Participatory evaluation of municipal obesity prevention clubs in Tehran city: Strengths, challenges, and future direction.

Background and aim: Community-based initiatives are important for obesity prevention. This study aimed to evaluate the activities of municipal obesity prevention clubs (OBCs) in Tehran, Iran, using a participatory approach. Methods: The evaluation team was formed, and the members identified the OBC's strengths, and challenges and provided suggestions for change through a participatory workshop, observation, focus group discussions, reviewing relevant documents (n = 97), and 35 interviews with involved stakeholders. The MAXQDA software was used for data analysis. Results: An empowerment training program for volunteers was identified as one of the strengths of OBCs. Despite the obesity prevention efforts of OBCs through public exercise sessions, healthy food festivals, and educational sessions, several challenges were identified that hinder participation in OBCs. These challenges included poor marketing strategies, poor training approaches in participatory planning, insufficient motivational support for volunteers, low perceived recognition of volunteers by the community, volunteers' low food and nutrition literacy, poor educational services in the communities, and limited funding for health promotion activities. Conclusion: Weaknesses in all stages of community participation, including information, consultation, collaboration, and empowerment, in OBCs were detected. Facilitating a more enabling environment for informing and involving citizens, expanding neighborhood social capital, and involving health volunteers, academia, and all potential governmental sectors to collaborate for obesity prevention is recommended.

Higher ultra-processed food intake is associated with higher DNA damage in healthy adolescents.

Ultra-processed food is one of the main contributors to energy supply and consumption in food systems worldwide, and evidence of their detrimental health outcomes in humans is emerging. This study aimed to assess ultra-processed food intake and its association with urinary levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG), a biomarker of DNA oxidative damage, in 139 healthy adolescents in Karaj City in Iran. Usual dietary intake was measured using a 168-item validated FFQ. The daily intake of ultra-processed food consumption was determined through the classification of NOVA, and general linear models were used to compare the urinary levels of 8-OHdG/creatinine (ng/mg creatinine) within tertiles of ultra-processed food intake. Adolescents in the higher tertile of ultra-processed food consumption had a significantly higher mean level of urinary 8-OHdG/creatinine in comparison with the lower tertiles in the crude model (Pfor trend: 0·003) and after adjustment for confounding variables, including total energy intake, sex, age, BMI for age Z-score, obesity and physical activity (Pfor trend: 0·004). This association was still significant after adjusting for dietary intake of whole grains, nuts, legumes, the ratio of MUFA:SFA (g/d) and Mediterranean dietary score (Pfor trend: 0·002). More studies are needed to explore the determinants of ultra-processed food supply, demand, consumption and health effects; such studies should be applied to develop evidence-informed policies and regulatory mechanisms to improve children's and adolescents' food environment policymaking and legislation with special attention to ultra-processed food.

Development and implementation of nutrition labelling in Iran: A retrospective policy analysis.

BACKGROUND: Nutrition labelling is a strategy to promote healthy eating and combat non-communicable diseases (NCDs). The present study aimed to provide an analysis of the nutrition labelling policy and its opportunities to improve in Iran. METHODS: Data were collected by 1) reviewing relevant documents and 2) semi-structured interviews with stakeholders through purposive and snowball sampling, continued until data saturation was achieved. A deductive content analysis was used by applying the policy triangulation framework and the Kingdon multiple stream theory. MAXQDA software was used to manage data analysis. RESULTS: Iran, is the first country in the Eastern Mediterranean region which has accomplished to implement nutrition traffic light labelling. The main contextual factors that affected nutrition labelling policy to become a national included health, political commitment, and international factors. Poor involvement of media for public awareness of nutrition traffic labeling, the inconsistency of nutrition traffic light color ranking using food standard guidelines, lack of consistency between nutrition traffic light colors and the healthy/unhealthy nature of some food products and the absence of a comprehensive evaluation plan were among the policy challenges identified. CONCLUSIONS: Strengthening the governance for a healthy food environment is recommended to improve the program. Also, establishing national portion sizes for food labelling, initiating public awareness campaigns, evaluation of the policy effect and public perception of the labels and their application are recommended.

Dietary flavonoid intake, total antioxidant capacity and lipid oxidative damage: A cross-sectional study of Iranian women.

OBJECTIVES: Although strong evidence supports the antioxidant potential of flavonoids in vitro, the effect of flavonoids at physiological concentrations on the overall antioxidant status in humans is inconsistent. The aim of this study was to examine cross-sectional associations between total flavonoid consumption, serum total antioxidant capacity (TAC), and malondialdehyde (MDA) levels in apparently healthy women. METHODS: Through a multistage cluster sampling, 170 women ages 20 to 48 y were recruited. The usual dietary flavonoid intake was estimated using a semiquantitive food frequency questionnaire (FFQ) by matching food items with the US Department of Agriculture flavonoid databases. General linear models were used to compare the biochemical parameters across tertiles of flavonoid intakes. RESULTS: As dietary anthocyanin intake rose from the lowest to the highest tertile, the multivariate-adjusted mean TAC concentrations significantly increased from 1.08 to 1.28 (Ptrend = 0.01). This association was still significant after adjustment for fruit and vegetable intake and antioxidant vitamins (Ptrend = 0.03). The highest tertile of total flavonoid intake and theaflavins had higher mean concentrations of TAC than did the lowest tertile, but there was no linear trend (P < 0.05). There were statistically significant positive relationships between dietary intake of grapes and eggplant as main food sources of anthocyanins and serum TAC (P = 0.02 and 0.04, respectively). No significant associations were found between MDA and flavonoids intakes (P > 0.05). CONCLUSIONS: The findings of the present study support the attribution of anthocyanins to overall antioxidant status. However, further research is needed to confirm these observed associations.