents with type-1 diabetes mellitus. Therefore, the objectives of this cross-sectional study were to compare IGF-1 levels in type-1 diabetic children and adolescents with that of healthy controls, and also to determine whether there is a relationship between IGF-1 and serum zinc levels. Methods: Thirty children and adolescents with type-1 diabetes mellitus and 30 age- and sex-matched healthy controls participated in the study. Serum IGF-1, serum zinc, fasting blood sugar, hemoglobin A1C (HbA1C) were measured by enzyme-linked immunosorbent assay, flame atomic absorption spectrophotometry, enzymatic colorimetry and ion-exchange chromatography methods, respectively. Results: The mean level of serum IGF-1 (ng/l) in the diabetics was significantly lower than in the controls (208.2 ± 15.7 and 317.0 ± 33.2, respectively; p=0.001). No relationship was found between the IGF-1 levels and serum zinc or the amount of glycemic control. Conclusion: IGF-1 levels of the diabetic children and adolescents were significantly lower compared to those of healthy controls and were independent of serum zinc levels and the amount of glycemic control. [ABSTRACT FROM AUTHOR]

Background The correlation between body iron stores and inflammation with insulin resistance in type 2 diabetes is not thoroughly investigated, especially in the Persian population. Methods A cross-sectional study was designed in Tehran, Iran. Fifty-four people with type 2 diabetes and 53 matched healthy participants were included. Serum ferritin, total iron binding capacity, insulin resistance, C-reactive protein and tumor necrosis factor-α were measured in both groups. Results Diabetic patients had higher insulin resistance, hemoglobin A1C and serum ferritin. Significant positive correlations were observed between insulin resistance with serum ferritin and tumor necrosis factor-α and between serum ferritin and tumor necrosis factor-α in diabetic patients. Conclusions Inter-relationship between insulin resistance, serum ferritin and TNF-α was found in type 2 diabetic patients. Serum iron even in the normal range had positive correlation with insulin resistance. It may be because the normal ranges determined for serum ferritin are too wide and the criteria for iron overload are too high. [ABSTRACT FROM AUTHOR]

Strenuous aerobic exercise is associated with oxidative stress and tissue damage. Therefore, we have investigated the effects of exercise and eicosapentaenoic acid supplementation, with or without vitamin E, on the plasma levels of vitamin C, E and A, IL-6, and glutathione peroxidase activity in basketball players. Thirty four male basketball players, enrolled in the study. Subjects received 2g EPA and/or 400 IU vitamin E or placebo depending on their groups. For 6 weeks, eight subjects took a daily EPA supplement together with vitamin E (group 1), nine received an EPA supplement together with placebo (group 2), nine were administered placebo along with vitamin E (group 3), and finally, eight subjects received placebo alone (group 4). As compared with group 4 (placebo), there were significant increases in vitamins C, E, and A in groups 1 and 3, but significant decreases in these parameters in group2 (P < 0.01). In addition, there were significant decreases in IL-6 in groups 1 and 3 (P < 0.01), whereas there were significant increases in glutathione peroxidase in groups1 and 3 (P < 0.01).There were significant differences in vitamin C between groups 3 and 4 (P < 0.05), and in vitamin E between groups 1 and 2, and groups 2 and 3 (P < 0.01), and in vitamin A between groups 1 and 2 (P < 0.05), and groups 1 and 4, 2 and 3, and 3 and 4 (P < 0.01), and in IL-6 between groups1 and 2 (P < 0.05), groups 1 and 3 (P < 0.01), 2 and 3 (P < 0.01), 2 and 4 (P < 0.01), and 3 and 4 (P < 0.05). [ABSTRACT FROM AUTHOR]

Backgrounds and Aim: Increased life expectancies and decreased fertility rates have led to ageing populations worldwide. This phenomenon is one of the most important public health challenges of the current century. Previous studies have shown that identifying factors affecting lifestyle and educational needs help in designing new strategies for health promotion. This study was conducted to investigate the preparedness of the elderly to adopt a healthy lifestyle and factors affecting it in the City of Tehran in 2007. Materials and Methods: This qualtative study included 60 elderly persons from Tehran elderly centers, using the focus group discussion method. Sampling was targeted and a qualitative methodology was used for analysis of the data collected. Results: The results shows that different elderly persons have different views with regard to what physical and mental health is and what factors cause healthiness. They believe that regular physical activity is very beneficial but that there are many difficulties in performing regular physical activity. Most of the subjects are in the prepation, action and maintenance stages as regards physical activity. On the other hand, nearly all the subjects are in the precontemplation stage with regard to fruit and vegetable consumption, despite the many obstacles in following a healthy diet. Conclution: The findings of this study show that many factors influence adoption of a healthy lifestyle by the elderly. Bearing these factors in mind, appropriate educational strategies aiming at facilitating adoption of a healthy lifestyle can be designed. [ABSTRACT FROM AUTHOR]

Iran is undergoing an epidemiological and nutritional transition. Over the last 2–3 decades, major changes in lifestyle and food consumption patterns have occurred, as well as in the socio-economic situation. Disease patterns have changed and some micronutrient deficiencies and chronic nutritional diseases, including obesity, are on the increase. Considering these, food habits, and the national food system, the Nutrition Department, Ministry of Health and Medical Education and the Iranian Nutrition Society jointly undertook to prepare food-based dietary guidelines (FBDGs). The process consisted of three phases: agreeing on food groups, designing pictorial FBDGs, and field testing them. Three working teams, supported by a large group of advisors consisting of nutritionists, epidemiologists, food/nutrition planners, and other relevant experts were formed. The first draft of the food groups consisted of 7 groups: Bread and Cereals; Meats and Eggs; Pulses; Fruits; Vegetables; Milk and Dairy Products; Miscellaneous (nuts, oils and fats, sugar and sweets, soft drinks). It was sent to 20 nutrition and public health experts for feedback. A suggestion was made to divide the Miscellaneous group into two – oils and fats, and Miscellaneous (sugars and sweets, pickled and salted food items). Three pictorial FBDGs were then designed: a plate, a pyramid, and a rectangle. Thus, three posters were prepared by the working teams and revised by a group of experts, followed by a preliminary evaluation. The final step will be field testing of the three revised, modified designs by the public and experts and their final evaluation. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: Investigation of the relationship between educational level, body mass index (BMI), waist-to-hip ratio (WHR), physical activity and parity in a group of Iranian men and women living in Tehran. Design: A cross-sectional study in a group of Iranian men and women. The subjects were classified into two educational levels: low education (≤12 y schooling) and high education (>12 y schooling); and BMI, WHR, physical activity and parity (in women) were compared in two groups in men and women, separately. Setting: Metabolic Unit of Tehran University of Medical Sciences in Tehran. Subjects: Three hundred and fifteen men aged 33.1 (22-46) and 403 women aged 27.9 (22-45). Results: After controlling for age and smoking, women with a higher level of education showed a significantly lower mean BMI than less educated women (24.8 ±4.2 vs 28.3 ±4.9, P<0.01), while more educated men had a higher mean BMI than less educated men (28.4 ±4.3 vs 26.7 ±4.5). In multiple regression analysis, physical activity in leisure time in men and years of education in women were the only determinants of BMI. After controlling for BMI, WHR was not related to the level of education in either men or women. Conclusion: The present data indicated an educational difference in BMI for the study population. In Iranian women, like the women in developed countries, the level of education was negatively related to BMI, while in men the association was positive. Sponsorship: This work was financially supported by the Institute of Public Health, Tehran University of Medical Sciences. [ABSTRACT FROM AUTHOR]

Abstract: Iranian indigenous front-line health worker, (FLHW) were locally trained to deliver environmental and primary health care services to mothers and children. After two years, there was a significant decline in crude birth and death rates and in infant and 1-5 year mortality rates in the test area as compared to a control area. One out of four encounters was referred to a health center physician, the remainder being handled by the FLHWs themselves. [ABSTRACT FROM AUTHOR]

Several letters to the editor are presented in response to articles in previous issues including "Frequency of Hospitalization Among Hospital Employees and Their Families," by S.B. Greene in the 1981 issue and "Evaluation of Rural Primary Health Care Services in Iran: Report on Vital Statistics in West Azarbaijan," by M.A. Barzegar in the July 1981 issue.