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.

Prevalence and Predictors of Vitamin D Deficiency and Insufficiency among Pregnant Rural Women in Bangladesh.

Although adequate vitamin D status during pregnancy is essential for maternal health and to prevent adverse pregnancy outcomes, limited data exist on vitamin D status and associated risk factors in pregnant rural Bangladeshi women. This study determined the prevalence of vitamin D deficiency and insufficiency, and identified associated risk factors, among these women. A total of 515 pregnant women from rural Bangladesh, gestational age ≤ 20 weeks, participated in this cross-sectional study. A separate logistic regression analysis was applied to determine the risk factors of vitamin D deficiency and insufficiency. Overall, 17.3% of the pregnant women had vitamin D deficiency [serum 25(OH)D concentration <30.0 nmol/L], and 47.2% had vitamin D insufficiency [serum 25(OH)D concentration between 30-<50 nmol/L]. The risk of vitamin D insufficiency was significantly higher among nulliparous pregnant women (OR: 2.72; 95% CI: 1.75-4.23), those in their first trimester (OR: 2.68; 95% CI: 1.39-5.19), anaemic women (OR: 1.53; 95% CI: 0.99-2.35; p = 0.056) and women whose husbands are farmers (OR: 2.06; 95% CI: 1.22-3.50). The risk of vitamin deficiency was significantly higher among younger pregnant women (<25 years; OR: 2.12; 95% CI: 1.06-4.21), nulliparous women (OR: 2.65; 95% CI: 1.34-5.25), women in their first trimester (OR: 2.55; 95% CI: 1.12-5.79) and those with sub-optimal vitamin A status (OR: 2.30; 95% CI: 1.28-4.11). In conclusion, hypovitaminosis D is highly prevalent among pregnant rural Bangladeshi women. Parity and gestational age are the common risk factors of vitamin D deficiency and insufficiency. A husband's occupation and anaemia status might be important predictors of vitamin D insufficiency, while younger age and sub-optimal vitamin A status are risk factors for vitamin D deficiency in this population.

Adherence to Dietary Approaches to Stop Hypertension (DASH)-Style Diet and the Risk of Cancer: A Systematic Review and Meta-Analysis of Cohort Studies.

Objective: Several investigators have proposed a protective association between dietary approaches to stop hypertension (DASH) style diet and risk of cancers; however, they have had inconsistent results. The present study aimed to systematically review the prospective cohort studies and if possible quantify the overall effect using meta-analysis. Methods: PubMed, Scopus, and Google Scholar were searched for cohort studies published up to July 2018. Relative risks (RRs) that were reported for fully adjusted models and their confidence intervals were extracted for meta-analysis. The random effects model was used to combine the RRs. Results: Seventeen studies were eligible to be included in the systematic review, from which nine reports assessed the association between the DASH diet and risk of mortality from all cancer types, four assessed incidence of colorectal cancer, and two studies assessed the risk of colon and rectal cancer separately. Four studies examined the association with the incidence of other cancers (breast, hepatic, endometrial, and lung cancer). Meta-analysis showed that high adherence to DASH is associated with a decreased mortality from all cancer types (RR = 0.84, 95% confidence interval [95%CI]: 0.81-0.86). Participants with the highest adherence to the DASH diet had a lower risk of developing colorectal (RR = 0.79, 95%CI: 0.75-0.83), colon (RR = 0.80, 95%CI: 0.74-0.87), and rectal (RR = 0.84, 95%CI: 0.74-0.96) cancers compared to those with the lowest adherence. Conclusion: DASH-style diet should be suggested as a healthy approach associated with decreased risk of cancer in the community. Prospective studies exploring the association for other cancer types and from regions other than the United States are highly recommended.

Determinants of Changes in Metabolic Syndrome Components in a 12-Year Cohort of Iranian Adults.

BACKGROUND: The prevalence of metabolic syndrome (MetS) and its components have been increasing globally; therefore, there is a need for better understanding of MetS components and their risk factors, as well as their development and changes over time. This study was designed to identify the determinants of the changes in the components of MetS in a cohort of Iranian adults from 2001 to 2013. METHODS: A total of 6504 adults, ≥35 years of age, were recruited from central Iran in 2001and were followed up in an ongoing longitudinal population-based study for 12 years. Of the total, 3356 subjects were followed between 2001 and 2007 and 1385 subjects were followed between 2001 and 2013. MetS components and its risk factors were measured by standard methods in 2001, 2007, and 2013. Mean changes in the MetS components from 2001 to 2013 were assessed using the Generalized Estimating Equations test with three time points. Multivariate linear regression model was applied to examine the association between socioeconomic and behavioral characteristics and changes in MetS components. Furthermore, multivariate logistic regression analysis was carried out to examine various factors associated with the development of abnormality of MetS components. RESULTS: Examining the biochemical and anthropometric characteristics of individuals from 2001 to 2013 revealed a significant increase in systolic and diastolic blood pressure, fasting blood sugar, waist circumference, and body mass index, and a significant decrease in total cholesterol, triglyceride, and physical activity levels. Results also indicated that age, gender, marital status, education levels, and area of residence were significantly associated with the changes in MetS components. CONCLUSION: This study concluded that baseline sociodemographic characteristics are important in determining changes of MetS components.

Prevalence and Trends of Vitamin D Deficiency among Iranian Adults: A Longitudinal Study from 2001-2013.

Vitamin D deficiency/insufficiency is currently considered to be a re-emerging public health problem globally. This study was designed to determine the prevalence of vitamin D deficiency and insufficiency and to investigate its trend from 2001 to 2013 in a longitudinal study of Iranian adults. This study was part of a population-based, longitudinal ongoing study of Iranian healthy adults aged 35 y and older at baseline. Serum vitamin D level was assessed in a sub-sample of 370 subjects, who were apparently healthy at the time of recruitment in 2001 and were free from MetS, in three phases (2001, 2007 and 2013) during the 12-y study period. Adjusted prevalence and trend of vitamin D deficiency were calculated. Mean serum vitamin D levels increased over the time of the study (52.12, 54.27 and 62.28 nmol/L, respectively) and the prevalence of vitamin D deficiency decreased (30.5, 27.0 and 24.4, respectively). However, the prevalence of vitamin D insufficiency did not change over this time period. The risk of vitamin D deficiency decreased significantly in 2007 [OR: 0.73 (95% CI: 0.53, 0.99)] and 2013 [OR: 0.50 (95% CI: 0.36, 0.70)] compared to the baseline. The present study demonstrated some improvement in serum vitamin D levels, while the prevalence of vitamin D inadequacy was still high. Considering the possible health consequences of vitamin D deficiency, there is an urgent need for developing population-wide strategies, such as supplementation and fortification, to prevent or control vitamin D deficiency.

Effects of Yogurt and Yogurt Plus Shallot Consumption on Lipid Profiles in Type 2 Diabetic Women.

BACKGROUND: Identification of food with lowering cholesterol level properties plays a vital role to control impaired lipid profile among type 2 diabetic patients. the current study aimed to evaluate the effects of yogurt and yogurt plus shallot intake on lipid profiles in type 2 diabetic women. METHODS: Forty-eight participants with type 2 diabetes were enrolled in this study. Participants in the first group (n = 22) received 150 ml of low-fat yogurt (1.5% fat) and those in the second group (n = 26) received 150 ml of low-fat yogurt (1.5% fat) plus shallot for 10 weeks. Serum triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) concentrations, and fasting blood sugar (FBS) were measured before and after each intervention. RESULTS: comparison of parameters between two groups after intervention showed that TG and TC concentrations decreased more in participants who consumed yogurt plus shallot than who consumed yogurt (P = 0.003 and P = 0.04, respectively), also LDL-C level of participants who were in yogurt plus shallot group was lower than that of participants in yogurt group, but this difference was marginally significant (P = 0.06). However, FBS level was not statistically different between two groups. CONCLUSIONS: This study found that yogurt plus shallot intake significantly decreased LDL-C, TG, and TC levels in diabetic women compared with yogurt intake.

Can sesame consumption improve blood pressure? A systematic review and meta-analysis of controlled trials.

Hypertension is a major risk factor for cardiovascular disease, myocardial infarction, stroke and renal failure. Sesame consumption may benefit blood pressure (BP) owing to its high polyunsaturated fatty acid, fibre, phytosterol and lignan contents. To clarify this, a systematic review and meta-analysis of controlled trials was conducted. The PubMed (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Library (Central) databases were systematically searched until August 2016. Eight controlled trials with a total of 843 participants met the eligibility criteria. A random effect meta-analysis showed that sesame consumption can reduce systolic BP (-7.83 mmHg, 95% CI: -14.12, -1.54; P < 0.05, I2 = 99%) and diastolic BP (-5.83 mmHg, 95% CI: -9.58, -2.08; P < 0.01, I2 = 98%). To reduce the heterogeneity, the meta-analysis was limited to high methodology quality trials (n = 4), which resulted in a significant reduction in systolic BP (-3.23 mmHg, 95% CI: -5.67, -0.79; I2 = 33%) and a non-significant reduction in diastolic BP (-2.08 mmHg, 95% CI: -4.85, 0.69; I2 = 62%). This study concluded that sesame consumption can reduce systolic and diastolic BP. However, further investigations with larger sample sizes and better methodology quality are required to confirm the BP-lowering effect of sesame consumption. © 2017 Society of Chemical Industry.

The Effect of Vitamin D Supplementation on the Androgenic Profile in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Clinical Trials.

It is suggested that vitamin D status is associated with androgenic profile in women with polycystic ovarian syndrome (PCOS). Although several clinical trials are known in this regard, the results were inconsistent. Therefore, this study was aimed to conduct a systematic review and meta-analysis of published clinical trials to elucidate the possible effect of vitamin D supplementation on the androgen levels in adult females with PCOS. PubMed, SCOPUS, and Google Scholar were searched to identify related articles published up to January 2017. Mean ± standard deviation (SD) of changes in serum total testosterone, sex hormone binding globulin (SHBG), and free testosterone were extracted to calculate Hedges' g to be used as effect size for meta-analysis. DerSimonian and Liard random effects model was incorporated to summarize the effects. Six clinical trials with 183 participants aged 18-41 years with follow-up period between 3-24 weeks were included. Our analysis revealed that vitamin D supplementation significantly reduces total testosterone (Hedges' g=-0.32, 95% CI: -0.55 to -0.10; p=0.005); this effect remained significant in single group trials after subgroup analysis. Vitamin D supplementation did not affect serum free testosterone (Hedges' g=-0.21, 95% CI: -0.44 to 0.079; p=0.08) or SHBG levels (Hedges' g=0, 95% CI, 0.22-0.22; p=0.98). The present systematic review and meta-analysis revealed that vitamin D supplementation might significantly affect serum total testosterone while it is not effective in improving other markers of androgenic profile. Future double-blind, placebo-controlled clinical trials are highly recommended.

Secular Trend of Metabolic Syndrome and Its Components in a Cohort of Iranian Adults from 2001 to 2013.

BACKGROUND: Metabolic syndrome (MetS) and its components increase the risk of developing cardiovascular diseases, type 2 diabetes, and all-cause mortality. Reports on the trends of MetS and its components in longitudinal studies are scarce, especially in low- and middle-income countries. This study was designed to investigate the prevalence and trends of MetS and its components in a cohort of Iranian adults from 2001 to 2013. METHODS: Participants were followed up for 12 years in a longitudinal population-based study of 6500 adults aged 35 years and older in 2001. Participants were randomly selected from three provinces in central Iran. Sociodemographic characteristics, anthropometry, blood pressure, and various biochemical indices were collected in 2001, 2007, and 2013. Secular trend and age-adjusted trend of MetS and its components were calculated from 2001 to 2013. RESULTS: The standardized prevalence of MetS, hypertension, low high-density lipoprotein cholesterol (HDL-C), abdominal obesity, and diabetes/impaired glucose tolerance (IGT) increased over the 12 years (6.9%, 5.5%, 12.0%, 2.3%, and 18.7%, respectively), while the prevalence of hypertriglyceridemia decreased by 15.5% during this period. The prevalence of MetS, low HDL-C, and abdominal obesity were higher in females than males in all three phases. Moreover, the increases in the prevalence of these metabolic abnormalities were higher in the rural population than in the urban population. CONCLUSIONS: The present study underscored the increasing trends in MetS and most of its risk factors, thus, to prevent an increase in the cardiovascular risk factors, there is a need to improve lifestyle by education, screening, and treatment of abnormalities.

Magnesium status and the metabolic syndrome: A systematic review and meta-analysis.

OBJECTIVES: To systematically review the published evidence regarding the association between Mg intake and serum concentrations with MetS and, if possible, to summarize the results using a meta-analysis. METHODS: PubMed, ISI Web of Science, Scopus, and Google Scholar were searched to identify related articles. Fully adjusted odds ratios (ORs) of MetS in participants with the highest intake of Mg compared with those who had the least consumption, and the mean difference in serum Mg levels between patients with MetS and their controls were extracted for the meta-analysis. RESULTS: In total, 9 articles with 31 876 participants were included in the meta-analysis regarding the association between dietary Mg intake and MetS, and 8 studies that assessed the mean level of serum Mg in 3487 individuals with and without MetS were eligible. Our analysis found that higher consumption of Mg is associated with lower risk of MetS (OR = 0.73; 95% confidence interval: 0.62, 0.86; P < 0.001); we also could find a significant but heterogeneous association between serum Mg and MetS (mean difference: -0.19; 95% confidence interval: -0.36, 0.03; P = 0.023). CONCLUSIONS: The present systematic review and meta-analysis found an inverse association between Mg intake and MetS. However, the inverse association for serum Mg levels was highly heterogeneous and sensitive. The link between Mg status and MetS should be confirmed by prospective cohort studies controlling the association for other nutrients related to MetS risk.

Effect of cinnamon, cardamom, saffron and ginger consumption on blood pressure and a marker of endothelial function in patients with type 2 diabetes mellitus: A randomized controlled clinical trial.

Herbal medicines with high amounts of phytochemicals have been shown to have beneficial effects on blood pressure (BP), endothelial function and anthropometric measures. This study aimed to determine the effect of herbal treatment on BP, endothelial function and anthropometric measures in patients with type 2 diabetes mellitus (T2DM). This clinical trial included 204 T2DM patients randomly assigned to four intervention groups receiving 3 g cinnamon, 3 g cardamom, 1 g saffron or 3 g ginger with three glasses of black tea, and one control group consuming only three glasses of tea without any herbals, for 8 weeks. Intercellular adhesion molecule-1 (ICAM-1), systolic and diastolic BP and anthropometric measures were collected at baseline and after 8 weeks. No significant difference was found between various medicinal plants in terms of influencing BP, serum soluble (s)ICAM-1 concentrations and anthropometric measures. However, in within-group comparison saffron and ginger intakes significantly reduced sICAM-1 concentrations (340.9 ± 14.4 vs 339.69 ± 14.4 ng/ml, p = 0.01, and 391.78 ± 16.0 vs 390.97 ± 15.8 ng/ml, p = 0.009, respectively) and ginger intake affected systolic BP (143.06 ± 0.2 vs 142.07 ± 0.2 mmHg, p = 0.02). Although administration of these herbal medicines as supplementary remedies could affect BP and sICAM-1 concentrations, there was no significant difference between the plants in terms of influencing anthropometric measures, BP and endothelial function.

Sesame fractions and lipid profiles: a systematic review and meta-analysis of controlled trials.

Increased plasma lipid profiles are among the most important risk factors of CHD and stroke. Sesame contains considerable amounts of vitamin E, MUFA, fibre and lignans, which are thought to be associated with its plasma lipid-lowering properties. This study aimed to systematically review the evidence and identify the effects of sesame consumption on blood lipid profiles using a meta-analysis of controlled trials. PubMed, CINAHL and Cochrane Library databases were searched (from 1960 to May 2015). A total of ten controlled trials were identified based on the eligibility criteria. Both the Cochrane Collaboration tool and the Rosendal scale were used to assess the risk of bias of the included studies. The meta-analysis results showed that consumption of sesame did not significantly change the concentrations of total blood cholesterol (-0·32 mmol/l; 95% CI -0·75, 0·11; P=0·14, I(2)=96%), LDL-cholesterol (-0·15 mmol/l; 95% CI -0·50, 0·19; P=0·39, I(2)=96%) or HDL-cholesterol (0·01 mmol/l; 95% CI -0·00, 0·02; P=0·16, I(2)=0%). However, a significant reduction was observed in serum TAG levels (-0·24 mmol/l; 95% CI -0·32, -0·15; P<0·001, I(2)=84%) after consumption of sesame. It was concluded that sesame consumption can significantly reduce blood TAG levels but there is insufficient evidence to support its hypocholesterolaemic effects. Further studies are required to determine the potential effect of sesame consumption on lipid profiles and cardiovascular risk factors.

Does the impact of metabolic syndrome on cardiovascular events vary by using different definitions?

BACKGROUND: Metabolic Syndrome (MetS) is a complex disorder which increases the risk of chronic diseases, including cardiovascular diseases and diabetes mellitus. As a result of modern lifestyles, the prevalence of MetS has been rising globally. This study aims to investigate whether overall prevalence of MetS varies when using different definitions of MetS and to identify the best and most predictive definition of the MetS for cardiovascular disease (CVD) events over 10 years in a cohort of an Iranian population. METHOD: Adults aged ≥ 35 years from urban and rural regions in central Iran were selected at baseline and followed up for more than 10 years. Data on socio-demographic characteristics, anthropometry, blood pressure and smoking status were collected at baseline. In addition, various biochemical indices were assessed. MetS was defined based on five available definitions, and cardiovascular events during 10 years follow up were confirmed by an expert group. The hazard ratios were calculated by the Cox proportional hazards model. RESULTS: The highest prevalence of MetS was observed by using AHA-NHBI definition (36.9%), followed by JIS definition (31.2%). On the other hand, EGIR (8.8%) provided the lowest prevalence. The risk of developing CVD, irrespective of definitions, was approximately two fold higher in the presence of MetS. After controlling for possible confounders, AHA-NHBI definition was found to be the best predictor of CVD. CONCLUSION: This study demonstrated a great variability in the prevalence of MetS among Iranian adults when using different definitions of MetS. CVD risk was significantly higher in MetS participants, as well as in participants with any risk factors of MetS; however, the AHA-NHBI definition was found to be the best predictor of CVD. Thus protective measures, including lifestyle modifications, plus control of individual risk factors is necessary to prevent cardiovascular events.

The metabolic syndrome and associated lifestyle factors among the Iranian population.

BACKGROUND: This study aims to evaluate the impact of the Isfahan Healthy Heart Program (IHHP) interventions concerning healthy behavior, on the prevalence of the metabolic syndrome (MetS) and its components in the Iranian population. MATERIALS AND METHODS: The IHHP targeted the population at large in three districts in central Iran from 2000 to 2007. Numerous interventional activities were performed to improve lifestyle. The main intervention strategies were public education through mass media, intersectional cooperation, health professional education, marketing and organizational development, legislation and policy development, as well as research and evaluation. MetS was defined based on the Adult Treatment Panel (ATP) III definition. The logistic regression method was applied to explore the relationship between lifestyle factors with components of metabolic risk factors. RESULTS: The mean age of the participants was 44.68 ± 14.43 years in 2001. The mean values of the MetS components differed from 2001 to 2007. The mean of systolic blood pressure (SBP) decreased from 126.7 ± 22.31 to 124.21 ± 20.0 and from 129.47 ± 23.08 to 126.26 ± 21.88 among females in both the intervention and reference areas. Similar changes were observed among males. The mean diastolic blood pressure (DBP) and triglycerides decreased significantly in the intervention area and increased significantly in the reference area in both sexes. High density protein cholesterol (HDL-C) was decreased in both sexes, from 2001 to 2007, in both areas. A strong relationship between tobacco control with high SBP and hypertriglyceridemia was found (P < 0.01). CONCLUSION: Lifestyle improvement programs could be useful to improve the MetS status among men and women.

Is the Association between Vitamin D and Metabolic Syndrome Independent of Other Micronutrients?

The incidence of metabolic syndrome (MetS) has been increasing globally and it is recognized as a major public health problem because MetS is associated with increased risk of diabetes, stroke, cancer, and other chronic diseases. Recently, MetS has been linked to vitamin D deficiency. However, the evidence on the association between vitamin D deficiency and the risk of MetS remains inconclusive. This review therefore aims to depict the existing evidence related to MetS and vitamin D deficiency, and examined some of the possible confounders which may affect the association between vitamin D status and risk of MetS. Earlier studies on the association between vitamin D deficiency and MetS have adjusted for the effect of some confounders including, age, sex, body mass index, race, physical activity, smoking, alcohol consumption, and energy intake. However, these studies failed to consider other potential confounders. There is evidence that vitamin A, zinc (Zn), and magnesium (Mg) play important roles in the activation and function of vitamin D and interact with gene expression. Furthermore, these micronutrients are also related to several components of the MetS including glucose intolerance, dyslipidemia, and obesity. Thus, there could be an interaction between these micronutrients, vitamin D, and MetS. This review highlights the possible interactions of vitamin A, Zn, Mg, and vitamin D with MetS and its components. The findings reinforce the need for further well-designed studies that take into account all potential confounders, including other micronutrients such as vitamin A, Zn, and Mg status, to investigate the independent association of vitamin D status with MetS and its components, and also to scrutinize for possible interactions among other nutrients which may have similar confounding effects.

Is responsiveness to weight loss diets affected by family history of diabetes?

BACKGROUND: Obesity is associated with many metabolic and chronic diseases, such as diabetes and cardiovascular disease. Family history of diabetes (FHD) is also an important risk factor for type 2 diabetes. Furthermore, the presence of FHD and obesity has a synergic effect on risk of diabetes incidence. The aim of this study was to determine whether FHD influence the weight loss induced by weight loss diet. METHODS: This study was an intervention between individuals with or without FHD. Seventy-eight positive FHD and 74 negative FHD individuals were participated in this study. Two groups were matched for age, gender, and body mass index (BMI). In the present study, expert interviewers collected socio-demographic data and prescribed dietary recommendations in a face-to-face method. RESULTS: Dietary intervention significantly reduces the body weight and BMI in both groups, but these reductions were not different between negative and positive FHD groups. This study could not find any significant association between FHD and responsiveness to weight loss diets (ß = -0.058; 95% confidence interval, -1.618 to 0.832; P = 0.526). CONCLUSION: Individuals with FHD have higher risk for obesity and chronic diseases, but in the current study there was no difference in responsiveness to weight loss in individuals with a positive family history and those without a family history.

Determinants of weight change in a longitudinal study of Iranian adults: Isfahan Cohort Study.

BACKGROUND: The extensive rise in the prevalence of obesity is a matter of great concern and poses a global threat to people's health. Obesity and overweight are considered to be the consequence of a collection of conditions including genetic, social, environmental, behavioral, and physical factors. The aim of this study was to investigate the determinants of weight change over seven years in a prospective study in an Iranian population. METHODS: The Isfahan Cohort Study (ICS) is an ongoing longitudinal study started in 2001. A total of 6504 adults aged ≥ 35 years participated in this study. Subjects were followed every 2 years by phone calls. The interview and measurements were repeated in 2007 for 3284 subjects with the same protocol as the baseline study. Obesity indices, including body mass index (BMI) and waist circumference (WC) were measured at both time points. For the purpose of data analysis, multiple multinomial logistic regression, Chi-square, and ANOVA tests were used. RESULTS: In males, weight gain was more frequent from normal to overweight (11.7%), while in females, weight gain was observed more from overweight to obesity (11.4%). Younger individuals gained weight more than older individuals (P < 0.001); it was the same for lower education level (P = 0.007).  Weight gain was negatively (OR: 0.98, 95% CI: 0.97-0.99 in male and OR: 0.96, 95% CI: 0.95-0.98 in female) and weight loss was positively (OR: 1.03, 95% CI: 1.01-1.05 in male and OR: 1.02, 95% CI: 1.01-1.04 in female) associated with age in both sexes. Education more than 12 years in women and between 6-12 years in men was negatively associated with weight gain while smoking was positively related to weight loss in females and weight gain in males. CONCLUSION: Our data showed that multiple factors affect weight change, among which age, smoking, and education are important determinants in Iranian adults.

Cheese consumption in relation to cardiovascular risk factors among Iranian adults- IHHP Study.

BACKGROUND/OBJECTIVE: It is expected that dairy products such as cheeses, which are the main source of cholesterol and saturated fat, may lead to the development or increase the risk of cardiovascular and metabolic diseases; however, the results of different studies are inconsistent. This study was conducted to assess the association between cheese consumption and cardiovascular risk factors in an Iranian adult population. SUBJECTS/METHODS: Information from the Isfahan Healthy Heart Program (IHHP) was used for this cross-sectional study with a total of 1,752 participants (782 men and 970 women). Weight, height, waist and hip circumference measurement, as well as fasting blood samples were gathered and biochemical assessments were done. To evaluate the dietary intakes of participants a validated food frequency questionnaire, consists of 49 items, was completed by expert technicians. Consumption of cheese was classified as less than 7 times per week and 7-14 times per week. RESULTS: Higher consumption of cheese was associated with higher C-Reactive Protein (CRP), apolipoprotein A and high density lipoprotein cholesterol (HDL-C) level but not with fasting blood sugar (FBS), total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and apolipoprotein B. Higher consumption of cheese was positively associated with consumption of liquid and solid oil, grain, pulses, fruit, vegetable, meat and dairy, and negatively associated with Global Dietary Index. After control for other potential confounders the association between cheese intake and metabolic syndrome (OR: 0.81; 96%CI: 0.71-0.94), low HDL-C level (OR: 0.87; 96%CI: 0.79-0.96) and dyslipidemia (OR: 0.88; 96%CI: 0.79-0.98) became negatively significant. CONCLUSION: This study found an inverse association between the frequency of cheese intake and cardiovascular risk factors; however, further prospective studies are required to confirm the present results and to illustrate its mechanisms.

Green tea catechins and blood pressure: a systematic review and meta-analysis of randomised controlled trials.

PURPOSE: Although previous literature has reported that regular green tea consumption may improve blood pressure, the evidence from these studies is not consistent. The present study systematically reviewed randomised controlled trials and examined the effect of green tea consumption on blood pressure using meta-analysis. METHODS: Search of ProQuest, PubMed, Scopus and Cochrane Library (CENTERAL) was conducted, to identify eligible articles. Articles from 1995 to 2013 were included. A random-effect model was chosen to calculate the effect of combined trials. RESULT: Thirteen studies were included in the meta-analysis. Green tea consumption significantly changed systolic blood pressure, by -2.08 mm Hg (95% CI -3.06, -1.05), and diastolic blood pressure, by -1.71 mm Hg (95% CI -2.86, -0.56), compared to the control. Changes in lipid profile, blood glucose and body mass index were also assessed in the meta-analysis. A significant reduction was found in total cholesterol (-0.15 mmol/L [95% CI -0.27, -0.02]) and low-density lipoprotein cholesterol (-0.16 mmol/L [95% CI -0.22, -0.09]). Changes in other parameters did not reach statistical significance. Subgroup analysis suggested a greater reduction in both systolic and diastolic blood pressure in studies that included participants with a baseline mean systolic blood pressure of ≥ 130 mm Hg, and studies involving consuming green tea as an extract. CONCLUSION: The present meta-analysis suggests that green tea and its catechins may improve blood pressure, and the effect may be greater in those with systolic blood pressure ≥ 130 mm Hg. The meta-analysis also suggests that green tea catechins may improve total and low-density lipoprotein cholesterol.

Pivotal role of mediterranean dietary regimen in the increase of serum magnesium concentration in patients with coronary artery disease.

Background. Recent studies confirmed cardioprotective role of intravenous magnesium for the prevention of cardiac events, but effect of dietary intake of this mineral via recommended dietary regimens on control and inhibition of coronary artery disease (CAD) risk factors has been questioned. The aim of the present study was to determine effect of Mediterranean dietary approach on serum magnesium concentration among Iranian patients with CAD. Method. Baseline characteristics and clinical data of 102 consecutive patients with the diagnosis of CAD and candidates for isolated coronary artery bypass surgery were entered into the study. Laboratory parameters especially serum magnesium concentration were measured after 12-14 h of overnight fasting and before operation. Nutritional status was assessed by food frequency questionnaire and the diet score was calculated on the basis of Mediterranean diet quality index (Med-DQI). Results. No significant differences were found in the concentrations of albumin, last fasting blood sugar, last creatinine, and lipid profiles between the groups with Mediterranean dietary score < 5 and the group with higher dietary score; however, serum magnesium concentration in the first group was higher than that in the group with higher dietary score. Linear multivariate regression analysis showed that the lower Mediterranean dietary score was a predictor for serum magnesium concentration after adjusting for confounders. Conclusion. Taking Mediterranean dietary regimen can be associated with increased level of serum magnesium concentration, and thus this regimen can be cardioprotective because of its effects on serum magnesium.