Apolipoprotein A2 -265 T>C polymorphism interacts with dietary fatty acids intake to modulate inflammation in type 2 diabetes mellitus patients.

OBJECTIVE: Several investigations have been conducted regarding the interaction between Apolipoprotein A2 (APOA2) -265 T>C polymorphism and dietary intake of saturated fatty acids (SFAs) on obesity in healthy individuals or type 2 diabetes mellitus (T2 DM) patients. The aim of the present study is to examine the effect of this interaction on inflammatory markers in T2 DM patients. METHODS: This is a comparative cross-sectional study on 180 T2 DM patients with known APOA2 genotype. Dietary intake was assessed by food-frequency questionnaire and serum levels of inflammatory markers (interleukin [IL]-18, pentraxin 3, and high-sensitivity C-reactive protein [hs-CRP]) were measured. The subjects were dichotomized into "high" and "low" categories, based on the median dietary intake of polyunsaturated fatty acids (PUFAs), monounsaturated fatty acids (MUFAs), and SFAs. The data were analyzed by analysis of covariance multivariate interaction model. RESULTS: In CC genotype, higher median intake of ω-3 PUFAs and MUFAs was associated with decreased serum levels of IL-18 and hs-CRP (P = 0.014 and 0.008, respectively). In T-allele carriers, higher median intake of SFAs was associated with increased serum hs-CRP level (P < 0.001). There was a significant relationship between APOA2 polymorphism and ω-3 PUFA intake on serum IL-18 level (P interaction = 0.03). Moreover, the relationship between this polymorphism and SFA and MUFA intake on serum hs-CRP level was statistically significant (P interaction = 0.03 and 0.024, respectively). CONCLUSIONS: In T2 DM patients, the dietary intake of antiinflammatory fatty acids, such as ω-3 PUFAs and MUFAs, could reduce the inflammatory effects associated with the CC genotype. In addition, proinflammatory fatty acids, such as SFAs, could overcome the antiinflammatory effect of the T-allele. Further studies are needed to confirm these findings.

The interaction between ApoA2 -265T>C polymorphism and dietary fatty acids intake on oxidative stress in patients with type 2 diabetes mellitus.

INTRODUCTION: Apolipoprotein A2 (APOA2) -265T>C polymorphism has been studied in relation to oxidative stress and various dietary fatty acids. Since the interaction between APOA2 polymorphism and dietary fatty acids on oxidative stress has not yet discussed, we aimed to investigate the interaction on oxidative stress in type 2 diabetes mellitus (T2DM) patients. METHODS: The subjects were 180 T2DM patients with known APOA2 genotype, either TT, TC or CC. Superoxide dismutase (SOD) activity was determined by colorimetric method. Total antioxidant capacity (TAC) and serum level of 8-isoprostane F2α were measured by spectrophotometry and ELISA, respectively. Dietary intake was collected through a food frequency questionnaire. Based on the median intake, fatty acids intake was dichotomized into high or low groups. The interaction between APOA2 polymorphism and dietary fatty acids intake was analyzed by ANCOVA multivariate interaction model. RESULTS: Higher than median intake of omega-6 polyunsaturated fatty acids (n-6 PUFA) was associated with increased serum level of 8-isoprostane F2α in subjects with TT/TC genotype (p = 0.004), and higher than median intake of omega-3 polyunsaturated fatty acids (n-3 PUFA) was associated with increased serum SOD activity in CC genotype (p < 0.001). There was a statistically significant interaction between APOA2 polymorphism and n-6 PUFA intake on 8-isoprostane F2α concentration as well as n-3 PUFA intake on serum SOD activity (p-interaction = 0.04 and 0.02, respectively). CONCLUSIONS: The current study shows the interaction between APOA2 polymorphism and dietary fatty acids intake on oxidative stress. More investigations on different populations are required to confirm the interaction.

A School-Based Intervention to Reduce Excess Weight in Overweight and Obese Primary School Students.

BACKGROUND: This study evaluated the effect of an intervention for reducing excess weight gain in primary school-age children in Tehran. METHODS: A cluster-randomized controlled trial was conducted in 12 primary schools in Tehran. Three hundred thirty-four pupils, 167 in the intervention and 167 in the comparison group, determined to be overweight or obese based on World Health Organization standards, were recruited for the study. The intervention included nutrition education and increased physical activity (PA) for the pupils, lifestyle modification for parents, and a change in food items sold at the schools' canteens. The entire intervention lasted approximately 18 weeks. Measures were taken before and immediately after the intervention. RESULTS: The intervention significantly reduced body mass index Z-score and hip circumference (p = .003 and p < .001, respectively). Waist circumference increased in both groups, but the increase was higher in the comparison group (p = .001). No significant difference was seen in time spent on TV viewing between groups (p = .08). Vigorous PA increased in the intervention group (p < .001), while the comparison group showed an increase in moderate activity only (p < .001). Energy intake increased significantly in the intervention group (p < .001). Neither triceps skinfold thickness nor time spent on the computer changed in the intervention group (p = .51 and p = .1, respectively), while they increased in the comparison group (p < .001 and p = .004, respectively). CONCLUSION: The study provides a successful model for the implementation of similar interventions throughout the country.

APO A2 -265T/C Polymorphism Is Associated with Increased Inflammatory Responses in Patients with Type 2 Diabetes Mellitus.

BACKGROUND: Apolipoprotein A2 (APO A2) is the second most abundant structural apolipoprotein in high density lipoprotein. Several studies have examined the possible effect of APO A2 on atherosclerosis incidence. Due to the role of inflammation in atherosclerosis, we aimed to determine the relationship between APO A2 -265T/C polymorphism and inflammation as a risk factor in type 2 diabetes mellitus (T2DM) patients. METHODS: In total, 180 T2DM patients, with known APO A2 -265T/C polymorphism, were recruited for this comparative study and were grouped equally based on their genotypes. Dietary intakes, anthropometric parameters, lipid profile, and inflammatory markers (i.e., pentraxin 3 [PTX3], high-sensitivity C-reactive protein [hs-CRP], and interleukin 18) were measured. The data were analyzed using an independent t-test, a chi-square test, and the analysis of covariance. RESULTS: After adjusting for confounding factors, in the entire study population and in the patients with or without obesity, the patients with the CC genotype showed higher hs-CRP (P=0.001, P=0.008, and P=0.01, respectively) and lower PTX3 (P=0.01, P=0.03, and P=0.04, respectively) in comparison with the T allele carriers. In the patients with the CC genotype, no significant differences were observed in the inflammatory markers between the obese or non-obese patients. However, regarding the T allele carriers, the plasma hs-CRP level was significantly higher in the obese patients compared to the non-obese patients (P=0.01). CONCLUSION: In the T2DM patients, the CC genotype could be considered as a risk factor and the T allele as a protective agent against inflammation, which the latter effect might be impaired by obesity. Our results confirmed the anti-atherogenic effect of APO A2, though more studies are required to establish this effect.

Association between ApoA-II -265T/C polymorphism and oxidative stress in patients with type 2 diabetes mellitus.

BACKGROUND: Apolipoprotein A-II (ApoA-II) constitutes approximately 20% of the total HDL protein content. The results of various studies on the relationship between cardiovascular diseases (CVD) and the plasma ApoA-II level are contradictory. The aim of this study was to determine the relationship between ApoA-II polymorphism and oxidative stress (OS) as a risk factor for CVD. METHODS: The present comparative study was carried out on 180 obese and non-obese patients with type 2 diabetes, with equal numbers of CC, TC, and TT genotypes of ApoA-II -265T/C gene. The ApoA-II genotype was determined by the TaqMan assay method. The anthropometric measurements and serum levels of lipid profile, superoxide dismutase activity (SOD), total antioxidant capacity (TAC), and 8-isoprostaneF2α were measured. RESULTS: After adjusting for confounding factors, in the total study population and in obese and non-obese groups, the subjects with CC genotype had a lower mean serum SOD activity (p=0.002, p=0.007 and p=0.005, respectively) and higher mean 8-isoprostaneF2α concentration (p<0.001, p=0.003 and p=0.004, respectively) than the T-allele carriers. In the TT/TC group, the mean 8-isoprostanF2α concentration was significantly higher in the obese subjects than the non-obese subjects (p=0.009). In the CC group, no significant differences were found in the OS factors between obese and non-obese groups. CONCLUSION: The T allele in patients with type 2 diabetes is a protective factor against OS; obesity inhibits this protective effect. The results of this study represent the anti-atherogenic properties of ApoA-II. However, further studies are needed in this field.

Children with Obesity Prioritize Social Support against Stigma: A Qualitative Study for Development of an Obesity Prevention Intervention.

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.

Predictors of dietary supplement use among female health workers in Tehran.

BACKGROUND: Despite the lack of evidence on the necessity of dietary supplements to meet nutrients requirements, the majority of people use them all over the world. This study aimed to investigate factors associated with supplement use in women who work in health centers in the city of Tehran. METHODS: Five hundred sixty three female health workers participated in a cross-sectional study carried out in 2010 in health centers of Tehran. Weight, height, and waist circumference were measured and body mass index was calculated. Data on demographic characteristics, lifestyle, and dietary supplement use were collected by interviewing. The analysis was conducted using univariate and multivariate logistic regression (MLR) in SPSS version 16. RESULTS: The prevalence of dietary supplement use was 53.8%. In univariate logistic regression model, age, education, husband's education, duration of employment, and tendency for changing weight at the time of the study were statistically significant predictors (P < 0.05). After MLR analysis, education (OR: 1.11, 95% CI: 1.05-1.17) and duration of employment (OR: 1.04, 95% CI: 1.02-1.06) remained significant in the model. Women with higher education and longer duration of employment had more tendency to use nutrient supplements. CONCLUSION: Our findings showed that education and duration of employment were the most important predictors for taking dietary supplements in this population.

Pre-pregnancy body size dissatisfaction and excessive gestational weight gain.

Body size dissatisfaction has been documented as a risk factor for obesity, but little is known about the effect of body size dissatisfaction on excessive gestational weight gain. The objective of the study was to determine the association of pre-pregnancy body size dissatisfaction with excessive gestational weight gain in Iranian pregnant women. This case-control study compared pre-gravid body satisfaction status in 182 women with excessive gestational weight gain and 180 women who gained weight within the guidelines of the Institute of Medicine. All the participants of the study were 35-41 weeks gestational age and received prenatal care in Shahid Akbarabadi Hospital. The women were asked to think back to their pre-pregnant state and report their body size satisfaction status measured by the Body Image Assessment for Obesity (BIA-O). According to this measurement, the women were divided into three categories: dissatisfied women with a thinner body size preference, dissatisfied women with a heavier body size preference and satisfied women. Among women with excessive gestational weight gain, 56.6% preferred a thinner body size, while 53.9% of those with adequate gestational weight gain were satisfied with their pre-gravid body sizes. After adjusting for cofounders, those with a thinner body size preference were more likely to gain weight excessively during pregnancy when compared to satisfied women (OR: 2.17, 95% CI: 1.17-4.02). Our result showed that thinner body size preference was associated with excessive gestational weight gain. Further studies are needed to investigate whether changes in women's feelings about their body sizes will decrease the proportion of women with excessive gestational weight gain.

Dietary calcium intake and risk of obesity in school girls aged 8-10 years.

BACKGROUND: Some studies have demonstrated the role of calcium in reducing body mass index (BMI) or fat mass. Though, BMI does not provide very valid information about changes in body fat mass, Fat Mass Index (FMI) relates body fat mass to height and allows comparing body fat mass of individuals at different heights. This study investigated the possible association between dietary calcium intake (CI) and other nutritional factors and weight status of girls aged 8-10 years. MATERIALS AND METHODS: In this case-control study, 110 girls aged 8-10 with FMI at or above 7.2 kg/m(2) as cases and 307 girls with FMI less than 7.2 kg/m(2) as controls were recruited through multistage cluster random sampling. FMI at or above 7.2 kg/m(2) was considered as the cutoff point for obesity. Body fat mass was assessed by a stand on bio impedance analyzer. In order to assess CI, participants were asked to complete a validated food frequency questionnaire. RESULTS: Mean and standard deviation of CI in the case group was significantly lower than the control group 649 ± 103 and 951 ± 152 mg/d, respectively (P < 0.01). After Adjustment for total energy intake, the percentage of energy from fat, carbohydrate and protein in quartiles of physical activity, inverse association between CI and obesity was significant and in the highest quartile of physical activity the association was weaker. By further adjustment for the effect of fruits and vegetable intake inverse association between CI and obesity became weaker but yet was significant. CONCLUSION: The inverse relationship between CI and FMI remained significant even after controlling for confounding factors. FMI may be more accurate, compared to BMI, in showing the association between CI and obesity.

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.