Dietary total antioxidant capacity and odds of lung cancer: a large case-control study.

BACKGROUND& AIMS: We aimed to study the association between dietary total antioxidant capacity (dTAC) and lung cancer (LC) odds in an Iranian population. METHODS: We recruited histopathologically diagnosed LC patients and healthy subjects from 10 provinces of Iran. Trained interviewers conducted face-to-face interviews using a structured questionnaire to collect demographic and other non-dietary information. Dietary habits in the previous year were evaluated using a validated food frequency questionnaire (FFQ). We calculated daily energy and nutrient intakes using the USDA Food Composition Table. DTAC was assessed as ferric reducing antioxidant power (FRAP) and total radical-trapping antioxidant parameters (TRAP) whose scores were calculated using published databases. The odd ratios (OR) of LC and 95% confidence intervals (CI) were estimated using unconditional logistic regression after adjusting for potential confounders. Moreover, we assessed the associations in stratified groups of age, gender, tobacco including waterpipe smoking, and opium use. RESULTS: Six hundered and sixty patients and 3,412 healthy controls were included in our study. Higher FRAP and TRAP scores were associated with a lower odd of LC (FRAP, upper tertile (T3) vs. lower tertile (T1): OR = 0.53, 95% CI: 0.40-0.68; TRAP, T3 vs. T1: OR = 0.44, 95% CI: 0.33-0.57) with a significant dose-response trend for both scores (p < 0.01). The inverse association was seen for both indicators in all histologic types of LC and in all stratified analyses including male/female, tobacco smokers/nonsmokers, opium users/nonusers, water pipe users/nonusers, and subjects under/over 50 years of age. However, Interaction between none of these variables with dTAC scores was significant. CONCLUSION: Higher dTAC is associated with a lower odd of LC. The strong association in all subgroups highlights the importance of an antioxidant-rich diet intake in all subjects, even in the low-risk group.

Dietary soluble, insoluble, and total fiber intake and their dietary sources in association with breast cancer.

BACKGROUND: A few studies have examined the association between different types of dietary fiber as well as their sources and the risk of breast cancer (BC) and the present study aimed to investigate these associations in a case-control study among Iranian women. METHODS: A total of 464 women with pathologically confirmed breast cancer within the past year and 498 age-matched healthy controls were included. Dietary intakes were assessed using a 168-item food frequency questionnaire. The association between dietary soluble, insoluble, total dietary fiber, as well as, fiber from fruits, vegetables, legumes, cereals, and nuts intake with odds of breast cancer was assessed using multivariate logistic regression analysis. RESULTS: Mean total dietary fiber intake of patients with and without cancer were 33.1 ± 15.3 g per day (g/d) and 34.2 ± 16.5 (g/d), respectively. Dietary total fiber (OR = 0.65; 95%CI: 0.47-0.90, Ptrend = 0.01), insoluble fiber (OR = 0.68; 95%CI: 0.49-0.93, Ptrend = 0.01), fruits' fiber (OR = 0.68; 95%CI: 0.49-0.94, Ptrend = 0.02), and vegetables' fiber (OR = 0.66; 95%CI: 0.48-0.91, Ptrend = 0.01) were significantly associated with reduced likelihood of developing breast cancer in all participants. Furthermore, dietary total and insoluble fiber, as well as, fiber from fruits were significantly associated with lower odds of breast cancer in premenopausal women (P < 0.05). In contrast, cereals' fiber significantly increased the risk of breast cancer by 84% in premenopausal women (OR = 1.84; 95%CI: 1.18-2.86, Ptrend = 0.009). In postmenopausal women, cereals' fiber had a significant inverse association with odds of breast cancer (OR = 0.56; 95%CI: 0.31-1.03, Ptrend = 0.04). Also, fiber from vegetables was significantly associated with a lower risk of breast cancer in postmenopausal women (OR = 0.53; 95%CI: 0.30-0.94, Ptrend = 0.03). CONCLUSION: Dietary fiber intake and more specifically insoluble, fruits', and vegetables' fiber intake might be associated with a reduced breast cancer risk, particularly in premenopausal women. Future prospective investigations are needed to confirm these findings.

Population attributable proportion and number of cancer cases attributed to potentially modifiable risk factors in Iran in 2020.

In the current study, we aimed to calculate the fraction of cancer attributable to modifiable risk factors in Iran in 2020. Population attributable fractions (PAFs) were calculated for established cancer risk factors using three data sources: the national cancer incidence reports, relative risks extracted from global and national meta-analyses, and exposure prevalence from national/subnational population-based surveys. In addition to overall cancers, the PAFs were estimated separately for each cancer site among men and women. Overall, 32.6% of cancers in 2020 in Iran were attributable to known risk factors. The PAF in men (40.2%) was twice as high as in women (21.1%). Cigarette smoking (15.4%), being overweight (5.0%), opium use (3.9%) and H. pylori infection (3.8%) were the leading causes of cancers. For men, the highest PAFs belonged to cigarette smoking (26.3%), opium use (6.8%) and being overweight (3.1%), while for women, the highest PAFs belonged to being overweight (7.2%), H. pylori infection (2.7%) and cigarette smoking (2.7%). Among Iranian men and women, the PAFs of waterpipe smoking were 2% and 0.9%, respectively. A third of incident cancers in Iran are due to modifiable exposures, mainly cigarette smoking, being overweight, and H. pylori infection. Opium consumption and waterpipe smoking collectively accounted for 8.8% of cancer occurrence in men and 1.3% in women in Iran. These emerging risk factors should be taken into consideration in future PAF studies.

Patterns of Nutrient Intake in Relation to Gastric Cancer: A Case Control Study.

Gastric Cancer (GC) is the most common cancer among Iranian men. We conducted a case-control study to investigate the association between patterns of nutrient intake and the risk of GC in Iran. We enrolled 178 GC patients and 271 controls matched for age and sex. We collected dietary intakes using a validated diet history questionnaire. We performed factor analysis on 28 nutrients using multivariate logistic regression models on tertiles of factor scores and estimated odds ratios (OR) and 95% confidence intervals (95% CI). We identified three nutrient patterns. The first pattern included pantothenic acid, riboflavin, zinc, animal protein, and calcium. Selenium, thiamin, carbohydrate, vegetable protein, niacin and low intake of vitamin E loaded the second pattern, and the third pattern was abundant in fiber, carotene, vitamin C and A. We found no significant association between GC and any of the dietary patterns. However, in the first patterns, men in the highest tertile had significantly higher odds of GC than the lowest (OR = 2.15, 95% CI: 1.13-4.09, p trend = 0.02). A dietary pattern loaded by animal products may increase the risk of GC among Iranian men. Larger studies are required to approve these findings in overall and in different subgroups.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1931697.

Dietary Inflammatory Index and Breast Cancer: report from a Large-Scale Case-Control Study.

OBJECTIVE: The relationship between diet, including its inflammatory potential, and breast cancer has led to inconsistent results. We investigated the association between a dietary inflammatory index (DII) and the odds of breast cancer in a large case-control study among women. METHODS: This case-control study was carried out on 412 women with pathologically confirmed breast cancer and 456 apparently healthy controls. DII scores were calculated from dietary intake data. Multi-variable adjusted logistic regression was used to obtain odds ratios for breast cancer across quartiles of DII. RESULTS: A total participants aged 45 ± 10.8 years were included in the present study. After adjustment for potential confounders, individuals in the highest quartile of DII scores had 1.5 times higher odds of breast cancer than those with the lowest (OR= 1.56; 95%CI: 1.04-2.35, Ptrend=0.02). Premenopausal women with the greatest DII had higher odds for breast cancer, compared with those with the lowest DII (OR= 1.92; 95% CI: 1.14-3.25, Ptrend=0.01). No significant association was seen between DII and odds of breast cancer in postmenopausal women. CONCLUSION: Dietary inflammatory index might be directly associated with odds of breast cancer particularly in premenopausal women. Prospective cohort studies are needed to confirm these findings.

Substitution of dietary macronutrients and their sources in association with breast cancer: results from a large-scale case-control study.

PURPOSE: To evaluate the association between dietary replacement of carbohydrates, proteins, fats, and their sources and odds of developing breast cancer (BC). METHODS: This hospital-based large-scale case-control study recruited 464 women with confirmed BC within the past year and 500 apparently healthy controls matched in terms of age and residential place. Dietary data as well as other variables were collected by trained interviewers. RESULTS: After adjustment for all possible confounders, substituting every 50 kcal of energy from dietary carbohydrates for the same amount of energy from total fats was associated with lower odds for developing BC among all participants [odds ratio (OR) 0.97, 95% confidence interval (CI) 0.95-0.99] as well as premenopausal women (OR 0.96, 95% CI 0.94-0.99). Replacing protein intake with fat was associated with a higher likelihood of BC among postmenopausal women (OR 1.11, 95% CI 1.03-1.20). Replacement of carbohydrates with MUFAs might be associated with a decreased odds of BC and replacement of dietary carbohydrates with PUFAs might be associated with an increased odds of BC in all participants as well as postmenopausal women (P < 0.05). The same association was shown for protein only in postmenopausal women. Substituting MUFAs for saturated (SFAs) and PUFAs was associated with a significant decreased odds of BC in the whole population (P < 0.05). The same association was observed for replacing MUFAs for PUFAs in postmenopausal women. CONCLUSION: Substitution of dietary carbohydrates for total fats and PUFAs might reduce the odds of breast cancer. Also, substituting MUFAs for carbohydrates, SFAs and PUFAs might lower the disease risk. Future prospective investigations are highly recommended.

The effect of nutrition education for cancer prevention based on health belief model on nutrition knowledge, attitude, and practice of Iranian women.

BACKGROUND: In recent years, nutrition has received an increasingly important role in the etiology of cancer. Thus, public education about dietary factors associated with cancer risk or prevention could be an important intervention for cancer prevention, particularly in low- and middle-income countries where the burden of cancer is increasing rapidly and the access to care is limited. The age-standardized incidence of breast cancer was 35.8 among Iranian women in 2020. We aimed to study the effect of nutrition education on the knowledge, attitude, and practice of Iranian women towards dietary factors related to cancer. METHODS: In this interventional study, 229 women from public health centers were recruited and underwent three 75-min sessions of education based on the Health Belief Model (HBM). Participants were interviewed by trained interviewers using a validated and reproducible nutrition-related cancer prevention knowledge, attitude, and practice questionnaire (NUTCANKAP) questionnaire designed based on the HBM. Nutritional knowledge, attitude, and practice of participants were assessed through this questionnaire. Three 24-h dietary recalls (one weekend and two nonconsecutive weekdays) were also collected before and one month after the intervention. RESULTS: The mean age of the participants was 45.14 years, and the mean BMI was 27.2 kg/m2. After the intervention, the participants had a higher intake of whole grain (p = 0.03) and a lower fat dairy (p = 0.009) and nuts (p = 0.04). However, the intake of high-fat dairy (p = 0.001) decreased after the intervention. We indicated significant differences in knowledge (p < 0.001) and nutritional practice scores (p = 0.01) after education. In addition, after the intervention, there were significant differences in the mean score of the HBM components, except for the perceived self-efficacy. CONCLUSION: Participation in a nutrition education program positively impacted the knowledge and nutritional practices linked to cancer prevention.

Setting and prioritizing evidence-informed policies to control childhood obesity in Iran: a mixed Delphi and policy dialogue approach.

BACKGROUND: The prevalence of childhood obesity (CO) and related complications is high and alarmingly increasing in Iran. This study applied a mixed Delphi & Policy Dialogue approach to exploring and prioritizing policy options to control childhood obesity in Iran. METHODS: This study is organized in three Delphi phases followed by a policy dialogue session. This study applied the advocacy collation framework and evidence-informed policy-making approach to enhance the chance of a feasible and acceptable policy package. The first step consisted of interviews with 30 experts and primary stakeholders. Based on their answers and a comprehensive literature review, a list of presumed effective policy options to combat CO in Iran was made. Then, panelists were asked to score each policy option using a five-point Likert scale in seven constructs. To maximize the spread of opinions, panelists were chosen to represent three perspectives: policy-makers at different levels, presidents of various organizations who would implement potential policy options, and academics. Twenty-one stakeholders were invited to discuss the policy options in a policy dialogue section. RESULTS: We introduced 27 policy options and asked stakeholders to rank them using seven criteria on a five-level Likert scale. Totally, 41 experts participated in round 2 (66.2% response rate), and 33 experts took part in round 3 (72% response rate). Participants believed that healthy schools, creating healthy environments in kindergartens and other child care centers, subsidizing healthy foods, educating healthy lifestyles in mass media, and increasing access to physical activity facilities are the most effective and feasible policies in controlling CO. After the policy dialogue, the healthy school remained the most prioritized policy. a policy package to combat CO in Iran was designed with the participation of all stakeholders. CONCLUSION: The advocacy collation framework and the evidence-informed policy-making approach were used to draft a policy package to combat CO, increasing the acceptability and feasibility of the developed policy package.

Dietary N-nitroso compounds intake and bladder cancer risk: A systematic review and meta-analysis.

Bladder cancer is the most common cancer of the urinary tract. While tobacco smoking is responsible for more than half of the bladder cancer cases, occupational exposures is also an established risk factor of bladder cancer. Strong evidence of carcinogenicity of N-nitroso compounds (NOCs) have been provided in animal and human studies, but the target organ of occurring cancer in human including bladder cancer is still obscure. A wide range of NOCs sources surrounded us like diet, drinking water, cigarette smoking, workplace, and indoor air population. We conducted a meta-analysis to elucidate the association between NOCs in drinking water and food source and bladder cancer risk. Ten articles were included after removing the duplicates and irrelevant articles. The majority studies of our meta-analysis was done on women, maybe because of cigarette smoking as a main risk factor among men which is more common among men than women. Although the number of articles was limited our meta-analysis showed no significant association between dietary intakes of NOCs and bladder cancer risk (OR = 0.96, 95% CI = 0.88, 1.05; I2 = 50%, P-value = 0.007), neither subgrouping of NOCS type and source of NOCs nor dose of nitrate and nitrite intake indicated any associations.

Dietary carbohydrate quality and risk of breast cancer among women.

BACKGROUND: A few studies have examined the relationship between carbohydrate quality index (CQI) and risk of breast cancer (BC) among women in Middle Eastern countries. We studied the associations between carbohydrate quality index and the risk of BC in overall and by menopausal status. METHODS: In this case-control study, dietary intake of 461 women with pathologically confirmed BC within the past year were examined. The same information were collected for 495 apparently healthy controls using a 168-item validated FFQ. Carbohydrate quality was determined by considering four criteria including: ratio of solid carbohydrates to total carbohydrates, dietary fiber intake, GI and the ratio of whole grains to total grains. RESULTS: Mean GI and GL of participants were totally 57.5 ± 7.2 and 245.7 ± 64.7, respectively. A trend toward significant association was seen between GI and odds of BC in the whole population; such that after stratifying analysis by menopausal status, premenopausal women in the highest quartile of GI were 1.85 times higher likely to have BC than those in the lowest quartile (95% CI: 1.12, 3.07, P = 0.01). We found that women with the greatest CQI had lower odds for BC, compared with those with the lowest CQI (0.63; 95% CI: 0.43-0.94, P = 0.03). This association was remained after stratifying analysis by menopausal status in premenopausal (0.55; 95% CI: 0.34-0.90, P = 0.04). CONCLUSION: We found that GI was directly and CQI inversely associated with odds of BC. In order to determine the effects of dietary carbohydrate quality prospective cohort studies are needed.

Association between dietary total antioxidant capacity and breast cancer: a case-control study in a Middle Eastern country.

OBJECTIVE: The aim of this study was to determine the relationship between dietary total antioxidant capacity (dTAC) and risk of breast cancer among Iranian women. DESIGN: In this hospital-based case-control study, dietary intake of participants was collected using a 168-item validated FFQ. Dietary TAC was assessed using FRAP assay considering. Logistic regression was used to obtain ORs for breast cancer across quartiles of dTAC. SETTING: Cancer Institute, Iran. PARTICIPANTS: We included 412 women with pathologically confirmed breast cancer and 456 apparently healthy controls. RESULTS: Mean dTAC was 11·3 ± 5·8 for cases and 12·1 ± 7·9 for controls. A trend towards significant inverse association was seen between dTAC and odds of breast cancer in the whole population; such that after controlling for several potential confounders, individuals in the highest quartile of dTAC were 0·39 times less likely to have breast cancer than those in the lowest quartile (0·61; 95 % CI: 0·38, 0·99, P < 0·05). In the stratified analysis by menopausal status, we found that postmenopausal women with the greatest dTAC had lower odds for breast cancer, compared with those with the lowest dTAC (0·47; 95 % CI: 0·24, 0·93, P < 0·05). This association strengthened after additional adjustment for BMI (0·28; 95 % CI: 0·11, 0·72, P < 0·05). No significant association was seen between dTAC and odds of breast cancer in premenopausal women. CONCLUSIONS: We found that dietary TAC was inversely associated with risk of breast cancer, in particular among postmenopausal women. Prospective cohort studies are needed to confirm these findings.

Association between dietary fat and fat subtypes with the risk of breast cancer in an Iranian population: a case-control study.

AIM: To examine the relationship between dietary fat intake and breast cancer (BC) development. METHOD: This case-control study included 473 women with breast cancer (pathologically confirmed) and 501 healthy subjects matched by age and residency. Dietary intakes of different types and sources of fatty acids were assessed using a validated food frequency questionnaire. The association between dietary fats and odds of BC was assessed using a logistic regression model in crude and multivariable-adjusted models. P values below 0.05 were regarded as statistically significant. RESULTS: Participants' age and body mass index were 44.0 ± 10.8 years and 28.4 ± 5.6 kg/m2, respectively. Individuals with the highest quartile of total fat intake and polyunsaturated fatty acid (PUFA) intake were 1.50 times more at risk to develop BC than others. A positive significant association was observed between animal fat (Q4 vs. Q1, OR = 1.89, 95 % CI = 0.93-3.81), saturated fatty acid (SFA) (Q4 vs. Q1, OR = 1.70, 95 % CI = 0.88-3.30), monounsaturated fatty acid (MUFA) (Q4 vs. Q1 OR = 1.85, 95 % CI = 0.95-3.61) and PUFA intake (Q4 vs. Q1, OR = 2.12, 95 % CI = 1.05-4.27) with BC risk in postmenopausal women. However, there was no association in premenopausal women. CONCLUSIONS: Total dietary fat and its subtypes might increase the risk of BC, especially in postmenopausal women. This observational study confirms the role of dietary fat in breast cancer development. Intervention studies involving different estrogen receptor subgroups are needed.

Adherence to "dietary approaches to stop hypertension" eating plan in relation to gastric cancer.

BACKGROUND: Although adherence to "Dietary Approaches to Stop Hypertension" (DASH) dietary pattern has been linked with reduced risk of several cancers. To our knowledge no studies have examined the association between the DASH dietary pattern and risk of gastric cancer. This study was performed to investigate the association between adherence to the DASH dietary pattern and odds of gastric cancer in Iran. METHODS: This hospital-based case-control study was conducted on 178 histo-pathologically confirmed patients with gastric cancer and 276 sex-matched healthy controls. A validated 146-item Diet History Questionnaire (DHQ) was used to assess participants' usual dietary intakes. The DASH dietary pattern scores were calculated using the method introduced by Fung. Unconditional logistic regression, in which potential confounders were taken into account, was applied to determine the association of adherence to the DASH dietary pattern and odds of gastric cancer. RESULTS: Mean age of cases and controls were 60.8 and 53.2 y, respectively. After controlling for age, sex and energy intakes, participants in the highest tertile were 62% less likely to have gastric cancer than those in the lowest tertile (OR 0.38; 95% CI 0.22,0.65; Ptrend < 0.004). Further adjustment for other potential confounders, including education, marital status, residential place, alcohol intake and smoking, did not change the association dramatically (OR 0.44; 95% CI 0.25, 0.78; Ptrend = 0.005). Even after additional controlling for H-Pylori infection and BMI, greatest adherence to the DASH dietary pattern was associated with a 54% decreased risk of gastric cancer (OR 0.46; 95% CI 0.26, 0.83; Ptrend = 0.01). CONCLUSIONS: Adherence to the DASH dietary pattern was associated with lower gastric cancer risk in this case-control study.

Adherence to the low carbohydrate diet and the risk of breast Cancer in Iran.

BACKGROUND: Previous studies on the link between macronutrients and breast cancer have mostly focused on individual macronutrients rather than their combination. This study investigates the association between adherence to a low carbohydrate diet and odds of breast cancer among women. METHODS: This hospital-based case-control study was carried out on 412 women with pathologically confirmed breast cancer within the past year and 456 apparently healthy controls that were matched in terms of age and residential place. Dietary data was collected using a 168-item validated FFQ. Participants were classified in terms of quintiles of percentages of energy intake from carbohydrates, proteins, and fats. Then, individuals in the highest quintile of fat and protein intake were given a score of 5 and those in the lowest quintile of these macronutrients were given a score of 1. Participants in the other quintiles of these macronutrients were given the corresponding score. In terms of carbohydrate intake, those in the highest quintile received a score of 1 and those in the lowest quintile received 5. The scores were then summed up to calculate the total low carbohydrate diet (LCD) score, which varied from 3 to 15. A higher score meant greater adherence to a low carbohydrate diet. RESULTS: The mean age of study participants was 45.2 y and mean BMI was 28.4 kg/m2. Mean LCD score of participants was 8.9 ± 2.5 (8.9 ± 2.6 in cases and 9.0 ± 2.5 in controls). Although no significant association was observed between adherence to the LCD score and odds of breast cancer in the study population, a trend toward significant positive association was seen between consumption of LCD and odds of breast cancer in postmenopausal women; after controlling for several potential confounders, individuals in the third quartile of LCD score were 1.94 times more likely to have breast cancer than those in the lowest quartile (95% CI: 1.00, 3.76). This association strengthened after controlling for dietary variables (2.50; 1.18-5.32). Even after further adjustment for BMI, this association remained significant (2.64, 1.23-5.67). No significant relationship was observed in premenopausal women, either before or after controlling for confounders. CONCLUSION: Adherence to LCD may be associated with increased odds of breast cancer in postmenopausal women. Prospective cohort studies are needed to confirm these findings.

Development and validation of a knowledge, attitude, and practice questionnaire on nutrition-related cancer prevention for Iranian women.

BACKGROUND: Designing cancer prevention programs needs information on knowledge, attitude, and practice of the community. Unfortunately, this information is not available in Iran. MATERIALS AND METHODS: We developed a questionnaire (NUTCANKAPQ) to assess the knowledge, attitude, and practice of Iranian women regarding cancer prevention dietary habits. We recruited women who had referred to public health-care centers in Tehran, Iran. To assess validity, we applied face, content, and construct validity methods. We performed test-retest approaches to assess reliability, and internal consistency of the questionnaire was assessed through Cronbach's alpha and intraclass correlation coefficients (ICCs). RESULTS: Qualitative content validity was carried out by an expert panel, and internal consistency was deemed satisfactory (Cronbach's alpha, >0.6). We also observed high reliability in the questionnaire (ICC = 0.85). The mean (± standard deviation) scores for knowledge, attitude, and practice of study participants were 28.3 (±14.1), 67.1 (±18.9), and 53.7 (±8.3), respectively. The result of exploratory factor analysis, Kaiser-Meyer-Olkin (KMO), implied that the model was reasonably fit (KMO > 0.6). The final questionnaire included seventy items. CONCLUSION: NUTCANKAPQ is a valid and reliable tool for the assessment of cancer-related nutrition knowledge, attitude, and practice among the Iranian population. Application of NUTCANKAPQ may provide important clues for policy-making and improvement of cancer prevention programs among the Iranian population.

Effects of n-3 polyunsaturated fatty acid supplementation on appetite: a systematic review and meta-analysis of controlled clinical trials.

BACKGROUND: The current studies explore the effect of omega-3 polyunsaturated fatty acids (PUFAs) on appetite. OBJECTIVE: To examine the effect of omega-3 polyunsaturated fatty acids (n-3 PUFAs) on appetite using a systematic review and meta-analysis of controlled clinical trials (CTs). PATIENTS AND METHODS: Online databases including PubMed, Scopus, ISI Web of Science, and Google Scholar were searched up to January 2022. A random-effects model was used to compare the overall standardized mean difference in appetite scores between n-3 PUFAs supplemented and control individuals. RESULTS: Fifteen eligible CTs with 1504 participants (872 for n-3 PUFA supplementation and 632 for placebo groups) were included in our systematic review. The meta-analysis showed no significant difference in overall appetite score between n-3 PUFAs supplemented and control groups (standardized mean difference [SMD] = 0.458, 95% confidence interval [CI] - 0.327, 1.242, P value = 0.25). However, the n-3 PUFA supplementation significantly increased the desire to eat (SMD = 1.07, 95% CI 0.116, 2.029, P = 0.02) compared to control. CONCLUSION: Although we found no effect of omega-3 supplementation on overall appetite score, it modestly increases the desire to eat. Further CTs evaluating the effect of PUFAs on appetite are still needed to confirm these findings.

Association between empirically derived nutrient patterns and breast cancer: a case-control study in a Middle Eastern country.

PURPOSE: The risk of breast cancer (BC) and related mortality have increased in Middle-East countries during recent decades. The relationship between several nutrient intakes and the risk of BC has been investigated in several studies. However, few studies have estimated the effects of patterns of different nutrient intake on the risk of BC in this region. METHODS: A total of 453 patients who were recently diagnosed with breast cancer and 516 healthy women participated in the current case-control study. To evaluate the dietary intakes, we used a validated 168-item food frequency questionnaire (FFQ) during the last year. Nutrient Patterns (NPs) were extracted through factor analysis (FA) of energy-adjusted twenty-six nutrients. The relationship between nutrient patterns and the risk of breast cancer in pre and post-menopausal women was estimated by multivariable regression. RESULTS: Four major nutrient patterns were identified in the current study. The first nutrient pattern was rich in animal protein, retinol, riboflavin, pantothenic acid, cobalamin, and calcium. Higher saturated fatty acids (SFAs), mono-unsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and trans fatty acids (TFAs), and lower intakes of niacin were observed in nutrient pattern 2. The third nutrient pattern was rich in fiber, potassium, and vitamin C. Nutrient pattern 4, was associated with higher intakes of vegetable protein, alpha-tocopherol, and magnesium. A significant inverse relationship was observed between adherence to nutrient pattern 3 and the risk of BC in all participants [odds ratio (OR) = 0.70, 95% confidence interval (CI): 0.50, 0.97, P = 0.03) and pre-menopausal women (OR = 0.59 (0.39-0.89), P = 0.01). CONCLUSION: Decreasing odds of breast cancer were observed by adherence to a nutrient pattern high in dietary fiber, vitamin C, and potassium. Future prospective investigations are recommended to confirm these findings.

Worse becomes the worst: obesity inequality, its determinants and policy options in Iran.

Background: This tracked obesity inequality and identified its determinants among the population of Iran. In addition, it examined the impact of implemented policies on these inequalities. Methods: This study was performed in two phases. First, we conducted a rapid review of the disparity in obesity prevalence in Iran. Then we investigated the main determinants of this inequality in a qualitative study. In addition, we examined Iran's policies to deal with obesity from the perspective of equality. We conducted 30 Semi-structured interviews with various obesity stakeholders selected through a purposive snowball sampling method between November 25, 2019, and August 5, 2020. In the inductive approach, we used the content analysis method based on the Corbin and Status framework to analyze the data using MAXQDA-2020. The consolidating criteria for reporting a Qualitative Study (COREQ-32) were applied to conduct and report the study. Results: Inequalities in the prevalence of obesity in terms of place of residence, gender, education, and other socioeconomic characteristics were identified in Iran. Participants believed that obesity and inequality are linked through immediate and intermediate causes. Inequality in access to healthy foods, physical activity facilities, and health care are the immediate causes of this inequality. Intermediate factors include inequality against women, children, and refugees, and inequality in access to information, education, and financial resources. Policymakers should implement equity-oriented obesity control policies such as taxing unhealthy foods, subsidizing healthy foods, providing healthy and free meals in schools, especially in disadvantaged areas, and providing nutrient-rich foods to low-income families. Also, environmental re-engineering to increase opportunities for physical activity should be considered. Of course, for the fundamental reduction of these inequalities, the comprehensive approach of all statesmen is necessary. Conclusion: Obesity inequality is a health-threatening issue in Iran that can prevent achieving human development goals. Targeting the underlying causes of obesity, including inequalities, must be considered.

Association between DASH diet and asthma symptoms among a large sample of adolescents: a cross-sectional study.

BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) diet, which has a lot of emphasis on the consumption of fruits, vegetables, and whole grains, and on the other hand, the consumption of red meat and sodium is limited, due to its anti-inflammatory properties, which can be related to reducing the risk of asthma. OBJECTIVES: The aim of this study was to determine the relationship between the DASH diet and asthma symptoms among children and adolescents. METHODS: This cross-sectional study was conducted among7667 children (3414 boys and 4253 girls) aged 6-7 and 13-14 years living in central Iran. Dietary food consumption was assessed using a multiple-choice questionnaire. Logistic regression was used to obtain odds ratios for the association between the DASH-like diet with current asthma and asthma symptoms. RESULTS: Our findings revealed that higher adherence to a DASH-like diet resulted in lower odds of asthma confirmed by a doctor among the whole population (OR = 0.53; 95%CI: 0.36-0.76) and also in females (OR = 0.47; 95%CI: 0.29-0.78). Moreover, the higher adherence to the DASH-like diet was inversely associated with the chance of wheezing in the past 12 months in all subjects (OR = 0.67; 95%CI: 0.51-0.86) and in boys (OR = 0.57; 95%CI: 0.38-0.85). CONCLUSION: The findings of the present study showed that following the DASH diet can be associated with the improvement of asthma symptoms in children and adolescents. However, more research is needed to improve dietary recommendations for asthma prevention.

Dietary Inflammatory Index and Head and Neck Cancer: A Multicenter Case-Control Study in Iran.

BACKGROUND: The inflammatory potential of diet may affect carcinogenesis. This study aimed to determine the association between dietary inflammatory index (DII) and the risk of head and neck cancer (HNC), as well as the interaction between DII and cigarette smoking in HNC development within the Iranian population. Study Design: This is a case-control study. METHODS: In this multicenter case-control study, participants' dietary intake was assessed using a validated 130-item food frequency questionnaire, from which DII was computed. The study recruited 876 new cases from referral hospitals across 10 provinces and 3409 healthy controls who were frequency-matched based on age, gender, and residential place. Logistic regression was used to obtain odds ratios (ORs) for HNC across tertiles of DII, which were adjusted for confounding variables. RESULTS: A higher pro-inflammatory diet was associated with an increased risk of all HNC (OR T3 vs. T1 [95% CI]: 1.31 [1.06, 1.62]; P-trend=0.013). There was a significant association between lip and oral cavity cancers and DII (OR T3 vs. T1 [95% CI]: 1.56 [1.16, 1.66]; P-trend=0.004). Furthermore, an inflammatory diet was associated with an increased risk of pharynx cancer (OR T3 vs. T1 [95% CI]: 2.08 [1.14, 3.79]; P-trend=0.02). Additionally, no significant association was observed between DII and larynx cancer, while an interaction was found between DII and tobacco use on the risk of HNC (OR T3 vs. T1 [95% CI]: 2.52 [1.78, 3.57]; P-interaction=0.03). CONCLUSION: DII was positively associated with HNC risk. There was a significant association between DII and the risk of lip, oral cavity, and pharynx cancers. Additionally, there was an interaction between tobacco use and DII in determining the risk of HNC.