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BACKGROUND: A high prevalence rate of hypertension (HTN) and its subsequent serious complications made this disease a major health-treatment concern in many societies. The current study aimed to investigate the prevalence of hypertension and its associated risk factors in Fasa PERSIAN COHORT in south of Iran in 2019. METHODS: This was an analytical-cross sectional study. The study population were the individuals covered by Fasa cohort. Information of the first phase of Fasa Persian cohort in south of Iran was used in this study. Independent t test, chi-square test, analysis of variances, Pearson correlation coefficient, and multiple stepwise regression were used to analyze the obtained data. Thereafter, the data was analyzed using SPSS software version 22, and P value < 0.05 was considered as statistically significant. RESULTS: Out of 10,111 individuals included in the study, 5546 (54.86%) subjects were women and 4565 (45.16%) other were men. The overall prevalence rate of hypertension was estimated as 46.6%. In the present study, (16/1%) of the participants were with HTN stage 1, and (17/9%) of them were with HTN stage 2. The results show that there were significant positive correlations among HTN and age, BMI, HDL, TG, BUN, ALP, smoking, physical activity, cardiovascular diseases, diabetes, and renal failure (P < 0.5). CONCLUSIONS: Prevalence of HTN in this study population is considerable. Therefore, it is suggested that health system should program some plans to prevent hypertension's prevalence and eliminate its risk factors.
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Hipertensão/epidemiologia , Adulto , Idoso , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/diagnóstico , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Fatores de RiscoRESUMO
Rivers, as the most prominent component of water resources, have a key role to play in increasing the life expectancy of living creatures. The essential characteristics of water pollutants can be described by water quality indices (WQIs). Hence, a ferocious demand for obtaining an accurate prediction of WQIs is of high importance for perception of pollutant patterns in natural streams. Field studies conducted on different rivers indicated that there is no general relationship to yield water quality parameters with a permissible level of accuracy. Over the past decades, several artificial intelligence (AI) models have been employed to predict more precise estimation of WQIs rather than conventional models. In this way, through the current study, multivariate adaptive regression spline (MARS) and least square-support vector machine (LS-SVM), as machine learning methods, were used to predict indices of the five-day biochemical oxygen demand (BOD5) and chemical oxygen demand (COD). To improve the proposed approaches, 200 series of field data, collected from Karoun River southwest of Iran, pertain to the nine independent input parameters, namely electrical conductivity (EC), sodium (Na+), calcium (Ca2+), magnesium (Mg2+), orthophosphate ([Formula: see text]), nitrite ([Formula: see text]), nitrate nitrogen ([Formula: see text]), turbidity, and pH. The performances of the LS-SVM and MARS techniques were quantified in both training and testing stages by means of several statistical parameters. Furthermore, the results of the proposed AI models were compared with those obtained using artificial neural network (ANN), adaptive neuro-fuzzy inference system (ANFIS), and multiple regression equations. Results of the present research work indicated that the proposed artificial intelligence techniques, as machine learning classifiers, were found to be efficient in order to predict water quality parameters.
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Análise da Demanda Biológica de Oxigênio , Monitoramento Ambiental/métodos , Aprendizado de Máquina , Rios/química , Poluentes da Água/análise , Qualidade da Água/normas , Irã (Geográfico) , Análise Multivariada , Redes Neurais de Computação , Análise de Regressão , Máquina de Vetores de SuporteRESUMO
OBJECTIVE: Chronic scrotal hyperthermia (SHT) can lead to serious disorders of the male reproductive system, with oxidative stress playing a key role in the onset of these dysfunctions. Thus, we evaluated the impact of caffeine, a potent antioxidant, on cellular and tissue disorders in mice with chronic SHT. METHODS: In this experimental study, 56 adult male NMRI mice were allocated into seven equal groups. Apart from the non-treated control group, all were exposed to heat stress. Two groups, termed "preventive" and "curative," were orally administered caffeine. The preventive mice began receiving caffeine immediately prior to heat exposure, while for the curative group, a caffeine regimen was initiated 15 consecutive days following cessation of heat exposure. Each treated group was subdivided based on pairing with a positive control (Pre/curative [Cur]+PC) or a vehicle (Pre/Cur+vehicle). Upon conclusion of the study, we assessed sperm characteristics, testosterone levels, stereological parameters, apoptosis, antioxidant and oxidant levels, and molecular markers. RESULTS: Sperm parameters, testosterone levels, stereological parameters, biochemical factors (excluding malondialdehyde [MDA]), and c-kit gene expression were significantly elevated in the preventive and curative groups, especially the former, relative to the other groups. Conversely, expression levels of the heat shock protein 72 (HSP72) and nuclear factor kappa beta (NF-κß) genes, MDA levels, and apoptotic cell density were markedly lower in both caffeine-treated groups relative to the other groups, with more pronounced differences observed in the preventive group. CONCLUSION: Overall, caffeine attenuated cellular and molecular abnormalities induced by heat stress in the testis, particularly in the mice treated under the preventive condition.
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One of the most common complications of chronic scrotal hyperthermia (SHT) is a serious disorder in the male reproductive system. The most important factor in the occurrence of these disorders is oxidative stress. Currently, we investigated the effects of epigallocatechin gallate (EGCG), as a highly potent antioxidant, against cells and tissue disorders in mice affected by chronic SHT. Fifty-six male adult NMRI mice were allocated into seven equal groups. Except the non-treated (Control) group, six other groups were exposed to heat stress. Two treated groups including Preventive and Curative received oral administration of EGCG (50 mg/kg/day) starting immediately before heat exposure and fifteen consecutive days after the end of the heat exposure, respectively. For each treated group, two subgroups including positive control (Pre/Cur + PC groups) and vehicle (Pre/Cur + vehicle groups) were considered. At the end of the study, sperm characteristics, testosterone levels, stereological parameters, apoptosis, oxidant state, and molecular assessments were performed. We found that the sperm parameters, testosterone levels, the numerical density of spermatogonia, primary spermatocytes, spermatids, sertoli, leydig cells, and seminiferous tubules, biochemical factors (except MDA), and expression of c-kit gene were significantly higher in the Preventive and Curative groups, especially in Preventive ones, compared to other groups (P < 0.05). This is while expression of HSP72 and NF-κß genes, MDA levels, as well as density of apoptotic cells considerably decreased in both EGCG-treated groups compared to other groups and it was more pronounced in Preventive ones (P < 0.05). Generally, EGCG attenuated cellular and molecular disorders induced by heat stress in the testis and it was more pronounced in Preventive status.
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Hipertermia Induzida , Sêmen , Masculino , Camundongos , Animais , Testículo , TestosteronaRESUMO
BACKGROUND: Identifying effective spinal cord injury (SCI) treatments remains a major challenge, and current approaches are still unable to effectively improve its. Currently, we investigated the combined effects of hyperbaric oxygen (HBO) along with coenzyme Q10 (CoQ10) in the recovery of SCI in rats. MATERIAL AND METHODS: Ninety female mature Sprague-Dawley rats were allocated into five equal groups, including; sham group, SCI group, HBO group (underwent SCI and received HBO), CoQ10 group (underwent SCI and received CoQ10), and HBO+CoQ10 group (underwent SCI and received HBO plus CoQ10). Tissue samples at the lesion site were obtained for evaluation of stereological, immunohistochemical, biochemical, molecular. Also, functional tests were performed to evaluate of behavioral properties. RESULTS: We found that a significant increase in stereological parameters, biochemical factors (GSH, SOD and CAT), IL-10 gene expression and behavioral functions (BBB and EMG Latency) in the treatment groups, especially HBO+CoQ10 group, compared to SCI group. In addition, MDA levels, the density of apoptotic cells, as well as expression of inflammatory genes (TNF-α and IL-1ß) were considerably reduced in the treatment groups, especially HBO+CoQ10 group, compared to SCI group. CONCLUSION: We conclude that co-administration of HBO and HBO+CoQ10 has a synergistic neuroprotective effects in animals undergoing SCI.
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Oxigenoterapia Hiperbárica , Traumatismos da Medula Espinal , Ratos , Feminino , Animais , Ratos Sprague-Dawley , Oxigênio/metabolismo , Medula Espinal/metabolismoRESUMO
BACKGROUND: Diabetic wounds are one of the most important issues in diabetic patients. It seems that Juglans regia L. leaf with antioxidant and anti-inflammatory potentials can be profitable for healing of diabetic wounds. The aim of present study was to investigate the topical administration of Juglans regia L. leaf extract in diabetic wound healing. METHODS: Seventy-five diabetic male rats were randomly divided into 5 groups (n = 15), including: untreated (Control) group, Eucerin group, 2% Juglans regia L. ointment (JRL 2%) group, 5% Juglans regia L. ointment (JRL 5%) group, and Phenytoin group as a reference drug. Sampling was performed at days 7, 14, and 21 after surgery. Evaluation tests included stereology, immunohistochemistry, molecular, and biomechanical. RESULTS: Our results showed that the wound closure rate, volumes of newly formed of epidermis and dermis, density of fibroblasts and blood vessels, collagen deposition, density of proliferation cells, expression levels of TGF-ß and VEGF genes, and biomechanical characteristics were significantly higher in extract groups compared to control and eucerin groups, however, these changes were considerable in the JRL 5% group (P < 0.05). This is while that the density of neutrophils and expression levels of TNF-α and IL-1ß genes in the extract groups, especially in the JRL 5% group, were significantly reduced compared to control and eucerin groups (P < 0.05). CONCLUSION: Topical administration of Juglans regia L. leaf extract, especially in 5% concentration, considerably accelerates diabetic wound healing.
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Diabetes Mellitus , Juglans , Administração Tópica , Animais , Antioxidantes , Colágeno , Diabetes Mellitus/tratamento farmacológico , Juglans/química , Juglans/metabolismo , Masculino , Pomadas , Fenitoína , Extratos Vegetais/química , Ratos , Fator de Crescimento Transformador beta/metabolismo , Fator de Necrose Tumoral alfa , Fator A de Crescimento do Endotélio Vascular , CicatrizaçãoRESUMO
The longitudinal dispersion coefficient (LDC) of river pollutants is considered as one of the prominent water quality parameters. In this regard, numerous research studies have been conducted in recent years, and various equations have been extracted based on hydrodynamic and geometric elements. LDC's estimated values obtained using different equations reveal a significant uncertainty due to this phenomenon's complexity. In the present study, the crow search algorithm (CSA) is applied to increase the equation's precision by employing evolutionary polynomial regression (EPR) to model an extensive amount of geometrical and hydraulic data. The results indicate that the CSA improves the performance of EPR in terms of R2 (0.8), Willmott's index of agreement (0.93), Nash-Sutcliffe efficiency (0.77), and overall index (0.84). In addition, the reliability analysis of the proposed equation (i.e., CSA) reduced the failure probability (Pf) when the value of the failure state containing 50 to 600 m2/s is increasing for the Pf determination using the Monte Carlo simulation. The best-fitted function for correct failure probability prediction was the power with R2 = 0.98 compared with linear and exponential functions.
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Corvos , Rios , Algoritmos , Animais , Reprodutibilidade dos Testes , Qualidade da ÁguaRESUMO
Non-alcoholic fatty liver disease (NAFLD) is defined as the condition of fat accumulation in the liver. This cross-sectional study aimed to investigate the relationship between body composition and fatty liver and determine of cut-off point for predicting NAFLD. Samples were selected from the nutrition clinic from 2016 to 2017 in Tehran, Iran. The liver steatosis was calculated using the CAP score through the FiroScan™ and body composition was measured using the dual-energy X-ray absorptiometry scan method. A total of 2160 patients participated in this study, 745 (34.5%) subjects had NAFLD. We found that fat-free tissue was inversely and fat tissue was directly correlated with the risk of NAFLD in almost all factors and the risk of developing NAFLD increases if the total fat exceeds 32.23% and 26.73% in women and men and abdominal fat exceeds 21.42% and 13.76% in women and men, respectively. Finally, we realized that the total fat percent had the highest AUC (0.932 for men and 0.917 for women) to predict the risk of NAFLD. Overall, the likelihood of NAFLD development rose significantly with increasing the amount of total fat and abdominal fat from the cut-off point level.
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Composição Corporal , Hepatopatia Gordurosa não Alcoólica/patologia , Absorciometria de Fóton , Tecido Adiposo/fisiologia , Adulto , Idoso , Área Sob a Curva , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de RiscoRESUMO
OBJECTIVE: Vitamin D deficiency and insulin resistance have great prevalence in society. The latest studies indicate an inverse association between Vitamin D levels, insulin resistance, and Type 2 diabetes. The objective of this study was to investigate the effect of vitamin D status on insulin resistance. METHODS: In a cross-sectional study, 2160 participants were randomly recruited from a nutrition clinic in Tehran, Iran, 1057 (48.9%) were female and 1103 (51.1%) male. Information was gathered by a questionnaire. Following 12-h fasting, fasting plasma glucose (FPG) and insulin levels, as well as 25-hydroxy vitamin D levels were measured. 2-H glucose and insulin levels measured after consumption of 75 g glucose, HOMA2-IR, and HOMA-ß indices were then calculated. RESULTS: The average serum Vitamin D was 22.3 + 8.9 nmol/L and the prevalence of Vitamin D deficiency was 100%. There was an inverse relationship between Vitamin D levels and age, BMI, waist circumference, and all metabolic parameters (p < 0.001 in all) and a direct association with levels of exercise. Two logistic regression models were used to adjust for confounding variables; firstly, for age, gender, and smoking and secondly, additionally for BMI and energy intake. Both models showed a significant inverse relationship between Vitamin D levels and FPG and insulin levels, 2-h glucose and insulin levels, and HOMA2-IR. The optimum cut point for vitamin D was calculated at about 25 nmol/L for preventing insulin resistance. CONCLUSION: This study illustrated that there is a statistically significant inverse relationship between Vitamin D levels and insulin resistance.
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Diabetes Mellitus Tipo 2 , Resistência à Insulina , Glicemia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Insulina , Irã (Geográfico)/epidemiologia , Masculino , Vitamina DRESUMO
OBJECTIVES: Insulin resistance is the most common metabolic change associated with obesity. The present study aimed to investigate the relationship between insulin resistance and body composition especially adipose tissue in a randomized Tehrani population. METHODS: This study used data of 2,160 individuals registered in a cross-sectional study on were randomly selected from among subjects who were referred to nutrition counseling clinic in Tehran, from April 2016 to September 2017. Insulin resistance was calculated by homeostasis model assessment formula. The odds ratio (95% CI) was calculated using logistic regression models. RESULTS: The mean age of the men was 39 (±10) and women were 41 (±11) (the age ranged from 20 to 50 years). The risk of increased HOMA-IR was 1.03 (95% CI: 1.01-1.04) for an increase in one percent of Body fat, and 1.03 (95% CI: 1.00-1.05) for an increase in one percent of Trunk fat. Moreover, the odds ratio of FBS for an increase in one unit of Body fat percent and Trunk fat percent increased by 1.05 (adjusted odds ratio [95% CI: 1.03, 1.06]) and 1.05 (95% CI: 1.02, 1.08). Also, the risk of increased Fasting Insulin was 1.05 (95% CI: 1.03-1.07) for an increase in one unit of Body fat percent, and 1.05 (95% CI: 1.02-1.08) for an increase in one unit of Trunk fat percent. CONCLUSIONS: The findings of the present study showed that there was a significant relationship between HOMA-IR, Fasting blood sugar, Fasting Insulin, and 2 h Insulin with percent of Body fat, percent of Trunk fat.
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Tecido Adiposo/metabolismo , Resistência à Insulina , Adulto , Biomarcadores , Composição Corporal , Índice de Massa Corporal , Pesos e Medidas Corporais , Estudos Transversais , Dieta , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/epidemiologia , Obesidade/etiologia , Obesidade/metabolismo , Razão de Chances , Vigilância em Saúde Pública , Curva ROC , Adulto JovemRESUMO
One of the main health problems in many societies is the increased opium abuse, which was found to be correlated with many problems like cardiovascular disease. This study aimed to evaluate the correlation of opium use with blood lipoproteins as the risk factor of CVD. This was a cross-sectional study conducted on participants of the first phase of the PERSIAN Cohort study who were aged between 35 and 70 years old. Demographic characteristics; history of smoking, alcohol, and opium consumption; medical history; and medications were asked and the related checklists were filled out. The levels of physical activity and fat intake were also registered. As well, lipoprotein profiles were investigated by blood sampling. The linear and logistic regression was used to analyze the relationship between opium and lipid profile and the statistical significant level was considered as < 0.05. Among 9300 participants with a mean age of 48.06 ± 9.44 years old, 49.6% of them were men. About 24.1% of the participants used opium. In the linear regression models, unlike TG (ß = 2.2, p = 0.36), total cholesterol (ß = - 2.5, p = 0.02), LDL (ß = - 2.0, p = 0.04), and HDL (ß = - 1.0, p = 0.04) were significantly lower in people who used opium compared to the others. In the logistic regression models, abnormal level of LDL (OR = 0.78, p = 0.003) and total cholesterol (OR = 0.82, p = 0.008) were less in people who used opium compared to the others. This study showed that there is a correlation between opium usage and lower levels of total cholesterol and LDL; however, the lower level of HDL in normal range was seen in opium users. Considering the current evidences, most of them showed the increased risks of ischemic heart disease, heart attack, hypertension, cerebrovascular disease, and cancer in opium users. Therefore, Healthcare providers and patients should be noticed about the deleterious effects of opium consumption on various vascular events. In addition, it is necessary for managers and policy makers of the health care system to take the necessary measures to raise the level of awareness and health literacy of the general public about the high-risk side effects of opium use and to take necessary and effective strategies to prevent and reduce its use.
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Lipídeos/sangue , Dependência de Ópio/sangue , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-IdadeRESUMO
AIM: To assess the association between dietary patterns no single food or group, and risk of insulin resistance (Fasting blood sugar (FBS), Fasting insulin, 2h-glucose, 2h-insulin and HOMA-IR). METHODS: In a cross-sectional, population-based study in Tehran, Iran, 2016-2017. Adults (n = 1500, 38% men) mean age 43.72 ± 14.9 years. Dietary intake was collected by semi-quantitative food frequency questionnaire and insulin resistance was evaluated by Fasting blood sugar (FBS), Fasting insulin, 2h glucose, 2h insulin and HOMA-IR. Associations were assessed by using correlation and multivariable linear regression. RESULTS: After controlling of the confounding factor or possible underlying such as gender, age, menopausal, BMI, physical activity and the amount of daily energy intake, unhealthy dietary pattern had a positive relationship with all indexes of insulin resistance except 2h glucose and HOMA-IR, healthy dietary pattern had negative and significant relationship with indexes of insulin resistance but apart from 2h glucose. CONCLUSIONS: It can be figured out that receiving diet rich in healthy foods might reduce the risk of creating insulin resistance.
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Diabetes Mellitus Tipo 2/epidemiologia , Dieta , Resistência à Insulina , Adulto , Glicemia , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Ingestão de Alimentos , Jejum , Comportamento Alimentar , Feminino , Humanos , Insulina/sangue , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The Tabari cohort study (TCS), part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN), is a large longitudinal prospective cohort designed to better understand the risk factors associated with major non-communicable diseases (NCDs) across two urban and mountainous regions in north of Iran. METHODS: The enrollment phase of TCS started in June 2015 and ended in November 2017. During this phase, individuals aged 35-70 years from urban and mountainous regions of Sari township (Mazandaran province) were invited to the cohort center by health volunteers (urban regions) and Behvarz (mountainous areas) using census information. Data was collected based on the PERSIAN cohort study protocols. Hypertension was defind as systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg or history of diagnosis with hypertension or taking antihypertensive medications among participants free from cardiovascular diseases. Diabetes was defined as fasting blood sugar ≥126 mg/dL or a history of diagnosis or taking glucoselowering medications among all participants. RESULTS: A total of 10,255 participants were enrolled in TCS, 59.5% of whom were female. Among the total population, 7,012 participants were urban residents (68.4%). The prevalence of daily smoking in the total population was 9.1%. Body mass index in 75.9% of participants was ≥25 kg/m2. The prevalence of hypertension, diabetes, and thyroid disorders were 22.2%, 17.2%, and 10.5%, respectively. CONCLUSION: The Tabari cohort is different from other cohorts in terms of levels of risk factors associated with NCDs. This study has certain important strengths including its population-based design and large sample size that provides a valid platform for conducting future investigations and trials. A biobank that has been designed to store blood, nail, hair and urine samples for future research is another strength of this study. Researchers who are interested in using the information can refer to the following web page: http://persiancohort.com.
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Hipertensão/epidemiologia , Doenças não Transmissíveis/epidemiologia , Adulto , Idoso , Anti-Hipertensivos/uso terapêutico , Índice de Massa Corporal , Diabetes Mellitus/epidemiologia , Estudos Epidemiológicos , Feminino , Humanos , Hipertensão/tratamento farmacológico , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Fumar/epidemiologia , Doenças da Glândula Tireoide/epidemiologiaRESUMO
Non-alcoholic fatty liver disease (NAFLD) is an example of pathological fat accumulation in the liver and one of the major health conditions in the world. This study aimed to examine the independent role of dietary patterns in the development of NAFLD. In a cross-sectional study, 1500 individuals referred to a nutrition clinic were randomly selected, their demographic, anthropometric and blood metabolic indices were obtained, and food frequency questionnaires were completed for them. Liver stiffness was calculated using the NAFLD score formula and fibroscan. The two dominant dietary patterns identified were the "healthy" and "unhealthy dietary patterns". A significant percentage of those with NAFLD (45%) were in the upper quartile of the unhealthy model; however, only 10% had the healthy pattern (p < 0.001). In this study, 32.9 and 13.9% of the healthy and unhealthy participants were in the upper quartile of the healthy diet pattern. Also, it was shown that waist circumference is a strong mediator of dietary patterns and NAFLD relationship, and the indirect effect of diet through abdominal circumference is 28 times greater than the direct effect on NAFLD. The results suggested that healthy and unhealthy dietary patterns are respectively associated with lower- and higher-risk of NAFLD but the role of waist circumference as a mediator deserves more consideration.
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Dieta , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Circunferência da Cintura , Adulto , Dieta/efeitos adversos , Dieta Saudável , Feminino , Humanos , Masculino , Hepatopatia Gordurosa não Alcoólica/induzido quimicamenteRESUMO
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide with no specific treatment. Weight loss is the most effective therapeutic strategy in its management; however, there is no consensus on its specifics. Thus, this study was conducted to evaluate the effects of weight loss on liver enzymes, markers of inflammation, oxidative stress and CK18-M30 (cytokeratin 18) as a biomarker of hepatocellular apoptosis. OBJECTIVES: To study the effect of weight reduction diet as an exclusive treatment for NAFLD. PATIENTS AND METHODS: Forty four patients with NAFLD received a diet including a 500 to 1000 kcal per day intake reduction as30% fat, 15% protein, and 55% carbohydrate for six months. Anthropometric parameters, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), lipid profile, malondialdehyde (MDA), TNF-α, IL-6, CK18-M30 were measured at baseline and at the end of the study. At the end of follow up, patients were classified as adherent or nonadherent to treatment according to a weight loss of ≥ 5%, or < 5% of initial body weight, respectively. RESULTS: Twenty five patients were classified as adherent group and nineteen as nonadherent group (9.7% vs. 1.9% total body weight loss after 6 months, respectively). After 6 months, changes in adherent and nonadherent groups were as follows: reduction in body weight from 93.7 ± 15.8 kg to 84.2 ± 13.4 kg vs. 94 ± 16.6 kg to 92.2 ± 16.2 kg (P < 0.05), BMI from 32.7 ± 3.9 to 29.5 ± 3.2 vs.31.8 ± 5.4 to 31.1 ± 5.3 (P < 0.001), and waist circumference from 105.1 ± 12.6 cm to 97.4 ± 9.8 cm vs.106.8 ± 14.2 cm to 103.7 ± 14 cm (P < 0.001), respectively. Diastolic blood pressure was significantly decreased in adherent group (from 80.2 ± 5.1 mmHg to 76.9 ± 5 mmHg; P < 0.001). Also, total cholesterol, LDL, triglyceride, ALT, AST, GGT and CK18-M30 levels were significantly decreased in the adherent group compared to nonadherent group (P < 0.05). CONCLUSIONS: This intervention offers a practical approach for treatment of patients with NAFLD with diet therapy.