Calcium-vitamin D-fortified milk is as effective on circulating bone biomarkers as fortified juice and supplement but has less acceptance: a randomised controlled school-based trial.

BACKGROUND: Hypovitaminosis D, especially during cold seasons, is quite prevalent among primary school children in Tehran. The present study aimed to compare the efficacy of calcium-vitamin D-fortified-milk, -orange juice and supplement in primary school children. METHODS: Children aged 9-12 years from both sexes were randomly assigned to one of six groups to receive plain milk, fortified milk, plain orange juice, fortified orange juice, supplement or placebo. Both fortified-milk and -juice contained 100 IU of vitamin D and 500 mg of calcium per 200 mL package, whereas supplement contained 200 IU of vitamin D and 500 mg of calcium. The duration of intervention was 12 weeks, from November 2008 to March 2009. RESULTS: A total of 410 children completed the study. Regression analysis with adjustment for both sex and initial values of 25(OH)D revealed that consumption of either supplement, fortified orange juice or fortified milk resulted in a 20.8 nm [confidence interval (CI) = 17.4-23.9], 9.9 nm (CI = 7.4-12.3) or 6.9 nm (CI = 3.3-10.5) increase in circulating 25(OH)D compared to the related control groups. However, changes in serum osteocalcin and intact parathyroid hormone in the supplement group did not differ from those of fortified milk or plain milk. The increment of osteocalcin in both plain milk and fortified milk was more than in fortified orange juice, although the difference was statistically insignificant. CONCLUSIONS: Despite having double amount of vitamin D and being more effective in raising serum 25(OH)D, supplementation did not confer additional benefit in terms of osteocalcin and intact parathyroid hormone compared to either fortified or plain milk.

Household food insecurity in the Islamic Republic of Iran: a systematic review and meta-analysis.

Using a systematic review of all available studies between 1991 and 2011, the prevalence of food insecurity in the Islamic Republic of Iran was estimated. After document evaluation and data aggregation, studies were analysed in separate categories based on the methods used: dietary recall, household income/expenditure or experiential/perception-based surveys. Meta-analysis of dietary-recall studies showed small non-significant increases between 1994 and 2004 in the prevalence of mild (from 8.8% to 9.3%) and moderate food insecurity (from 5.4% to 5.6%). Severe food insecurity was 3.8% and 3.7% in 1994 and 2004 respectively. Prevalence of food insecurity (moderate to severe) based on household income/expenditure surveys was consistently reported to be 10%. A separate meta-analysis of experiential/perception-based studies revealed rates of mild, moderate and severe food insecurity of 28.6%, 14.9% and 6.0% respectively. By combining study results in this manner makes it possible to come up with more realistic estimates for evidence-informed policy-making, until development of a national food insecurity surveillance system.

Iranian Female Adolescent's Views on Unhealthy Snacks Consumption: A Qualitative Study.

BACKGROUND: Given the increasing prevalence of obesity among Iranian adolescents and the role of consumption of unhealthy snacks in this issue, interventions that focus on factors influencing food choice are needed. This study was designed to delineate factors associated with unhealthy snack use among female Iranian adolescents. METHODS: The theory of Planned Behavior served as the framework of the study. Qualitative data were collected via nine focus group discussions in two middle schools (6(th) to 8(th) grades) in a socio-economically diverse district in the city of Tehran in spring 2008. The study sample included 90 female adolescents aged 12-15 years. The sampling strategy was purposive method. Data analyzed using the "framework" method. RESULTS: Major factors identified by the respondents were taste, peer pressure, parental influence, easy access to unhealthy snacks, limited availability of healthy snacks, appeal of snacks, habit, high price of healthy snacks, and media advertisements. Nutritional value and healthiness was not one of the first priorities when buying snacks, as adolescents thought it was too early for them to worry about illness and adverse consequences of eating junk foods. CONCLUSIONS: For developing culturally sensitive evidence-based interventions that can motivate adolescents to choose healthy snacks, a broad range of factors should be taken into account.