The association between daytime sleep and general obesity risk differs by sleep duration in Iranian adults.

BACKGROUND: Sleep duration and daytime napping and obesity are related to adiposity; however, it is not clear whether the association between daytime napping and adiposity measures can differ by sleep duration. AIM: To clarify the association between daytime napping and general and abdominal obesity based on sleep duration of participants. SUBJECTS AND METHODS: This cross-sectional study was conducted on 1,683 individuals (837 men and 846 women) aged ≥ 35 years. Height, weight and waist circumference (WC) were measured according to the standard protocols. Body mass index (BMI) was calculated. Self-reported sleep duration (in a 24-hour cycle) was recorded. The odds of general and abdominal obesity were compared between nappers and non-nappers, stratified by their sleep duration (≤ 6 h, 6-8 h, ≥ 8 h). RESULTS: The mean (SD) age of participants was 47.48 ± 9.35 years. Nappers with a short sleep duration (≤ 6 h) had greater BMI and higher risk for overweight/obesity compared with counterpart non-nappers after adjustment for potential confounders (OR = 1.61, 95% CI = 1.07-2.41). In subjects with moderate sleep duration (6-8 h), nappers had a tendency towards higher BMI in comparison with non-nappers (28.04 ± 0.25 vs. 26.93 ± 0.51 kg/m2; p = 0.05), however, no significant difference was observed for the risk of obesity. Daytime napping was not related to the risk of obesity in long sleepers. No significant association was observed for abdominal obesity measures. CONCLUSIONS: Daytime napping is associated with increased risk of overweight/obesity in short sleepers. However, in subjects with longer sleep duration, it is not related to the risk of overweight/obesity.

Long-term association of nut consumption and cardiometabolic risk factors.

BACKGROUND AND AIMS: Long-term associations between nut consumption and cardiometabolic risk factors are not well known. We investigated the relationship between nut consumption and cardiometabolic risk factors including dyslipidemia, hypertension, diabetes mellitus (DM), and obesity in a cohort of Iranian adults. METHODS AND RESULTS: The study was conducted within the framework of the Isfahan Cohort Study on 1387 healthy participants. The participants were followed up for 12 years. A validated food frequency questionnaire was completed, and anthropometric measurements, blood pressure, and fasting serum lipids and blood sugar were evaluated in three phases. Mixed-effects binary logistic regression was applied to examine the associations between nut consumption and cardiometabolic risk factors. The participants were classified according to the tertiles of nut consumption as cut-points, and associations were evaluated between the thirds of nut intake. Subjects in the last third were less likely to have hypercholesterolemia [OR (95% CI): 0.76 (0.60-0.97)], hypertriglyceridemia [OR (95% CI): 0.74 (0.58-0.93)], and obesity [OR (95% CI): 0.79 (0.50-0.98)] but more likely to have DM [OR (95% CI): 1.85 (1.27-2.68)] than those in the first third. However, after adjustment for various potential confounders, the associations remained significant only for obesity [OR (95% CI): 0.67 (0.48-0.94)] and DM [OR (95% CI): 2.23 (1.37-3.64)]. CONCLUSION: After adjustment for potential confounders, we observed an inverse association for nut consumption and obesity but positive association for DM and nut intake. On the basis of our findings, it is suggested that incorporation of nuts into people's usual diet may have beneficial effects for individuals with lower risk such as subjects without DM.

Body mass index, waist-circumference and cardiovascular disease risk factors in Iranian adults: Isfahan healthy heart program.

Considering the main effect of obesity on chronic non-communicable diseases, this study was performed to assess the association between body mass index (BMI), waist-circumference (WC), cardio-metabolic risk factors and to corroborate whether either or both BMI and WC are independently associated with the risk factors in a sample of Iranian adults. This cross-sectional study was performed on data from baseline survey of Isfahan Healthy Heart Program (IHHP). The study was done on 12,514 randomly-selected adults in Isfahan, Najafabad and Arak counties in 2000-2001. Ages of the subjects were recorded. Fasting blood glucose (FBG), 2-hour post-load glucose (2hpp), serum lipids, systolic and diastolic blood pressure (SBP and DBP), BMI, WC, smoking status, and total daily physical activity were determined. Increase in BMI and WC had a significant positive relation with the mean of FBG, 2hpp, SBP, DBP, serum lipids, except for HDL-C (p<0.001 for all). After adjustment for age, smoking, physical activity, socioeconomic status (SES), and BMI, the highest odds ratio (OR) (95% CI) for diabetes mellitus (DM) according to WC was 3.13 (1.93-5.08) and 1.99 (1.15-3.44) in women and men respectively. Moreover, the highest ORs based on BMI with adjustment for age, smoking, physical activity, SES, and WC were for dyslipidaemia (DLP) [1.97 (1.58-2.45) in women and 2.96 (2.41-3.63) in men]. The use of BMI or WC alone in the models caused to enhance all ORs. When both BMI and WC were entered in the model, the ORs for all risk factors, in men, according to BMI, were more compared to WC. However, in women, ORs for DM and hypertension (HTN) in WC quartiles were more than in BMI quartiles. BMI is the better predictor of DM, HTN, and DLP in men compared to WC. Conversely, in women, WC is a superior predictor than BMI, particularly for DM and HTN. Furthermore, the measurement of both WC and BMI in Iranian adults may be a better predictor of traditional risk factors of CVDs compared to BMI or WC alone.

White rice consumption and CVD risk factors among Iranian population.

Association between white rice intake and risk factors of cardiovascular diseases remained uncertain. Most of the previous published studies have been done in western countries with different lifestyles, and scant data are available from the Middle East region, including Iran. This cross-sectional study was conducted in the structure of Isfahan Healthy Heart Program (IHHP) to assess the association between white rice consumption and risk factors of cardiovascular diseases. In the present study, 3,006 men were included from three counties of Isfahan, Najafabad, and Arak by multistage cluster random-sampling method. Dietary intake was assessed with a 49-item food frequency questionnaire (FFQ). Laboratory assessment was done in a standardized central laboratory. Outcome variables were fasting blood glucose, serum lipid levels, and anthropometric variables. Socioeconomic and demographic data, physical activity, and body mass index (BMI) were considered covariates and were adjusted in analysis. In this study, Student's t-test, chi-square test, and logistic regression were used for statistical analyses. Means of BMI among those subjects who consumed white rice less than 7 times per week and people who consumed 7-14 times per week were almost similar--24.8 +/- 4.3 vs 24.5 +/- 4.7 kg/m2. There was no significant association between white rice consumption and risk factors of cardiovascular diseases, such as fasting blood sugar arid serum lipid profiles. Although whole grain consumption has undeniable effect on preventing cardiovascular disease risk, white rice consumption was not associated with cardiovascular risks among Iranian men in the present study. Further prospective studies with a semi-quantitative FFQ or dietary record questionnaire, representing type and portion-size of rice intake as well as cooking methods and other foods consumed with rice that affect glycaemic index (GI) of rice, are required to support our finding and to illustrate the probable mechanism.

Healthy bread initiative: methods, findings, and theories--Isfahan Healthy Heart Program.

The scientific evidences show that the content, baking methods, and types of bread can make health impacts. Bread, as a major part of Iranian diet, demonstrates a significant potential to be targeted as health promotion subject. Healthy Food for Healthy Communities (HFHC) was a project of Isfahan Healthy Heart Program (IHHP), consisting of a wide variety of strategies, like Healthy Bread (HB) Initiative. The HB Initiative was designed to improve the behaviour of both producers and consumers, mainly aiming at making high-fibre, low-salt bread, eliminating the use of baking soda, providing enough rest time for dough before baking (at least one hour), and enough baking time (at least one minute in oven). A workshop was held for volunteer bakers, and a baker-to-baker training protocol under direct supervision was designed for future volunteers. Cereal Organization was persuaded to provide less refined flour that contained more bran. Health messages in support of new breads were disseminated by media and at bakeries by health professionals. Evaluation of the HB Initiative was done using before-after assessments and population surveys. While HB was baked in 1 (0.01%) bakery at baseline, 402 (41%) bakeries in the intervention area joined the HB Initiative in 2009. Soda was completely eliminated and fibre significantly increased from 4 +/- 0.4 g% before study to 12 +/- 0.6 g% after the intervention (p < 0.001). The preparation and baking times remarkably increased. Wastage of bread decreased from 13 +/- 1.8 g% to 2 +/- 0.5 g% and was expressed as the most important advantage of this initiative by consumers. People who lived in Isfahan city consumed whole bread 6 times more than those who lived in reference area Arak (p < 0.001). The HB Initiative managed to add new breads as a healthy choice that were compatible with local dishes and made a model to solve the longstanding problems of bread. It used various health promotion approaches but was best consistent with Beattie's model.

Potato consumption and cardiovascular disease risk factors among Iranian population.

BACKGROUND: Previous studies investigated the effects of dietary glycaemic index and glycaemic load on cardiovascular risk factors. Little evidence is available regarding the association between potato intake and cardiovascular risk factors in Iran. OBJECTIVE: This cross-sectional study was conducted in the first stage of Isfahan Healthy Heart Programme. METHODS: A total of 4774 subjects were included in the present study. Dietary intake was assessed with a 49-item food frequency questionnaire. Biochemical assessments were done according to the standard protocol. RESULTS: There were significant associations between potato consumption and diabetes mellitus (odds ratio (OR): 1.38; 95% CI: 1.14-1.67; p < 0.001), high fasting blood sugar level (OR: 1.40; 95% CI: 1.17-1.68; p < 0.001) and low serum high density lipoprotein level (OR: 1.10; 95% CI: 1.01-1.20; p = 0.02) remained after adjustments for possible confounding factors. CONCLUSION: We found a positive relation between potato consumption, high fasting blood glucose level and diabetes mellitus.

The association of dietary macronutrient quality indices with depression and anxiety symptoms and quality of life in Iranian adults: The LipoKAP study.

BACKGROUND: Macronutrients' quality may impact differently on mental health and quality of life (QOL). This study aimed to investigate the potential relationship between the carbohydrate quality index (CQI), fat quality index (FQI), protein quality index (PQI), the affective mental symptoms and QOL among Iranian adults. METHODS: The LipoKAP is a cross-sectional study, conducted with 2456 adults in Iran. A validated food frequency questionnaire was used to evaluate usual dietary intakes. A validated Iranian version of the Hospital Anxiety and Depression Scale was used to assess the severity of anxiety and depression. QOL was assessed by EQ-5D. RESULT: In the fully adjusted model, participants in the highest tertile of CQI had lower QOL than those in the lowest tertile (OR = 1.35; 95 % CI: 1.06, 1.73). Individuals in the top tertile of FQI (OR = 0.71; 95 % CI: 0.55, 0.91) and PQI (OR = 0.78; 95 % CI: 0.60; 1.01) were less likely to report lower QOL than those in the bottom tertile. An inverse association was found between PQI and depressive symptoms (OR = 0.72, 95 % CI: 0.55, 0.95), but not for CQI and FQI. LIMITATIONS: The cross-sectional design of the study and the use of a memory-based dietary tool may limit the generalizability of our findings. CONCLUSION: Higher PQI was associated with lower risk of depressive symptoms and having a low-quality life. Although CQI and FQI were not related to depressive and anxiety symptoms, higher values of FQI were associated with better QOL, while CQI showed an inverse association.

The effect of educational and encouraging interventions on anthropometric characteristics and perilipin-1 levels: TABASSOM Study.

BACKGROUND: Perilipin protein located in lipid droplets is involved in formation and storage of lipid in adipocytes; thus, it is considered as one of the obesity biomarkers. This study was performed to examine the effect of educational and encouragement interventions and lifestyle modifications on anthropometric characteristics and perilipin-1 level. METHODS: This quasi-experimental study was conducted on subsample of TABASSOM Study. Participants were 42 overweight and obese children and adolescents aged 6-18 years old and 80 overweight and obese adults aged 19-65 years old. Anthropometric characteristics including weight, height, waist circumference (WC), body fat percentage (BFP), and perilipin-1 level were measured at the first and the end of study (after one year). RESULTS: After intervention, the mean of perilipin-1 decreased significantly in total children and adolescents (before vs. after: 26.79 ± 13.17 vs. 22.57 ± 8.03; P = 0.006) and girls (27.75 ± 10.51 vs. 22.00 ± 8.15; P = 0.001), but decreasing was not significant in boys. In adults, perilipin-1 levels were significantly reduced in total subjects (before vs. after: 16.19 ± 13.42 vs. 15.34 ± 11.25; P = 0.029) and men (18.02 ± 15.78 vs. 15.44 ± 10.61; P = 0.003). There was no significant difference in mean of body mass index (BMI), WC, and BFP in both groups after 12 months. CONCLUSION: Educational and encouraging interventions and lifestyle modifications could lead to decreasing perilipin-1 level in adults, children, and adolescents.

Validity and reproducibility of a semi-quantitative food frequency questionnaire for Iranian adults.

AIM: To validate a semi-quantitative food frequency questionnaire (SFFQ) and assess the dietary intake of Iranian adults. METHODS: This study was conducted among 113 healthy adults in Iran. We administered twelve 24-hour dietary recalls (24DRs) during a year as a reference method. The 165-item SFFQ was administered twice, along with the first and last 24DRs. To examine validity and reproducibility of SFFQ, the correlation coefficients (r) and de-attenuated correlation coefficients and intra-class correlation coefficient (ICC) between 24DRs and SFFQ were calculated. The Bland-Altman method was used to assess agreement between the two methods. RESULTS: De-attenuated correlations varied from 0.42 (polyunsaturated fatty acids) to 0.62 (energy) (all P < .001) for nutrients and from 0.48 (oils and fats) to 0.65 (sweets) for food groups (all P < .05). We found reasonable reproducibility of SFFQ for both nutrients and food groups. ICC (95%CI) varied from 0.47 (0.15-0.74) for saturated fatty acids to 0.64 (0.47-0.76) for energy and from 0.43 (0.15-0.62) for oils and fats to 0.58 for grains (0.31-0.69). According to the Bland-Altman plots, we observed an acceptable level of agreement between the two methods. CONCLUSIONS: We found reasonable relative validity and acceptable reproducibility of SFFQ. This SFFQ can be used to classify individuals based on their dietary intake in our population.

Do lifestyle interventions affect dietary diversity score in the general population?

OBJECTIVE: The dietary diversity score (DDS) is a good indicator of diet quality as well as of diet-disease relationships; therefore, the present study was undertaken to reveal the effect of a lifestyle intervention on this index. DESIGN: A baseline and three evaluation studies were conducted in two intervention districts (Isfahan and Najaf-Abad) and a reference area (Arak), all located in central Iran. The Isfahan Healthy Hearth Programme (IHHP) targeted the entire population of nearly 2 million in urban and rural areas of the intervention communities. One of the main strategies of the lifestyle intervention phase in the IHHP was healthy nutrition. Usual dietary intake was assessed using a forty-nine-item FFQ. A diversity score for each food group was calculated and the DDS was considered the sum of the diversity scores of the food groups. RESULTS: There were significant increases in DDS in both intervention areas (P = 0.0001) after controlling for confounding factors. There was a significant interaction between area and evaluation stage with regard to DDS (P = 0.0001). The effect of the intervention on the diversity scores of all food groups was also significant (P = 0.0001 for all) after adjusting for socio-economic status. CONCLUSION: The community-based lifestyle intervention in the IHHP was successful in improving DDS which might be related to an increase of diet quality of the population that in turn might decrease the risks of chronic diseases.

The effect of educational and encouragement interventions on anthropometric characteristics, obestatin and adiponectin levels.

BACKGROUND: Lifestyle modification is the most important strategy for control of obesity and overweight. Obestatin and adiponectin are the biomarkers of obesity. Thus, this study was performed to examine the effect of educational and encouragement interventions and lifestyle modifications on obesity anthropometric as well as obestatin and adiponectin levels. METHODS: This semi-experimental study was conducted on a subsample of TABASSOM study. Participants were 41 overweight and obese children and adolescents aged 6-18 years old and 45 overweight and obese adults aged 19-65 years old. Anthropometric characteristics including height, weight, waist and hip circumferences, and body fat percentage (BFP) were measured at the first and after one year at the end of study. We implemented some educational and encouragement interventions regarding dietary modification and physical activity during the study. Obestatin and adiponectin levels were measured at the first and end of study by enzyme-linked immunosorbent assay (ELISA) method. RESULTS: The study did not show significant effect on anthropometric characteristics such as body mass index (BMI) and waist circumference (WC). BFP decreased significantly in boys, total children and adolescent group, and waist-to-hip ratio (WHR) decreased significantly only in adolescent boys after 1 year (P < 0.050). CONCLUSION: Educational and encouraging interventions and lifestyle modifications could lead to decrease of body WHR and BFP in adolescent boys. This is helpful in controlling the increasing rate of obesity.

Usual energy and macronutrient intakes in a large sample of Iranian middle-aged and elderly populations.

AIM: The present study aimed to assess the usual distribution of energy and macronutrient intake among a large representative sample of Iranian healthy middle-aged and elderly people. METHODS: In this cross-sectional study, a second follow-up survey of the Isfahan Cohort Study (ICS) was carried out; 1922 people aged 40 years and older were investigated. Dietary intakes were collected using 24-hour recall and two or more consecutive food records. Distribution of energy and macronutrient intake was estimated using traditional and National Cancer Institute (NCI) methods. RESULTS: The mean usual intake of energy was 1749.2 kcal based on the NCI method. Carbohydrate constituted 59.98% and protein 17.42% of total energy intake. The mean contributions of total fat, saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFAs) to energy intake were 25.74%, 9.5%, 4.92 and 7.75%, respectively. Approximately 7% of studied females aged 51-70 years met the recommended or higher levels for fibre. Females had significantly higher compliance of the recommended cholesterol level than males (age range of 40-70 years; P < 0.0001). CONCLUSIONS: It appears that Iranian middle-aged and elderly people are advancing towards a high risk of obesity and non-communicable chronic diseases. Nutritional interventions for improving the diet amongst this at-risk population are necessary.

Association of Animal and Plant Proteins Intake with Hypertension in Iranian Adult Population: Isfahan Healthy Heart Program.

BACKGROUND: There is evidence regarding the relationship between dietary proteins intake and blood pressure (BP), but they had inconsistent results. Therefore, this study was designed to assess the association between different kinds of protein intake (animal and plant protein) and BP. MATERIALS AND METHODS: Data were collected from Isfahan Healthy Heart Program. We performed a cross-sectional study among 9660 randomly selected Iranian adults aged ≥19-year-old that they were selected from three large Iranian regions in 2007. A simplified validated 48-item-food frequency questionnaire was used to assess dietary intake including all kinds of protein. Systolic and diastolic BPs were measured in duplicate by trained personnel using a standard protocol. Multivariable regressions were applied to assess the relationship between protein intake and BP levels and the presence of hypertension (HTN). RESULTS: More frequent consumption of animal, plant, and total protein intake were inversely associated with BP in a crude model (P < 0.001); however, after adjustment for potential confounders this relationship remained only for plant protein (P = 0.04). The risk of HTN occurrence decreased in the highest quintile of total and plant protein consumption by 19% (odds ratio [OR] = 0.81; confidence interval [CI]: [0.65-0.96]; P for trend = 0.004) and 18% (OR = 0.82; [CI: (0.67-0.94]; P for trend = 0.03), respectively. CONCLUSIONS: More frequent protein intake, especially plant protein consumption was inversely associated with BP and risk of HTN among Iranian adults.

Association of glycaemic index and glycaemic load with metabolic syndrome in an Iranian adult population: Isfahan Healthy Heart Program.

AIM: There is controversy around the clinical effects of the dietary glycaemic index (GI) and glycaemic load (GL) on cardiovascular diseases risk factors such as metabolic syndrome (MetS). So, the present study was performed to evaluate the relationship between GI or GL and metabolic syndrome in an Iranian adult population in 2007. METHODS: The study was based on data from a sub-sample of the Isfahan Healthy Heart Program (IHHP), collected across three cities in central Iran, in the year 2007. This was a cross-sectional survey of 1618 randomly selected adults aged ≥19 years. Nutritional assessment was conducted by a single 24-hour recall questionnaire. Fasting serum lipids, anthropometric indicators and blood pressure were measured by standard methods. Analysis of covariance was used to compare metabolic syndrome components according to energy-adjusted GI and GL levels. To expose the effect of potential confounders, hierarchical logistic regression models were utilised to determine adjusted odds ratios (OR) and 95% CI. RESULTS: After adjustment for age, gender, body mass index and energy intake, high GI was found to be significantly associated with MetS (OR 95% CI) (1.46 (1.01-2.12)). This was attenuated marginally by excluding the confounding effects of dietary fibre intake (1.29 (1.01-1.74)). All hierarchical models illustrated no significant association between energy-adjusted GL and the risk of MetS adjusted for confounders. CONCLUSIONS: There is a positive relationship between dietary GI, but not GL, and the presence of MetS after adjustment for potential confounders. However, studies with long duration of follow up and experimental studies are still required to confirm this relationship.

The Effect of Nutrition Consultation on Dietary Diversity Score of Cardiac Patients Referred to Cardiac Rehabilitation Research Center Isfahan Cardiovascular Research Institute during 2008-2013.

BACKGROUND: Dietary diversity score (DDS) measurement was used to assessment of diet quality in different disease like cardiovascular disease. One way to improve the cardiovascular patient's ability is cardiac rehabilitation program that include exercise training, nutrition consultation and psychological treatment. No study was designed to compare the DDS before and after dietary consultation among cardiac rehabilitation patients, so this study was designed to examine this purpose. METHODS: Subjects were participated in the 2-month cardiac rehabilitation program. All patients that completed the cardiac rehabilitation program and 2 dietary records (before and after nutritional counseling in cardiac rehabilitation program) enrolled in study. Kant et al method was used for scoring dietary diversity. Data were analyzed using the statistical package for social sciences (SPSS version 20). Wilcoxon test were used to compare DDS score for each subgroup and pair sample T test was used to compare total DDS after and before nutrition counseling. P < 0.05 was considered as statistically significant. RESULTS: The differences between DDS of grain, fruit, vegetable and meat before and after nutrition counseling were not significant (P = 0.635, P = 0.423, P = 0.826, P = 0.207 respectively), but differences of DDS for dairy and total DDS before and after nutrition counseling were significant (P = 0, P = 0.001). CONCLUSIONS: Dietary diversity was increased after nutrition counseling among patients with cardiac disease.

Socioeconomic determinants and metabolic syndrome: Results from the Isfahan Healthy Heart Program.

Introduction: The prevalence of metabolic syndrome (MetS) is increasing in Iran. We assessed the relationship between socioeconomic status (SES) and Mets components in the Iranian population. MATERIALS AND METHODS: The sample for this study comprised a random cross-section of men and women from two province districts who participated in the Isfahan Healthy Heart Program (IHHP) in 2007. Each participant completed a questionnaire, underwent anthropometric testing and blood pressure measurements, and provided a blood sample. Mets was defined based on ATPIII criteria. Several SES dimensions, such as education, occupation, and number of children, as well as home, car, and personal computer ownership, were assessed to determine the participant's SES. RESULTS: A higher-than-average income, car ownership, owning or renting a private home, and having a computer are increasing towards increment in SES. All MetS components were more prevalent in participants defined as having a lower SES, while low HDL levels were more common in participants having an SES II (P>0.001). A multivariate analysis showed that having the lowest SES (I) increased the risk of MetS by 1.72 [1.44-2.07], whereas subjects having an SES III had a 1.23 [1.04-1.47] lower risk for MetS. CONCLUSIONS: The relationship between SES and Mets is due largely to behavioural factors, such as practicing unhealthy eating habits. Given the high prevalence of Mets in Iran, we propose that regular health check-ups may be useful in the early detection of the syndrome and, consequently, in the prevention of its effects. In addition, the early detection of MetS may result in the early diagnosis and prevention of cardiovascular diseases.

Validation of a simplified food frequency questionnaire for the assessment of dietary habits in Iranian adults: Isfahan Healthy Heart Program, Iran.

BACKGROUND: Dietary assessment is the first step of dietary modification in community-based interventional programs. This study was performed to validate a simple food frequency questionnaire (SFFQ) for assessment of selected food items in epidemiological studies with a large sample size as well as community trails. METHODS: This validation study was carried out on 264 healthy adults aged ≥ 41 years old living in 3 district central of Iran, including Isfahan, Najafabad, and Arak. Selected food intakes were assessed using a 48-item food frequency questionnaire (FFQ). The FFQ was interviewer-administered, which was completed twice; at the beginning of the study and 2 weeks thereafter. The validity of this SFFQ was examined compared to estimated amount by single 24 h dietary recall and 2 days dietary record. Validation of the FFQ was determined using Spearman correlation coefficients between daily frequency consumption of food groups as assessed by the FFQ and the qualitative amount of daily food groups intake accessed by dietary reference method was applied to evaluate validity. Intraclass correlation coefficients (ICC) were used to determine the reproducibility. RESULTS: Spearman correlation coefficient between the estimated amount of food groups intake by examined and reference methods ranged from 0.105 (P = 0.378) in pickles to 0.48 (P < 0.001) in plant protein. ICC for reproducibility of FFQ were between 0.47-0.69 in different food groups (P < 0.001). CONCLUSION: The designed SFFQ has a good relative validity and reproducibility for assessment of selected food groups intake. Thus, it can serve as a valid tool in epidemiological studies and clinical trial with large participants.

Relationship between legumes consumption and metabolic syndrome: Findings of the Isfahan Healthy Heart Program.

BACKGROUND: Epidemiologic studies have shown an inverse association between dietary fiber and metabolic syndrome (MetS). Therefore, the purpose of this study was to investigate the association between MetS and consumption of legumes in adults in Isfahan, Iran. METHODS: This cross-sectional study was carried out on 2027 individuals who were a subsample of the 3rd phase of the Isfahan Healthy Heart Program (IHHP). Basic characteristics information such as age, sex, smoking status, and physical activity were collected using a questionnaire. A validated 48-item food frequency questionnaire was used to assess dietary behaviors. Blood pressure, waist circumference (WC), glucose, triacylglycerols, and high-density lipoprotein cholesterol were measured, and MetS was defined based on Adult Treatment Panel III guidelines. Multiple logistic regression models examined associations of frequency consumption of legumes with MetS occurrence and its components. RESULTS: All MetS components were less prevalent among subjects with regular legume intake (P < 0.01). Legume intake was inversely associated with the risk of MetS, after adjustment for confounding factors in women. Life style adjusted odds ratio of Mets between highest and lowest tertile and no consumption (as reference category) of legume intake were 0.31 (0.13, 0.70), 0.38 (0.17, 0.87), respectively, in women (P = 0.01). CONCLUSION: This study showed that age has a crucial role in MetS incidence; therefore, after further age adjustment to lifestyle adjusted model there was no significant difference in lower and higher tertile of legume intake and MetS.

Comparison of effects of soft margarine, blended, ghee, and unhydrogenated oil with hydrogenated oil on serum lipids: A randomized clinical trail.

BACKGROUND: Trans fatty acids (TFAs) are known as the most harmful type of dietary fats. Therefore, this study was done to compare the effects of some different oils including unhydrogenated, blended, ghee, and soft magazine with hydrogenated oil on serum lipid profile of healthy adults. METHODS: This study was a randomized clinical trial conducted on 206 healthy participants of 20 to 60 years of age. Subjects were randomly divided into 5 groups and each of them was treated with a diet containing unhydrogenated oil, ghee, blended oil, soft margarine, or hydrogenated oil for 40 days. Fasting serum lipids were measured before and after the study. RESULTS: Compared to hydrogenated oil, total cholesterol (TC) and triglyceride (TG) had a significant reduction in all groups, LDL-C declined in unhydrogenated oil and soft margarine groups, and apolipoprotein (Apo) B only in unhydrogenated oil group (all P < 0.05). However, there was a significant enhancement in ApoA of ghee oil (P < 0.001). CONCLUSION: Consuming unhydrogenated oil, ghee, soft margarine, and blended oil had some beneficial effects on serum lipids.