Association of the triglyceride glucose index with all-cause and cardiovascular mortality in a general population of Iranian adults.

BACKGROUND: The triglyceride glucose (TyG) index is a new and low-cost marker to determine insulin resistant which may be a predictor of cardiovascular disease (CVD). Although available evidence showed that its association with CVD mortality (CVM) and all-cause mortality (ACM) may differ in different populations, scarce data are available in this regard specially in low and middle-income countries. PURPOSE: To examine the association between TyG index and risk of CVM and ACM in Iranians. METHODS: This prospective cohort study included 5432 adults (age ≥ 35 years) with no history of CVD events. Fasting glucose and triglyceride were measured at baseline in all participants and TyG index was calculated. Cox frailty model was used to calculate hazard ratios (HRs) for CVM and ACM across the tertiles of TyG index. RESULTS: After a median follow-up of 11.25 years, a total number of 191 cardiovascular deaths, and 487 all-cause mortality was recorded. The risk of both CVM and ACM increased across the tertiles of TyG index. In the adjusted model for lifestyle and metabolic variables, the risks of ACM and CVM increased by 41% (95% CI 1.11, 1.81; P for trend = 0.005) and 64% (95% CI 1.07, 2.50; P for trend = 0.024), respectively. However, adjustment for diabetes mellitus disappeared the significance for both ACM and CVM. These associations may vary by sex. TyG was not related to the risk of non-CVD mortality. CONCLUSION: The predicting value of TyG index for ACM and CVM might be mediated by diabetes status. Further studies are required to confirm these findings.

Bovine Colostrum in Increased Intestinal Permeability in Healthy Athletes and Patients: A Meta-Analysis of Randomized Clinical Trials.

BACKGROUND: Increasing intestinal permeability causes chronic inflammation, which is one of the etiological factors of many diseases that presently constitute global challenges. AIMS: Considering the importance of developing therapies to eliminate the increased intestinal permeability, in this systematic review and meta-analysis, we analyze the impact of bovine colostrum (BC) on the gut barrier and its permeability. METHODS: Online databases, including PubMed, ISI Web of Science, and Scopus, were searched to find pertinent articles up to March 2022. Weighted mean difference (WMD) and 95% confidence intervals (CI) were considered as effect sizes. The random-effects model was used to pool the study results. RESULTS: A total of ten articles were included in the meta-analysis. The pooled effect revealed a significant reduction in the 5-h urinary lactulose/rhamnose ratio after BC consumption [mean difference (MD): -0.24; 95% CI -0.43 to -0.04; I2 = 99%] and urinary lactulose/mannitol ratio (MD: -0.01; 95% CI -0.02 to -0.001; I2 = 29.8%). No differences were observed in the plasma intestinal fatty acid-binding protein (I-FABP) between BC and control groups (MD: 2.30; 95% CI -293.9 to 298.5; I2 = 92%). CONCLUSIONS: BC supplementation significantly reduced intestinal permeability; however, to confirm the results, more randomized clinical trials considering different quality, dose, and duration are needed.

Ultra-processed food consumption and cardiovascular events rate: An analysis from Isfahan Cohort Study (ICS).

BACKGROUND AND AIMS: The contribution of ultra-processed foods (UPFs) to daily energy intake and, therefore, their health effects may vary between countries. We aimed to investigate the association between UPFs and the incidence risk of cardiovascular events (CVEs) and cardiovascular mortality in the Isfahan cohort study. METHODS AND RESULTS: In 2001, 6504 participants aged ≥35 years were enrolled and followed until 2017. Dietary intake was assessed using a validated food frequency questionnaire, and the NOVA system was applied for UPF classification. Any new case of CVE, including fatal and non-fatal myocardial infarction (MI) or stroke, unstable angina (UA), and CVD death, was recorded. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated through Cox proportional hazards regression models. A total number of 819 CVE, 164 MI, 348 UA, 172 strokes, and 181 cardiovascular deaths were recorded during 61352.5 person-years of follow-up. The median (IQR) of UPF consumption was 2.47 (1.00-5.23) times/week. In the fully adjusted model, individuals in the fourth quartile of UPFs had no higher risk for incident MI and UA (HR = 1.12, 95% CI: 0.87, 1.46; P for trend = 0.364), stroke (HR = 0.93, 95% CI: 0.58, 1.46; P for trend = 0.601), cardiovascular mortality (HR = 0.95, 95% CI: 0.61, 1.47; P for trend = 0.596), and CVE (HR = 1.08, 95% CI: 0.88,1.34; P for trend = 0.515) in comparison with those in the first quartile. CONCLUSION: This mid-term prospective cohort study provides no evidence for a significant association between UPF and CVE risk. Longer studies are required to confirm this association.

Burden of colorectal cancer and its risk factors in the North Africa and Middle East (NAME) region, 1990-2019: a systematic analysis of the global burden of disease study.

OBJECTIVE: The geographical differences in incidence rates of colorectal cancer (CRC) and its burden due to modifiable risk factors warrant investigating the CRC burden and its risk factors in different regions. In the current study, we aimed to estimate the burden of CRC and the share of its risk factors in the North Africa and Middle East (NAME), from 1990 to 2019. STUDY DESIGN: Systematic review. METHODS: The rates of incidence, prevalence, death, years of life lost (YLL), years lived with disability (YLD), and disability adjusted life years (DALYs) of CRC were estimated through the framework of the Global Burden of Diseases (GBD), Injuries and Risk Factors Study 2019 by age, sex, between 1990 and 2019. The CRC-related DALYs attributable to each lifestyle and metabolic risk factor was also estimated through a comparative risk assessment approach. RESULTS: In NAME region, the trends of incidence, prevalence, death, YLL, YLD, and DALYs of CRC were increasing, with higher rates in males than females over this period. High and high-middle socio-demographic index (SDI) countries had greater CRC DALYs rate compared with middle- and low-SDI countries in 2019, except for Palestine [434.66 (95% UI: 368.82, 503.88)]. In NAME region, like the global, dietary risk (33.18%), low whole grain intake (19.79%), and low intake of milk (15.77%) were the major contributing risk factors to DALYs due to CRC in 2019. CONCLUSIONS: Due to increasing trend of CRC burden and the considerable role of lifestyle and metabolic factors in its burden in NAME region, implementing fundamental strategies to minimize CRC burden and its risk factors is imperative.

First Iranian guidelines for the diagnosis, management, and treatment of hyperlipidemia in adults.

This guideline is the first Iranian guideline developed for the diagnosis, management, and treatment of hyperlipidemia in adults. The members of the guideline developing group (GDG) selected 9 relevant clinical questions and provided recommendations or suggestions to answer them based on the latest scientific evidence. Recommendations include the low-density lipoprotein cholesterol (LDL-C) threshold for starting drug treatment in adults lacking comorbidities was determined to be over 190 mg/dL and the triglyceride (TG) threshold had to be >500 mg/dl. In addition to perform fasting lipid profile tests at the beginning and continuation of treatment, while it was suggested to perform cardiovascular diseases (CVDs) risk assessment using valid Iranian models. Some recommendations were also provided on lifestyle modification as the first therapeutic intervention. Statins were recommended as the first line of drug treatment to reduce LDL-C, and if its level was high despite the maximum allowed or maximum tolerated drug treatment, combined treatment with ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, or bile acid sequestrants was suggested. In adults with hypertriglyceridemia, pharmacotherapy with statin or fibrate was recommended. The target of drug therapy in adults with increased LDL-C without comorbidities and risk factors was considered an LDL-C level of <130 mg/dl, and in adults with increased TG without comorbidities and risk factors, TG levels of <200 mg/dl. In this guideline, specific recommendations and suggestions were provided for the subgroups of the general population, such as those with CVD, stroke, diabetes, chronic kidney disease, elderly, and women.

Association of omega-6 polyunsaturated fatty acids with blood pressure: A systematic review and meta-analysis of observational studies.

OBJECTIVES: This systematic review and meta-analysis aimed at summarizing earlier findings on the association of n-6 PUFAs levels in diets or blood with blood pressure. METHODS: PubMed/Medline, Scopus, and Web of Science were searched for observational studies. Publications with data on the risk of hypertension, or the correlation between n-6 PUFAs or mean values of serum n-6 PUFAs levels in normotensive and hypertensive were included. RESULTS: Twenty-two studies (16 cross-sectional studies, 5 cohorts and one case-control) were eligible. Combining 14 extracted effect sizes showed that higher circulatory/dietary n-6 PUFAs tended to be associated with 10% lower risk of HTN (95% CI: 0.81, 1.00), whereas combining 23 effect sizes illustrated no difference in circulatory/dietary n-6 PUFAs mean levels between normotensive and hypertensive subjects. According to subgroup analysis based on fatty acid types, total n-6 PUFAs (OR = 0.82, 95% CI: 0.70, 0.97) and linoleic acid (OR = 0.56, 95% CI: 0.39, 0.82) were inversely related to the risk of HTN. Circulatory/dietary n-6 PUFAs were correlated neither with systolic nor with diastolic blood pressure. CONCLUSIONS: Higher circulatory/dietary n-6 PUFAs tend to be associated with lower odds of HTN. Particularly, total n-6 PUFAs and linoleic acid were associated with lower risk of HTN.

The relationship between nut consumption and premature coronary artery disease in a representative sample of Iranians: Iran-premature coronary artery disease (IPAD) study.

OBJECTIVE: The cardioprotective effects of nuts are well established. However, the positive impacts of nuts in preventing CVD at a younger age, a condition known as premature coronary artery disease (PCAD), is still debated. Therefore, we aim to determine the association between nuts and PCAD occurrence and its severity in different Iranian ethnicities. DESIGN: This case-control study was conducted within the framework of the Iran-premature coronary artery disease (I-PAD) study, an ongoing multi-centric study on Iranian patients of different ethnicities. SETTING: This multi-centric case-control study was conducted in among 3253 persons under the age of 70 years in women and 60 years in men from different ethnicities in Iran. PARTICIPANTS: Information on nut consumption was collected using a validated FFQ. Subjects were selected from among the candidates for angiography. Cases were those whose coronary angiography showed stenosis of more than 75 % in at least one vessel or more than 50 % of the left main artery, while the control group participants had normal angiography results. RESULTS: In the crude model, compared to the first quartile, the highest quartile of nut consumption was significantly associated with a lower risk of PCAD (OR = 0·26, 95 % CI (0·21, 0·32); Pfor trend = 0·001). In the top quartile of nut intake, a substantial decrease in PCAD was observed after controlling for putative confounders (OR = 0·32; 95 % CI (0·24, 0·43); Pfor trend = 0·001). Additionally, a 75 % decrease in the risk of severe PCAD was observed in the participants in the highest quartile of nut intake. CONCLUSION: A significant inverse association was observed between nut intake and the risk and severity of PCAD in the Iranian population. Large-scale clinical trials are required to confirm these findings.

The influential role of parents' socioeconomic status and diet quality on their children's dietary behavior: results from the LIPOKAP study among the Iranian population.

PURPOSE: There is a paucity of evidence regarding the influential factors on Iranian children's diet quality. To assess this issue, we explore the relationship between parental diet quality, socioeconomic status (SES), and nutritional knowledge with their children's diet quality using a cross-sectional sample of the Iranian population. METHODS: In this study, paired parents along with one of their children (aged 6-18 years old) who lived with them were included. Dietary intake was assessed using a food frequency questionnaire (FFQ) and diet quality was determined using an Alternative Healthy Eating Index-2010 (AHEI). Nutritional knowledge and SES were also explored using validated questionnaires. Multiple linear regression analysis was used and beta (ß) and corresponding 95% confidence interval (CI) were reported. RESULTS: After controlling for potential confounders, the parents' AHEI was significantly associated with their children's diet quality (ß = 12.34, 95% CI: 10.75, 13.93; P < 0.001). The nutritional knowledge of parents was significantly associated with children's AHEI after controlling for potential confounders (ß = 1.63, 95% CI: 0.14, 3.11; P = 0.032). Moreover, the parents' SES was inversely associated with the AHEI of children (ß=-3.76, 95% CI: -5.40, -2.11; P < 0.001); however, further adjustment for confounders attenuated this relationship (Model 3: ß = 0.87, 95% CI: -0.76, 2.34; P = 0.269). CONCLUSIONS: We found that the children's diet quality could be influenced by their parents' SES, nutritional knowledge, and diet quality. Our findings suggest that improving the nutritional knowledge of parents not only may improve the healthy eating pattern of parents but also could influence their children's diet quality.

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.

Epidemiology of emotional and psychological problems in Iranian children: Protocol of a cross-sectional study in Isfahan.

Background: The present study aimed at providing comprehensive epidemiological data about the prevalence of psychological and emotional problems in a representative sample of Iranian children and evaluates the major and common determinants of parents and family environment of these problems. Materials and Methods: The epidemiology of emotional and psychological problems in Iranian children is a cross-sectional study was conducted on 786 families and their 800 children during 2019-2021 in Isfahan, Iran. Personality traits, psychological health, marital satisfaction, individual's perceptions of his/her family and quality of life of parents were evaluated using Iranian-validated questionnaires. Various aspects of emotional, general, psychological, and sleep health as well as physical activity levels and nutritional habits of children also have been assessed using Iranian validated instruments. Data on sociodemographic characteristics representing parents and family status also have been collected. Results: The mean age of parents and children was 39.5 ± 5.5 and 10.20 ± 1.90 (years), respectively. The mean duration of marriage was 16.1 ± 5.1 years and majority of parents his or her wife were at bachelor degree while parents with other degrees of education were sufficiently available in our study. The participated children were nearly equally distributed in terms of gender. A large portion (81.9%) of questionnaires about children was filled by mothers. Majority of children (62.2%) were first birth order. Conclusion: The current study provides comprehensive data about various psychological, emotional, and educational problems of Iranian children and new insights about family environment and parental interrelationship as key risk factors for the aforementioned problems in which may have implications for both clinical and preventive psychological health to improve individual educational and treatment efficacy and problem-solving in problematic children.

Longitudinal association of dietary carbohydrate and the risk cardiovascular disease: a dose-response meta-analysis.

Previous findings on the association of dietary carbohydrate with cardiovascular disease (CVD) events and mortality are inconsistent. We aimed to assess the relationship between dietary carbohydrate and the incidence of cardiovascular events and mortality. A comprehensive literature search of MEDLINE (PubMed), Scopus, ISI Web of Science, and EMBASE, was performed up to June 2019. Prospective cohort studies which examined dietary carbohydrate in relation to fatal and non-fatal myocardial infarction, fatal and non-fatal stroke, heart failure, and sudden cardiac death were included in our study. Summary HRs and 95% CIs were estimated using a random-effects model. A total of 19 cohort studies including 15,663,111 participants were identified. Combining 27 effect sizes with 1,577,225 CVD cases led to a significant association between dietary carbohydrate and total CVD events (HR= 1.05, 95% CI: 1.00, 1.10; I2 = 38.5%), but no association was observed between dietary carbohydrate and CVD mortality (HR = 1.02; 95% CI: 0.91, 1.14; I2=27.1%, derived from 8 effect sizes with 106,412 events), and CHD events (HR = 1.03, 95% CI: 0.98, 1.09; I2 = 46.6%, derived from 18 effect sizes with 1,549,281 events). Moreover, using 8 effect sizes with 6,829 cases, higher carbohydrate intake was associated with increased risk of stroke (HR = 1.13; 95% CI: 1.01, 1.27; I2= 0.0%). In subgroup analysis by sex, higher carbohydrate intake increased the risk of total CVD events (HR: 1.10; 95% CI: 1.03, 1.17; I2 = 0.0%), and CHD (HR: 1.10; 95% CI: 1.01, 1.20; I2= 15.0%), but not stroke and CVD mortality in women. No significant association was found in men. Low- to very-low-certainty evidence suggests that higher carbohydrate intake is directly but slightly associated with CVD and stroke risk, while no association was found for CHD and CVD mortality. We also found sex-specific associations.

High-sensitivity C-reactive protein and low-density lipoprotein cholesterol association with incident of cardiovascular events: Isfahan cohort study.

BACKGROUND: There are many studies on high-sensitivity C-reactive protein (hs-CRP) association with cardiovascular disease (CVD); however, just a few studies investigated whether the low-density lipoprotein cholesterol (LDL-C) could participate in hs-CRP prognostic strength. This study aimed to determine the alliance of hs-CRP and LDL-C in different concentrations in occurrence cardiovascular events in the Isfahan Cohort Study (ICS). METHODS: 3277 participants aged 35 and above were included in the current analysis. We evaluated the association of elevated hs-CRP levels (≥ 3 mg/dL) and CVD events including myocardial infarction, ischemic heart disease, stroke, CVD, CVD mortality, and all-cause mortality in those with LDL-C ≥ or < 130 mg/dL Cox frailty models was used to determine possible interactions. RESULTS: In both crude and fully adjusted models, there was no significant interaction between LDL-C and hs-CRP levels with the incidence of MI, stroke, CVD mortality, and all-cause death. Neither elevated LDL-C alone nor elevated CRP alone were associated with the risk of all cardiovascular events and all-cause death. However, participants with elevated concentrations of both hs-CRP and LDL-C had a greater risk of ischemic heart disease (IHD) (hazards ratio (HR) 1.44; 95% CI 1.03-2.02) and CVD (HR 1.36; 95% CI 1.01-1.83) than those with low LDL-C and hs-CRP. CONCLUSION: These results indicate that despite a null association between elevated levels of CRP or LDL-C alone and CVD events, concurrent rise in LDL-C and hs-CRP levels is associated with higher risk of IHD and CVD.

Association between ultra-processed foods consumption and micronutrient intake and diet quality in Iranian adults: a multicentric study.

OBJECTIVE: To identify ultra-processed foods (UPF) contribution to daily energy and nutrient intake in Iranians and examine whether UPF intake is associated with nutrient profile and diet quality. DESIGN: In this cross-sectional study, a validated FFQ was used to evaluate usual dietary intake over the preceding year. NOVA system was applied to categorise foods based on their levels of processing. Diet quality was evaluated using the nutrient adequacy ratio (NAR), Nutrient Rich Food Index (NRF) and hybrid nutrient density. SETTING: The LIPOKAP study conducted in five cities of Iran (Isfahan, Birjand, Bandar Abbas, Kermanshah and Shahrekord). PARTICIPANTS: A total of 1994 adults aged ≥18 years were recruited using stratified multistage random cluster sampling method. RESULTS: UPF were responsible for 8·5 % of daily energy intake. In the adjusted model, UPF consumption was inversely associated with carbohydrate, protein, refined and whole grains, fibre, fruit and meat, but was positively linked to energy, total fat, saturated and trans fatty acids and cholesterol. Compared with those in the lowest tertile, individuals in the highest tertile of UPF had smaller NAR for Ca, Mg, Zn, Fe, phosphorus, thiamin, niacin, folate and vitamin C. Both NRF and hybrid nutrient density decreased when the share of daily energy intake from UPF increased. CONCLUSION: The higher consumption of UPF is associated with poorer diet quality and lower nutrient intake. It is recommended that UPF be replaced with minimally processed foods to improve diet quality and nutrient profile.

Red and processed meat consumption and risk of incident cardiovascular disease and mortality: Isfahan cohort study.

To investigate the cardiovascular risks associated with red and/or processed meat intake in a large population-based cohort study in Iran. A total of 5432 participants from the Isfahan Cohort Study (ICS) were enrolled. Diet was assessed using a validated, 48-item food frequency questionnaire. Cox proportional hazards regression models were applied to calculate hazard ratios (HRs) for the CVD risk associated with red and processed meat intake. Median follow-up was 11.2 years. Compared to the first tertile, the highest tertile of red meat intake, either alone or in combination with processed meat was associated with a 50% reduced risk of stroke (95% CI: 0.31-0.77; 95% CI: 0.33-0.82, respectively), but increased risk of CVD mortality with corresponding HRs of 1.58 (95% CI: 1.06-2.35) and 1.47 (95% CI: 1.02-2.08), respectively. Red meat and red plus processed meat intake were inversely associated with stroke risk, but positively linked with CVD mortality.

Isfahan COVID cohort study: Rationale, methodology, and initial results.

Background: The Isfahan COVID Cohort (ICC) study was designed to investigate the short- and long-term consequences of patients with COVID-19 in Iran. This report presents the rationale, methodology, and initial results of ICC. Materials and Methods: ICC is a 5-year multicentric prospective cohort study that is ongoing on two groups including 5000 patients hospitalized with moderate or severe and 800 nonhospitalized patients with mild or asymptomatic COVID-19 in Isfahan. The ICC endpoints are morbidity, mortality, incident cases, or worsening of underlying noncommunicable diseases (NCDs) and their risk factors. In the current analysis, we examined the persistent symptoms and incident NCDs or risk factors in 819 previously hospitalized patients who completed 1-year follow-up. Results: The two most common symptoms were joint pain/myalgia (19.7%) and dry cough/dyspnea (18.7%). Around 60% of patients had at least one symptom which was more common among women than men and in middle aged than younger or older patients. Female (odds ratio [OR] =1.88, 95% confidence interval [CI]: 1.39-2.55) and highly-educated patients (OR = 2.18, 95% CI: 1.56-3.04) had higher risk of having any symptom in 1-year follow-up. New cases of hypertension followed by diabetes then coronary heart disease (CHD) were the most common incident NCDs. Conclusion: During 1-year follow-up after hospital discharge, about 60% of patients experienced persistent symptoms. Incident hypertension, diabetes, and CHD were the most common events seen. Close monitoring and extensive health services with integrative approaches are needed to improve the health status of these patients.

Dairy products consumption and the risk of hypertension in adults: An updated systematic review and dose-response meta-analysis of prospective cohort studies.

AIMS: With an increase in the number of published prospective cohort studies, we sought to summarize the relationship between dairy products consumption and the risk of hypertension (HTN). DATA SYNTHESIS: We searched PubMed, Web of Science, Embase, Science direct, and Scopus. Pooled RRs and 95% CIs were calculated using a random effects model. The certainty of the evidence was assessed by Grading of Recommendations Assessment, Development and Evaluation (GRADE). Sixteen studies were included in the current meta-analysis. We found an inverse association between total dairy products (RR = 0.90; 95% CI: 0.87, 0.94; n = 16), low-fat dairy products (RR = 0.86; 95% CI: 0.77, 0.96; n = 8), milk (RR = 0.94; 95% CI: 0.90, 0.99; n = 11), and fermented dairy (RR = 0.95; 95% CI: 0.91, 0.99; n = 8) consumption and the risk of HTN. However, in subgroup analysis, despite a significant association for total dairy products in women, Americans, longer and larger studies, and self-reported HTN, no associations were found in males, Europeans, or Asians, and studies which followed participants for <10 years or had <3000 participants or measured HTN. Dose-response analysis revealed a non-linear association between total dairy products and milk consumption and the risk of HTN, but a linear association for low-fat dairy products. CONCLUSIONS: Higher dairy products consumption was associated with reduced risk of HTN. This association was dependent on sex, geographical region of study, and the stage of HTN. However, the certainty of the evidence was graded either as low or very low.

Higher Dietary Acid Load Is Associated With an Increased Risk of Calcium Oxalate Kidney Stones.

OBJECTIVES: Diet-dependent net acid load may influence the risk of kidney stone formation by affecting calcium and citrate excretion. However, to date, little research has investigated the relationship between dietary acid load and kidney stones. Therefore, this study sought to assess whether a diet high in potential acid load was related to the risk of calcium oxalate stone formation. METHODS: This case-control study was conducted on 430 participants (including 215 newly diagnosed patients with calcium oxalate stones and 215 controls matched for sex and age). Dietary intake was assessed using a validated food frequency questionnaire over the preceding year. Dietary acid load was estimated based on the potential renal acid load (PRAL) and net endogenous acid production (NEAP). The association between dietary acid load indices and kidney stone was examined using multivariable logistic regression. RESULTS: Mean PRAL (standard error) was significantly lower in cases versus controls (-5.3 ± 1.3 vs. -1.7 ± 1.3, P = .048). Corresponding values for NEAP were 39.4 ± 0.8 and 41.8 ± 0.8, respectively (P = .032). After adjustment for potential confounders, the odds ratios (95% confidence intervals) of calcium oxalate stones in the top tertile of PRAL and NEAP were 1.45 (0.89-2.38, P = .136) and 1.88 (1.14-3.09, P = .013), respectively. Adjustment for potassium and protein in 2 separate models did not substantially change the results. CONCLUSIONS: A diet high in potential acid load, measured by NEAP, was associated with higher risk of calcium oxalate stone formation, independent of potassium and protein intake. Prospective longitudinal studies are warranted to confirm the veracity of our results.

High dietary acid load score is not associated with the risk of metabolic syndrome in Iranian adults.

Background and objective: The association between dietary acid load and metabolic syndrome (MetS) risk is not well-known. Therefore, we aimed to investigate the relationship between dietary acid load and the risk of MetS among Iranian adults. Methods: This cross-sectional study was carried out on 1430 Iranian adults. Dietary intakes were assessed using a validated food frequency questionnaire. Dietary acid load was estimated using potential renal acid load (PRAL) and net endogenous acid production (NEAP). MetS was defined according to the ATP-III criteria. The risk of MetS and its components was explored using logistic regression test. Results: Totally, 205 individuals were identified to have MetS. No significant association for MetS was found across the quartiles of PRAL and NEAP either in the crude model [Q4 PRAL: OR (95% CI): 0.94 (0.67-1.32), and NEAP: OR (95% CI): 0.88 (0.63-1.25)] or fully-adjusted model [Q4 PRAL: OR (95% CI): 0.90 (0.61-1.33), and NEAP: OR (95% CI): 1.05 (0.70-1.57)]. Amongst the components of MetS, higher scores of NEAP was associated with an increased risk of impaired blood sugar after adjustment for potential confounders [OR (95% CI): 1.35 (0.93-1.96)]. No significant association was found for other components either with PRAL or with NEAP. Conclusion: Our findings suggest no association between dietary acid load and MetS risk in Iranian adults. However, higher dietary acid load, measured by NEAP, but not PRAL, was associated with increased risk of impaired fasting blood sugar. Longitudinal studies are warranted to explore whether a diet low in potential acid load could reduce MetS risk.

The Role of Sarcopenic Obesity in Cancer and Cardiovascular Disease: A Synthesis of the Evidence on Pathophysiological Aspects and Clinical Implications.

Obesity is globally a serious public health concern and is associated with a high risk of cardiovascular disease (CVD) and various types of cancers. It is important to evaluate various types of obesity, such as visceral and sarcopenic obesity. The evidence on the associated risk of CVD, cancer and sarcopenic obesity, including pathophysiological aspects, occurrence, clinical implications and survival, needs further investigation. Sarcopenic obesity is a relatively new term. It is a clinical condition that primarily affects older adults. There are several endocrine-hormonal, metabolic and lifestyle aspects involved in the occurrence of sarcopenic obesity that affect pathophysiological aspects that, in turn, contribute to CVD and neoplasms. However, there is no available evidence on the role of sarcopenic obesity in the occurrence of CVD and cancer and its pathophysiological interplay. Therefore, this review aims to describe the pathophysiological aspects and the clinical and epidemiological evidence on the role of sarcopenic obesity related to the occurrence and mortality risk of various types of cancer and cardiovascular disease. This literature review highlights the need for further research on sarcopenic obesity to demonstrate the interrelation of these various associations.

The Associations Between Tea and Coffee Drinking and Risk of Calcium-Oxalate Renal Stones.

Findings regarding the association between tea and coffee consumption and oxalate-calcium stone are sparse and uncertain. The purpose of this study was to investigate the relations of tea and coffee with the risk of calcium oxalate stone formation. A total sample of 215 newly diagnosed patients with calcium oxalate stones and 215 controls matched for sex and age were recruited. Dietary intake of participants was assessed using a validated food frequency questionnaire over the preceding year and participants were asked to determine how many glasses of tea and cups of coffee they usually use. The associations between tea and coffee and kidney stone were examined using multivariable logistic regression. Compared with controls, cases had greater intake of tea (2.18±0.76 vs. 1.82±0.79 glasses/d) but lower intake of coffee (1.18±0.38 vs. 1.26±0.44 cups/week). After adjustment for potential confounders, compared with those who drank <2 glasses of tea/d, individuals with tea consumption of ≥4 glasses/d had greater risk for having calcium oxalate stone (OR= 2.73; 95 % CI: 1.50, 4.99). In the crude model, compared with coffee consumption for <1 cup/week, consumption of ≥1 cup/week was associated with a 38 % decrease in the risk of calcium oxalate stone. However, adjustment for potential confounders disappeared the significance (OR=0.81; 95 % CI: 0.48, 1.35). These results suggest that while high consumption of tea is associated with increased risk of calcium oxalate kidney stone, coffee drinking is not pertinent. However, due to low consumption of coffee in this population, our results should be interpreted cautiously.