Curcumin as a major active component of turmeric attenuates proteinuria in patients with overt diabetic nephropathy.

BACKGROUND: Diabetic nephropathy (DN) is a common cause of end-stage renal disease (ESRD). The benefits and effects of renin-angiotensin system blocker drugs are obvious in decreasing albuminuria, but there is a need to find other drugs that can decrease albuminuria. The aim of our study is to evaluate the effect of short-term administration of curcumin on overt albuminuria in patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: A randomized, double-blind clinical trial was performed on 46 patients with T2DM, overt albuminuria ≥300 mg/24 h, and estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2. After the random allocation of the patients, they were divided into two groups. In the curcumin group, the patients received 500 mg (one capsule) of curcumin with each meal (three times/day after meal) for 16 weeks. Other variables including blood urea nitrogen (BUN), creatinine (Cr), fasting blood sugar (FBS), 2-h postprandial blood sugar (2-h pp BS), lipid profile, 24-h urine analysis for albuminuria, serum albumin, and hemoglobin A1C (HbA1C) were checked at baseline and bimonthly too. RESULTS: two groups at baseline were comparable in terms of basic characteristics (P > 0.05). Albuminuria decreased significantly from 900.42 ± 621.91 at the baseline to 539.68 ± 375.16 at the end of the study in the curcumin group (P Time = 0.002); however, no statistically significant changes were observed in the placebo group (519.94 ± 214.33 at the baseline vs. 444.00 ± 219.10 at the end of the trial; P Time = 0.43), and the decrease was significantly higher in the curcumin group than that of the placebo group (P Intervention = 0.01). No significant differences were observed between the placebo and curcumin in terms of changes in serum BUN, Cr, FBS, 2-h pp BS, HbA1C, lipid profile, and albumin. CONCLUSION: Our study showed that curcumin as an active turmeric metabolite was an effective adjuvant therapy for ameliorating macroscopic proteinuria in type 2 diabetic patients. Its effect may appear after 2 months of therapy and even in patients with a mild decrease in GFR. Further studies with larger sample size and longer duration are recommended.

Comparing of goal setting strategy with group education method to increase physical activity level: A randomized trial.

BACKGROUND: Designing an intervention to increase physical activity is important to be based on the health care settings resources and be acceptable by the subject group. This study was designed to assess and compare the effect of the goal setting strategy with a group education method on increasing the physical activity of mothers of children aged 1 to 5. MATERIALS AND METHODS: Mothers who had at least one child of 1-5 years were randomized into two groups. The effect of 1) goal-setting strategy and 2) group education method on increasing physical activity was assessed and compared 1 month and 3 months after the intervention. Also, the weight, height, body mass index (BMI), waist and hip circumference, and well-being were compared between the two groups before and after the intervention. RESULTS: Physical activity level increased significantly after the intervention in the goal-setting group and it was significantly different between the two groups after intervention (P < 0.05). BMI, waist circumference, hip circumference, and well-being score were significantly different in the goal-setting group after the intervention. In the group education method, only the well-being score improved significantly (P < 0.05). CONCLUSION: Our study presented the effects of using the goal-setting strategy to boost physical activity, improving the state of well-being and decreasing BMI, waist, and hip circumference.

Lifestyle interventions for hypertension treatment among Iranian women in primary health-care settings: Results of a randomized controlled trial.

BACKGROUND: Lifestyle factors such as weight, salt intake, and physical activity have shown to be important in treating hypertension. The object of this study was to describe feasibility and to assess the effectiveness of a multicomponent lifestyle intervention on high blood pressure (BP) of Iranian women. MATERIALS AND METHODS: This randomized controlled trial was conducted in four health centers by recruiting 161 women aged 35-65 years with high BP and randomizing them to a 4-week lifestyle modification (n = 80) or control group (n = 81). BP level and other health behavioral factors were assessed before and after the 4-week intervention and also after 6 months. RESULTS: The mean systolic BP changed from 158.8 (±8.1) mmHg to 153.2 (±6.4) mmHg during 4-week and to 145.5 (±4.6)) mmHg after 6 months in the intervention group (P < 0.001). There was a significant difference between two groups of study after 4-week mean = 5.6 (confidence interval [CI] = 5.1-6.6) and 6 months follow mean (CI = 12.3-14.6).(P < 0.001) A significant correlation was detected between systolic BP (SBP) and diastolic BP (DBP) with weight, body mass index, waist circumference, salt intake, and physical activity level (P < 0.001). Stepwise regression analyses indicated that the weight, dietary salt intake, and physical activity level were significant predictors of SBP and DBP. CONCLUSION: The results of this study suggest that lifestyle modification program is associated with improvements in BP level in Iranian women.

Effects of multicomponent lifestyle modification on blood pressure control in health centers: Design of the study.

BACKGROUND: Designing an intervention based on healthcare settings resources and patient acceptability is potentially important in the prevention of high blood pressure(BP) and other risk factors of cardiovascular disease. To explain a multicenter randomized controlled trial that is designed to examine the effects of the multicomponent lifestyle modification program on BP. MATERIALS AND METHODS: The effectiveness of the lifestyle modification program versus usual care in health-care centers is evaluated in a randomized controlled trial. Patients aged 30years or older having a systolic blood pressure(SBP) of 140-179mmHg or a diastolic blood pressure(DBP) of 90-109 mm Hg or patients taking antihypertensive medications are eligible for the study. -The primary outcomes measured are SBP and DBP levels. Mediator outcomes include physical activity level, stress scale, dietary composition, and weight measurements. All measurements will be conducted after the 4weeks of intervention and also at 6months. CONCLUSION: Outcomes of the study will present the effects of implementing multicomponent lifestyle intervention programs to control BP in health-care centers settings.

Association of an adult obesity, blood pressure adulthood socio-economic position.

BACKGROUND: The purpose of this study is to investigate an effect of childhood and adulthood socio-economic position on selected cardiovascular risk factors including obesity, blood pressure level and smoking behavior. MATERIALS AND METHODS: This is a cross-sectional study performed on 479 individuals, randomly selected by random clustered sampling from men and women aged 30-50 years, living in Esfahan. Their demographic characteristics, education, occupation and smoking behavior were questioned. Their weight, height and blood pressure were also measured, and their BMI (Body Mass Index) was calculated. The data were analyzed by SPSS 19 software. RESULTS: In men, the odds ratio for ever smoking to never smoking at higher levels of education in comparison with the lower levels was 6.08 (2.65-14.11). For manual occupation to non-manual occupation, it was 3.55 (1.88-6.68). The odds ratio for obesity and overweight vs no overweight, for manual occupation to non-manual occupation was 3.12 (1.81-5.40) in men and for father's occupation it was 2.03 (1.10-3.74). In women, their education with the odds ratio of 2.11 (1.17-3.82) and father's occupation with the odds ratio of 6.63 (3.50-12.58) altered their chance of being obese or overweight. Also, in women, the mean systolic blood pressure was significantly lower at higher educational levels and in those whose fathers' occupation were manual but lower in manual workers. CONCLUSION: The current socio-economic position in individuals is associated with an obesity and smoking behavior, particularly in men. Childhood socio-economic position increases the chance of an obesity and higher blood pressure, particularly in women.

Association of vitamin D deficiency and coronary artery disease with cardiovascular risk factors.

BACKGROUND: Vitamin D deficiency is a prevalent condition in many countries. The aim of this study is to elucidate whether deficient vitamin D status is associated with coronary artery disease considering cardiovascular risk factors. MATERIALS AND METHODS: We measured 25 (OH) D serum levels in 57 patients that were diagnosed with coronary artery disease upon coronary angiography and 62 individuals in the control group who were matched for age and sex with the patients and examined the association between serum 25 (OH) D and coronary artery disease with regard to cardiovascular risk factors. RESULTS: The odds ratio of being affected by coronary artery disease in individuals with vitamin D deficiency (25 (OH) D < 30 ng/ml) was 5.8 (1.77 - 18.94) after adjustment with cardiovascular risk factors, i.e., blood pressure, diabetes, smoking, obesity, physical activity and high blood cholesterol in comparison with the control group. CONCLUSION: Low levels of 25 (OH) D are associated with prevalent coronary artery disease independent of cardiovascular risk factors. Further investigations could demonstrate the need for vitamin D supplementations in order to prevent atherosclerosis.

Obesity and cardiometabolic risk factors in a representative population of Iranian adolescents and adults in comparison to a Western population: the Isfahan Healthy Heart Programme.

OBJECTIVE: The aim of the present study was to develop reference data for the Iranian population for anthropometric values and cardiometabolic data in comparison with those in Americans, as representative of a Western population. DESIGN: The present cross-sectional survey, conducted as part of the baseline survey of a community-based interventional study (the Isfahan Healthy Heart Programme), used a two-stage clustering design and was conducted in 12 600 randomly selected adults (> or =19 years of age) and 2000 adolescents (aged 11-18 years) living in three cities in the central part of Iran. For comparison with a Western population, comparable data for Americans were derived from the data sets of the Second and Third National Health and Nutrition Examination Surveys (NHANES II and NHANES III). RESULTS: Iranian women had significantly higher mean BMI, waist circumference (WC), hip circumference (HC) and waist:hip ratio (WHR) than Iranian men and American women; but the mean BMI of Iranian men was lower than that of American men. The mean serum TAG level of Iranian men was significantly higher than that of Iranian women, whereas the mean serum total cholesterol (TC), LDL cholesterol (LDL-C) and HDL cholesterol (HDL-C) levels were significantly higher in Iranian women than in men. The Iranian population had lower mean TC, LDL-C and TAG levels than the Americans, but such difference was not documented for HDL-C. Iranian adolescents had significantly lower mean BMI and higher mean TAG than did American adolescents. CONCLUSIONS: Our findings provide serious evidence for health professionals and policy makers about the very high prevalence of generalized and abdominal obesity in Iran. Controlling this emerging health problem, notably in women, should become a national priority in Iran and necessitates comprehensive public health programmes.

Gender differences in obesogenic behaviour, socioeconomic and metabolic factors in a population-based sample of Iranians: the IHHP study.

This study investigated the gender differences in association of some behavioural and socioeconomic factors with obesity indices in a population-based sample of 12,514 Iranian adults. The mean body mass index (BMI), waist circumference (WC), and the waist-to-hip ratio (WHR) were significantly higher in women than in men. Current and passive smoking had an inverse association with BMI among males whereas current smoking, transportation by a private car, and longer duration of watching television (TV) had a positive association with BMI among females. Current and passive smoking, cycling, and Global Dietary Index (GDI) had an inverse association with WC among males. Higher consumption of fruits and vegetables, current and passive smoking, duration of daily sleep, and GDI had an inverse association with WC among females. Using a private car for transportation had a significant positive association with WHR among both males and females. Living in an urban area, being married, and having a higher education level increased the odds ratio of obesity among both the genders. Non-manual work also increased this risk among males whereas watching TV and current smoking increased this risk among females. Such gender differences should be considered for culturally-appropriate interventional strategies to be implemented at the population level for tackling obesity and associated cardiometabolic risk factors.

Effects of a lifestyle modification trial among phenotypically obese metabolically normal and phenotypically obese metabolically abnormal adolescents in comparison with phenotypically normal metabolically obese adolescents.

This study aimed to assess the effects of a 2-month lifestyle modification trial on cardio-metabolic abnormalities and C-reactive protein (CRP) among obese adolescents with metabolic syndrome [phenotypically obese metabolically abnormal (POMA)] and obese adolescents without a cardio-metabolic disorder [phenotypically obese metabolically normal (POMN)], as well as in normal-weight adolescents with at least one cardio-metabolic disorder [phenotypically normal metabolically obese (PNMO)]. The study comprised 360 adolescents assigned in three groups of equal number of POMN, POMA and PNMO. They were enrolled in a trial consisting of aerobic activity classes, diet and behaviour modification, and were recalled after 6 months. Overall, 94.7% of participants completed the 2-month trial, and 87.3% of them returned after 6 months. The mean CRP was not significantly different between the POMA and PNMO groups, but was higher than in the POMN group. After the trial, body mass index (BMI) and waist circumference (WC) decreased in obese participants, and the mean body fat mass decreased in all groups. At 2 months, the mean total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and CRP decreased in the POMA and PNMO groups. After 2 and 6 months, the decrease in mean TC, LDL-C, TG, CRP and systolic blood pressure was greater in the POMA than in the POMN group. The magnitude of decrease in CRP correlated with that of BMI, WC, fat mass, TG, TC and LDL-C. Lifestyle modification programmes for primordial/primary prevention of chronic diseases would be beneficial at the population level and should not be limited to obese children.

Association of physical activity and the metabolic syndrome in children and adolescents: CASPIAN Study.

BACKGROUND/AIM: To determine the association of physical activity and the metabolic syndrome in a large national-representative sample of children. METHODS: This study was performed in 2003-2004 on 4,811 school students aged 6-18 years, selected by multi-stage random cluster sampling from six provinces in Iran. We assessed the level of physical activity using a standardized questionnaire, and categorized it to the tertiles. The metabolic syndrome was defined based on criteria analogous to those of the Adult Treatment Panel III. RESULTS: The participants comprised 2,248 boys and 2,563 girls with a mean age of 12.07 +/- 3.2 years. In all age groups, boys were more physically active than girls. The metabolic syndrome was detected in 14.1% of participants, and its prevalence was higher in those subjects in the 1st, 2nd and 3rd tertiles of physical activity, respectively (15.1 vs.14.2 and 13.1%, respectively, p <0.05). This difference was seen in boys, while no difference was found between girls in the 2nd and 3rd tertiles of physical activity. Physical activity was linked to a cluster of factors consisting of high-density lipoprotein-cholesterol and waist circumference, followed by triglycerides in boys, and of triglycerides, waist circumference and blood pressure in girls. In both genders, before and after adjustment for age and body mass index, low levels of physical activity significantly increased the risk of having the metabolic syndrome [in boys: OR: 1.8, 95% CI: 1.1, 2.1; and in girls, OR: 1.6 (1.1, 1.9)]. CONCLUSION: We found an association between physical activity and the metabolic syndrome, which was independent of body mass index and age. Children should be encouraged to have greater physical activity.