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

Background and Objective: Hypertension in long time can cause cardiovascular disorders and increase chance of stroke. This study was done to determine the association between some dietary factors and risk of hypertension. Methods: This cross-sectional study was conducted on the fourth phase (2008-11) of Tehran lipid and glucose study (TLGS). In this study 6089 subjects (2807 males and 3282 females), aged 19-70 years, were participated and dietary, demographic, anthropometric and blood pressure of each subject were collected. Dietary intake was assessed using a validated and reliable food frequency questionnaire with 147-items. Odds ratio for hypertension according to quartiles of dietary factors was determined using logistic regression with adjustment for confounder variables. Results: The rate of hypertension was 29.8%. Mean of weight, body mass index, waist circumference, prevalence of abdominal obesity and alliteration in the hypertensive subjects were significantly higher than normotensive subjects (P

Background and Objective: Insulin resistance (IR) is one of the factors affecting dyslipidemia in type 2 diabetes which increases the risk of cardiovascular diseases. This study was done to determine the association of homeostasis model assessment of insulin resistance with lipid profiles in type 2 diabetes. Methods: This descriptive study was conducted on 72 patients with type 2 diabetes in Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran during 2011. Anthropometric indces, fasting serum glucose, serum insulin and lipid profiles were measured and IR index and atherogenic lipid parameters were calculated. The mean of lipid profiles and parameters were compared across the IR tertiles. The association of homeostasis model assessment and insulin resistance in each tertile with lipid profiles was determined. Results: The mean±SD of IR index was 0.9±0.3, 2.1±0.4 and 4.4±1.6 in the 1th, 2th and 3th tertiles, respectively. In the 3th tertile, serum triglyceride and atherogenic lipid parameters were significantly high and serum HDL-C level was non-significantly low than normal reference range. IR index in the 2th and 3th tertiles was significantly related to serum Triglyceride (P2.8, was inversely associated with HDL-C and directly associated with atherogenic lipid parameter. Conclusion: There is association between Insulin resistance with lipid metabolic abnormality in type 2 diabetic patients.

Background and Objective: Limited studies on the relation between the cardiovascular diseases (CVDs) risk factors and dietary glycemic index (GI) and glycemic load (GL) are available. This study was done to determine the association between glycemic index, glycemic load and cardiovascular risk factors in adults. Materials and Methods: This descriptive study was carried out on 2284 subjects (1327 males, 957 females) with 19-84 age in Tehran, Iran during 2005-08. Dietary GI and GL were assessed using a validated semi quantitative food-frequency questionnaire. Blood pressure, Anthropometric, fasting blood of glucose and lipid profiles including total cholesterol, triglyceride, high density lipoprotein (HDL) and low density lipoprotein (LDL) as a CVDs risk factors were measured. The mean intake of nutrient, adjusted for energy production, gender, age, according to GI and GL, using general linear model analysis covariance test was measured. Data were analyzed using SPSS-15, one-way analysis variance, Chi-Square, partial correlation and Linear regression. Results: The mean intakes of glycemic index and glycemic load were 68.3 and 244.8, respectively. Dietary GI and GL was inversely associated with whole grain and positively associated with refined grained, fruits, dairy products and simple sugar. After adjustment for lifestyle and dietary variables, dietary GI was inversely associated with triglyceride and HDL cholesterol concentrations among obese subjects. Dietary GL was inversely associated with fasting and 2-h blood glucose among non-obese subjects after adjustment for confounders. Conclusion: GI in obese men associated with serum increase triglyceride and reduced HDL-C. Glycemic load in a non-obese man is correlated with reducing fasting blood glucose.

Background and Objective: Malnutrition in hospital increases the mortality of patients. The aim of this study was to investigate the prevalence of malnutrition and related risk factors in hospitalized patients. Materials and Methods: This descriptive study was carried out on 446 patients (217 males, 229 females) during 6 months, admitted to the Taleghani hospital in Tehran, Iran during 2005. Anthropometric measurements and previous admission to hospital in previous 6 months for each patient was recorded. Mild, moderate and severe malnutrition were considered as BMI=18-20 kg/m2 and TSF, or MAMC10% in previous 6 months respectively. Results: The prevalence rate of malnutrition as a general was 52% with following subdivision: 14%, 10% and 28% in mild, moderate and severe, respectively. The highest prevalence of malnutrition observed in gastrointestinal ward, males, those aged 18-29 year and patients with secondary and high school education. In malnourished patients, the prevalence of TSF, MAC and MAMC

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

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

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

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

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

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

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

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

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

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

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

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