Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study.

BACKGROUND & AIMS: Although functional gastrointestinal disorders (FGIDs), now called disorders of gut-brain interaction, have major economic effects on health care systems and adversely affect quality of life, little is known about their global prevalence and distribution. We investigated the prevalence of and factors associated with 22 FGIDs, in 33 countries on 6 continents. METHODS: Data were collected via the Internet in 24 countries, personal interviews in 7 countries, and both in 2 countries, using the Rome IV diagnostic questionnaire, Rome III irritable bowel syndrome questions, and 80 items to identify variables associated with FGIDs. Data collection methods differed for Internet and household groups, so data analyses were conducted and reported separately. RESULTS: Among the 73,076 adult respondents (49.5% women), diagnostic criteria were met for at least 1 FGID by 40.3% persons who completed the Internet surveys (95% confidence interval [CI], 39.9-40.7) and 20.7% of persons who completed the household surveys (95% CI, 20.2-21.3). FGIDs were more prevalent among women than men, based on responses to the Internet survey (odds ratio, 1.7; 95% CI, 1.6-1.7) and household survey (odds ratio, 1.3; 95% CI, 1.3-1.4). FGIDs were associated with lower quality of life and more frequent doctor visits. Proportions of subjects with irritable bowel syndrome were lower when the Rome IV criteria were used, compared with the Rome III criteria, in the Internet survey (4.1% vs 10.1%) and household survey (1.5% vs 3.5%). CONCLUSIONS: In a large-scale multinational study, we found that more than 40% of persons worldwide have FGIDs, which affect quality of life and health care use. Although the absolute prevalence was higher among Internet respondents, similar trends and relative distributions were found in people who completed Internet vs personal interviews.

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.

The association between dietary total antioxidant capacity and odds and severity of irritable bowel syndrome among Iranian adults: a cross-sectional study.

BACKGROUND: Little evidence is available in terms of the role of dietary antioxidants in the management of irritable bowel syndrome (IBS) disease. This study aimed to examine the association between dietary total antioxidant capacity (dTAC) and odds of IBS and its severity. METHODS: This cross-sectional study was conducted on 3,362 Iranian adults who were referred to health centers in Isfahan province, Iran. Participants' dietary intakes were collected using a semi-quantitative validated food frequency questionnaire (DS-FFQ). The dTAC was measured by the ferric-reducing antioxidant power (FRAP) method. Multivariable binary or ordinal logistic regression analyses were performed to estimate any associations between dTAC and odds of IBS, IBS severity, and IBS subtypes. RESULTS: The average age and BMI of the participants and dTAC score were 36.3 ± 7.87 year, 24.9 ± 3.82 kg/m2. The prevalence of IBS, IBS with constipation (IBS-C), IBS with diarrhoea (IBS-D), mixed IBS (IBS-M), and un-subtyped IBS (IBS-U) were 22.2, 7.5, 4.6, 3.8, and 6.2%, respectively. In crude and adjusted models, the results did not show any significant association between dTAC and odds of IBS among whole and gender-age stratified populations. Being in the third compared with the first tertile of dTAC was not also significantly associated with odds of IBS severity. Besides, there were no significant associations between dTAC and odds of IBS-C, IBS-D, IBS-M, and IBS-U. CONCLUSION: This study indicates that dTAC may not be associated with the odds of IBS and its severity even after stratification for gender and body mass index.

The Association between Adherence to the MIND Diet and Irritable Bowel Syndrome.

BACKGROUND AND AIMS: No earlier study examined the association between adherence to the MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) diet and odds of irritable bowel syndrome (IBS). This study was conducted to examine the relationship between adherence to the MIND diet and odds of IBS among Iranian adults. METHODS: In this cross-sectional study, dietary intakes of 3,362 adults were examined using a validated Dish-Based 106-item Semi-Quantitative Food Frequency Questionnaire (DS-FFQ). The MIND diet score was constructed based on participants' dietary intakes obtained from DS-FFQ. IBS was evaluated using a modified Persian version of the Rome III questionnaire. RESULTS: Overall, 22.2% of the study population were affected by IBS (n = 748). We observed no significant relationship between adherence to the MIND diet and odds of IBS in the whole population (OR: 0.97; 95% CI: 0.71-1.31). By gender and BMI status, no significant association between adherence to the MIND diet and odds of IBS was seen. Also, no significant association was found between adherence to the MIND diet and IBS subtypes. CONCLUSION: No significant association was found between adherence to the MIND diet and odds of IBS. Further studies are needed to examine the association between dietary patterns and IBS.

Dietary phytochemical index in relation to risk of stroke: a case-control study.

BACKGROUND & AIM: No study explores the association of dietary phytochemical index (DPI) with stroke. This study was undertaken to obtain the required insight in this regard in Iranian adults. METHODS: This hospital-based case-control study was carried out on 195 stroke patients (diagnosed based on clinical and brained CT findings) and 195 control subjects with no history of cerebrovascular diseases or neurologic disorders). Data collection on dietary intakes was done using a 168-item validated FFQ. DPI was calculated using the McCarty equation. Logistic regression model in different models was used to evaluate the association between DPI and stroke. RESULTS: Mean age of study participants was 64.8 years, and 53.4% of them were male. Individuals in the highest tertile of DPI were younger (63 ± 11 vs. 67.4 ± 13 y, P = 0.01) and less likely to be physically active (2804 ± 5714 vs. 4772 ± 11912 M, P = 0.03). After adjustment for potential confounders, no significant relationship was observed between DPI and stroke risk (OR: 0.76; 95% CI: 0.39-1.49). However, when we considered the effect of dietary intakes, subjects in the top tertile of DPI were 61% less likely to have a stroke than those in the bottom tertile (OR: 0.39; 95% CI: 0.16-0.95). When BMI was controlled, the association between DPI and stroke became strengthened (OR: 0.32; 95% CI: 0.12-0.86). CONCLUSION: We found evidence indicating a significant inverse association between DPI and odds of stroke in adults. Further prospective studies are warranted to confirm this association.

The association between adherence to the MIND diet and stroke: a case-control study.

OBJECTIVES: Although some components of MIND diet were associated with stroke, no information is available on the association between adherence to the MIND diet and odds of stroke. This study was conducted to investigate the association between adherence to the MIND diet and odds of stroke among Iranian adults. METHODS: This case-control study was done on 193 hospitalized stroke cases and 195 hospital-based controls in Al-Zahra hospital, Isfahan, Iran. Dietary intakes of study participants were assessed using a validated 168-item food frequency questionnaire (FFQ). The MIND diet score was computed based on participants' dietary intakes obtained from FFQ. Stroke was confirmed by a trained neurologist using standard imaging methods. RESULTS: After controlling for age, sex, energy intake, physical activity, smoking, hypertension, diabetes, dyslipidemia, and heart disease, there was no significant association between adherence to the MIND diet and stroke (OR: 0.54; 95% CI: 0.26, 1.12). However, after further adjustment for BMI, we found that those with the greatest adherence to the MIND diet were less likely to have stroke compared with those with the lowest adherence; such that greater adherence to the MIND diet was associated with a 59% reduced odds of stroke (OR: 0.41; 95% CI: 0.18-0.94). CONCLUSION: In conclusion, we found that adherence to the MIND diet was inversely associated with odds of stroke in a case-control study. Further studies are required to confirm these findings.

Dietary Inflammatory Potential in relation to General and Abdominal Obesity.

Background/Aims: Limited data are available on the association of Dietary Inflammatory Potential (DIP) with general and abdominal obesity in developing countries. The aim of this study was to examine the association between DIP score with general and abdominal obesity among Iranian adults. Methods. This cross-sectional study was conducted among adults in Isfahan, Iran. Dietary intakes were assessed by using a validated, self-administrated, dish-based, semiquantitative food frequency questionnaire. DIP was calculated based on standard method. Data regarding height, weight, and waist circumference (WC) were collected using a self-reported questionnaire. Overweight or obesity was defined as body mass index (BMI) ≥25 kg/m2, and abdominal obesity was defined as WC ≥ 80 cm for women and ≥94 cm for men. Results. Mean age of study participants was 36.8 ± 8.08 years. The prevalence of general and abdominal obesity was 46.5% and 52.9%, respectively. We observed that higher DIP scores were significantly associated with a lower odds of general obesity (OR: 0.66; 95% CI: 0.58-0.74). Stratified by sex, this significant association was seen only for women (OR: 0.58; 95% CI: 0.46-0.72). In addition, no significant association was found between DIP scores and abdominal obesity. Conclusions. We found a significant inverse association between consumption of a proinflammatory diet and general obesity. In the gender-stratified analysis, this was seen in women, but not in men. There was no significant association between the DIP scores and abdominal obesity.

Dietary intake of branched-chain amino acids in relation to general and abdominal obesity.

PURPOSE: Despite the huge evidence on the link between dietary protein intake and obesity, limited studies have examined the role of individual amino acids in this regard. This study aimed to investigate the association between dietary total and individual BCAAs intake and odds of general and abdominal obesity in a large group of adults. METHODS: This cross-sectional study was conducted among 8691 adults aged 18-55 years in Isfahan, Iran. Dietary BCAAs were assessed using a validated dish-based 106-item semi-quantitative food frequency questionnaire (DS-FFQ). Information about weight and waist circumference was collected through a self-reported validated questionnaire. General obesity was defined as body mass index (BMI) ≥ 30 kg/m2, and abdominal obesity was defined as waist circumference (WC) ≥ 88 cm for women and ≥ 102 cm for men. RESULTS: Mean age of study participants was 36.8 ± 8.1 years. Prevalence of general obesity was 9.2% in men and 9.7% in women and that of abdominal obesity was 13.3% and 36.2% in men and women, respectively. We found that participants in the top tertile of total BCAAs intake had higher odds of general obesity compared with those in the bottom tertile (OR: 1.42; 95% CI: 1.09-1.84). Such significant association was seen in men (OR: 1.57; 95% CI: 1.05-2.34), but not in women (OR: 1.33; 95% CI: 0.94-1.89) in our stratified analysis. We found no significant association between total BCAAs intake and odds of abdominal obesity. Stratified by sex, no significant association was observed between total BCAAs intake and odds of abdominal obesity [for men: (OR: 1.10; 95% CI: 0.74-1.65) and for women: (OR: 1.08; 95% CI: 0.84-1.38)]. Assessing the association with individual BCAAs, a significant positive association was observed between dietary intake of valine (OR: 1.42; 95% CI: 1.10-1.84), leucine (OR: 1.43; 95% CI: 1.10-1.86), and isoleucine (OR: 1.42; 95% CI: 1.09-1.84) with general obesity. We observed no significant association between dietary intake of individual BCAAs intake and odds of abdominal obesity. CONCLUSION: Dietary BCAAs intake was associated with an increased odds of general obesity, in particular among men. No significant association was observed between dietary BCAAs and abdominal obesity. LEVEL OF EVIDENCE: Level V, descriptive cross-sectional study.

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.

Empirically derived food-based dietary inflammatory index is associated with increased risk of psychological disorders in women.

Purpose/introduction: There is no study on the association of empirically derived food-based dietary inflammatory index (FDII) and risk of psychological disorders. We investigated the association between FDII and odds of psychological disorders in Iranian adults.Methods and materials: In this cross-sectional study, data on dietary intakes of 3363 Iranian adult participants were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire. FDII score was constructed based on participants' dietary intakes of 28 pre-defined food groups. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ) was used to assess psychological disorders. Depression, anxiety and psychological distress were defined based on standard criteria.Results: After controlling for potential confounders, participants in the top quintile of FDII score had a greater odds of depression (OR: 1.49; 95% CI: 1.08-2.06), anxiety (OR: 1.92; 95% CI: 1.24-2.96), and psychological distress (OR: 1.55; 95% CI: 1.10-2.19) compared with those in the bottom quintile. When we did the analyses stratified by gender, we found a significant positive association between FDII score and depression (OR: 1.57; 95% CI: 1.04-2.35), anxiety (OR: 1.99; 95% CI: 1.19-3.34), and psychological distress (OR: 1.68; 95% CI: 1.10-2.56) among women comparing the highest and the lowest quintiles. We found no significant association between FDII score and psychological disorders in men.Conclusion: We found that greater FDII score was positively associated with psychological disorders. In the gender-stratified analysis, this was seen in women but not in men.

Adherence to Mediterranean dietary pattern is inversely associated with depression, anxiety and psychological distress.

Background: Few studies have assessed adherence to the Mediterranean diet in relation to psychological health, in particular in the Middle East.Objective: To examine the association between adherence to Mediterranean dietary pattern and prevalence of psychological disorders among a large population of Iranian adults.Design: In this cross-sectional study on 3172 Iranian adults aged 18-55 years, we used a validated food frequency questionnaire for the assessment of dietary intakes. Adherence to the Mediterranean dietary pattern was examined using the Trichopoulou et al. method. To assess psychological health, the Iranian validated version of the Hospital Anxiety and Depression Scale (HADS) was used. Psychological distress was assessed through the use of General Health Questionnaire (GHQ).Results: Mean age of study participants was 36.54 ± 4.97 years. After controlling for potential confounders, participants with the greatest adherence to the Mediterranean diet had lower odds for depression (OR: 0.60, 95% CI: 0.46-0.78), anxiety (OR: 0.61, 95% CI: 0.42-0.86) and psychological distress (OR: 0.60, 95% CI: 0.45-0.79) compared with those with the lowest adherence. When the association with components of Mediterranean diet was examined, we found that high intake of fruits and vegetables was associated with a lower odds of depression, anxiety and psychological distress. In contrast, high intake of grains was positively associated with depression, anxiety and psychological distress.Conclusion: We found evidence indicating an inverse association between adherence to Mediterranean dietary pattern and odds of psychological disorders including depression, anxiety and psychological distress.

Dietary intake of branched-chain amino acids in relation to depression, anxiety and psychological distress.

BACKGROUND: There is no previous study that examined the association between branched-chain amino acids (BCAAs) intake and odds of psychological disorders. The aim of this study was to investigate the association between dietary BCAAs and odds of psychological disorders including depression, anxiety, and psychological distress in a large sample of Iranian adults. METHODS: In this cross-sectional study on 3175 Iranian adults aged 18-55 years, a validated food frequency questionnaire was used to assess dietary intakes. BCAAs intake was computed by summing up the amount of valine, leucine, and isoleucine intake from all food items in the questionnaire. Psychological health was examined through the use of Iranian validated version of the Hospital Anxiety and Depression Scale (HADS). Psychological distress was assessed using General Health Questionnaire (GHQ). For depression and anxiety, scores of 8 or more on either subscale were considered as psychological disorders and scores of 0-7 were defined as "normal". In terms of psychological distress, the score of 4 or more was defined as psychological distress. RESULTS: Mean age of study participants was 36.2 ± 7.8 years. Overall, 26.4% (n = 837) of study subjects had depression, 11.9% (n = 378) had anxiety and 20.9% (n = 665) were affected by psychological distress. After controlling for potential confounders, participants in the highest tertile of total BCAAs intake had lower odds of depression (OR: 0.76; 95% CI: 0.60-0.96) and anxiety (OR: 0.66; 95% CI: 0.47-0.91) compared with those in the lowest tertile. Participants in the top tertile of valine intake had a lower odds of depression (OR: 0.76; 95% CI: 0.60-0.96) and anxiety (OR: 0.65; 95% CI: 0.47-0.90) compared with those in the bottom tertile. A significant inverse association was also seen between leucine intake and depression (OR: 0.77; 95% CI: 0.61-0.98) and anxiety (OR: 0.66; 95% CI: 0.47-0.91). In addition, a significant inverse association was observed between isoleucine intake and odds of depression (OR: 0.75; 95% CI: 0.59-0.95) and anxiety (OR: 0.62; 95% CI: 0.45-0.86). There was no significant association between isoleucine intake and odds of psychological distress. CONCLUSION: Evidence indicating an inverse association between dietary intake of BCAAs and odds of depression and anxiety was found. Prospective studies are required to confirm these findings.

Adherence to Alternative Healthy Eating Index (AHEI-2010) is not associated with risk of stroke in Iranian adults: A case-control study.

Background: Stroke is a major global health problem that contributes to a significant burden of morbidity and mortality. The association of several foods and nutrients with stroke has been well-established. However, the effect of the whole diet on stroke is poorly understood. In this work, we aimed to examine the association between the quality of whole diet, as measured using Alternate Healthy Eating Index-2010 (AHEI-2010), and risk of stroke in Iranian adults. Methods: In this hospital-based case-control study, 193 stroke patients (diagnosed based on clinical and brain CT findings) and 193 controls with no history of cerebrovascular diseases or neurologic disorders were included. The participants' dietary intakes were examined using a validated 168-item semi-quantitative food frequency questionnaire. AHEI-2010 was constructed based on earlier studies. Participants were classified according to tertiles of AHEI-2010 scores and multivariate logistic regression was used to evaluate the association between whole diet quality and risk of stroke. Results: Individuals with greater adherence to AHEI-2010 had a higher intake of fruits, vegetables, nuts and legumes, whole grains and carbohydrate, and a lower intake of trans-fatty acids, sugar-sweetened beverages, total energy and fat (P < 0.05). After adjusting for potential confounders, adherence to AHEI-2010 was not significantly associated with a reduced risk of stroke (OR: 0.92; 95% CI: 0.56-1.51). Conclusion: We found that adherence to AHEI-2010 was not associated with risk of stroke in Iranian adults. Further prospective studies are warranted to validate this finding and clarify the relationship between whole diet and stroke.

Legume and nut consumption in relation to depression, anxiety and psychological distress in Iranian adults.

PURPOSE: Although considerable research has been devoted to the link between consumption of legume and nuts and metabolic abnormalities, few studies have examined legume and nut consumption in relation to psychological disorders. The current study aimed to examine the association of legume and nut consumption with depression, anxiety and psychological distress in Iranian adults. METHODS: This cross-sectional study was carried out among 3172 adult participants aged 18-55 years. Assessment of legume and nut consumption was conducted using a validated dish-based 106-item semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used to examine psychological health. Scores of 8 or more on either subscale in the questionnaire were considered to indicate the presence of depression or anxiety. Data on psychological distress were collected using the General Health Questionnaire (GHQ), in which the score of 4 or more was considered as having psychological distress. RESULTS: The mean age of participants was 36.5 ± 7.9 years. In the fully adjusted model, men in the top quintile of legume and nut consumption were 66% less likely to be anxious than those in the bottom quintile (OR 0.34; 95% CI 0.14-0.82). However, such significant relationship was not observed among women (OR 1.06; 95% CI 0.63-1.77). We failed to find any other significant association between legume and nut consumption and depression or psychological distress after adjustment for potential confounders either in men or women. CONCLUSIONS: We found that consumption of legume and nuts was associated with lower odds of anxiety in men, but not in women. No other significant association was seen among participants. Legume and nut consumption might be promising and, along with medications, could be used to prevent, control or delay psychological disorders.

Association between dietary insulin index and load with obesity in adults.

PURPOSE: Hyperinsulinemia is linked to the development of various chronic diseases, especially obesity given to the role of insulin responses in body fat accumulation; hence, the current study aimed to examine the association of insulinemic potential of the diet with general and abdominal obesity among a large population of Iranian adults. METHODS: This cross-sectional study was carried out among 8691 adult participants aged 18-55 years. Dietary data were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire. Dietary insulin index (DII) was computed through considering food insulin index values published earlier. Dietary insulin load (DIL) was also calculated using a standard formula. Assessment of anthropometric measures was conducted through a self-administered questionnaire. General obesity was defined as body mass index ≥ 25 kg/m2, and abdominal obesity as waist circumference ≥ 94 cm for men and ≥ 80 cm for women. RESULTS: Mean age of study participants was 36.8 ± 8.1 years; 60.3% were women. Compared with the lowest quintile, women in the highest quintile of DIL were less likely to be abdominally obese (OR 0.73; 95% CI 0.57-0.92). Such significant association was not seen after controlling for potential confounders (OR 0.86; 95% CI 0.44-1.67). Neither in crude nor in adjusted models, we observed a significant association between DIL and general obesity among men and women. In terms of dietary insulin index, men in the top quintile of DII were more likely to be generally overweight or obese compared with those in the bottom quintile (OR 1.27; 95% CI 1.00-1.62). This association became non-significant after controlling for demographic characteristics (OR 1.14; 95% CI 0.84-1.56). Furthermore, in thefully adjusted model, women in the top quintile of DII were more likely to have general obesity compared with those in the bottom quintile (OR 1.40; 95% CI 1.07-1.84). CONCLUSIONS: We found that adherence to a diet with a high DII was associated with greater odds of general obesity among women, but not in men. Although such information might help to draw conclusions on the practical relevance of the shown findings, further studies, specifically of prospective design, are warranted.

Dietary total antioxidant capacity in relation to stroke among Iranian adults.

Objective: This study was conducted to investigate the association between dietary TAC and odds of stroke among Iranian adults.Methods: This case-control study was done on 195 hospitalized stroke cases and 195 hospital-based controls in Al-Zahra hospital, Isfahan, Iran. Dietary TAC was estimated using the ferric-reducing antioxidant power (FRAP) international databases. Stroke was confirmed by a trained neurologist using standard imaging methods.Results: Mean dietary TAC was not significantly different comparing cases and controls (10.2 ± 6.0 vs. 10.4 ± 4.8, P = 0.61). However, after adjustment for potential confounders including dietary intakes of fiber and omega-3 fatty acids, we found an almost significant inverse association between dietary TAC and odds of stroke; such that each unit increase in dietary TAC was associated with 29% reduced odds of stroke (OR: 0.71; 95% CI: 0.50-1.01, P = 0.06). When we examined the association across tertiles of dietary TAC, we found that after controlling for potential confounders, those in the top tertile of dietary TAC were 51% less likely to have a stroke than those in the bottom tertile (0.49; 0.23-1.00).Discussion: We found an almost significant inverse association between dietary TAC and odds of stroke.

Water intake and intra-meal fluid consumption in relation to general and abdominal obesity of Iranian adults.

OBJECTIVE: The aim of this study was to examine the association between whole-day water intake and intra-meal fluid consumption and odds of general and abdominal obesity among adults. METHODS: This cross-sectional study was conducted among 7958 adults in Isfahan, Iran. Daily water consumption was assessed through the use of a pre-tested questionnaire by asking questions about the average number of glasses of water consumed in a day. Intra-meal fluid consumption was also analysed. Data regarding height, weight and waist circumference were collected using a validated self-administered questionnaire. Obesity was defined as body mass index ≥30 kg/m2, and abdominal obesity was defined as waist circumference >88 cm for women and >102 cm for men. RESULTS: After taking potential confounders into account, individuals who were taking more than eight glasses of water in a day had 78% greater odds of general obesity (OR: 1.78; 95% CI: 1.08-2.94) compared with those who were taking less than two glasses of water. Individuals with much water intake had no significant greater odds of abdominal obesity. Compared with those who were consuming less than a glass of intra-meal fluids, subjects with 1-2 glasses of fluids between meals had 34% greater odds of general obesity (OR: 1.34; 95% CI: 1.04-1.59). Although subjects with greater intra-meal fluid intake had greater odds of abdominal obesity in crude model, this association became non-significant after adjustment for potential confounders (comparing > 4 glasses vs. ≤1 glass: OR: 1.65; 95% CI: 0.81-3.34). CONCLUSIONS: We observed that taking more than eight glasses of water in a day and consuming 1-2 glasses of fluids between meals was associated with greater odds of general obesity.

Higher vitamin B6 intake is associated with lower depression and anxiety risk in women but not in men: A large cross-sectional study.

Objective: The prevalence of depression and anxiety is increasing worldwide. Diet as a modifiable factor for mental health has received great attention. The aim of the present study was to evaluate the association of vitamin B6 intake with depression and anxiety. Methods: This cross-sectional study was performed among 3362 adults in 2011. Anxiety and depression were evaluated using an Iranian validated version of the Hospital Anxiety and Depression Scale (HADS) questionnaire. Dietary intakes were evaluated by a validated 106 item self-administered Willett-format dish-based semi quantitative food-frequency questionnaire (DFQ). Results: The mean intake of vitamin B6 (mg/day) was significantly lower in anxious (1.93 ± 0.74 vs. 2.0 ± 0.74; P = 0.02) and depressed (1.86 ± 0.72 vs. 1.99 ± 0.74; P = 0.001) people than healthy participants. The lower level of vitamin B6 intake (tertile 1), after adjustment for the impacts of various confounding variables, in total population and women was associated with the higher odds of depression (OR = 1.41; 95% CI: 1.19, 2.31; P < 0.001. OR = 1.33; 95% CI: 1.08, 2. 21; P = 0.02, respectively). Also, the lower level of vitamin B6 intake (tertile 1) in total population and women was associated with the higher odds of anxiety (OR = 2.30; 95% CI: 1.31, 4.04; P < 0. 001, OR = 2.30; 95% CI: 1.19, 4.46; P = 0.04). Conclusion: The association of lower intakes vitamin B6 intake with increased risk of depression and anxiety was clearly supported by current study. A reasonable approach to tackle these disorders could be the improvement of nutritional status, accordingly large randomized controlled trials are suggested for providing more evidence.

Egg consumption and prevalence of psychological disorders in adults.

PURPOSE: No previous study has examined the associations between egg consumption and prevalence of psychological disorders. The present study was conducted to determine the association between egg consumption and depression in a large sample of Iranian adults. METHODS: This cross-sectional study was conducted on 3172 adults in Isfahan, Iran. Egg consumption was assessed by using a validated, self-administered, dish-based, semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale was used to screen for anxiety and depression. The Iranian validated version of General Health Questionnaire with 12 items was used to assess psychological distress. Depression, anxiety and psychological distress were defined according to standard criteria. RESULTS: The mean age of the study participants was 36.5 ± 7.9 years. Depression, anxiety and psychological distress were prevalent among 28.4, 13.6 and 23% of the study subjects, respectively. After controlling for potential confounders, no significant association was observed between egg intake and depression (OR for comparing extreme quartiles: 1.08; 95% CIs 0.80-1.45) and anxiety (OR 0.79; 95% CIs 0.54-1.16), as well as psychological distress (OR 1.03; 95% CIs 0.76-1.41) in the whole population. In men, significant positive associations were observed between egg intake and depression before controlling for BMI (OR 1.68; 95% CIs 1.01-2.80); however, the associations became non-significant after taking BMI into account (OR 1.62; 95% CIs 0.96-2.72). CONCLUSIONS: We found no significant association between egg intake and psychological disorders. Further studies, in particular of prospective design, are warranted.

Adherence to the pro-inflammatory diet in relation to prevalence of irritable bowel syndrome.

OBJECTIVE: There is no prior study that examined the association between nutrient-based dietary inflammatory index (DII) and odds of Irritable Bowel Syndrome (IBS). We examined the association between DII score and odds of IBS and its severity among Iranian adults. METHODS: In this cross-sectional study, dietary intakes of 3363 Iranian adults were examined using a validated Dish-based 106-item Semi-quantitative Food Frequency Questionnaire (DS-FFQ). DII was calculated based on dietary intakes derived from DS-FFQ. IBS was assessed using a modified Persian version of Rome III questionnaire. RESULTS: After adjustment for potential confounders, we found that participants in the highest quintile of DII score had greater chance for IBS compared with those in the lowest quintile (OR: 1.36; 95% CI: 1.03-1.80). By gender, we found a significant association between DII score and IBS among women (OR: 1.41; 95% CI: 1.00-2.00). By BMI status, overweight or obese (BMI ≥ 25 kg/m2) individuals in top quintile of DII score had greater odds for IBS than those in the bottom quintile (OR: 1.64; 95% CI: 1.07-2.53). No significant association was observed between a pro-inflammatory diet and severity of IBS symptoms. CONCLUSIONS: Consumption of a pro-inflammatory diet was associated with increased odds of IBS, in particular among women and those with BMI ≥ 25 kg/m2.