The association between dietary inflammatory index and risk of neuromyelitis optica spectrum disorder: a case-control study.

BACKGROUND AND AIM: Neuromyelitis optica spectrum disorder (NMOSD) is a severe and rare inflammatory disease affecting the central nervous system through optic neuritis and transverse myelitis. Present study aimed to investigate the association between dietary inflammatory index (DII) and risk of NMOSD. METHODS: In this case-control study, 30 NMOSD cases and 90 aged matched healthy individuals were recruited. Habitual dietary intakes were assessed by a validated 168-item food frequency questionnaire to calculate the DII score. A multiple adjusted regression was used to determine the odd ratio (OR) of NMOSD across DII tertiles. The Residual method was applied to adjust the energy intake. RESULTS: Participants in the top of DII tertile were more likely to have NMOSD in the crude model compared to those with the lowest one (OR: 4.18; 95%CI: 1.43-12.21). It was the case when multivariable confounders were considered in adjustment model I (OR: 3.98; 95%CI: 1.34-11.82) and II (OR: 4.43; 95%CI: 1.36-14.38), such that, individuals with a greater DII score had 3.98 and 4.43-time higher risk of NMOSD in model I and II, respectively. CONCLUSION: The Present study suggests that greater adherence to a pro-inflammatory diet may be associated with an increased risk of NMOSD.

Association between alternative healthy eating index (AHEI) with metabolic health status in adolescents with overweight and obesity.

BACKGROUND: There has been lack of evidence on the association between healthy dietary patterns and metabolic health status of adolescents. The present study aimed to evaluate the association between alternative healthy eating index (AHEI) and metabolic health status among a relatively representative sample of Iranian adolescents with overweight/obesity. METHODS: Adolescents with extra body weight (n = 203, aged 12-18 y), were selected for this cross-sectional study by a multistage cluster random-sampling method. Habitual dietary intakes and diet quality of individuals were assessed using validated food frequency questionnaire and AHEI-2010, respectively. Data on other covariates were also gathered by pre-tested questionnaires. To determine fasting glucose, insulin and lipid profiles, fasting blood samples were collected. Participants were categorized as having metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO) phenotypes, based on two approaches (International Diabetes Federation (IDF) and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR)). RESULTS: The overall prevalence of MUO was 38.9% (based on IDF criteria) and 33.0% (based on IDF/HOMA-IR criteria). After considering all potential confounders, participants in highest tertiles of AHEI-2010 had lower odds of MUO profile according to both IDF (OR = 0.05; 95% CI: 0.01-0.15) and IDF/HOMA-IR (OR = 0.05; 95% CI: 0.02-0.19) definitions. This association was stronger in adolescents with overweight compared with obese ones and also among girls than boys. Moreover, each unit increase in AHEI-2010 score was associated with lower risk of MUO based on both criteria. CONCLUSIONS: Higher adherence to AHEI-2010 was inversely associated with odds of MUO in Iranian adolescents with overweight/obesity.

Maternal caffeine consumption during pregnancy and risk of low birth weight: a dose-response meta-analysis of cohort studies.

BACKGROUND & OBJECTIVES: Earlier published studies on maternal caffeine intake during pregnancy in relation to the risk of low birth weight (LBW) (birth weight <2500 g) have indicated conflicting findings. Therefore, the present systematic review and meta-analysis was conducted to examine the association between maternal caffeine intake and risk of LBW. METHODS: We searched for relevant articles published up to Jan 2021 through PubMed and Scopus. For this purpose, we used MESH (Medical Subject Heading) and non-MESH keywords. Cohort studies that considered maternal caffeine intake as the exposure variable and LBW as the main outcome variable were included in the systematic review. Finally, seven cohort studies were considered in this systematic review and meta-analysis. RESULTS: Combining seven effect sizes, we found a significant positive association between maternal caffeine intake and risk of LBW (RR: 1.70; 95% CI: 1.19-2.43). We also found that each additional 100-mg per day of maternal caffeine intake was significantly associated with an increased risk of LBW (RR: 1.12; 95% CI: 1.03-1.22; Pheterogeneity = 0.020). In addition, nonlinear dose-response analysis showed a significant relationship (Pnonlinearity < 0.001) between maternal caffeine intake and risk of LBW. CONCLUSIONS: In this systematic review and meta-analysis, we found a significant positive association between maternal caffeine intake and risk of LBW.

Dietary fiber intake, depression, and anxiety: a systematic review and meta-analysis of epidemiologic studies.

BACKGROUND: Findings of previous studies on relationship between dietary fiber intake and depression were inconsistent. We performed a meta-analysis on the association of dietary fiber intake with depression and anxiety in epidemiologic studies. METHODS: We conducted a systematic search of electronic databases, up to May 2021. Data from 18 publications (12 cross-sectional, five cohort and one case-control studies) on dietary fiber consumption in relation to depression or anxiety were included. For depression, fifteen studies were conducted on adults and three others on adolescents. Anxiety was not included in the analysis, due to insufficient eligible studies. RESULTS: Total dietary fiber intake was associated with a 10% lower odds of depression (OR = 0.90; 95% confidence interval [CI]: 0.86, 0.95) in adults and a 57% lower odds (OR = 0.43, 95% CI: 0.32, 0.59) in adolescents. Dose-response meta-analysis revealed an inverse linear association between total dietary fiber intake and odd of depression in adults; such that each 5-g increase in total dietary fiber intake was associated with a 5% reduction in risk of depression (OR = 0.95; 95% CI: 0.94, 0.97). An inverse significant association was observed between intake of fiber from vegetables (OR = 0.73; 95% CI: 0.66, 0.82) and soluble fiber (OR = 0.80, 95% CI: 0.71, 0.91) and odds of depression. However, cereal fiber, fiber from fruits and insoluble fiber were marginally associated with a reduction in having depression. CONCLUSIONS: High intake of dietary fiber was protectively associated with depression in adults, in a dose-response fashion.

Effects of sumac supplementation on metabolic markers in adults with metabolic syndrome: a triple-blinded randomized placebo-controlled cross-over clinical trial.

BACKGROUND: Despite the prior evidence of the impacts of sumac on glycemic indices, lipid profile and visceral fat, there is a lack of evidence regarding the efficacy of sumac in cases with metabolic syndrome (MetS). Therefore, we aimed to assess the effect of sumac supplementation on MetS markers among adults with this syndrome. METHODS: In this triple-blinded randomized placebo-controlled cross-over clinical trial 47 adults with MetS were randomly assigned to receive 500 mg sumac or placebo (lactose) capsule, twice a day. Each phase took 6 weeks and there was a 2-week washout between phases. All clinical evaluations and laboratory tests were conducted before and after each phase. RESULTS: At the baseline of the study, mean (± SD) age, weight, and waist circumference of participants were respectively 58.7 (± 5.8) yr, 79.9 (± 14.3) kg, and 107.6 (± 10.8) cm. Intention to treat analysis (ITT) analyses revealed that sumac supplementation decreased systolic blood pressure by 5 mmHg (128.8 ± 21.4 at the baseline vs. 123.2 ± 17.6 after 6 weeks intervention, P = 0.001). The comparison of changes in two trial arms showed that sumac supplementation significantly reduced systolic blood pressure (sumac group -5.59 ± 10.6 vs. control group 0.76 ± 10.5, P = 0.004), but did not change anthropometric indices or diastolic blood pressure. Similar results were also found in the per-protocol analyses. CONCLUSIONS: This cross-over trial revealed that sumac supplementation could reduce systolic blood pressure in men and women with MetS. Daily intake of 1000 mg sumac, as an adjuvant therapy, may be beneficial in management of MetS in adults.

Associations of Fruit and Vegetable Intake with Metabolic Health Status in Overweight and Obese Youth.

INTRODUCTION: The objective of this study was to assess the relationship between fruit and vegetable intake with metabolic health status among overweight and obese Iranian youth. METHODS: In total, 203 obese and overweight youth including 101 boys and 102 girls, 12-18 years, were randomly recruited through a multistage cluster sampling approach in this study. A validated Persian format of food frequency questionnaire was used to estimate participants' usual food intake. Adolescents were categorized in accordance with the International Diabetes Federation (IDF) criteria as well as IDF plus insulin resistance (HOMA-IR) definition into metabolically healthy obese and metabolically unhealthy obese (MUO). RESULTS: Based on IDF criteria, youth in the third tertile of vegetable and the combination of fruit and vegetable intake had 66% (odds ratio = 0.34, 95% CI: 0.12-0.95) and 73% (odds ratio = 0.27, 95% CI: 0.09-0.81) lower odds of MUO compared to those in the first tertile, in the fully-adjusted model. According to IDF plus HOMA-IR definition, inverse associations were also found between vegetable (odds ratio = 0.36, 95% CI: 0.12-1.02) and the combination of fruit and vegetable (odds ratio = 0.25, 95% CI: 0.08-0.79) intake with MUO phenotype. Stratified analysis indicated inverse associations between intake of vegetables and the combination of fruits and vegetables with MUO phenotype (based on IDF definition) in overweight, but not obese subjects. CONCLUSION: The current study demonstrated that greater consumption of vegetables as well as the combination of fruits and vegetables was related to a lower risk of MUO phenotype, particularly in overweight youth.

The effect of sumac supplementation on insulin resistance, inflammation, oxidative stress, and antioxidant capacity in adults with metabolic syndrome: A randomized crossover clinical trial.

The impact of sumac supplementation was not previously examined in patients with metabolic syndrome (MetS). So, we investigated the influence of sumac supplementation on insulin resistance, inflammation, oxidative stress, and antioxidant markers in adults with MetS. The current study was a single-center, triple-blind, randomized, placebo-controlled crossover clinical trial that was conducted on 47 patients with MetS. Participants were randomly divided into two groups of intervention and control in the first phase. They received capsules containing 500 mg sumac or placebo (lactose) twice a day, after lunch and dinner, for 6 weeks. After a 2-week washout period, the subjects crossed over to the alternate arm. In both arms, fasting venous blood samples were obtained at baseline and at the sixth week of the intervention to determine glycemic status, high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), total antioxidant capacity (TAC), and antioxidant enzymes activity. The mean (±SD) age, weight, and body mass index of participants were respectively 58.7 ± 5.83 years, 79.9 ± 14.35 kg, and 31.6 ± 4.6 kg/m2 ; 80.9% of subjects were females (n = 38). Based on per-protocol analyses, the serum fasting insulin concentration was unexpectedly decreased in the placebo group (change in sumac vs. control: 0.95 ± 3.9 vs. -1.17 ± 3.9 mU/L; p = 0.04). Sumac supplementation, compared to control, has marginally enhanced catalase activity (change in sumac vs. control: 2.91 ± 9.5 vs. -1.07 ± 9.1 nmol/min/ml; p = 0.06). This supplementation has also increased serum TAC and the activity of superoxide dismutase, but these changes were not significant. This intervention did not affect other insulin resistance, inflammatory, or oxidative stress markers. We found that 1 g/day sumac consumption for 6 weeks, as adjuvant therapy, could improve the antioxidant defense system in adults with MetS but did not affect insulin resistance, inflammation, or oxidative stress.

Serum vitamin D levels in relation to type-2 diabetes and prediabetes in adults: a systematic review and dose-response meta-analysis of epidemiologic studies.

BACKGROUND: Findings of observational studies that investigated the relationship between vitamin D deficiency and abnormal glucose homeostasis were contradictory. This meta-analysis of epidemiologic studies evaluated the association of vitamin D status and risk of type-2 diabetes (T2D) and prediabetes in adults. METHODS: A systematic search was conducted on all published articles in five electronic databases (including MEDLINE/PubMed, EMBASE, Institute for Scientific Information, Scopus and Google scholar), up to August 2020. Twenty-eight prospective cohort and nested case-control studies and 83 cross-sectional and case-control investigations that reported relative risks (RRs) or odds ratios (ORs) with 95% confidence intervals (CIs) for abnormal glucose homeostasis in relation to serum vitamin D levels in adults were included in the analysis. RESULTS: In prospective studies, high versus low level of vitamin D was respectively associated with significant 35%, 30% and 51% decrease in risk of T2D (RR:0.65; 95%CI: 0.55-0.76; 27 effect sizes), combined T2D and pre-diabetes (RR:0.70; 95%CI: 0.52-0.95; 9 effect sizes) and pre-diabetes (RR:0.49; 95%CI: 0.26-0.93; 2 effect sizes). These inverse associations were significant in almost all subgroups. Dose-response analysis in prospective studies showed that each 10 ng/ml increase in serum vitamin D levels resulted in 12% and 11% reduced risk of T2D (RR:0.88; 95%CI: 0.83-0.94) and combined T2D and prediabetes (RR:0.89; 95%CI: 0.87-0.92), respectively. In cross-sectional and case-control studies, highest versus lowest level of serum vitamin D was linked to reduced odds of T2D (OR:0.64; 95%CI: 0.57-0.72; 42 effect sizes) and combined T2D and pre-diabetes (OR:0.79; 95%CI: 0.74-0.85; 59 effect sizes); but not pre-diabetes (OR:0.64; 95%CI: 0.17-2.37; 11 effect sizes). CONCLUSION: This meta-analysis of epidemiologic studies disclosed that serum vitamin D level was reversely associated with the risk of T2D and combined T2D and prediabetes in adults, in a dose-response manner. However, the association was not remarkable for pre-diabetes.

Dietary methyl donor micronutrients intake in relation to psychological disorders in adults.

Previous investigations have mostly studied an individual methyl donor nutrient in relation to psychological disorders and the findings were inconsistent. We investigated the association of methyl donor micronutrients (folate, B6, B12, choline, betaine and methionine) with psychological disorders in Iranian adults. In this cross-sectional study, dietary intakes of 3299 adults were collected using a validated food frequency questionnaire. Methyl donor micronutrient score (MDMS) was calculated based on energy-adjusted deciles of each nutrient. Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), validated for Iranians, have been applied to assess depression, anxiety and psychological distress. Participants had a mean age of 36·3 ± 7·9 years, of whom 58·5 % were women. After considering potential confounders, adults in the top quartile of MDMS, compared to the bottom one, had decreased odds of anxiety (OR: 0·53, 95 % CI: 0·37, 0·75), depression (OR: 0·75, 95 % CI: 0·58, 0·97) and psychological distress (OR: 0·61, 95 % CI: 0·46, 0·80). Among women, the top quartile of MDMS was protectively associated with anxiety (OR: 0·60, 95 % CI: 0·40, 0·90), depression (OR: 0·68, 95 % CI: 0·50, 0·93) and psychological distress (OR: 0·53, 95 % CI: 0·38, 0·74). Overweight and obese subjects in the highest quartile of MDMS had a 67 %, 35 % and 53 % lower odds of anxiety (95 % CI: 0·20, 0·56), depression (95 % CI: 0·44, 0·94) and psychological distress (95 % CI: 0·31, 0·70), respectively. We found that high consumption of methyl donor micronutrients was related to a reduced odds of psychological disorders, especially in women and overweight or obese individuals.

Effect of zinc supplementation on mortality in under 5-year children: a systematic review and meta-analysis of randomized clinical trials.

BACKGROUND: Several clinical trials evaluated the effect of zinc supplementation on mortality in children, but the results were inconsistent. We aimed to conduct a systematic review and meta-analysis on the impact of zinc supplementation on mortality in under 5-year children. METHODS: A comprehensive search was conducted using the electronic (PubMed, Scopus, Web of Science) databases, and Google Scholar, up to June 2020. Randomized clinical trials (RCTs) that reported the effect of zinc supplementation on death incidence in under 5-year children were included in the analysis. Screening was performed based on title/abstract and full-text. A random effects model was applied to calculate the summary relative risk (SRR). Risk of Bias 2.0 tool was used to rate the quality of trials. The body of evidence was assessed by the GRADE approach. RESULTS: Combining 30 RRs from 28 RCTs including 237,068 participants revealed that zinc supplementation has significantly reduced the risk of all-causes mortality by 16% in children (SRR: 0.84, 95% CI: 0.74, 0.96). A follow-up duration of less than 1 year after supplementation resulted in 54% reduced risk of mortality (0.46; 0.33, 0.63) with no heterogeneity between investigations. Subgroup analysis by zinc dosage showed that assigning ≥ 10 mg/d zinc to under five children and duration of less than 11 months of intervention decreased the risk of all-cause mortality by 44% (0.56; 0.42, 0.75) and 48% (0.52; 0.38, 0.72), respectively. In low birth weight (LBW) infants, zinc supplementation was reduced all-cause mortality by 52% (0.48; 0.23, 1.00). Zinc supplementation significantly reduced the risk of death from pneumonia (0.70: 0.64, 0.98) and infection (0.54; 0.39, 0.76), also changed the risk of mortality from diarrhea by 15% (0.85; 0.70, 1.03) and sepsis by 57% (0.43; 0.18, 1.02). CONCLUSION: This meta-analysis on RCTs revealed that zinc supplementation in under 5-year children has significantly reduced the risk of all-cause mortality. Notable decreases were found in trials with a dose of 10 mg/d or more zinc supplementation, a maximum of 11 months of supplementation, a follow-up less than one year and especially in LBW infants.

Dietary calcium intake in relation to blood lipids and lipoproteins profiles: A systematic review and meta-analysis of epidemiologic studies.

AIMS: Findings of prior investigations on the association between calcium intake and lipid profiles were inconsistent. We performed a systematic review and meta-analysis on epidemiologic studies to evaluate the relationship of dietary calcium intake with blood lipids and lipoproteins. DATA SYNTHESIS: A systematic search up to April 2021 was performed in different electronic databases, including MEDLINE (PubMed), Scopus, Web of Science (ISI), and Google Scholar for epidemiological studies that considered dietary calcium intake as the exposure and reported risk of dyslipidemia or blood lipids and lipoproteins concentrations (as mean ± SD or mean ± SE or median (Inter Quartile Range) as the outcomes of interest in adult populations from both genders (18 years or older), regardless of their health status. Nineteen cross-sectional studies were included in the analysis. Combining estimates from 11 studies (including 33,304 subjects) revealed that individuals in the highest category of calcium intake, compared to the lowest one, had 5.94 mg/dL lower circulating triglyceride (TG) concentration (weighted mean difference (WMD): -5.94; 95% CI: -8.27, -3.62), 4.02 mg/dL lower circulating low-density lipoprotein cholesterol (LDL-c) levels (WMD: -4.02; 95% CI: -7.08, -0.95), and 1.56 mg/dL higher blood high-density lipoprotein cholesterol (HDL-c) (WMD: 1.56; 95% CI: 0.81, 2.30). Although meta-analysis on 13 studies (including 38,714 participants) did not reveal a significant relationship between dietary calcium intake and odds of dyslipidemia or hyperlipidemia in the whole population, the highest vs. lowest level of calcium intake was related to 42% decreased odds of low blood HDL-c levels in females (95% CI: 0.40, 0.84) and 41% increased odds in males (95% CI: 1.21, 1.65). CONCLUSIONS: This meta-analysis demonstrated that individuals with the highest dietary calcium intake might have lower blood TG, LDL-c, and higher HDL-c concentrations as compared to those with the lowest calcium intake. However, the linkage between dietary calcium intake with odds of hyperlipidemia or dyslipidemia was not significant. Because of the cross-sectional nature of included studies, causality could not be proven. Further prospective studies are needed to affirm these findings.

Dietary total antioxidant capacity in relation to metabolic health status in overweight and obese adolescents.

BACKGROUND: Although several studies evaluated the relationship between individual dietary antioxidants and metabolic health conditions, data on the association between dietary total antioxidant capacity and metabolic health among children and adolescents is limited. This study investigated the relationship between dietary total antioxidant capacity and metabolic health status in Iranian overweight/obese adolescents. METHODS: This cross-sectional study was conducted on 203 overweight/obese adolescents. Dietary intakes were evaluated by a validated food frequency questionnaire. Ferric Reducing-Antioxidant Power (FRAP) was considered to indicate dietary total antioxidant capacity. Anthropometric parameters and blood pressure status were measured. Fasting blood samples were obtained to determine circulating insulin, glucose, and lipid profile. Two different methods (modified International Diabetes Federation (IDF) criteria and IDF criteria along with insulin resistance) were applied to classify participants as metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO). RESULTS: According to IDF and IDF/HOMA definitions, a total of 79 (38.9%) and 67 (33.0%) adolescents were respectively defined as MUO. Considering IDF criteria, the highest tertile of FRAP was related to lower odds of being MUO in the maximally-adjusted model (OR: 0.40; 95%CI: 0.16-0.96), compared to the lowest tertile. However, based on the IDF/HOMA-IR criteria, no significant relation was found between FRAP and odds of MUO (OR: 0.49; 95%CI: 0.19-1.23) after considering all possible confounders. CONCLUSIONS: Adolescents with higher intakes of dietary antioxidants have a lower possibility of being MUO based on IDF criteria. However, no substantial relation was found considering HOMA-IR/IDF definition. Further prospective cohort studies need to be done to confirm these findings.

The association between carotenoid intake, mental health, and sleep quality among university students.

BACKGROUND: The impact of carotenoid intake on the risk of mental disorders and poor sleep quality is unclear. Thus, we sought to examine the association between carotenoid intake, mental health, and sleep quality among university students. METHODS: A total of 368 healthy university students (181 men, 49%), aged 18 to 43 years, volunteered for this study. Dietary intake, physical activity, sleep quality, mental health, and body mass index (BMI) were evaluated. A multivariable logistic regression analysis test was used to estimate the odds ratio (OR) and 95% confidence interval (CI). RESULTS: The mean age of the participants was 22.9 ± 3.9 years and mean BMI was 23.1 ± 3.8 kg/m2. The students in the highest quartile of carotenoid intake had a significantly lower risk of poor sleep quality (OR = 0.19, 95% CI: 0.09 to 0.40; P < 0.001) and depression (OR = 0.27, 95% CI: 0.12 to 0.59; P = 0.001). In the sex-stratified subgroup analysis, the depression risk was significant for men (OR = 0.28, 95% CI: 0.07 to 0.59; P = 0.007), but not for women. Furthermore, we did not observe any specific relationship between carotenoid intake and the risk of anxiety or stress. CONCLUSION: It appears that the students with higher carotenoid intake may have a better quality of sleep and lower risk of depression. More longitudinal and in-depth qualitative and quantitative research, with a longer-term follow-up, is needed to support the veracity of our findings.

Adherence to Mediterranean Diet and Its Association with Metabolic Health Status in Overweight and Obese Adolescents.

Background: Obesity is becoming more prevalent around the world and greatly contributes to chronic disease progression. Previous studies have investigated individual food groups in relation to metabolic health status of adolescents, mainly in Western countries. Limited data are available on the association between dietary patterns and metabolic health in Middle East nations, where childhood overweight/obesity is increasing drastically. Therefore, we investigated the relationship between the Mediterranean diet and metabolic health status among Iranian adolescents. Methods: This cross-sectional study was conducted on 203 overweight/obese adolescents. Dietary intakes were evaluated by a validated food frequency questionnaire. Anthropometric parameters and blood pressure were measured. Fasting blood samples were obtained to determine circulating insulin, glucose, and lipid profile. Two different methods were applied to classify participants as metabolically healthy obese (MHO) or unhealthy obese (MUO): International Diabetes Federation (IDF) criteria and IDF along with insulin resistance (HOMA-IR) criteria. Results: A total of 79 (38.9%) and 67 (33.0%) adolescents were, respectively, categorized as MUO, based on IDF and IDF/HOMA definitions. Considering IDF criteria, higher adherence to the Mediterranean diet was related to lower odds of being MUO, both in the crude (OR: 0.17; 95%CI: 0.08-0.37) and fully adjusted model (OR: 0.33; 95% CI: 0.13-0.84). Excluding each component from the score made the association insignificant, except for two components of meat and dairy products. Based on the IDF/HOMA-IR criteria, there was no significant association between Mediterranean diet score and MUO, after considering all potential confounders (OR: 0.47; 95% CI: 0.17-1.30). Conclusions: We found an inverse association between the Mediterranean diet and odds of MUO among Iranian adolescents, based on IDF criteria. No significant relation was found when MUO was defined based on HOMA-IR/IDF criteria. Further prospective cohort studies are needed to confirm these findings.

The Association between Dietary Total Antioxidant Capacity and Glioma in Adults.

OBJECTIVE: We assessed the relation between dietary total antioxidant capacity (TAC) and risk of glioma among Iranian adults. Design: A hospital-based case-control study. Setting: This case-control investigation was done in 2011. Usual dietary intakes of participants during the preceding year were examined using a food frequency questionnaire. Data on dietary TAC from foods was gathered from published databases that provided the antioxidant capacity for each food item, measured by ferric reducing antioxidant power. Participants: Cases were individuals with pathologically confirmed glioma that were diagnosed during the last month (n = 128). Controls were individuals, aged between 20 and 75 years, who were hospitalized or were outpatients referred to other wards of the same hospitals (n = 256). Results: Compared with participants in the lowest quartile, those in the highest quartile of dietary TAC had a lower odds of glioma (OR: 0.28, 95%CI: 0.15-0.45). This association was strengthened when potential confounders were taken into account (OR: 0.13; 95%CI: 0.05-0.35). Such inverse association was also seen for men (OR: 0.05, 95%CI: 0.01-0.19), but not for women. Furthermore, significant inverse associations were seen between dietary intakes of vitamin C (OR for Q4 vs. Q1: 0.14, 95%CI: 0.05-0.36; P-trend < 0.01), vitamin B6 (OR for Q4 vs. Q1: 0.35, 95%CI: 0.13-0.97; P-trend = 0.02) and ß-carotene (OR for Q3 vs. Q1: 0.43, 95%CI: 0.19-0.98; P-trend = 0.57) and glioma, after controlling for potential covariates. Conclusions: We found that dietary TAC as well as dietary intake of vitamin C, vitamin B6, and ß-carotene was inversely associated with odds of glioma in adults.

The effects of whole grain intake on anthropometric measures in overweight and obese children: a crossover randomised clinical trial.

Whole-grain foods have been reported to affect body weight and satiety. However, we are aware of no study in this regard among children. The present study aimed to determine the effects of whole grain consumption on anthropometric measures in overweight or obese children. In this randomised crossover clinical trial, forty-four overweight or obese girls participated. After a 2-week run-in period, subjects were randomly assigned to either intervention (n 44) or non-intervention (n 44) groups. Subjects in the intervention group were given a list of whole-grain foods and were asked to obtain half of their grain servings from these foods each day for 6 weeks. Individuals in the non-intervention group were asked not to consume any of these foods. A 4-week washout period was applied. Then, participants were crossed over to the alternate arm. The measurements were done before and after each phase. Mean age, weight and BMI of participants were 11·2 (sd 1·49) years, 51·2 (sd 10·2) kg and 23·5 (sd 2·5) kg/m2, respectively. Despite the slight reduction in weight and BMI, there were no significant differences in changes in these anthropometric measures. We found a significant effect of whole grain intake on waist circumference (-2·7 v. 0·3 cm, P = 0·04). No significant changes in hip circumference were observed. Changes in the prevalence of overweight, obesity and abdominal obesity were not significantly different. This study indicated a beneficial effect of whole-grain foods on waist circumference in overweight children; however, these foods did not influence weight and BMI.

Combined Healthy Lifestyle Is Inversely Associated with Upper Gastrointestinal Disorders among Iranian Adults.

OBJECTIVE: Although lifestyle-related factors have separately been examined in relation to functional gastrointestinal disorders (FGIDs), there is no epidemiological data on the combined association of lifestyle factors with these conditions. We aimed to examine how combinations of several lifestyle factors were associated with functional dyspepsia (FD), its symptoms, and gastroesophageal reflux disease (GERD) in a large group of Iranian adults. DESIGN, SETTING, AND SUBJECTS: In a cross-sectional study on 3,363 Iranian adults, we calculated the "healthy lifestyle score" for each participant by summing up the binary score given for 5 lifestyle factors, including dietary habits, dietary intakes, psychological distress, smoking, and physical activity. A dish-based 106-item semi-quantitative validated food frequency questionnaire, General Practice Physical Activity Questionnaire, General Health Questionnaire, and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. To assess FGIDs, a validated Persian version of ROME III questionnaire was used. RESULTS: After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle had 79 and 74% lower odds of FD (OR: 0.21; 95% CI: 0.05-0.92) and GERD (OR: 0.26; 95% CI: 0.09-0.69), respectively, compared with those with the lowest score. They were also less likely to have early satiation (OR: 0.28; 95% CI: 0.11-0.73), postprandial fullness (OR: 0.22; 95% CI: 0.09-0.50), and epigastric pain (OR: 0.44; 95% CI: 0.21-0.92). In addition to the combined healthy lifestyle score, low levels of psychological distress, a healthy diet, healthy dietary habits, and nonsmoking were separately and protectively associated with FGIDs. CONCLUSION: We found that adherence to a healthy lifestyle was associated with lower odds of GERD, FD, and its symptoms in this group of Iranian adults, in a dose-response manner. Individual lifestyle-related factors were also associated with these conditions.

The association between meal and snack frequency and irritable bowel syndrome.

OBJECTIVE: The relationship between daily meal and snack frequency with irritable bowel syndrome (IBS) was less investigated in the literature. We aimed to evaluate this association with IBS symptoms. DESIGN: A cross-sectional study. SETTING: This investigation was performed in Isfahan, a large province in the centre of Iran. Individuals were asked to complete a self-administered questionnaire to quantify the numbers of daily main meals (one, two or three), snacks (never, 1-2, 3-5 or >5) and the total of them (<3, 3-5, 6-7 or ≥8). IBS and its subtypes were diagnosed according to Rome Ш criteria. PARTICIPANTS: General adults (n 4669, 2063 men and 2606 women). RESULTS: The prevalence of IBS was 18·6 % in males and 24·1 % in females. Individuals consuming three main meals had 30 % decreased risk of IBS (OR 0·70, 95 % CI 0·52, 0·94) compared with those with one main meal in the crude model. After adjustments for all potential confounders this relation disappeared (OR 0·67, 95 % CI 0·43, 1·03). Gender-specified analysis revealed that women consuming three main meals per day had 32 % decreased likelihood of having IBS symptoms compared with one daily main meal takers (OR 0·68, 95 % CI 0·47, 0·99). This relation remained significant after adjustment for potential confounders (OR 0·56, 95 % CI 0·36, 0·89). A decreased likelihood of IBS in the highest category of main meal consumption compared with the lowest one was found in obese or overweight subjects (OR 0·54, 95 % CI 0·32, 0·91), after adjustment for all confounders. CONCLUSIONS: Our findings suggested that there was no significant relation between main meal or snack frequency and IBS in Iranian adults, but a small inverse association was found among females and overweight/obese individuals in subgroup analysis. Further prospective studies are needed confirming these associations.

Magnesium intake, insulin resistance and markers of endothelial function among women.

OBJECTIVE: We investigated the association of dietary Mg intake with insulin resistance and markers of endothelial function among Iranian women. DESIGN: A cross-sectional study. SETTING: Usual dietary intakes were assessed using a validated FFQ. Dietary Mg intake was calculated by summing up the amount of Mg in all foods. A fasting blood sample was taken to measure serum concentrations of glycemic indices (fasting plasma glucose and insulin) and endothelial function markers (E-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1). Insulin resistance and sensitivity were estimated using the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), Homeostasis Model Assessment ß-cell function (HOMA-ß) and quantitative insulin sensitivity check index (QUICKI). PARTICIPANTS: Iranian female nurses (n 345) selected by a multistage cluster random sampling method. RESULTS: The Mg intake across energy-adjusted quartiles was 205 (se 7), 221·4 (se 8), 254·3 (se 7) and 355·2 (se 9) mg/d, respectively. After adjustments for potential confounders, QUICKI level was significantly different across quartiles of Mg intake (Q1: 0·34 (se 0·02), Q2: 0·36 (se 0·01), Q3: 0·40 (se 0·01), and Q4: 0·39 (se 0·02), P = 0·02); however, this association disappeared after considering markers of endothelial function, indicating that this relation might be mediated through endothelial dysfunction. After controlling for all potential confounders, Mg intake was inversely, but not significantly, associated with serum concentrations of sICAM (Q1: 239 (se 17), Q2: 214 (se 12), Q3: 196 (se 12), and Q4: 195 (se 17), P = 0·29). There was no other significant association between dietary Mg intake and other indicators of glucose homoeostasis or endothelial markers. CONCLUSIONS: Higher dietary Mg intake was associated with better insulin sensitivity in Iranian females. This linkage was mediated through reduced endothelial dysfunction.

Association between sleep duration and sleep quality with sugar and sugar-sweetened beverages intake among university students.

BACKGROUND AND AIM: Both short sleep duration and intake of sugar or sugar-sweetened beverages (SSBs) are associated with weight gain; but the linkage between sleep characteristics and sugar or SSBs intake was less studied. We aimed to evaluate the associations of sleep duration and sleep quality with sugar and SSBs intake among Iranian adults. METHOD: This cross-sectional study consisted of 395 adults chosen among students of Isfahan University of Medical Sciences, based on a multistage cluster random sampling method. Sleep characteristics and dietary intakes and were assessed using the Pittsburgh Sleep Quality Index (PSQI) and a 147-item validated food frequency questionnaire, respectively. RESULTS: Mean age and percentage of women in the study population were 22.79 (year) and 51.8%, respectively. No significant difference was observed between sleep duration and sugar intake, but short sleepers (< 6 h/d) had higher consumption of SSBs intake (86.54 vs. 65.73 g/day; P = 0.05) in comparison with those who had more than 8 h/d of sleep. Poor quality sleepers had significantly higher intake of SSBs compared with those with good quality of sleeping (87.09 vs. 56.73 g/day; P = 0.004). No significant correlation was found between sleep duration and SSBs intake. However, sleep quality score was positively correlated with SSBs intake (rp:0.14, P = 0.007) in whole population, such that higher quality score (defined as poor sleep quality) was correlated with greater consumption of SSBs. Similar results were found in younger individuals (rp:0.27, P = 0.002) and non-obese participants (rp:0.14, P = 0.006). CONCLUSION: We found that sleep duration was not associated with sugar or SSBs intake in Iranian adults. Poor sleep quality was correlated with high consumption of SSBs, especially in younger and non-obese individuals. More prospective investigations are required to confirm these findings.