Effect of vitamin D supplementation or fortification on bone turnover markers in women: a systematic review and meta-analysis.

Vitamin D is a vital indicator of musculoskeletal health, as it plays an important role through the regulation of bone and mineral metabolism. This meta-analysis was performed to investigate the effects of vitamin D supplementation/fortification on bone turnover markers in women. All human randomised clinical trials reported changes in bone resorption markers (serum C-terminal telopeptide of type-I collagen (sCTX) and urinary type I collagen cross-linked N-telopeptide (uNTX)) or bone formation factors (osteocalcin (OC), bone alkaline phosphatase (BALP) and procollagen type-1 intact N-terminal propeptide (P1NP)) following vitamin D administration in women (aged ≥ 18 years) were considered. Mean differences (MD) and their respective 95 % CI were calculated based on fixed or random effects models according to the heterogeneity status. Subgroup analyses, meta-regression models, sensitivity analysis, risk of bias, publication bias and the quality of the included studies were also evaluated. We found that vitamin D supplementation had considerable effect on sCTX (MD: -0·038, n 22) and OC (MD: -0·610, n 24) with high heterogeneity and uNTX (MD: -8·188, n 6) without heterogeneity. Our results showed that age, sample size, dose, duration, baseline vitamin D level, study region and quality of studies might be sources of heterogeneity in this meta-analysis. Subgroup analysis also revealed significant reductions in P1NP level in dose less than 600 µg/d and larger study sample size (>100 participants). Moreover, no significant change was found in BALP level. Vitamin D supplementation/fortification significantly reduced bone resorption markers in women. However, results were inconsistent for bone formation markers.

The association of dietary carbohydrate quality and quantity with obesity among Iranian adolescents: a case-control study.

BACKGROUND: Adolescent obesity is considered as a major health concern worldwide which is closely linked to the quality of diet. The purpose of the present study was to assess the carbohydrate quality and quantity in relation to odds of overweight and obesity in adolescents. METHODS: This case-control study with a 1:1 ratio was conducted on 406 adolescents (14 to 18 years old) matched for age and gender. Participants were selected by multistage cluster random sampling method from March to October 2019 in Shiraz, Iran. Dietary intakes of the study population were assessed by a validated semi-quantitative food frequency questionnaire. Also anthropometric indices were measured using standard methods and demographic information was recorded via face to face interview. The relation between low carbohydrate diet score (LCDS) and carbohydrate quality index (CQI), and odds of obesity was evaluated by multiple Logistic regression. RESULTS: After adjusting the role of potential confounders, the participants in the third tertiles of LCDS (OR = 0.443, 95% CI = (0.260 to 0.755)) and CQI (OR = 0.005, 95% CI = (0.001 to 0.025)) had less odds of being overweight and obese compared to the first tertile. CONCLUSION: The present study found an inverse relationship between dietary quantity and quality of carbohydrate intake and the odds of overweight and obesity in a sample of Iranian adolescents.

The association between ultra-processed foods and conventional markers of cardiovascular risk in an adult Iranian population.

BACKGROUND AND AIMS: According to the NOVA classification system, ultra-processed foods result from extensive industrial processing and use ingredients derived from food and non-food products, which can negatively impact on cardiovascular disease risk factors. Despite this, few studies have investigated UPFs in Middle Eastern populations regardless of high consumption in this region. METHODS AND RESULTS: This cross-sectional study was conducted on data from the Prospective Epidemiological Research Studies in Iran Kharemeh cohort (n = 6611). Food frequency questionnaires were assessed and the ratio of total UPFs energy/total energy intake was calculated. Data was categorized into tertiles of UPF consumption using the NOVA classification system. Kruskal-Wallis tests were used to assess differences in nutrient and food intakes between tertiles and logistic regression analysis was applied to assess the associations between UPFs and CVD risk factors. After adjustment for potential confounders the logistic regression analysis revealed significant positive relationships between intakes of UPFs and waist circumference (WC) (T2: OR; 1.34, 95% CI; 1.13-1.60 - T3: OR; 1.41, 95% CI; 1.18-1.69, P ˂0.001), low-density lipoprotein cholesterol (LDL-C) (T2: OR; 1.20, 95% CI; 1.05-1.37 - T3: OR; 1.27, 95% CI; 1.11-1.45, P ˂0.001), non-high-density lipoprotein cholesterol (non-HDL) (T2: OR; 1.21, 95% CI; 1.07-1.37 - T3: OR; 1.24, 95% CI; 1.10-1.41, P ˂0.001) and LDL-C to HDL-C ratio (T2: OR; 1.15, 95% CI; 1.02-1.31 - T3: OR; 1.21, 95% CI; 1.07-1.38, P = 0.002). CONCLUSION: The consumption of UPFs was positively associated with WC and atherogenic blood lipids. However, increased intakes of fiber and unsaturated fats were also found in those consuming more UPFs, which was not expected. These findings offer insights into an understudied population and warrant further research.

Dietary Antioxidant Capacity Indices are Negatively Correlated to LDL-Oxidation in Adults.

Introduction: Former research studies have demonstrated controversial associations between dietary indices and oxidative stress biomarkers including oxidized low-density lipoprotein (ox-LDL) and malondialdehyde (MDA). So, in this cross-sectional study, we aimed to assess the association of dietary total antioxidant capacity (DTAC), oxidative balance score, and phytochemical index (PI) with ox-LDL/MDA in a healthy adult population of Shiraz, Iran. Methods: 236 individuals participated in this cross-sectional study. DTAC, OBS, and PI were calculated using a 168-item food frequency questionnaire (FFQ), which was previously validated in Iran. We measured ox-LDL and MDA in blood samples of the participants using commercially existing kits. Crude and adjusted models of linear regression were used to evaluate the relation of dietary indices with ox-LDL and MDA. Results: There was a significant association between ox-LDL and DTAC in both crude (ß = -1.55; 95% CI: -2.53, -0.58; P-trend = 0.002) and adjusted (ß = -1.65 95% CI: -2.66, -0.64; P-trend = 0.001) models. Also, a negative association was observed between ox-LDL and PI in the crude (ß = -1.26 95% CI: -2.33, -0.29; P-trend = 0.01) and adjusted (ß = -1.36 95% CI: -2.38, -0.34; P-trend = 0.01) models. Conclusion: Results of this study showed that DTAC and PI were inversely associated with ox-LDL as markers of lipid peroxidation. But no correlations were seen between MDA and dietary antioxidant indices.

The Association between Dietary Diversity Score and Risk of Prostate Cancer: (A Case-Control Study).

There are few studies that evaluated the relationship between dietary diversity score (DDS) and risk of cancer. The purpose of this study was to examine the association of DDS with the risk of prostate cancer (PC) among Iranian men. This case-control study was performed among 60 cases with prostate cancer and 60 hospital-based controls. Anthropometric measurements were done and demographic information was recorded using standard protocols. A validated 160-item semi-quantitative food frequency questionnaire (FFQ) was used to assess usual dietary intakes. Also, Binary logistic regression was performed to estimate the risk of PC in relation to DDS. After controlling for several confounders (age, body mass index, physical activity, energy intake, job, education, and antihypertensive drugs usage) higher adherence to DDS (OR = 0.33; 95% CI (0.11-0.97)), fruits group (OR = 0.19; 95% CI (0.06-0.63)), and vegetables group (OR = 0.17; 95% CI (0.05 - 0.58)) were significantly associated with lower risk of PC. In contrast, greater adherence to the meat group (OR = 3.88; 95% CI (1.32-11.42)) was significantly associated with increased PC risk. Our results showed that adherence to a diet with higher DDS, especially higher amounts of fruits and vegetables and a lower amount of meat could decrease the risk of PC.

The effect of calcium supplement intake on lipid profile: a systematic review and meta-analysis of randomized controlled clinical trials.

Despite the potential role of dietary calcium in fat excretion, the favorable effects of calcium supplements on lipid profile remains inconclusive. The current study aimed to review the effect of calcium supplement intake on lipid profile in randomized controlled clinical trials (RCTs). This systematic review and meta-analysis was conducted in PubMed, Scopus, Embase, and Central. RCTs which assessed the effects of calcium supplementation on lipid profile were included. All outcomes were recorded as continuous variables, and the effect size was measured. We classified studies according to dose of supplement, study duration, and dyslipidemia. Calcium supplement intake was associated with a significant reduction in low density lipoprotein cholesterol (LDL-C) level (WMD:-0.08; 95%CI:-0.16,-0.01)(mmol/l), especially with intakes of at least 1000 mg/day (WMD:-0.13; 95%CI:-0.23,-0.03)(mmol/l), with intakes of at least 12 weeks (WMD:-0.08; 95%CI: -0.16,-0.00)(mmol/l), and in individuals without dyslipidemia (WMD:-0.15; 95%CI:-0.26,-0.04)(mmol/l). Also, in another subgroup analysis, consumption of less than 1000 mg/day calcium supplement caused a significant increase in Total Cholesterol (TC) level (WMD: 0.24; 95%CI: 0.05,0.42) (mmol/l). In other blood lipids or study subgroups we observed no significant effect. We concluded that calcium supplements had a favorable effect on LDL-C level, especially in individuals without dyslipidemia, higher calcium intakes, and longer period of consumption.

Evaluating the effects of dark chocolate formulated with micro-encapsulated fermented garlic extract on cardio-metabolic indices in hypertensive patients: A crossover, triple-blind placebo-controlled randomized clinical trial.

This study aimed to investigate the health-related effects of microencapsulated fermented garlic extract (FGE) containing dark chocolate in hypertensive adults. For this purpose, 36 hypertensive adults (15 males vs. 21 females) were randomized to receive the FGE (5 g/day) dark chocolate containing 650 mg of FGE powder or the placebo. Intervention periods lasted for 6 weeks and were separated by a 3-week wash-out period. The response variables included blood pressure, anthropometric indices, lipid profile, and inflammatory and oxidative stress indices. Statistical analyses were performed using the Pkcross procedure, and Cohen's d was estimated for all response variables. There was no significant inter-period difference between the mean changes of body weight, waist circumference, and body mass index (BMI). Furthermore, no significant change was confirmed in participants' blood pressure, triglycerides, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), serum homocysteine, high-sensitive c-reactive protein (hs-CRP), malondialdehyde (MDA), and total antioxidant capacity (TAC). It seems that the dose of FGE used in this study was not sufficient to cause any significant changes in the outcomes. Therefore, further studies with dose-response designs and longer durations are recommended.

Determinants and consequences of food insecurity in families having children under the age of 2 years.

Background: Today, food insecurity is recognized as an important public health problem that can have detrimental effects on families. Aim: The aim of this study was to assess the determinants and consequences of food insecurity in families having children under the age of 2 years. Method: In this cross-sectional study, 307 mothers and their children under the age of 2 years were selected by stratified random sampling. Demographic and socioeconomic data were collected by completing questionnaires through face-to-face interview. Household food insecurity (HFI) status was determined using the United States Department of Agriculture (USDA) household food security questionnaire. Results: Based on the results, 67.4% of families were high food secure. Low and very low food security was 25.7% and 6.9%, respectively. House size (Beta = -0.019, 95% CI: -0.029, -0.009), father's job (Beta = -4.758, 95% CI:-6.777, -2.738), father education (Beta = -0.370, 95% CI: -0.717, -0.023), and economic status (Beta = -0.628, 95% CI: -0.809, -0.448) were significantly related to the USDA total food insecurity score (p < 0.05). Regression analysis showed that children birth weight, father's body mass index (BMI), and mother's waist circumference had a significant positive correlation with weight for age (Z-score) of children. Children's birth weight, father's BMI, and HFI status had significant and positive correlation with weight for length (Z-score). Moreover, the significant association between children's birth height, mother's BMI, and mother's waist circumference with length for age (Z-score) were observed (p < 0.05). Conclusion: We found the father's job was the most effective factor in food insecurity and economic status of the family was in the second place. Also, HFI had a relationship with weight status of children under the age of 2 years.

Association between plant and animal proteins intake with lipid profile and anthropometric indices: A cross-sectional study.

BACKGROUND: Results of studies on the effects of plant and animal proteins on lipid profile are controversial. So we aimed to assess the relationship between plant and animal protein intake with lipid profile and novel anthropometric indices in healthy individuals. METHOD: In this cross-sectional study, 236 participants have selected from Shiraz medical centers (Iran) through random cluster sampling. Food intakes were assessed using a 168-items food frequency questionnaire (FFQ). Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were measured. Anthropometric indices including a body shape index (ABSI), abdominal volume index (AVI), buddy roundness index (BRI), and conicity index (CI) were calculated. RESULTS: In the crude and fully adjusted models, more consumption of plant proteins was associated with TG levels (OR = 2.31; 95% CI: 1.08, 4.95; P = 0.03 and OR = 2.39; 95% CI: 1.03, 5.15; P = 0.04). Also, there was a significant direct association between plant proteins and BRI in the curd model (OR = 3.55; 95% CI: 1.32, 9.54; P = 0.01), and after adjusting for age and energy intake (OR = 3.32; 95% CI: 1.21, 9.14; P = 0.01). More consumption of plant proteins was related to higher CI in the crude model (OR = 3.06; 95% CI: 1.12, 8.31; P = 0.03), but not in the fully adjusted model. CONCLUSION: We found that a higher intake of plant proteins was associated with a higher TG level, BRI, and CI index. However, more research is needed to confirm these relations and provide the evidence needed to exert these findings into clinical practice.

Effect of flaxseed consumption on central obesity, serum lipids, and adiponectin level in overweight or obese women: A randomised controlled clinical trial.

BACKGROUND: Flaxseed may be beneficial for the management of obesity due to its high content of alpha-linolenic acid, fibre, and lignans. OBJECTIVE: We aim to evaluate the effect of flaxseed consumption on serum lipids, adiponectin, leptin, and anthropometric indices in overweight or obese women. METHODS: This randomised controlled clinical trial involved 60 overweight or obese women. Participants were randomly allocated into two groups: (a) a balanced diet plus 30 g/day milled flaxseed (as treatment group) and (b) a balanced diet plus 30 g/day milled rice (as control group). Anthropometric indices, serum lipids, leptin, and adiponectin level were measured at baseline and at the end of intervention after 12 weeks. RESULTS: After 12 weeks of intervention, there was significantly higher reduction rate in waist circumference (WC) and waist-to-hip ratio (WHR) (both P < .05) in the flaxseed-consuming group compared with the control group. Moreover, adiponectin level was significantly increased from (12.11 ± 7.1) to (17.15 ± 6.1) in the flaxseed-consuming group compared with the control group from (12.48 ± 4.7) to (12.01 ± 5.8) (P = .002). However, no significant difference was observed in serum lipid level in the study groups before and after the intervention (all P > .05). CONCLUSION: Flaxseed consumption may improve adiposity markers, such as adiponectin level. Thus, flaxseed consumption could be an adjunctive therapy to attenuate central obesity. Serum lipid profile has not changed meaningfully after flaxseed consumption.

Adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and mental health in Iranian university students.

PURPOSE: Examining the association between adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and mental health in Iranian university students. METHODS: This cross-sectional study was conducted among 240 university students (mean age 21.5 years; 86.7% female). Mental health was evaluated using validated Persian versions of the 12-item general health questionnaire (GHQ-12) and the 21-item depression, anxiety, and stress scale (DASS-21). The lower the subjects' scores on these questionnaires, the better their mental health. Usual past-year dietary intakes were assessed by a validated 168-item semi-quantitative food frequency questionnaire. The DASH score was computed based on energy-adjusted intakes of eight major dietary components emphasized or minimized in the DASH pattern. The higher the DASH score of a subject, the greater his/her adherence to the DASH pattern. RESULTS: The Pearson's correlation coefficients of DASH score with GHQ-12 total score, DASS-21 total score, and DASS-21 depression, anxiety, and stress subscale scores were - 0.431, - 0.441, - 0.434, - 0.325, and - 0.408, respectively (all P < 0.001). Compared to those in the lowest tertile, subjects in the highest tertile of DASH score had lower means of GHQ-12 total score (mean difference - 4.6; P < 0.001), DASS-21 total score (mean difference - 9.1; P < 0.001), and DASS-21 depression, anxiety, and stress subscale scores (mean differences for depression, anxiety, and stress - 3.6, - 2.4, and - 3.2, respectively; all P < 0.001). CONCLUSIONS: The findings indicate that greater adherence to the DASH dietary pattern is associated with better mental health in Iranian university students. However, prospective studies of sufficient methodological quality are needed to confirm these findings.

Comparison of blood lipid-lowering effects of olive oil and other plant oils: A systematic review and meta-analysis of 27 randomized placebo-controlled clinical trials.

Objective: We aim to report a systematic review and meta-analysis of randomized controlled trials (RCTs) on effects of olive oil consumption compared with other plant oils on blood lipids. Methods: PubMed, web of science, Scopus, ProQuest, and Embase were systematically searched until September 2017, with no age, language and design restrictions. Weighed mean difference (WMD) and 95% confidence interval (CI) were expressed as effect size. Sensitivity analyses and pre specified subgroup was conducted to evaluate potential heterogeneity. Meta-regression analyses were performed to investigate association between blood lipid-lowering effects of olive oil and duration of treatment. Results: Twenty-seven trials, comprising 1089 participants met the eligibility criteria. Results of this study showed that compared to other plant oils, high-density lipoprotein level increased significantly more for OO (1.37 mg/dl: 95% CI: 0.4, 2.36). Also OO consumption reduced total cholesterol (TC) (6.27 mg/dl, 95% CI: 2.8, 10.6), Low-density lipoprotein (LDL-c) (4.2 mg/dl, 95% CI: 1.4, 7.01), and triglyceride (TG) (4.31 mg/dl, 95% CI: 0.5, 8.12) significantly less than other plant oils. There were no significant effects on Apo lipoprotein A1 and Apo lipoprotein B. Conclusion: This meta-analysis suggested that OO consumption decreased serum TC, LDL-c, and TG less but increased HDL-c more than other plant oils.

Effects of Canola Oil Consumption on Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.

Hyperlipidemia is a well- known risk factor of cardiovascular disease. A healthy diet containing vegetable oils such as canola oil (CO) may help to reduce serum lipids. This study aimed to quantify the effects of CO on lipid parameters using a systematic review and meta-analysis of randomized controlled trials. PubMed, Web of Science, Scopus, ProQuest, and Embase were systematically searched until December 2017, with no time and design restrictions. Also, a manual search was performed to find extra relevant articles. Lipid parameters including total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglycerides (TG), apolipoprotein A1 (Apo A1), and apolipoprotein B (Apo B) were entered the meta-analysis. Weighed mean difference (WMD) and 95% confidence interval (CI) were stated as the effect size. Sensitivity analyses and prespecified subgroup were conducted to evaluate potential heterogeneity. Twenty-seven trials, comprising 1359 participants, met the eligibility criteria. Results of this study showed that CO consumption significantly reduced TC (-7.24 mg/dl, 95% CI, -12.1 to -2.7), and LDL (-6.4 mg/dl, 95% CI, -10.8 to -2), although it had no effects on HDL, TG, Apo B, and Apo A1. Effects of CO on TC and LDL significantly decreased after CO consumption in subgroups of >50 years of age participants and >30 intervention duration subgroup. Moreover, CO decreased LDL and TC compared to sunflower oil and saturated fat. This meta-analysis suggested that CO consumption improves serum TC and LDL, which could postpone heart disease progression. Key Teaching Points CO consumption could decrease serum TC and LDL, although it had no effects on other blood lipids. There was an overall significant effect of canola oil on TC and LDL compared to sunflower oil and saturated fats. CO could have beneficial effects on serum TC and LDL just when consumed longer than 30 days. CO consumption improved lipid profiles in participants older than 50 years.

Improving diet quality among adolescents, using health belief model in a collaborative learning context: a randomized field trial study.

This study aimed to assess the impact of educational intervention, based on health belief model (HBM) and collaborative learning techniques on diet quality in adolescents. In this field trial study, 311 students aged 13-15 years old were included, of which 163 and 148 allocated in the experimental and comparison groups, respectively. They were selected through a stratified random sampling from 16 urban, secondary schools in 4 educational districts of Shiraz, the largest city in southern Iran. The revised children diet quality index was used to assess their diet quality. Using HBM as a framework for targeting determinants of dietary behavior, the intervention was performed in a collaborative learning context during the educational year (2015-16). Constructs of HBM and diet quality were measured before and after the intervention. All HBM's constructs and knowledge had significantly improved in the experimental group and mean differences were increased after the intervention. Diet quality improved in the experimental group (P < 0.001), which was significantly different from the comparison group (P = 0.001). The findings support the integration of appropriate models/theories into the context of collaborative learning methods to target large number of behavioral determinants, and ultimately increase the effectiveness of the educational interventions amongst adolescents.

Western Dietary Pattern, But not Mediterranean Dietary Pattern, Increases the Risk of Prostate Cancer.

BACKGROUND AND AIM: Prostate cancer is the most common cancer among men. Several studies have investigated the effects of dietary patterns on prostate cancer risk, but this topic is still a matter of debate. This study aimed to examine the association between dietary patterns and prostate cancer risk. METHODS: In a case-control study, 60 newly diagnosed prostate cancer cases and 60 hospital-based controls were selected from two main hospitals of Shiraz, Iran. Data on dietary intakes, anthropometric features, and demographic characteristics were collected. To determine the dietary patterns factor analysis, and to estimate the odds ratios (ORs), multivariable logistic regression was performed. RESULTS: Two major dietary patterns were identified: Western dietary (WD) pattern and Mediterranean dietary (MD) pattern. After adjusting for potential confounders, men who had higher scores for WD pattern (above the median) were more likely to have prostate cancer (OR = 5.15; 95% CI (1.44-18.47); P = 0.01) compared with men who had lower scores. A nonsignificant inverse association was found for MD pattern (OR = 0.62; 95% CI (0.22-1.77); P = 0.37). CONCLUSIONS: Our findings suggest that WD pattern may increase the risk of prostate cancer and the beneficial effects of MD pattern on prostate cancer risk need further research.

Greater adherence to the dietary approaches to stop hypertension (DASH) dietary pattern is associated with lower blood pressure in healthy Iranian primary school children.

PURPOSE: The dietary determinants of children blood pressure (BP) are poorly understood. We examined the association between adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and BP in healthy Iranian primary school children. METHODS: This cross-sectional study was conducted among a representative sample (n = 407) of healthy Shirazi students aged 6-12 years. Subjects' systolic and diastolic BP were measured by a validated oscillometric BP monitor. Usual dietary intakes over the past 12 months were assessed using a valid and reproducible 168-item semi-quantitative food frequency questionnaire via face-to-face interviews. A DASH score was calculated for each subject based on his/her energy-adjusted intakes of 8 major dietary components emphasized or minimized in the DASH dietary pattern. The higher the DASH score of a subject, the more his/her adherence to the DASH dietary pattern. RESULTS: After controlling for several potential confounders in the analysis of covariance models, multivariable-adjusted means of systolic and mean BP of subjects in the highest tertile of DASH score were significantly lower than those in the lowest tertile (for systolic BP: mean difference -6.2 mmHg, P = 0.010; and for mean BP: mean difference -5.4 mmHg, P = 0.013). Furthermore, a similar but statistically insignificant difference was found in terms of multivariable-adjusted means of diastolic BP (mean difference -3.9 mmHg, P = 0.146). CONCLUSIONS: The findings suggest that greater adherence to the DASH dietary pattern is associated with lower BP in healthy Iranian primary school children. However, future prospective studies of adequate methodological quality are warranted to confirm these findings.

Association between overweight/obesity and eating habits while watching television among primary-school children in the city of Shiraz, Iran.

OBJECTIVE: It has been reported that television (TV) viewing is associated with childhood obesity in Western countries. The present study aimed to investigate the relationship between obesity and eating habits while watching TV among primary-school children in the Middle East. DESIGN: Cross-sectional. SETTING: Children were recruited from primary schools of four educational districts in Shiraz, Iran. Anthropometric indices of mass (kg) and height (m) were measured, and BMI (percentile) was calculated. Demographic characteristics, TV viewing behaviours and physical activity data were collected from parents during face-to-face interviews and a 3d dietary record was completed. Subject Children (n 607) aged 6-10 years. RESULTS: Mean (sd) age of children was 8·16 (1·37) years, of whom 9·1 and 8·4 % were overweight and obese, respectively. Children who spent ≥2 h watching TV on weekdays (OR=1·99; 95 % CI 1·09, 3·60) and weekend days (OR=1·86; 95 % CI 1·01, 3·43) had higher odds of being obese, even after adjusting for physical activity. Children who ate breakfast while watching TV had higher odds of being overweight v. those who did not watch TV while eating breakfast (OR=2·70; 95 % CI 1·02, 7·60). There were no associations between TV viewing during other meals (lunch and dinner) and overweight/obesity. CONCLUSIONS: TV viewing for ≥2 h daily increases the risk of being obese in Iranian children aged 6-10 years, independent of physical activity. Further, breakfast consumption while watching TV may increase the risk of overweight/obesity, independent of total TV viewing time.

A Western dietary pattern is associated with higher blood pressure in Iranian adolescents.

PURPOSE: The dietary determinants of adolescent blood pressure (BP) are not well understood. We determined the association between major dietary patterns and BP in a sample of Iranian adolescents. METHODS: This cross-sectional study was conducted among a representative sample (n = 557) of Shirazi adolescents aged 12-19 years. Participants' systolic and diastolic BP was measured using a validated oscillometric BP monitor. Usual dietary intakes during the past 12 months were assessed using a valid and reproducible 168-item semiquantitative food frequency questionnaire through face-to-face interviews. Principal component factor analysis was used to identify major dietary patterns based on a set of 25 predefined food groups. RESULTS: Overall, three major dietary patterns were identified, among which only the Western pattern (abundant in soft drinks, sweets and desserts, salt, mayonnaise, tea and coffee, salty snacks, high-fat dairy products, French fries, and red or processed meats) had a significant association with BP. After adjusting for potential confounders in the analysis of covariance models, multivariable adjusted means of the systolic and mean BP of subjects in the highest tertile of the Western pattern score were significantly higher than those in the lowest tertile (for systolic BP: mean difference 6.9 mmHg, P = 0.001; and for mean BP: mean difference 4.2 mmHg, P = 0.003). A similar but statistically insignificant difference was observed in terms of diastolic BP. CONCLUSIONS: The findings suggest that a Western dietary pattern is associated with higher BP in Iranian adolescents. However, additional large-scale prospective studies with adequate methodological quality are required to confirm these findings.

Pre-meal screen-time activities increase subjective emotions, but not food intake in young girls.

PURPOSE: To determine the effect of pre-meal screen-time activities on subjective emotions, subjective appetite, and food intake (FI) in 9-14 year-old girls. METHODS: In this clinical study, 31 girls completed four 45-min treatment conditions of television viewing (TVV), video game playing (VGP), a challenging computer task (CT), and sitting without screen exposure (control) in a randomized order. Each treatment condition was followed immediately by an ad libitum pizza lunch, and FI was calculated from the weight of the consumed pizza. Subjective appetite was assessed at baseline, 15, 30, and 45 min during the treatment condition, and upon trial completion at 75 min. Subjective emotions were assessed at baseline and at 45 min. RESULTS: FI was not affected by screen type, but was positively correlated with body composition (fat mass [FM, kg], fat free mass [FFM, kg]) in all treatment conditions. Subjective appetite was not affected by screen type, but increased with time in all treatment conditions (p < 0.0001). Subjective emotions were affected by VGP only. Anger, excitement, frustration, and upset feelings were increased at 45 min following VGP. VGP led to increased frustration compared to control (p = 0.0003), CT (p = 0.007) and TVV (p = 0.0002). CONCLUSION: Exposure to TVV or CT before eating did not affect subjective emotions, subjective appetite, or FI, and no difference was found between screen activities and the control condition for average appetite or FI. Despite a change in subjective emotions during the VGP condition, there was no increase in subjective appetite or subsequent FI. These findings suggest that physiologic signals of satiation and satiety are not overridden by environmental stimuli of pre-meal screen-time exposure among young girls. (Clinical trial number NCT01750177).

Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women: a randomized controlled trial.

PURPOSE: Controversy exists regarding whether increasing dairy intake without energy restriction would lead to weight loss. We aimed to compare the potential weight-reducing effects of kefir drink (a probiotic dairy product) and milk in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women. METHODS: One hundred and forty-four subjects were assessed for eligibility in this single-center, multi-arm, parallel-group, randomized controlled trial. Of these, seventy-five eligible women aged 25-45 years were randomly assigned to three groups, labeled as control, milk, and kefir, to receive an outpatient dietary regimen for 8 weeks. Subjects in the control group received a diet providing a maintenance level of energy intake, containing 2 servings/day of low-fat dairy products, while those in the milk and kefir groups received a weight maintenance diet, containing 2 additional servings/day (a total of 4 servings/day) of dairy products from low-fat milk or commercial kefir drink, respectively. Anthropometric outcomes including weight, body mass index (BMI), and waist circumference (WC) were measured every 2 weeks. RESULTS: Fifty-eight subjects completed the study. Using analysis of covariance models in the intention-to-treat population (n = 75), we found that at 8 weeks, subjects in the kefir and milk groups had significantly greater reductions in weight, BMI, and WC compared to those in the control group (all p < 0.01). However, no such significant differences were found between the kefir and milk groups. CONCLUSIONS: Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women. However, further studies are warranted.