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BackgroundNon-alcoholic fatty liver disease (NAFLD) is a widespread liver condition associated with diabetes, metabolic syndrome, and cardiovascular diseases, yet public awareness remains low. Early detection of risk factors is crucial, but liver biopsy, the diagnostic gold standard, is invasive and costly. Non-invasive anthropometric indices provide a safer alternative. This study examines these indices to identify the most reliable predictor of NAFLD in adults.MethodsIn the present cross-sectional study, we used the Fasa Cohort Data, conducted on about 10,000 people, of whom 1,047 were diagnosed with NAFLD. NAFLD diagnosis in this study was confirmed by physicians based on medical history and ultrasonographic evaluations, ensuring accurate and reliable identification of cases. General, anthropometric, and dietary assessments were performed using interviews, tools, and valid questionnaires. Biochemical evaluation was also done. Waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), Body mass index (BMI), a body shape index (ABSI), body roundness index (BRI), and visceral fat index (VAI) were also calculated using these measurements and formulas. This study used descriptive tests, binary logistic regression, and ROC curve analysis.ResultsIn both crude and adjusted models, significant associations were found between WHR, WHtR, BMI, and VAI with NAFLD. ROC analysis revealed that WHtR and BMI were the most accurate predictors of NAFLD in both genders (WHtR: men AUC = 0.750, women AUC = 0.702; BMI: men AUC = 0.754, women AUC = 0.701). BRI showed significant accuracy, but WHR (men: AUC = 0.727, women: AUC = 0.640) and VAI (men: AUC = 0.621, women: AUC = 0.622) were less effective. ABSI demonstrated poor predictive power (men: AUC = 0.530, women: AUC = 0.505) and is not recommended for NAFLD prediction.ConclusionBased on the findings, BMI and WHtR emerge as the most practical and accessible indicators for early screening of NAFLD in both men and women, while ABSI shows minor effectiveness in identifying the disease.

BackgroundDiseases and disorders related to mental health are spreading like other chronic diseases all around the world. Considering the role of food in the prevention and treatment of these disorders, including major depression, investigating the relationship between different food patterns and this disorder is of particular importance. The aim of this study was to compare Dutch healthy eating and healthy eating indexes and anthropometry in patients with major depression with healthy individuals.MethodsIn this case-control study, the final analysis was performed on 67 men and 111 women with an age range of 20–30 years. Height (cm), weight (kg), food frequency questionnaire (FFQ), physical activity (MET-min/week), demographic and PHQ-9 questionnaires were taken from all participants. In the following, all the food ingredients and their components were extracted and used to calculate HEI-2015 and DHD. Statistical analysis was performed using SPSS software with independent t-test, logistic regression and chi-square.ResultsIt was found that people with major depression in this study were mostly women and occupied. The average HEI-2015 in healthy people and those with major depression was 58 and 54.3, respectively. Also, the average DHD in these people was 60.5 and 55, respectively. HEI-2015 and DHD had a significant negative correlation with depression score (r = −0.16, p-value = 0.03) (r = −0.19, p-value = 0.01). Also, in the logistic regression model, before and even after adjusting confounders, HEI-2015 and DHD had a reduced odds ratio in people suffering from major depression. The two groups did not differ significantly in terms of the average factors of height, weight and body mass index (BMI).ConclusionIt seems that HEI2015 and DHD have a significant relationship in reducing major depression. However, due to the small number of studies in this regard, especially in the field of DHD, the need for more studies seems necessary.

Background: Studying the dietary antioxidant quality (DAQ) score as a modifiable factor to lessen the negative effects of obesity on health is vital due to the rising global trend of obesity. Therefore, this study aimed to determine how adult obesity and meal-based DAQ scores correlate. Materials and Methods: A cross-sectional study including 850 men and women in Tehran was conducted. Three 24-hour dietary recalls were used to evaluate dietary consumption. Based on the design of DAQs, the meal-based DAQ score was evaluated. Higher scores indicate better DAQ. The overall DAQ score varied from 0 to 5. To investigate the relationship between DAQs and obesity in each meal, logistic regression analysis was utilized. Results: There was no correlation between a higher breakfast DAQ score and being overweight or obese (for overweight: OR = 0.69; 95% CI: 0.38–1.24/for obesity: OR = 0.65; CI 95%: 0.31–1.37). In the basic model, a higher lunch DAQ score was inversely related to probabilities of being overweight (OR: 0.62; 95% CI: 0.39–0.99) Such a connection remained significant after relevant confounders were considered (OR: 0.48; 95% CI: 0.27-0.84). In both the raw and fully adjusted models, there was no discernible correlation between the meal DAQ score and overweight or obesity. Conclusion: We discovered that a higher DAQ score for lunch was substantially associated with a lower risk of being overweight but not obese. To verify our findings, additional prospective research in various populations is required.

Background: Childhood obesity and overweight have become major public health problems worldwide. To combat this problem, effective, sustainable, and consistent strategies are needed. In this study, the long-term effect of a school-based intervention for weight reduction was evaluated in primary school students in Tehran, Iran. Methods: This was a cluster randomized controlled trial (RCT) conducted in 12 primary schools in a low- to middle-class district in Tehran, Iran. The participants were 334 overweight or obese primary school students (girls =164) based on World Health Organization standards, equally distributed in the intervention (n=167) and comparison (n=167) groups. It was a multi-component intervention and included nutrition education and increased physical activity (PA), a lifestyle modification program for parents, and changing the food items sold in canteens of the schools. Body mass index Z-score [BMI-Z] was determined as the primary outcome and measured at baseline, three months after baseline, at post-test (after 18 weeks), and follow-up (13-month). In total, 205 students (59.5%) completed the follow-up. Analyses were carried out based on the intention-to-treat principle using linear mixed models. Results: After 13 months, the BMI Z-score decreased in both intervention and comparison groups. However, the change was more significantly observed in the intervention group (adjusted change: 0.098, 95% CI: (0.03-0.16) compared with comparison group (P=0.003(. The intervention had a more significant effect on BMI Z-score among girls (adjusted change: 0.36, 95% CI: (0.27-0.45) compared with the comparison group (P

BackgroundThis tracked obesity inequality and identified its determinants among the population of Iran. In addition, it examined the impact of implemented policies on these inequalities.MethodsThis study was performed in two phases. First, we conducted a rapid review of the disparity in obesity prevalence in Iran. Then we investigated the main determinants of this inequality in a qualitative study. In addition, we examined Iran’s policies to deal with obesity from the perspective of equality. We conducted 30 Semi-structured interviews with various obesity stakeholders selected through a purposive snowball sampling method between November 25, 2019, and August 5, 2020. In the inductive approach, we used the content analysis method based on the Corbin and Status framework to analyze the data using MAXQDA-2020. The consolidating criteria for reporting a Qualitative Study (COREQ-32) were applied to conduct and report the study.ResultsInequalities in the prevalence of obesity in terms of place of residence, gender, education, and other socioeconomic characteristics were identified in Iran. Participants believed that obesity and inequality are linked through immediate and intermediate causes. Inequality in access to healthy foods, physical activity facilities, and health care are the immediate causes of this inequality. Intermediate factors include inequality against women, children, and refugees, and inequality in access to information, education, and financial resources. Policymakers should implement equity-oriented obesity control policies such as taxing unhealthy foods, subsidizing healthy foods, providing healthy and free meals in schools, especially in disadvantaged areas, and providing nutrient-rich foods to low-income families. Also, environmental re-engineering to increase opportunities for physical activity should be considered. Of course, for the fundamental reduction of these inequalities, the comprehensive approach of all statesmen is necessary.ConclusionObesity inequality is a health-threatening issue in Iran that can prevent achieving human development goals. Targeting the underlying causes of obesity, including inequalities, must be considered.

Background: Mental health disorders are one of the most important and increasing health problems in the youth of today’s societies. Some dietary intake and body mass status are factors that affect mental health. This study aimed to investigate the relationship between the intake of branched-chain amino acids (BCAAs) and aromatic amino acids (AAAs) and anthropometric and dietary inflammatory indices with mental health, including depression, anxiety, and stress. Methods: In this case-control study, the data of 138 teenage girls aged 13–18 years were collected. Three-day 24-hour food recall and standard anthropometric methods were used to calculate the dietary inflammation intake score of normal and energy-adjusted diets. Mental health disorders were diagnosed by the DASS-21 questionnaire. Statistical analysis used Student’s t-test, correlation, and multiple regression were used to analyze the data based on the study’s statistical requirements. Results: Based on the findings, 59 (42%) of the girls had mental disorders, and 79 (58%) were healthy. The average weight of stressed people was significantly higher than that of healthy people, and the BMI of anxious people was significantly higher than that of nonanxious people (P < 0.05). A significant positive correlation was found between stress and weight and energy intake. Additionally, there was a significant negative correlation between BCAAs and mental health. The average intake of BCAAs was significantly lower in patients (P = 0.01). The trend analysis showed significantly lower BCAA levels among the 4th quartile of mental disorders. No significant relationship was observed between DII, AAA, and anthropometric indices. After adjustment of the results, no relationship was observed between mental health and the studied factors. Conclusions: BCAA might be related to mental health. Further studies in different age and sex groups are highly recommended.

Abstract Background and objective Due to the growing global trend of obesity, it is necessary to study the diet quality as a modifiable factor to reduce the dangerous consequences of obesity. Therefore, the aim of this study was to evaluate the association between meal-based diet quality index-international (DQI-I) with obesity in adults. Methods This cross-sectional study was performed on 850 men and women in Tehran (aged 20–59 y). Dietary intakes were assessed using three 24-h dietary recalls. Meal-based Diet quality was assessed based on the construction of DQI-I. The total DQI-I score ranged from 0 to 100, with higher scores denoting better diet quality. Multiple linear regression analysis was used to examine the association of DQI-I and BMI in each meal and Logistic regression analysis was used to examine the association of DQI-I and obesity in each meal. Results The mean (± SD) of age, body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR) were 42.35(± 10.90) years, 27.32(± 5.61) kg/m2, 89.09 (± 12.04) cm and 0.86 (± 0.11), respectively. In none of the meals, after adjusting for confounders, no significant difference in BMI was observed in the both women and men groups. After controlling of confounders, there was not any relationship between meal-based DQI-I and BMI resulted from multiple linear regression analysis also there was not any significant association between meal-based DQI-I and obesity resulted from Logistic regression analysis. Conclusion In this study, we did not find any significant association between meal-specified DQI with obesity. To reach the better evaluation, more prospective studies with large sample size are needed.

BackgroundReports about the magnitude of co-existence of under- and over-nutrition is limited in Afghanistan. This study aimed to assess the prevalence of double burden of malnutrition (DBM) at individual and household level in Afghanistan.MethodsThis study was done based on the Afghanistan National Nutrition Survey 2013, which included a representative sample of 126,890 individuals (including more than 18,000 households) throughout Afghanistan. Intra-individual DBM was defined as the co-existence of "overweight/obese" and "stunting or micronutrient deficiencies" (including anemia, vitamin A deficiency, vitamin D deficiency and iodine deficiency). At the household level, DBM was considered as having at least one household member as overweight/obese and at least one another member of that household as undernourished (stunted, wasted, underweight or any micronutrient deficiency). SPSS and Stata software were used in the current analysis. Cross-tabulations was used to estimate the prevalence and its 95% confidence interval(CI). This study was ethically approved at Tehran University of Medical sciences.ResultsThe overall prevalence of intra-individual DBM was 12.5% (95% CI: 12.1; 12.9). Among the whole study participants at individual level of DBM, 11.7% (11.3; 12.1) of individuals had overweight along with stunting simultaneously and 20.5% (18.8; 22.4) had overweight and micronutrient deficiencies at the same time at individual level. The household level of DBM was found among 28.6% (95% CI: 27.9; 29.4) of households; such that 27.3% (26.6; 28.1) of households had at least one member with overweight and another member with stunting or wasting or underweight. Co-existence of overweight and micronutrient deficiencies at the same household was seen in 38.3% (35.5; 41.2).ConclusionThis study demonstrated a high prevalence of DBM at individual and household level in Afghanistan. Therefore, developing appropriate national macro-policies and strategies and designing appropriate programs such as public awareness programs, subsidization, food assistance programs, food fortification and dietary supplementation should be implemented by the ministry of public health, inter- related organs and international health agencies to reduce the burden of this problem in this country.

Abstract Background Dietary recommendation help persons with diabetes adopt to healthy eating habits to achieve optimal glycemic control. Socioeconomic-status and neighborhood support system can influence adherence to dietary recommendation. The purpose of our study is to assess the association of household-socioeconomic status and neighborhood-support system with adherence to dietary recommendation among persons with type 2 diabetes mellitus (T2DM). Methods Facility-based cross-sectional-survey was conducted in Brong Ahafo region, Ghana. Six hospitals were randomly selected and 530 individuals with T2DM consecutively recruited from the selected hospitals for the study. Structured-questionnaires were used to collect socio-demographic variables. Adherence to dietary-recommendation was the outcome-variable, and was assessed using perceived dietary-adherence questionnaire. Results Age (years) (P-value = 0.005), Physical-Activity level (P-value = 0.024) Receive-moderate Social-Support (P-value = 0.004) and High-Socioeconomic status (P-value = 0.046) were significantly correlated with adherence to dietary-recommendation. Age (years) regression coefficient (β) -0.089, 95%CI (− 0.12, − 0.001), Being married β0.103, 95%CI (0.002, 0.02), moderate and low-social support system β 0.309, 95%CI (0.17, 0.38) and β-0.192, 95%CI (− 0.26, − 0.06) respectively, and high-socioeconomic status β 0.197, 95%CI (0.06, 0.25) were significantly associated with adherence to dietary-recommendation. Conclusion Social-support system and socioeconomic-status could be associated with adherence to dietary-recommendation. Therefore, health workers should consider patients’ social support system and socioeconomic status as modifiable factors for optimum adherence.

Abstract 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.

Objective(s): Cyclic AMP (adenosine monophosphate) response element-binding protein (CREB) and Brain-derived neurotrophic factor (BDNF) are reported to broadly involve in learning capacity and memory. BDNF exerts its functions via tropomyosin receptor kinase B (TrkB). BDNF transcription is regulated by stimulating CREB phosphorylation. The CREB-TrkB-BDNF pathway is reported to be affected by diabetes, which may contribute to its cognitive deficits. This study was conducted to investigate the effect of vitamin D supplementation on the hippocampal fraction of this pathway in an animal model of type-1 diabetes mellitus (T1DM). Materials and Methods: Thirty-six adult male Sprague-Dawley rats were randomly divided into 4 groups as follows: Group 1: normal healthy rats (n=8); group 2: normal healthy rats receiving sesame oil supplementation as placebo (n=8); Group 3: diabetic rats receiving sesame oil (n=10); and Group 4: diabetic rats treated with 4300 IU/kg/week vitamin D dissolved in sesame oil (n=10). Diabetes was induced by intraperitoneal (IP) injection of streptozotocin. Blood and hippocampal samples were acquired at the end of the experiment. RNA was extracted from the hippocampus, and real-time PCR (polymerase chain reaction) was performed for BDNF and TrkB gene expression. Results: Administration of vitamin D (4300 IU/kg/week) in a T1DM animal model increased CREB phosphorylation in the hippocampus, but the serum and hippocampal BDNF levels and TrkB and BDNF gene expression did not change significantly.Conclusion: Vitamin D increased hippocampal CREB phosphorylation in a T1DM animal model. Our findings showed that vitamin D might be protective against central nervous system complications in diabetes. However, future studies are warranted.

Given that average salt intake among Iranians is approximately 10–15 g per day particularly from sodium hidden in bread, cheese, and fast food; lowering this mineral has been followed up seriously in this country for almost 10 years (since 2009). The main objective of the present study was to provide an opportunity to recognize unwanted and unfavorable outcomes of implementing decisions and policies together with associated problems of salt reduction in bread in order to achieve national and global health promotion goals. Thus, this qualitative and retrospective policy analysis was completed to evaluate the policy of salt reduction in bread in Iran. To collect the data, the researchers traveled to six cities in different regions, wherein relevant documents were utilized added to interviews with key actors. Related websites were correspondingly searched to find reports on this policy. Moreover, the researchers referred to some organizations in-person to search documents in this area. Five group discussions were also held to obtain public opinions in this regard. Data analysis was further carried out using framework analysis. The findings revealed that allocation of the highest rates of subsidy to wheat, flour, and bread had led to elimination of competitiveness in wheat, flour, and bread supply chain in Iran. Despite the presence of proper structures as coordinators of other organizations working on public health, there was no intersectoral collaboration in terms of maintaining health of bread products and lowering salt content in this staple food. With regard to changes in priorities of the Iranian Ministry of Health and Medical Education, attempts made to improve bread quality had also failed. In addition, first-line staff (i.e. bakers) had viewed formulation and implementation of the given policy as a top-down one. Given the ambiguities in establishment of new standards, there were similarly contradictions in execution of the policy at various levels. With reference to education provided at a national level, it was concluded that some people had become more sensitive to salt reduction in bread to some extent.

Objective(s): The aim of this study was to investigate the effect of vitamin D on glucose metabolism, as well as the expression of five key genes involved in the development of diabetes complications in liver tissue of diabetic rats. Materials and Methods: Twenty-four male Sprague–Dawley rats were randomly divided into three groups (8 rats in each group). The first group served as control and the other two groups received an intraperitoneal injection of 45 mg/kg streptozotocin to develop diabetes. Groups were treated for four weeks either with placebo or vitamin D (two injections of 20000 IU/kg). Thereafter, serum levels of glucose, insulin and HbA1c were assessed. Liver tissue was examined for the level of advanced glycation end products (AGEs) and the gene expression of AGE cellular receptor (AGER), glyoxalase-1 (GLO-1), aldose reductase (AR), O-linked N-acetylglucosamine transferase (OGT) and glutamine/ fructose-6-phosphate aminotransferase (GFAT). Results: Vitamin D injection resulted in a significant increase in plasma level of 25-hydroxycholecalciferol, which could improve hyperglycemia about 11% compared to placebo-receiving diabetic rats (P=0.005). Insulin level increased as a result of vitamin D treatment compared to control (3.31±0.65 vs. 2.15±0.79; P= 0.01). Serum HbA1c and liver AGE concentrations had a slight but insignificant reduction following vitamin D intake. Moreover, a significant decline was observed in gene expression of AGER and OGT in liver tissue (P=0.04 and PConclusion: Vitamin D might contribute in ameliorating diabetes complications not only by improving blood glucose and insulin levels, but also by suppressing AGER and OGT gene expression in the liver.

Abstract Background Obesity, widely recognized as a serious health concern, is characterized by profoundly altered metabolism. However, the intermediate metabolites involved in this change remain largely unknown. Objective: We conducted targeted metabolomics profiling to identify moieties associated with adult obesity. Methods In this case-control study of Iranian adults, 200 obese patients were compared with 100 controls based on 104 metabolites profiled by a targeted metabolomic approach using liquid chromatography coupled to triple quadrupole mass spectrometry (LC-MS/MS). The analysis comprised acylcarnitines, diacyl-phosphatidylcholines (PCaa), acyl-alkyl-phosphatidylcholines (PCae), sphingomyelins (SM), lyso-phospholipids (LPC) and amino acids. We performed multivariable linear regression to identify metabolites associated with obesity, adjusting for age, sex, total energy intake, total physical activity, smoking, and alcohol consumption. The Bonferroni correction was used to adjust for multiple testing. Results A pattern of 19 metabolites was significantly associated with obesity. Branched chain amino acids, alanine, glutamic acid, proline, tyrosine LPCa C16:1, PCaa C32:1, PCaa C32:2 and PCaa C38:3 were positively, while serine, asparagine, LPCa C18:1, LPCa C18:2, LPCe C18:0, PCae C34:3, PCae C38:4 and PCae C40:6 were negatively associated with obesity (all p

Background: Although major dietary patterns and sleep quality independently affect psychiatric disorders, their interactive association on depression is not clear. This study assesses the independent association of dietary patterns and sleep quality on depression, and also investigates their interactive associations on depression among overweight and obese women in Iran Methods: Cross-sectional study was conducted among 304 participants, age 18 and above in 2018 at Tehran Iran. Usual dietary intake was collected with 174-FFQ. Participants’ biochemical parameters and depression were measured using standard protocol. Major dietary patterns were extracted by factor analysis and grouped into Fruits&Vegetable group (healthy dietary pattern), High Fat diary&Red Meat group (unhealthy dietary pattern) and Crackers&High Energy Drinks group (western dietary patterns). Results: After adjusting for confounders poor sleep was associated with moderate and high depression; AOR (95%CI): 0.41(0.19-0.90) and 0.29(0.13-0.60) respectively. However, healthy dietary patterns (tertiles 2nd and 3rd) interact with sleep for depression; AOR (95%CI): 4.168(1.166-14.992) and 2.966(1.068-8.234) respectively. Unhealthy dietary pattern tertiles 2nd and 3rd interact with sleep for depression; AOR (95%CI): 2.925(1.055-8.113) and 4.216(1.182-15.042) respectively and Western dietary pattern tertile 3rd interacts with sleep for depression; AOR (95%CI): 4.264(1.494-12.169). Conclusion: Sleep deprivation could be associated with depression. However, sleep quality could interacts with dietary patterns to be associate with depression among overweight and obese people.

Abstract Introduction Psychological distress is a pervasive mental condition among persons with chronic noncommunicable diseases. Aim To examine whether interactions between patients’ psychological distress and adherence to dietary recommendations predict glycemic controls among persons with type 2 diabetes mellitus in Ghana. Methods Facility‐based cross‐sectional study involving 530 persons with type 2 diabetes mellitus was conducted between October 2018 and September 2019. Six health facilities were randomly selected and normal‐weight persons with type 2 diabetes mellitus (T2DM) at baseline consecutively recruited from patients’ registers. Structured questionnaires were used to collect sociodemographic data. Glycemic control was the main outcome variable, and was determined using HbA1c%. Statistical Package for Social Sciences version 22 was used in data analysis. Results Systolic blood pressure (mm Hg), diastolic blood pressure (mm Hg), total cholesterol, and fasting blood sugar were statistically significant for glycemic control (HbA1c%) (p‐value

Background: Mental health disorders are one of the most important and increasing health problems in the youth of today's societies. Some dietary intake and body mass status are factors that affect mental health. This study aimed to investigate the relationship between the intake of branched-chain amino acids (BCAAs) and aromatic amino acids (AAAs) and anthropometric and dietary inflammatory indices with mental health, including depression, anxiety, and stress. Methods: In this case-control study, the data of 138 teenage girls aged 13--18 years were collected. Three-day 24-hour food recall and standard anthropometric methods were used to calculate the dietary inflammation intake score of normal and energy-adjusted diets. Mental health disorders were diagnosed by the DASS-21 questionnaire. Statistical analysis used Student's t-test, correlation, and multiple regression were used to analyze the data based on the study's statistical requirements. Results: Based on the findings, 59 (42%) of the girls had mental disorders, and 79 (58%) were healthy. The average weight of stressed people was significantly higher than that of healthy people, and the BMI of anxious people was significantly higher than that of nonanxious people (P < 0.05). A significant positive correlation was found between stress and weight and energy intake. Additionally, there was a significant negative correlation between BCAAs and mental health. The average intake of BCAAs was significantly lower in patients (P = 0.01). The trend analysis showed significantly lower BCAA levels among the 4th quartile of mental disorders. No significant relationship was observed between DII, AAA, and anthropometric indices. After adjustment of the results, no relationship was observed between mental health and the studied factors. Conclusions: BCAA might be related to mental health. Further studies in different age and sex groups are highly recommended. [ABSTRACT FROM AUTHOR]

Background: Serum levels of lipocalin 2 (LCN 2) and retinol-binding protein-4 (RBP 4), increase in type 2 diabetes mellitus (T2DM). We sought to determine whether serum LCN 2 and RBP 4 change after an intervention with omega-3 fatty acids supplementation in diabetic patients.Methods: Forty-five type 2 diabetic patients from Iranian Diabetic Association in Tehran, Iran in 2013 were randomly recruited into two groups: one group received 4 g/d omega-3 for 10 wk; and the control group received placebo. Blood samples, food intake records, anthropometric measurements were obtained from all participants at the beginning and end of the study.Results: Fasting RBP 4 plasma levels significantly changed after 10 wk supplementation (P = 0.01). The LCN 2 concentrations decreased in omega-3 group, but the changes were not statistically significant. Omega-3 supplementation had no noticeable effect on anthropometric factors.Conclusions: These findings provide a rationale for omega-3 supplements aimed at lowering serum RBP 4 levels in T2DM. Keywords: Omega-3 fatty acid, Lipocalin, Retinol-binding protein, Diabetes mellitus

Background: Childhood obesity and overweight have become major public health problems worldwide. To combat this problem, effective, sustainable, and consistent strategies are needed. In this study, the long-term effect of a school-based intervention for weight reduction was evaluated in primary school students in Tehran, Iran. Methods: This was a cluster randomized controlled trial (RCT) conducted in 12 primary schools in a low- to middle-class district in Tehran, Iran. The participants were 334 overweight or obese primary school students (girls =164) based on World Health Organization standards, equally distributed in the intervention (n=167) and comparison (n=167) groups. It was a multi-component intervention and included nutrition education and increased physical activity (PA), a lifestyle modification program for parents, and changing the food items sold in canteens of the schools. Body mass index Z-score [BMI-Z] was determined as the primary outcome and measured at baseline, three months after baseline, at post-test (after 18 weeks), and follow-up (13-month). In total, 205 students (59.5%) completed the follow-up. Analyses were carried out based on the intention-to-treat principle using linear mixed models. Results: After 13 months, the BMI Z-score decreased in both intervention and comparison groups. However, the change was more significantly observed in the intervention group (adjusted change: 0.098, 95% CI: (0.03-0.16) compared with comparison group (P=0.003(. The intervention had a more significant effect on BMI Z-score among girls (adjusted change: 0.36, 95% CI: (0.27-0.45) compared with the comparison group (P<0.001) (than among boys (adjusted change: -0.14, 95% CI: (-0.23--0.05) compared with the comparison group (P=0.002). Conclusion: The intervention was an effective way to reduce BMI in the girls and the effect lasted for a relatively long time. [ABSTRACT FROM AUTHOR]

Background: Recent studies show that Iranians, especially women, do not have enough physical activity and if serious measures are not taken to resolve this problem, the consequences will be harmful to the society. The purpose of this advocacy paper was to determine and explain the responsibilities of all organizations and institutions responsible for promoting physical activity to root out the problem. Methods: After a thorough library search we conducted nine in-depth interviews with the relevant policymakers and government officials, managers, and practitioners in promoting physical activity. All interviews were recorded. To analyze, all of voice files were typed, saved as Word files, and exported to MAXQDA10 software by the research team. To find the main themes, all the files were read carefully several times. Then they were coded, categorized, and organized based on the main objectives of the study. In this way, themes and subthemes were emerged. Results: According to the participants in the study current state of physical activity in the country, especially among women, is not promising. The participants explained about the main obstacles for promotion of physical activity in the country and recommended practical strategies for its promotion. The strategies were suggested in three areas: Promoting culture, social protection, and adjusting current policies to overcome the existing barriers. Conclusion: Regarding the unfavorable state of physical activity in the country presentation of this advocacy document can be an effective step in promoting physical activity, thus reducing chronic diseases and improving general health in the country.

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-1β, IL-2/IL-4, CCP-A white blood cells and neutrophils, lymphocyte, monocytes, and eosinophils numbers. TNF-α decreased in all groups, but its reduction was significant in group CE. IL-1β increased 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.

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.

Objective (s): To explore predictors of the sedentary behavior, this current descriptive, analytical study was developed among a sample of adolescents in Tabriz, Iran.Methods: Information on adolescent sedentary behaviors including TV viewing, video game playing and physical activity was collected by using A modified version of the Adolescent Physical Activity and Recall Questionnaire (APARQ). In addition an anonymous self-administrated questionnaire used to collect data on demographic characteristics, perceived family support and self-efficacy. Logistic regression analysis was performed to examine the association between sedentary behavior and independent variables including gender, psychosocial predictors and modrate, vigorouse physical activity.Results: In all 402 adolescent students were studied. The mean age of students was 12.93 (SD=0.49) years; and51.5 % was female. Overall the mean time of sedentary behaviors on adolescents was 193.55 (SD=99.15) minutes/day, this figure for girls and boys were 170.25 (SD=89.20) and 218.25 (SD=103.34) minutes/day (P

Background: This study was conducted to investigate the effects of Brewer's yeast supplementation on serum lipoproteins and blood pressure in patients with Type 2 diabetes mellitus.Methods: In a randomized double blind clinical trial, 90 adults with type 2 diabetes mellitus were recruited, and divided randomly into 2 groups, trial group received brewer's yeast (1800 mg/day) and control group received placebo for 12 weeks. Weight, BMI, food consumption (based on 24 hour food recall), fasting serum lipoproteins (Cholesterol, Triglyceride, LDL-c, HDL-c), systolic and diastolic blood pressures were measured before and after the intervention. Data analyses were performed by Statistical Package for Social Sciences ver. 18.0, and the statistical tests included Independent t-test, Paired t-test, Kolmogorov-Smirnov and analysis of covariance. This trial was registered in Iranian Registry of Clinical Trials (IRCT), No.IRCT138807062513N1.Results: Eighty-four subjects (21 men and 63 women) aged 46.3±6.1 years completed the study. After 12 weeks supplementation, systolic and diastolic blood pressures were decreased in the group receiving brewer's yeast (4.1±1.5, P=0.007 and 5.7±0.6, P=0.001 respectively). No-significant changes in LDL-c, HDL-c, Triglyceride and Cholesterol were shown.Conclusion: Supplementation with Brewer's yeast besides the usual treatment of type 2 diabetes mellitus can reduce systolic and diastolic blood pressures in diabetic patients.

BACKGROUND/OBJECTIVES: The objectives were to evaluate the effects of improvement of vitamin D status on biomarkers of oxidative stress (OS) in type 2 diabetic (T2D) subjects and whether vitamin D receptor (VDR)-FokI polymorphisms could modulate the response to vitamin D3 intake. SUBJECTS/METHODS: Subjects with T2D were allocated to one of the two groups to receive either plain doogh (PD; containing 150 mg calcium and no vitamin D/250 ml, [n.sub.1] = 50) or vitamin D3-fortified doogh (FD; containing 500 IU/250 ml, [n.sub.1] = 50) twice a day for 12 weeks. Outcomes were changes in serum 25-hydroxyvitamin D (25(OH)D), superoxide dismutase, glutathione (GSH), total antioxidant capacity (TAC) and malondialdehyde (MDA). VDR genotypes in 140 T2D subjects in FD were determined by FokI restriction enzyme. RESULTS: After 12 weeks, serum 25(OH)D increased significantly in FD (from 38.5 ± 202.2 to 72.0 ± 23.5, P < 0.001) as compared with PD (from 38.8 ± 22.8 to 33.4 ± 22.8, P = 0.28). Comparisons between FD and PD revealed significant differences in changes of serum MDA (-0.54 ± 0.82 µmol/l vs +0.17 ± 1 µmol/l, P < 0.001), GSH (+8.4 ± 40.1 ng/l vs - 13.1 ± 29.4 ng/l, P = 0.002) and TAC (+0.14 ± 0.43 mmol/l vs +0.02 ± 0.45 mmol/l bovine serum albumin equivalent, P = 0.03). Although there was no significant association between FokI genotypes and OS biomarkers, ff variant subgroup showed the weakest response to vitamin D. CONCLUSIONS: Improvement of vitamin D status via daily intake of FD ameliorates OS biomarkers in T2D subjects and the interactive effect of FokI genotypes cannot be ruled out. European Journal of Clinical Nutrition (2015) 69, 216-222; doi: 10.1038/ejcn.2014.240; published online 26 November 2014, INTRODUCTION There is mounting interest in the role of vitamin D in type 2 diabetes (T2D) and its complications. (1) Cardiovascular disease is the leading cause of morbidity and mortality [...]