Comparison of Dutch healthy eating and healthy eating indexes and anthropometry in patients with major depression with health subjects: a case-control study.

Background: Diseases 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. Methods: In 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. Results: It 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). Conclusion: It 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.

The Effects of Vitamin D Supplementation on Lipid and Inflammatory Profile of Healthy Adolescent Boys: A Randomized Controlled Trial.

BACKGROUND: Deficiency of vitamin D, an anti-inflammatory micronutrient with some favorable effects on lipid profiles, has been found to be highly prevalent in adolescents. We aimed to investigate the effect of a school-based vitamin D supplementation regimen on the correction of vitamin D deficiency as well as lipid and inflammatory profiles of healthy adolescent boys. METHODS: In this randomized single-blind placebo-controlled trial, seventy-one healthy adolescent boys (age 17 years old) were recruited from one high school in Tehran, Iran, and randomly assigned to two groups. The supplement group received vitamin D pearls at a dose of 50,000 IU monthly for 6 months, this dose is indeed defined by the Ministry of Health in Iran for a potential national school-based vitamin D supplementation program. The other group was given placebo pearls for the same duration. Before and after the treatment, the serum levels of 25-hydroxy vitamin D (25(OH) D), parathyroid hormone (PTH), retinol, lead (Pb), the lipid profile and the inflammatory biomarkers were measured and compared. RESULTS: Between-groups statistical analysis showed that a dose (50,000 IU/month) vitamin D significantly increased the serum levels of 25-hydroxyvitamin D (25 (OH) D) (p < 0.001) and decreased serum levels of PTH (p = 0.003). No significant change was observed in serum levels of retinol and Pb. Between-group analysis revealed that the serum levels of TG (P = 0.001) decreased while an increase in serum levels of HDL (p = 0.021) was observed (p < 0.05). Both the within- and between-group analysis showed that serum tumor necrosis factor receptor 2 (TNFR2) concentration declined while serum interleukin-10 (IL-10) increased in response to vitamin D supplementation (p < 0.05). CONCLUSION: A supplementation regimen of (50,000 IU/month) vitamin D in a context with high rates of vitamin deficiency has shown positive impacts on the serum vitamin D, lipid profile and inflammatory biomarkers in healthy adolescent boys.

Serum Levels of Vitamin D, Retinol and Zinc in Relation to overweight among Toddlers: Findings from a National Study in Iran.

BACKGROUND: Some studies have examined the association between micronutrient deficiencies and overweight in children, but data in this regard are conflicting. This study was done to investigate the association between serum levels of vitamin D, A and zinc with overweight in a large sample of Iranian toddlers. METHODS: A total of 4261 toddlers, aged 15-23 months, who had an Iranian birth certificate and attended primary health care, were included in the current cross-sectional study. Weight and height were measured by experts based on standard protocols and body mass index (BMI) was calculated. Based on WHO criteria, overweight was defined as BMI-z-score of ≥1SD. Serum levels of 25(OH)D3 , retinol and zinc were measured for each toddler. Binary logistic regression was applied to assess the association of 25(OH)D3 , retinol and zinc levels with overweight. RESULTS: Mean age of study participants was 19.2 ± 8.4 months. After controlling for potential confounders, children in the highest quartile of serum 25(OH)D3 levels had lower odds of overweight compared with those in the lowest quartile (OR: 0.79, 95% CI: 0.63-0.99). Furthermore, a marginally significant inverse association was found between serum levels of 25(OH)D3 and overweight among urban toddlers (OR: 0.75, 95%CI: 0.56-1.00). Such a relationship was not seen for rural children. No other significant association was seen between serum levels of retinol and zinc and overweight either before or after controlling for covariates. CONCLUSION: In conclusion, we found a significant inverse association between serum levels of vitamin D and overweight among toddlers. Further studies, particularly of prospective nature, are required to confirm our findings.

Plasma metabolomic profiling of amino acids and polar lipids in Iranian obese adults.

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 < 0.00048). CONCLUSIONS: A metabolomic profile containing 9 amino acids and 10 polar lipids may serve as a potential biomarker of adult obesity. Further studies are warranted to replicate these findings as well as investigate potential changes in this profile after weight reduction.

The Association between Dietary Fat Pattern and the Risk of Type 2 Diabetes.

Despite several studies examining single dietary fats on type 2 diabetes (T2D) incidence, little is known about the effects of multiple fatty acids on the risk of T2D. We aimed to address this question in the Tehran Lipid and Glucose Study (TLGS) population. Dietary intakes of participants without T2D (n=2,139) were assessed using the validated food frequency questionnaire. To assess the risk of T2D after 6 years of follow-up, we used multivariate Cox proportional hazard regression models. Three major dietary fat patterns were: (1) high amounts of dietary cholesterol, saturated fats, oleic acid, linoleic acid, linolenic acid, and trans fats; (2) high amounts of long-chain polyunsaturated fats; and (3) high amounts of dietary cholesterol and saturated fats. Dietary total fat intake hazard ratio [HR=1.31, 95% confidence interval (CI)=0.77~2.23 and HR=0.69, 95% CI=0.27~1.76, in the second and third tertile, respectively] was not related to the development of T2D. Animal- and plant-based dietary fat intakes were additionally not related to the risk of T2D. After adjustment for confounding variables, there was no significant association between dietary fat pattern score and T2D incidence. Whereas, the third pattern had a borderline negative association with diabetes development (HR=0.56, 95% CI=0.29~1.07). These novel data suggest that dietary fat composition may modify the risk of T2D incidence.

Policy analysis of salt reduction in bread in Iran.

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.

Revising the Comprehensive Feeding Practices Questionnaire Used in Planning Preventive Overweight, Obesity, and Underweight Programs for 2-5-year-old Children.

BACKGROUND: Overweight, obesity, and underweight are common child health problems in Iran. Child-feeding practices are one of the major factors affecting children's weight through eating behavior and dietary intake. The Comprehensive Feeding Practices Questionnaire (CFPQ), a 49-item measure comprising 12 subscales, assesses parental child-feeding practices. It is used to determine factors that may affect the development of overweight, obesity, and underweight and therefore, helps us plan appropriate preventive action. The aim of this study was to revise and adapt CFPQ to be used for 2-5-year-old children. METHODS: This study including, 300 mothers selected by simple systematic random sampling, was conducted in the rural and urban areas of Birjand city, Iran. Health workers interviewed the mothers and completed questionnaire according to the standard protocol. Exploratory factor analysis (EFA), tests for internal consistency, and test-retest reliability were conducted. RESULTS: EFA resulted in a final questionnaire with 39 items distributed over seven factors, including Healthy Eating Guidance, Modeling, Parent Pressure, Monitoring, Emotion Regulation, Child Control, and Restriction. The internal consistency reliability for the proposal scales was acceptable for five out of the seven factors and all of the seven factors demonstrated excellent test-retest reliability. CONCLUSIONS: The revised CFPQ is a valid tool for determining the various aspects of parental feeding practices aiming to prevent overweight, obesity, and underweight among 2-5-year-old children.

Association of Socioeconomic Status and Food Security with Anthropometric Indices Among 2-5-year-old Urban Children in Eight Different cities in Iran.

INTRODUCTION: Child nutrition status is very important in all societies, which is influenced by the interaction of multiple factors including food security and socioeconomic status in both genders. The aim of this study was to examine the relationship between food security and socioeconomic status with anthropometric indices among 2-5-year-old urban children in eight different cities in Iran. MATERIALS AND METHODS: In this cross-sectional study, anthropometric Z scores of 7028 children of urban area were measured by using World Health Organization (WHO) Anthro software based on WHO 2007 standards. Family food security was assessed by using HFIAS 9-item questionnaire. Socioeconomic status as well as health factors were analyzed using the SPSS. RESULTS: Based on the present study, significant correlation was observed between sleep time, birth weight, and food security (P < 0.05) with body mass index (BMI), while the rest of the variables including age, family size, number of children, parents' education, breastfeeding duration, watching TV, playing computer games, playing outdoors, number of main eating, and number of snacks showed no significant relation (P > 0.05). CONCLUSION: It was shown that 2-5 years old children's life are the most vital and vulnerable to the hazards of undernutrition or overweight and obesity, which could affect the whole health of the person. As food security affects BMI, it is important to focus more on this issue in order to improve child's health status.

Effectiveness of vitamin D therapy in improving metabolomic biomarkers in obesity phenotypes: Two randomized clinical trials.

BACKGROUND: Uncertainty remains about the effect of vitamin D therapy on biomarkers of health status in obesity. The molecular basis underlying this controversy is largely unknown. OBJECTIVE: To address the existing gap, our study sought to compare changes in metabolomic profiles of obesity phenotypes (metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO)) patients with sub-optimal levels of vitamin D following vitamin D supplementation. METHODS: We conducted two randomized double-blind clinical trials on participants with either of the two obesity phenotypes from Tehran province. These phenotypes were determined by the Adult Treatment Panel-III criteria. Patients in each of the MHO (n = 110) and MUHO (n = 105) groups were separately assigned to receive either vitamin D (4000 IU/d) or placebo for 4 months. Pre- and post-supplementation plasma metabolomic profiling were performed using Liquid chromatography coupled to a triple quadrupole mass spectrometry. Multivariable linear regression was used to explore the association of change in each metabolite with the trial assignment (vitamin D/placebo) across obesity phenotypes. RESULTS: Metabolites (n = 104) were profiled in 82 MHO and 78 MUHO patients. After correction for multiple comparisons, acyl-lysophosphatidylcholines C16:0, C18:0, and C18:1, diacyl-phosphatidylcholines C32:0, C34:1, C38:3, and C38:4, and sphingomyelin C40:4 changed significantly in response to vitamin D supplementation only in MUHO phenotype. The interaction analysis revealed that vitamin D therapy was different between the two obesity phenotypes based on acyl-lysophosphatidylcholines C16:0 and C16:1 and citrulline which were altered significantly after supplementation. Changes in metabolites were associated with changes in cardiometabolic biomarkers after the intervention. CONCLUSIONS: Vitamin D treatment influenced the obesity-related plasma metabolites only in adults with obesity and metabolically unhealthy phenotype. Therefore, not all patients with obesity may benefit from an identical strategy for vitamin D therapy. These findings provide mechanistic basis highlighting the potential of precision medicine to mitigate diseases in health-care settings.

Second National Integrated Micronutrient Survey in Iran: Study Design and Preliminary Findings.

BACKGROUND: The main objective of the Second National Integrated Micronutrient Survey (NIMS-II) was to assess the nutritional status of four micronutrients, namely iron, zinc, and vitamins A and D, and also to conduct an anthropometric assessment of selected groups of children, adolescents, pregnant women, and adults, disaggregated by sex and residential area in nationally representative samples. This paper reports the design of the study along with preliminary findings. METHODS: In this study, 32 770 individuals were selected by using single-stage cluster sampling. Venous blood samples were collected on site for laboratory analysis; interviews were conducted, and anthropometric measurements were performed. RESULTS: The prevalence of anemia was highest (17.1%) among 15- to 23-month-old children; vitamin A deficiency was 18.3% in this age group. As regards iron deficiency anemia, the prevalence in all age/sex groups was less than 5%, ranging from 0.5% in 6-year-old children to 4.2% in 15- to 23-month-old children. Zinc and vitamin D deficiencies were highest among pregnant women (8% and 85.3%, respectively). Finally, the prevalence of overweight and obesity among adults was 40.3% and 29.2%, respectively. CONCLUSION: Results of this study can help in designing nutritional intervention programs for nationwide implementation. Of all micronutrient deficiencies, vitamin D deficiency was the most prevalent in all study groups. Thus, appropriate actions should be taken in our community.

Obesity-Related Metabolomic Profiles and Discrimination of Metabolically Unhealthy Obesity.

A particular subgroup of obese adults, considered as metabolically healthy obese (MHO), has a reduced risk of metabolic complications. However, the molecular basis contributing to this healthy phenotype remains unclear. The objective of this work was to identify obesity-related metabolite patterns differed between MHO and metabolically unhealthy obese (MUHO) groups and examine whether these patterns are associated with the development of cardiometabolic disorders in a sample of Iranian adult population aged 18-50 years. Valid metabolites were defined as metabolites that passed the quality control analysis of the study. In this case-control study, 104 valid metabolites of 107 MHO and 100 MUHO patients were separately compared to those of 78 normal-weight metabolically healthy (NWMH) adults. Multivariable linear regression was used to investigate all potential relations in the study. A targeted metabolomic approach using liquid chromatography coupled to triple quadrupole mass spectrometry was employed to profile plasma metabolites. The study revealed that, after Bonferroni correction, branched-chain amino-acids, tyrosine, glutamic acid, diacyl-phosphatidylcholines C32:1 and C38:3 were directly and acyl-carnitine C18:2, acyl-lysophosphatidylcholines C18:1 and C18:2, and alkyl-lysophosphatidylcholines C18.0 were inversely associated with MHO phenotype. The same patterns were observed in MUHO patients except for the acyl-carnitine and lysophosphatidylcholine profiles where acyl-carnitine C3:0 and acyl-lysophosphatidylcholine C16:1 were higher and acyl-lysophosphatidylcholines C18:1, C18:2 were lower in this phenotype. Furthermore, proline, and diacyl-phosphatidylcholines C32:2 and C34:2 were directly and serine, asparagines, and acyl-alkyl-phosphatidylcholine C34:3 were negatively linked to MUHO group. Factors composed of amino acids were directly and those containing lysophosphatidylcholines were inversely related to cardiometabolic biomarkers in both phenotypes. Interestingly, the diacyl-phosphatidylcholines-containing factor was directly associated with cardiometabolic disorders in the MUHO group. A particular pattern of amino acids and choline-containing phospholipids may aid in the identification of metabolic health among obese patients.

An Explanation for Variation in Age at Menopause in Developing Countries Based on the Second National Integrated Micronutrient Survey in Iran.

BACKGROUND: It is reported that women in developing countries reach menopause earlier compared to developed countries. This seems to be due to underestimation of age at menopause as pre-menopause women who will reach menopause at older ages are commonly excluded in cross-sectional settings. In this study, we propose an estimation method which can deal with this bias. We also assessed major determinants of menopause. METHODS: The second national integrated micronutrient survey in Iran completed in 2015 is a population-based study with a nationally representative sample of 4,898 Iranian women aged 50 to 60 years. We used data on menopause status and menopausal age (asked retrospectively) to estimate the median survival time. We also used Logistic regression to model menopausal status on the current age and to estimate the median age, at which 50% of women will experience menopause. Demographic, lifestyle, and anthropometric determinants were also examined. RESULTS: The estimated age at menopause was 51.2 (51.0-51.3) years in the logistic model and 50.5 (48.1, 53.7) years in survival analysis. In both models, the age at menopause was significantly lower among rural and underweight women. In addition, survival analysis showed that smokers and women with smaller family size had significantly lower age at menopause. CONCLUSION: While many studies stress a gap in age at menopause between developed and developing countries, this study with a reliable estimation method showed that such a gap might originate from an underestimation of age at menopause in developing countries rather than a real difference.

Development, validity, and reliability of a food frequency questionnaire for antioxidants in elderly Iranian people.

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

Identification and prioritization of food insecurity and vulnerability indices in iran.

BACKGROUND: Food security is a multi-dimensional phenomenon. The objective of this study was to identify and prioritize major indices for determining food insecurity in Iran. METHODS: Descriptive study using the Delphi method was conducted through an email-delivered questionnaire. Forty-three senior experts at national or provincial level were selected based on their work experience and educational background through study panel consultation and snowballing from Tehran and other cities of Iran. During two rounds of Delphi, participants were asked to identify priority indicators for food security at provincial level in Iran. RESULTS: Sixty five percent of Delphi panel participated in the first round and eighty-nine percent of them participated in the second round of Delphi. Initially, 243 indices were identified through review of literature; after excluding indictors, which was not available or measurable at provincial level in Iran, 103 indictors remained. The results of study showed that experts identified "percentage of individuals receiving less than 70% of daily energy requirement" with a median score of 90, as the most influential index for determining food insecurity. "Food expenses as a proportion of the overall expenses of the family", "per capita of dietary energy supply", and "provision of micro-nutrient supply requirement per capita" with median of 80 were in the second rank of food security priority indicators. CONCLUSION: Out of 243 identified indicators for food security, 38 indicators were selected as the most priority indicators for food security at provincial level in Iran.

Dietary factors as the major determinants of overweight and obesity among Iranian adolescents. A cross-sectional study.

This study investigated the determinants of overweight/obesity in adolescents. A cross-sectional survey was carried out on 1157 adolescents. Weight and height were measured. Information on socio-economic status (SES), dietary intakes, physical activity, and sedentary behaviours were collected by a self-administered questionnaire. Binary and multivariate binary logistic regressions were used to obtain the relationships and odds-ratios, respectively. The prevalence of overweight and obesity was higher among adolescents in low- or high-income families, adolescents whose mothers worked out of home, adolescents whose parents were both overweight, adolescents who watched a lot of TV or had excessive energy intake, adolescents with lower physical activity or lower intake of dietary fibre, those who skipped breakfast ≥ 4 times per week, and those with low and high fat intake. However, multiple logistic regression analysis showed that only energy intake was associated with increased odds and vegetables and fibre intake were associated with a reduction in the odds of being overweight (all p<0.05). Adolescents from middle SES showed a lower risk of overweight/obesity than low and high SES due to better dietary intakes and less sedentary behaviours. Therefore, in overweight/obesity prevention programs, adolescents with determined risk factors from families with low and high SES should receive attention.

Association of vegan diet with RMR, body composition and oxidative stress.

BACKGROUND: There is increasing evidence to suggest that a vegetarian diet low in fat and high in complex carbohydrates offers the potential for decreasing the risk of chronic disease. However, there is little information about the effect of vegetarian diets on resting metabolic rate (RMR). The objective of this study was to determine the association of vegan diet with RMR and body composition and oxidative stress. MATERIAL AND METHODOLOGY: This research is a cross-sectional descriptive analytic study in which two groups of vegetarians and non vegetarians were compared. RMR was determined by indirect calorimetry, the amount of body fat mass (FM), the percentage of free fat mass (FFM), the markers of oxidative stress (MAD), poteins (PCO) and total anti-oxidatant capacity were measured in 20 vegetarians and 20 non-vegetarians. The two groups were matched with regard to body mass index, sex and menstrual cycle. Energy and macronutrient intakes were determined using a 3-day food record and body composition was determined by bioelectric impedance. RESULTS: VEG reported a lower relative intake of protein (40.45 ± 19.41 g, 56.96 ± 11.94 g, p = 0.04), whereas no differences were observed in daily energy, carbohydrate or fat intakes and body composition. NVEG exhibited a higher absolute RMR (1354.7 ± 192.6, 1569.10 ± 348.24 Kcal/24 h, p = 0.02). PCO plasma density was seen significantly higher among non-vegetarians (1.09 ± 3.6, 0.81 ± 0.42, p = 0.02). No significant differences were seen in plasma density of TAC between two groups and MAD was higher amoung vegetarians. CONCLUSION: These results suggest that the lower RMR observed in VEG is partially mediated by differences in dietary macronutrient composition.

Body change techniques in Iranian adolescents. Relationship to sex and body weight status.

OBJECTIVE: Several studies indicated that techniques to change body weight and appearance were prevalent and different among adolescents. The aim of the study, therefore, was to assess differences in frequency and type of body change techniques used among adolescents by sex and body weight status. METHODS: A sample of 758 adolescents aged 12-18 years were recruited from private and public schools in Tehran. Information about socio-demographic background and body change techniques were collected via a self-administered questionnaire. RESULTS: A high percentage of adolescents used body change techniques frequently to alter their body appearance. Girls changed normal eating pattern significantly (p=0.007) to lose weight more frequently than boys while boys used this method significantly (p=0.01) to gain weight more frequently than girls. Overweight/obese adolescents exercised significantly to change muscle size (p=0.03) and changed normal diet to lose weight (p<0.001) more frequently than normal weight adolescents. The relation between sex and body weight status with body change techniques (p<0.0) implied that male and female adolescents especially overweight/obese adolescents were frequently trying to change their body appearance. CONCLUSION: Significant differences existed in using body change techniques according to sex and body weight status and these should be considered in obesity prevention programs for adolescents.

Efficacy of omega-3 fatty acid supplementation on serum levels of tumour necrosis factor-alpha, C-reactive protein and interleukin-2 in type 2 diabetes mellitus patients.

INTRODUCTION: Consumption of omega-3 fatty acids can alter the inflammatory response in diabetic patients. This study aimed to determine the effects of omega-3 fatty acid supplementation on the serum levels of C-reactive protein (CRP), interleukin (IL)-2 and tumour necrosis factor-alpha (TNF-α) in type 2 diabetes mellitus patients. METHODS: A randomised, double-blind, placebo-controlled clinical trial was conducted on 84 subjects aged 45-85 years with at least a two-year history of type 2 diabetes mellitus. Participants were randomly assigned to the treatment or control group. Each subject in the treatment group received three omega-3 capsules per day (eicosapentaenoic acid 1,548 mg; docosahexaenoic acid 828 mg; other omega-3 fatty acids 338 mg), while each subject in the control group received three placebo capsules (sunflower oil 2,100 mg) for a period of eight weeks. At the beginning of the study and post intervention, fasting blood samples were taken and serum concentrations of IL-2, TNF-α and CRP were assessed and compared. RESULTS: Serum IL-2 and TNF-α levels were significantly reduced in the treatment group compared to the controls (p < 0.01). There was no significant change in serum CRP levels. CONCLUSION: Short-term omega-3 fatty acid supplementation (3 g/day for eight weeks) can decrease the serum levels of TNF-α and IL-2 in diabetic patients, with no change in CRP levels. Consumption of omega-3 fatty acid supplements is highly recommended to alleviate inflammation caused by type 2 diabetes mellitus.

Effects of daily milk supplementation on improving the physical and mental function as well as school performance among children: results from a school feeding program.

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

The effects of probiotic and conventional yoghurt on lipid profile in women.

Many studies have been done on the hypocholesterolaemic effect of probiotic yoghurt. The results, however, are not conclusive. The aim of the present study was to test the effect of probiotic and conventional yoghurt on the lipid profile in women. In a randomised trial, ninety female volunteers aged 19-49 years were assigned to three groups. Subjects consumed daily 300 g probiotic yoghurt containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 or 300 g conventional yoghurt or no yoghurt for 6 weeks. Fasting blood samples, 3 d dietary records and anthropometric measurements were collected at baseline (T1), end of week 3 (T2) and end of week 6 (T3). Lipid profile parameters were determined by enzymic methods. Results showed no significant difference in lipid profile within any group throughout the study. Comparing mean differences (T1 - T3) among the three groups showed: no difference in TAG and LDL-cholesterol, a decrease in cholesterol in both conventional (P < 0.05) and probiotic yoghurt groups (P < 0.005) compared with the control group, a decrease in total:HDL-cholesterol ratio for conventional (P < 0.05) and probiotic yoghurt groups (P < 0.001) compared with the control group, and an increase in HDL-cholesterol in the probiotic yoghurt group (P < 0.05) compared with the control group. Positive changes in lipid profile were observed in both yoghurt groups. Any added effect, therefore, is due to the consumption of fermented milk products.