Higher dietary phytochemical index is associated with anthropometric indices in children and adolescents: The weight disorders survey of the CASPIAN-IV study.

Objectives: The present study aimed to determine the association of total dietary phytochemical intake with generalized and abdominal obesity in children and adolescents. Material and methods: This nationwide cross-sectional study was conducted in 4296 students aged 6-18 years. Dietary phytochemical index (DPI) was calculated as a percentage of daily energy derived from phytochemical-rich foods divided by total daily energy intake. Results: The mean ± standard error of DPIs in the first, second, third and fourth quartiles were 12.70 ± 3.28, 20.36 ± 1.84, 27.52 ± 0.08 and 41.10 ± 0.26, respectively. Anthropometric measures including weight Z-score (-0.04 vs. 0.05, P = 0.023), body mass index (BMI) Z-score (-0.05 vs. 0.06, P = 0.013), waist circumference (WC) (65.80 cm vs. 66.95 cm P = 0.022), hip circumference (HC) (80.20 cm vs. 81.37 cm, P = 0.046), and neck circumference (NC) (30.06 cm vs. 30.45 cm, P = 0.031) were significantly lower among participants in the upper DPI quartile compared to those in the lower quartiles. In overweight and obese children, higher adjusted DPI scores had inverse correlation with BMI, WC, HC, wrist circumference, and NC (ßs = -0.077, -0.10, -0.119, -0.01, and -0.032, respectively; P < 0.05). Comparison of the fourth quartile with the first quartile of DPI revealed beneficial effects of higher phytochemical intake on reducing the risk of obesity/overweight and abdominal obesity. However, these results were not statistically significant (P = 0.073). Conclusion: Higher DPI score was associated with lower risk of generalized and abdominal obesity in children and adolescents. However, the results were not statistically significant. Consuming phytochemical-rich foods can be encouraged to prevent childhood obesity.

Association between Dietary Antioxidant Quality Score and Anthropometric Measurements in Children and Adolescents: The Weight Disorders Survey of the CASPIAN-IV Study.

BACKGROUND: Limited experience exists on the relationship between anthropometric measures and dietary antioxidant intake in the pediatric age group. We aimed to investigate the association of dietary antioxidants intake and anthropometric measurement in children and adolescents. METHODS: This nationwide study was conducted in 4270 children and adolescents, aged 6-18 years. Demographic and anthropometric data were assessed. Children and adolescents were classified as underweight, healthy weight or overweight/obese based on body mass index percentiles. Dietary intake was obtained by a 168-item semi-quantitative validated food frequency questionnaire. Energy and nutrients intake was estimated using the Nutritionist IV software. Dietary antioxidant quality score (DAQS) was calculated based on the daily dietary intake of selenium, zinc, vitamin A, vitamin C and vitamin E compared with daily recommended intake. RESULTS: After adjustment for age, gender, living area (rural or urban), energy intake and physical activity level, DAQS was positively associated with waist circumference (WC), hip circumference and waist-to-height ratio (WHtR) in under-weight children and adolescents (B = 1.614, 1.634 and 0.01, respectively; all ps < 0.05). Increased DAQS was significantly associated with higher WC and WHtR in normal-weight children and adolescents (B = 0.536 and 0.003, respectively; all ps <0.05). CONCLUSION: Dietary intakes of some antioxidants were higher in children and adolescents with excess weight. DAQS was correlated with some anthropometric measurements in under-weight and normal-weight subjects. It can provide a novel approach to assess the role of antioxidant intake on health promotion and diet-based therapies in under-weight and normal-weight children and adolescents.

Reference values for lipid profile in Iranian children and adolescents: the CASPIAN-V study.

BACKGROUND: We aimed to develop the age- and sex-specific reference values for lipid profile of Iranian pediatric population. METHODS: Fasting lipid profiles of 3843 participants, aged 7 to 18 years, were extracted from a surveillance survey on Iranian children and adolescents living in 30 provinces across the country. RESULTS: The mean (SD) age of participants was 12.3(3.1) years, and 52.3% of them were boys. Significant differences were observed between genders comparing the levels of triglyceride (TG) (P = 0.04), total cholesterol (TC) (P = 0.02), low-density lipoprotein- cholesterol (LDL-C) (P = 0.01), and non-high-density lipoprotein cholesterol (non-HDL-C) (P = 0.03). In both genders, TG levels increased with age in the 75th and higher percentiles. Among boys, TC showed a decreasing trend at all percentiles and all age groups. In girls, TC levels increased with age at all percentiles except for the 75th and 90th percentiles. Among boys, the levels of LDL-C and HDL-C decreased with age in all percentiles. However, LDL-C and HDL-C concentrations increased up to the 50th percentile in girls and then decreased with age. The non-HDL-C level decreased in the 50th and higher percentiles among boys and in the 90th and 95th percentiles among girls. The TG/HDL-C ratio increased with age at all percentiles in boys. In girls, TG/HDL-C ratio increased with age in the 50th and higher percentiles. CONCLUSIONS: Based on the observed differences, it seems necessary to determine age- and sex-specific cut-off values for lipid parameters of children and adolescents in different populations.

Effect of inulin-type fructans in patients undergoing cancer treatments: A systematic review.

BACKGROUND AND OBJECTIVE: Current studies give us inconsistent results regarding the inulin consumption in cancer patients. The results of to-date studies are summarized in this systematic review. METHODS: Web of Science (Science citation index expanded), PubMed (Medline), Embase and CENTRAL Science direct, Google scholar, Scopus and Cochrane were searched. Cochrane Collaboration's 'Risk of Bias' tool was used to assess the quality of included articles. RESULTS: Our search yielded 2652 studies after the elimination of duplicates. Three randomized controlled trials (RCTs), reporting results from 197 patients, were eligible for inclusion in the present systematic review. Risk of bias in these studies was assessed as high and moderate. CONCLUSION: The available evidence is inconclusive regarding the effect of inulin and oligofructose on cancer outcomes. Nonetheless, possible inulin positive effects including improved stool consistency after abdomen radiotherapy and increased stool butyrate content which is involved in controlling tumor cells proliferation and apoptosis should not be denied. Further research is needed in this area before strong conclusions can be drawn.

Comparing the effectiveness of vitamin D plus iron vs vitamin D on depression scores in anemic females: Randomized triple-masked trial.

Background: Low levels of 25-hydroxyvitamin D (25(OH)D) have been related to depression and anxiety. It seems that anemia is associated with vitamin D deficiency. We aimed to evaluate the effects of iron-vitamin D co-supplementation versus vitamin D alone on depression scores in anemic females with low levels of serum 25-hydroxyvitamin D. Methods: This randomized controlled trial was conducted on eighty premenopausal females who were recruited between May 2015 and October 2015 from primary health care centers. Women with anemia and low concentrations of 25(OH)D were randomized to either 1000 IU/d vitamin D plus 27 mg/d iron (D-Fe) or vitamin D plus placebo supplements (D-P) for 12 weeks. Depressive and anxious symptoms were evaluated with the Beck Depression Inventory (BDI) with subscales 1-13 and 14-21 and Beck Anxiety Inventory (BAI). To compare the groups, Mann-Whitney or chi-squared tests were used and within groups comparison was performed using Wilcoxon signed ranks test. The study was registered on www.clinicaltrial.org as NC 01876563. Results: The serum concentrations of 25(OH)D were increased significantly in both groups at the end of the study. In both groups, there was a significant improvement in total BDI, the BDI subscale, and the BAI scores (p<0.001). No differences were found between groups (p>0.05). Conclusion: Although the potential positive effect of vitamin D on mental health was evident, iron plus vitamin D co-supplementation did not demonstrate any significant benefits over vitamin D alone, neither in depression score reduction nor anxiety symptoms.

Effects of Maternal Diet During Pregnancy on the Risk of Childhood Acute Lymphoblastic Leukemia: A Systematic Review.

Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in children that can be affected by maternal diet. The aim of this study was to evaluate maternal dietary risk factors of ALL. We searched MEDLINE, Cochrane Library, Springer Link, Wiley Online, Science Direct, Mosby, ISI Web of Science, OVID, ProQuest, and Scopus from database inception until February 2, 2016. Two reviewers scanned titles, abstracts, and keywords of articles after excluding duplicates. We included case-control studies evaluating the relationship between maternal diet during pregnancy and childhood ALL. The search resulted in 2,940 papers, of which 11 full-text articles met the criteria for inclusion in the review and were analyzed. The finding of these studies suggest that maternal diet composed largely of vegetables, fruits, and protein sources before and during pregnancy can reduce the risk of ALL in offspring. Maternal alcohol intake had no effect. Nevertheless, inherent limitations of case-control studies like measurement error, random error, recall bias, and selection bias preclude conclusive evidence. Persuading pregnant women to follow a healthy diet rich in fruits, vegetables, and protein may reduce the risk of childhood ALL. Avoiding alcohol intake seems prudent.

Controlling childhood obesity: A systematic review on strategies and challenges.

BACKGROUND: Childhood obesity is a global health problem with short- and long-term health consequences. This systematic review presents a summary of the experiences on different family-, school-, and clinic-based interventions. MATERIALS AND METHODS: Electronic search was conducted in MEDLINE, PubMed, ISI Web of Science, and Scopus scientific databases. We included those studies conducted among obese individuals aged up to 18 years. Our search yielded 105 relevant papers, 70 of them were conducted as high quality clinical trials. RESULTS: Our findings propose that school-based programs can have long-term effects in a large target group. This can be related to this fact that children spend a considerable part of their time in school, and adopt some parts of lifestyle there. They have remarkable consequences on health behaviors, but as there are some common limitations, their effects on anthropometric measures are not clear. Due to the crucial role of parents in development of children's behaviors, family-based interventions are reported to have successful effects in some aspects; but selection bias and high dropout rate can confound their results. Clinic-based interventions revealed favorable effects. They include dietary or other lifestyle changes like increasing physical activity or behavior therapy. It seems that a comprehensive intervention including diet and exercise are more practical. When they have different designs, results are controversial. CONCLUSION: We suggest that among different types of interventional programs, a multidisciplinary approach in schools in which children's family are involved, can be the best and most sustainable approach for management of childhood obesity.

Reference curves of anthropometric indices in two national studies conducted among Iranian children in 2003-2004 and 2009-2010: The Caspian study.

BACKGROUND: Reference percentile curves are usually used as a screening tool to determine growth disorders. Anthropometric indices are population-dependent and may differ according to ethnicity, dietary pattern and lifestyle habits. This study aims to compare the curves of anthropometric measures obtained in two national studies conducted among Iranian children and adolescents in 2003-2004 and 2009-2010. MATERIALS AND METHODS: Anthropometric measures obtained in two nationwide surveys conducted in 10-18-year-old Iranian students were compared. Lambda-mu-sigma (LMS) Chart Maker Pro program was used to develop age- and gender-specific percentiles and to smooth and fit the model. RESULTS: In 2003-2004, the mean and standard deviation (SD) of body mass index (BMI) and waist circumference (WC) were 18.98 ± 3.81 kg/m(2) and 67.50 ± 11.05 cm in boys; and 19.44 ± 3.78 kg/m(2) and 66.55 ± 9.89 cm in girls, respectively. In 2009-2010, the corresponding figures were 19.16 ± 4.07 kg/m(2), 69.42 ± 11.43 cm, 19.63 ± 4.11 kg/m(2), and 67.29 ± 9.69 cm, respectively. Height curves did not show considerable changes in two studies. Comparison of two series of studies showed that the weight, BMI, WC, and waist-to-height ratio were lower in adolescent girls than boys especially in higher percentiles. Moreover, in both genders, weight, BMI, and WC percentiles decreased. CONCLUSION: The growth charts of Iranian children and adolescents aged 10-18 years have changed over 5 years. The reference growth curves change over time in the pediatric age group, repeated surveys should be conducted to update the age- and gender-specific reference curves in different populations.

Effectiveness of date seed on glycemia and advanced glycation end-products in type 2 diabetes: a randomized placebo-controlled trial.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a chronic medical condition affecting more than 95% of people with diabetes. Traditionally, some medicinal plants have been considered as an effective approach in management of T2DM. This trial evaluated the effects of date seed powder (DSP) on glycemia indices and oxidative stress in T2DM patients. METHODS: In this trail, 43 patients with T2DM were randomized to two groups: either 5 g/d of the DSP or placebo for 8 weeks. Levels of glycemic indices, lipolpolysaccharide (LPS), and soluble receptor for advanced glycation end products (s-RAGE), as well as other parameters associated with oxidative stress were assessed at baseline and after 8 weeks. Independent t-test and analysis of covariance (ANCOVA) were used for between-groups comparisons at baseline and the post-intervention phase, respectively. RESULTS: The results showed that supplementation with DSP significantly decreased HbA1c (-0.30 ± 0.48%), insulin (-1.70 ± 2.21 µU/ml), HOMA-IR (-1.05 ± 0.21), HOMA-B (-0.76 ± 21.21), lipopolysaccharide (LPS) (-3.68 ± 6.05 EU/mL), and pentosidine (118.99 ± 21.67 pg/mL) (P < 0.05, ANCOVA adjusted for baseline and confounding factors). On the other hand, DSP supplementation significantly increased total antioxidant capacity (TAC) (0.50 ± 0.26 mmol/L), superoxide dismutase (SOD) (0.69 ± 0.32 U/ml), and s-RAGE (240.13 ± 54.25 pg/mL) compared to the placebo group. FPG, hs-CRP, GPx, CML, and uric acid had no significant within- or between-group changes. CONCLUSION: Supplementation of DSP could be considered an effective strategy to improve glycemic control and oxidative stress in T2DM patients (Registration ID at www.irct.ir : IRCT20150205020965N10).

The effect of bitter almond (Amygdalus communis L. var. Amara) gum as a functional food on metabolic profile, inflammatory markers, and mental health in type 2 diabetes women: a blinded randomized controlled trial protocol.

BACKGROUND: Using functional foods in the prevention and treatment of type 2 diabetes mellitus (T2DM) has increased across the world owing to their availability, cultural acceptability, and lower side effects. The present study will aim to examine the impact of bitter almond (Amygdalus communis L. var. Amara) gum as a functional food on metabolic profile, inflammatory markers, and mental health in women with T2DM. METHODS: We will conduct a randomized, triple-blind, placebo-controlled trial. A total of 44 women with T2DM will be randomly allocated into two groups: an intervention group (n = 20) and a placebo group (n = 20). Patients will receive either 5 g/d of bitter melon gum or a placebo for 8 weeks. Clinical and biochemical outcome parameters which include glycemic indices, lipid profile, inflammatory markers, oxidative stress indices, tryptophan (Trp), kynurenine (KYN), cortisol, glucagon-like peptide 1 (GLP-1), leptin, adiponectin, ghrelin, peroxisome proliferator-activated receptor (PPAR) gene expression, brain-derived neurotrophic factor (BDNF), endothelial cell adhesion molecules, plasminogen, cluster deference 4 (CD4), cluster deference 8 (CD8), anthropometric indices, blood pressure, dietary intake, and mental health will be measured at the baseline and end of the study. Statistical analysis will be conducted using the SPSS software (version 24), and P value less than 0.05 will be considered statistically significant. DISCUSSION: The present randomized controlled trial will aim to investigate any beneficial effects of bitter almond gum supplementation on the cardio-metabolic, immune-inflammatory, and oxidative stress biomarkers, as well as mental health in women with T2DM. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethical Committee of the Tabriz University of Medical Sciences (IR.TBZMED.REC.1399.726). TRIAL REGISTRATION: Iranian Registry of Clinical Trials ( www.irct.ir/IRCT20150205020965N7 ).

The Effect of Bariatric Surgery on Irisin Level: a Systematic Review and Meta-analysis.

This systematic analysis and meta-analysis aimed to assess changes in the plasma levels of irisin after bariatric surgery. Search strategy, study screening, and data gathering were all conducted using a checklist and the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Two researchers independently extracted the data, and a third person was included to resolve disagreements. The results illustrated no statistical difference between before and after surgery irisin plasma levels (P = 0.216, 95% CI = -1.812-0.410, SMD = -0.701, I-squared = 94.9%). BMI exhibited a meaningful decline after surgery compared to preoperative values (SMD = -3.09, 95% CI = -4.59--1.59, I-squared = 95.5%, P<0.05). According to our analysis, it can be concluded that irisin plasma levels are not significantly influenced by bariatric surgery.

Relationship between obesity and depression, anxiety and psychological distress among Iranian health-care staff.

BACKGROUND: Psychological-related disorders such as obesity are a key contributor to morbidity and mortality. AIMS: To assess the association between general and abdominal obesity with depression and anxiety among Iranian health-care staff. METHODS: This cross-sectional study was conducted under the framework of the Study on the Epidemiology of Psychological Alimentary Health and Nutrition. A total of 4361 Iranian health-care staff were analysed for general obesity and 3213 for central obesity. Overweight and obesity was defined as body mass index 25.0-29.9 and ≥ 30.0 kg/m², respectively. Abdominal obesity was defined as waist circumference (WC) ≥ 88 cm for females and ≥ 102 cm for males. The Iranian validated versions of the Hospital Anxiety and Depression Scale and the General Health Questionnaire were used to assess depression and anxiety. RESULTS: Stratified analysis by sex revealed no significant relationship between general obesity, depression and anxiety among males. However, we found an inverse association between abdominal obesity (WC > 102 cm) and severe depression among males. In females, abdominal obesity was significantly associated with anxiety, before and after taking confounders into account. No significant association was seen between abdominal obesity and psychological distress in either sex after controlling for potential confounders. CONCLUSIONS: Abdominal obesity was associated with anxiety in Iranian adult females but not in males. Further studies, particularly prospective research, are required to confirm these findings.

Changes in Bone Turnover, Inflammatory, Oxidative Stress, and Metabolic Markers in Women Consuming Iron plus Vitamin D Supplements: a Randomized Clinical Trial.

We aimed to investigate whether combination of vitamin D and iron supplementation, comparing vitamin D alone, could modify bone turnover, inflammatory, oxidative stress, and metabolic markers. Eighty-seven women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years were randomly assigned into two groups: (1) receiving either 1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe); (2) vitamin D3 plus placebo supplements (D-P), for 12 weeks. In D-Fe group, significant decrease in red blood cells (RBC) (P = 0.001) and hematocrit (Hct) (P = 0.004) and increases in mean corpuscular hemoglobin concentration (MCHC) (P = 0.001), 25OHD (P < 0.001), osteocalcin (P < 0.001), high-density cholesterol (HDL) (P = 0.041), and fasting blood sugar (FBS) (P < 0.001) were observed. D-P group showed significant decrease in RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), mean corpuscular volume (MCV) (P = 0.004), mean corpuscular hemoglobin (MCH) (P < 0.001), MCHC (P = 0.005), serum ferritin (P < 0.001), and low-density cholesterol (LDL) (P = 0.016) and increases of 25OHD (P < 0.001), osteocalcin (P < 0.001), C-terminal telopeptide (CTX) (P = 0.025), triglyceride (TG) (P = 0.004), FBS (P < 0.001), and interleukin-6 (IL-6) (P = 0.001) at week 12. After the intervention, the D-P group had between-group increases in mean change in the osteocalcin (P = 0.007) and IL-6 (P = 0.033), and decreases in the RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), and MCV (P = 0.001), compared with the D-Fe group. There were significant between-group changes in MCH (P < 0.001), MCHC (P < 0.001), ferritin (P < 0.001), and serum iron (P = 0.018). Iron-vitamin D co-supplementation does not yield added benefits for improvement of bone turnover, inflammatory, oxidative stress, and metabolic markers, whereas, vitamin D alone may have some detrimental effects on inflammatory and metabolic markers. IRCT registration number: IRCT201409082365N9.

Comparison of the Prevalence and Trend of Malnutrition between 0-6 Years and 7-11 Years Old Iranian Children: A Systematic Review and Meta-Analysis.

BACKGROUND: To plan for decreasing the prevalence of malnutrition among children, reliable data of current status are required. The aim of the present cross-sectional study was to estimate the prevalence and trend of malnutrition among Iranian children. METHODS: PubMed, ISI Web of Science, Scopus, Google Scholar, and Iranian databases including SID and Magiran were searched for studies published prior to October 2017 with MeSH terms of Malnutrition, Nutrition Disorders, Wasting, Stunting, Underweight, Undernutrition, Nutrition, Anthropometry, Weight, and Children and Iran. Three random effect models were applied to estimate the pooled prevalence of underweight, stunting, and wasting. Meta-regression and cumulative meta-analysis were performed. All analyses were also conducted separately for two different age groups including 0-6 years old (preschool) and 7-11 years old (primary school). Seventy-five studies (information of 1,069,815 individuals) were included in the final meta-analysis. RESULTS: The overall prevalence of underweight, stunting, and wasting was estimated to be 8.4% [95% confidence interval (CI): 7.6-9.1], 14.5% (95% CI: 13.1-15.9) and 5.6% (95% CI: 5-6.2) in children age 0-6 years, and 6.6% (95% CI: 4.8-8.4), 7.3% (95% CI: 5.6-9.1), and 8.3% (95% CI: 6-10.7) in children age 7-11 years, respectively. CONCLUSIONS: The cumulative meta-analysis showed a decrease in the general trend of malnutrition in both preschool and primary school children of Iran. Stunting and wasting were the most common form of malnutrition in Iranian preschool and primary school children, respectively. The decreasing trend of malnutrition was much more noticeable about stunting.

Effects of Iron on Vitamin D Metabolism: A Systematic Review.

Vitamin D is a prohormone nutrient, which is involved in skeletal and extra-skeletal functions. Iron is another essential nutrient that is necessary for the production of red blood cells and oxygen transport. This element plays important roles in enzymatic systems including those required for Vitamin D activation. To the best of our knowledge, there is no exclusive review on the relationship between iron deficiency anemia (IDA), as the most prevalent type of anemia, and Vitamin D deficiency and the effect of recovery from iron deficiency on Vitamin D status. The aim of this study was to conduct a systematic search of observational and clinical trials in this field. The databases of PubMed, ProQuest, Cochrane Library, ISI Web of Knowledge, and SCOPUS were searched comprehensively. English-language human studies conducted on iron deficient patients or interventions on the effect of iron therapy on Vitamin D were extracted (n = 10). Our initial search yielded 938 articles. A total of 23 papers met the inclusion criteria. Thirteen studies were excluded because they were not relevant or not defining anemia types. The final analysis was performed on ten articles (3 cross-sectional and 7 interventional studies). Observational data indicated a positive relationship between iron status and Vitamin D, while trials did not support the effectiveness of iron supplementation on improving Vitamin D status. The mechanism underlying this association may involve the reduction of the activation of hydroxylases that yield calcitriol. Future randomized controlled trials with large sample sizes and proper designs are needed to highlight underlying mechanisms.

Effect of Cucurbita ficifolia and Probiotic Yogurt Consumption on Blood Glucose, Lipid Profile, and Inflammatory Marker in Type 2 Diabetes.

BACKGROUND: Control of blood sugar, hypertension, and dyslipidemia are key factors in diabetes management. Cucurbita ficifolia (pumpkin) is a vegetable which has been used traditionally as a remedy for diabetes in Iran. In addition, consumption of probiotics may have beneficial effects on people with Type 2 diabetes. The aim of this study was an investigation of the effects of C. ficifolia and probiotic yogurt consumption alone or at the same time on blood glucose and serum lipids in diabetic patients. METHODS: Eighty eligible participants randomly were assigned to four groups: 1 - green C. ficifolia (100 g); 2 - probiotic yogurt (150 g); 3 - C. ficifolia plus probiotic yogurt (100 g C. ficifolia plus 150 g yogurt); and 4 -control (dietary advice) for 8 weeks. Blood pressure, glycemic response, lipid profile, and high-sensitive C-reactive protein (hsCRP) were measured before and after the intervention. RESULTS: Total cholesterol (TC) decreased significantly in yogurt and yogurt plus C. ficifolia groups (within groups P = 0.010, and P < 0.001, respectively). C. ficifolia plus yogurt consumption resulted in a decrease in triglyceride (TG) and an increase in high-density lipoprotein cholesterol (HDL-C) (within groups P < 0.001 and P = 0.001, respectively). All interventions led to a significant decrease in blood sugar, hemoglobin A1c (HbA1c), hsCRP, and low-density lipoprotein cholesterol (LDL-C) level within groups. Blood pressure decreased significantly in Cucurbita group and yogurt group (within groups P < 0.001, and P = 0.001 for systolic blood pressure [SBP] and P < 0.001, and P = 0.004 for diastolic blood pressure [DBP], respectively). All variables changed between groups significantly except LDL-C level. CONCLUSIONS: Variables including TG, HDL-C, TC, fasting blood sugar, HbA1c, SBP, DBP, and hsCRP changed beneficially between groups. It seems that consumption of C. ficifolia and probiotic yogurt may help treatment of diabetic patients.

Association of ghrelin with cardiometabolic risk factors in Iranian adolescents: the CASPIAN-III study.

Introduction: Current evidence suggests that ghrelin could contribute to the development of metabolic syndrome (MetS) in adults, but limited experience exists in adolescents. This study aims to explore the association of ghrelin levels with the MetS components among Iranian adolescents. Methods: In this case-control study, 32 adolescents with MetS and 148 healthy controls were selected randomly from the childhood and Adolescence Surveillance and Prevention of Adult Non communicable disease (CASPIAN-III) study. MetS was defined according to the Adult Treatment Panel III (ATP III) criteria modified for children and adolescents. Anthropometric measures (including body mass index [BMI], waist circumference [WC] and waist to height ratio [WHtR]), blood pressure (BP) and biochemical data (including fasting blood sugar [FBS], triglyceride [TG], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC] and gerlin) were measured. Results: Total ghrelin level was significantly higher in students without MetS compared to those with MetS (748.89 ± 85.04 vs. 728.72 ± 90.36 [pg/mL]; P < 0.001). Significant negative correlations were seen between ghrelin levels and BMI, WC, WHtR, TG, and TC. Ghrelin had also relatively strong inverse correlations with FBS (r = -0.59, P< 0.001), LDL-C (r = -0.56, P < 0.001), and positive correlation with HDL-C (r = 0.60, P < 0.001). Compared with the children with MetS, in those without MetS, ghrelin was significantly associated with HDL-C and LDL-C. A decreasing trend was observed in the mean ghrelin level across increasing number of MetS components (P for trend <0.001). Conclusion: We observed a relationship between ghrelin concentration and MetS components in adolescents.

Iranian risk model as a predictive tool for retinopathy in patients with type 2 diabetes.

OBJECTIVE: Diabetic retinopathy (DR) is the leading cause of blindness in patients with type 1 or type 2 diabetes. The gold standard for the detection of DR requires expensive equipment. This study was undertaken to develop a simple and practical scoring system to predict the probability of DR. METHODS: A total of 1782 patients who had first-degree relatives with type II diabetes were selected. Eye examinations were performed by an expert ophthalmologist. Biochemical and anthropometric predictors of DR were measured. Logistic regression was used to develop a statistical model that can be used to predict DR. Goodness of fit was examined using the Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve. RESULTS: The risk model demonstrated good calibration and discrimination (ROC area=0.76) in the validation sample. Factors associated with DR in our model were duration of diabetes (odds ratio [OR]=2.14, confidence interval [CI] 95%=1.87 to 2.45); glycated hemoglobin (A1C) (OR=1.21, CI 95%=1.13 to 1.30); fasting plasma glucose (OR=1.83, CI 95%=1.28 to 2.62); systolic blood pressure (OR=1.01, CI 95%= 1.00 to 1.02); and proteinuria (OR=1.37, CI 95%=1.01 to 1.85). The only factor that had a protective effect against DR were body mass index and education level (OR=0.95, CI 95%=0.92 to 0.98). CONCLUSIONS: The good performance of our risk model suggests that it may be a useful risk-prediction tool for DR. It consisted of the positive predictors like A1C, diabetes duration, sex (male), fasting plasma glucose, systolic blood pressure and proteinuria, as well as negative risk factors like body mass index and education level.

Effects of pure eicosapentaenoic and docosahexaenoic acids on oxidative stress, inflammation and body fat mass in patients with type 2 diabetes.

BACKGROUND: N-3 Fatty acids reduce the risk of cardiovascular disease. Previous studies have shown that they may reduce inflammation, oxidative stress, and fat mass in patients with type 2 diabetes, but the results are inconclusive, due, in part, to type of omega-3 fatty acids used. The aim of this study was to determine the effects of pure eicosapentaenoic (EPA) and docosahexaenoic acids (DHA), the two major omega-3 fatty acids, on inflammation, oxidative stress, and fat mass in patients with type 2 diabetes. METHODS: Sixty patients with DM-II were randomly allocated to receive daily either ~1 gr EPA or ~1 gr DHA, or a canola oil as placebo for 12 weeks in a randomized triple-blind, placebo-controlled trial. Serum MDA, CRP, body weight, BMI, and fat mass were measured at baseline and after intervention. RESULTS: Forty-five patients with a mean (±SD) age of 54.9 ± 8.2 years with BMI of 27.6 ± 4.1 kg/m(2) and fasting blood glucose 96.0 ± 16.2 mg/dl completed the intervention. Neither EPA nor DHA had significant effects on serum FBS, C-reactive protein, body weight, BMI, and fat mass after intervention (P > 0.05). In addition, while MDA increased 18% in the placebo group (P = 0.009), it did not change in the EPA or DHA group (P > 0.05). CONCLUSIONS: Twelve weeks of supplementation with 1gr/d EPA or DHA prevent increasing oxidative stress without changing marker of inflammation. This study is the first report demonstrating that neither EPA nor DHA have effects on body fat mass in type 2 diabetic patients.