Higher global diet quality score is inversely associated with odds of metabolic syndrome among Iranian adults.

BACKGROUND: Growing research underscores the significance of diet quality in the development of Metabolic Syndrome (MetS). Our study investigates the correlation between the Global Diet Quality Score (GDQS) and MetS, along with its components, in Iranian adults. METHODS: This study utilizes data from the Yazd Health Study (YaHS) and includes a final analysis of 2,904 participants aged 20-70 years. Dietary data were gathered using food frequency questionnaires. MetS was defined in line with the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. GDQS was derived by totaling the points across all 25 food groups, with scores ranging from 0 to 49. To examine the association between GDQS and MetS, multivariable logistic regression analyses were conducted in both crude and adjusted models. RESULTS: Participants who had the highest adherence to GDQS had a 20% lower chance of having MetS than those who had the lowest adherence after adjusting for confounding variables in Model II (T3 vs. T1: OR = 0.80; 95% CI: 0.46-0.99, P-trend = 0.045). There was no association between GDQS and MetS components including increased blood pressure, fasting blood glucose (FBG), triglyceride, abdominal obesity and reduced high-density lipoprotein (HDL) in crude and adjusted models. CONCLUSION: higher adherence to GDQS was inversely related to odds of MetS. Further longitudinal and clinical trials investigations are required to confirm these associations.

Dietary approaches to stop hypertension (DASH) diet improves hepatic fibrosis, steatosis and liver enzymes in patients with non-alcoholic fatty liver disease: a randomized controlled trial.

PURPOSE: Recent evidence suggests that adherence to dietary approaches to stop hypertension (DASH) diet can be effective in managing non-alcoholic fatty liver disease (NAFLD). We investigated the effect of DASH diet on hepatic fibrosis, steatosis and liver enzymes in patients with NAFLD. METHODS: This 12-week randomized controlled trial was conducted among seventy patients with NAFLD who were randomly assigned into two groups including intervention group (DASH diet containing 50-55% carbohydrate, 15-20% protein, and 30% total fat) and the control group (a healthy diet containing 50-55% carbohydrate, 15-20% protein, and 30% total fat). Both diets were calorie-restricted (500-700 kcal lower than the energy requirement). The primary outcomes included hepatic fibrosis, hepatic steatosis, alanine transaminase (ALT), aspartate transaminase (AST) and gamma-glutamyl transpeptidase (GGT). RESULTS: At the baseline, there was no significant difference between two groups in the level of hepatic fibrosis (P = 0.63), hepatic steatosis (P = 0.53), ALT (P = 0.93), AST (P = 0.18) and GGT (P = 0.76). A significant reduction was found in the intervention group compared to the control group in hepatic fibrosis (23 grades reduction vs. 7 grades reduction; P = 0.008) and hepatic steatosis (31 grades reduction vs. 9 grades reduction; P = 0.03) after intervention. In addition, a significant change was observed in the intervention group compared to control group in ALT ( - 8.50 ± 8.98 vs. - 2.09 ± 7.29; P = 0.002), and AST ( - 5.79 ± 6.83 vs. - 0.51 ± 6.62; P = 0.002). CONCLUSIONS: Adherence to DASH diet may be effective in management of NAFLD. TRIAL REGISTRATION: The trial was registered on 06 February 2022 at Iranian Registry of Clinical Trials (IRCT20170117032026N3) with URL: https://www.irct.ir/trial/60887 .

Insulinaemic potential of diet and lifestyle and risk of type 2 diabetes in the Iranian adults: result from Yazd health study.

BACKGROUND: Previous studies have shown that insulin directly affects the risk of type 2 diabetes mellitus (T2DM) but the relationship between insulinaemic potential of diet and lifestyle and the T2DM risk is still unknown. Accordingly, we aimed to investigate the relationship between the insulinaemic potential of diet and lifestyle based on indices including empirical dietary index for hyperinsulinaemia (EDIH), empirical lifestyle index for hyperinsulinaemia (ELIH), empirical dietary index for insulin resistance (EDIR) and empirical lifestyle index for insulin resistance (ELIR) and the T2DM risk in the Iranian adults. METHODS: This study was performed on data of enrollment phase of the Yazd Health Study (YaHS) and TAghzieh Mardom-e-Yazd (Yazd Nutrition Study) (TaMYZ) on 5714 adults aged 20-70 years (mean: 36.29 years). A validated food frequency questionnaire and clinical tests were used to assess food intake and T2DM ascertainment, respectively. We used the Cox regression analysis for determining the relationship between the indices and T2DM risk. RESULTS: After adjusting for confounding variables, our findings showed that diet with higher ELIH score is 2.28 times more likely for T2DM risk (RR 2.28 [95% CI 1.69-2.56]), but there was no significant relationship between the EDIH, ELIR and EDIR scores and T2DM risk in adults, in the entire study population. CONCLUSIONS: Our findings suggest that diets with higher ELIH score increases the T2DM risk, but there was no significant relationship between the EDIH, ELIR and EDIR scores and T2DM risk. Further epidemiological studies are needed to confirm our findings.

Interaction between CETP Taq1B polymorphism and dietary patterns on lipid profile and severity of coronary arteries stenosis in patients under coronary angiography: a cross-sectional study.

AIM: Evidence indicates there are still conflicts regarding CETP Taq1B polymorphism and coronary artery disease risk factors. Current findings about whether dietary patterns can change the relationship of the Taq1B on lipid profile and the severity of coronary arteries stenosis appears to be limited. The present research made an attempt to investigate this possible relationship. METHODS: This cross-sectional study involved 453 male and female participants with a mean age of 57 years. A validated 178-item food frequency questionnaire (FFQ) was used to assess dietary usual intake. Dietary patterns were extracted through principal component analysis (PCA). Taq1B variant was genotyped by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Two-way ANOVA was used to test the interaction between Taq1B polymorphism and dietary patterns. RESULTS: Two dietary patterns were detected: the western dietary pattern (WDP) and the traditional dietary pattern (TDP). The frequency of Taq1B genotypes turned out to be 10.4, 72.4, and 17.2% for B1B1, B1B2, and B2B2, respectively. A significant difference was observed in TG and TG/HDL-C levels among TaqIB genotypes in higher adherence to TDP (P = 0.01 and P = 0.03, respectively). Taq1B showed a significant interaction with TDP for modulating TG levels and TG/HDL-C ratio (P = 0.02 and P = 0.04, respectively). Greater compliance to WDP demonstrated a significant difference in TG and TG/HDL-C levels across rs708272 genotypes (P = 0.03) after adjusting for confounding factors. Other lipid components and coronary arteries stenosis scores failed to show any relationship or significant difference across Taq1B genotypes or dietary patterns. CONCLUSION: Adherence to TDP may adjust the association between the Taq1B variant and TG and TG/HDL-C levels in patients undergoing coronary angiography. To better understand the relationships, we suggest prospective studies in different race groups with multivariate approaches.

The nutritional content required to design an educational application for infertile women.

BACKGROUND: Infertility has been considered as a critical health problem for couples and society. Given the worldwide exponential rise of infertility, mobile phone-based applications are drastic ways to deliver nutrition educational content to women with infertility. The present study aimed to prepare the required educational content for designing a mobile phone-based nutrition educational application for women with infertility. METHODS: Educational contents were initially determined based on the literature review and library studies. As a result, a researcher-made questionnaire was designed containing 28 items in six dimensions. To ensure about the questionnaire's validity, a panel of experts (15 nutritionists and 5 infertility specialists) was asked to review the items, make revisions (if necessary), and confirm the final contents. The questionnaire reliability was also corroborated using the KR-20 coefficient (0.89). RESULTS: While the amount of consumed calories per meal and between meals were not significantly effective on fertility, factors such as main definitions, disease and treatment instructions, personal activities and habits, and menstruation were deemed necessary by the respondents. Participants also suggested adding sections entailing introductions to different types of diets, users' suggestions and opinions, and of the address and contact information of senior nutrition centers to the questionnaire. CONCLUSIONS: Followed by obtaining the required valid and reliable contents, a mobile phone- based nutrition education application can be designed to improve the patients' knowledge and facilitate their treatment process.

Determining the content and needs assessment a mobile-based self-care program in infertile men.

BACKGROUND: Infertility is a public health problem in the world, using new technology, such as mobile phones, is increasing in the field of health. This study aimed to determine the Necessity of self-care training contents by performing a needs analysis among men with infertility problems to design a mobile phone-based application. METHODS: Followed by reviewing the related literature, a questionnaire including 40 educational items and seven software features was designed in three general sections and distributed among 30 specialists in nutrition (n = 18) and infertility (n = 12). The validity of the questionnaire was confirmed by a panel of experts in nutrition, infertility, and medical informatics. The questionnaire's reliability was also corroborated by Cronbach's alpha of 86.4. RESULTS: All items related to the software features and most items in the questionnaire were deemed necessary by participants. However, the items: "Occupation and history of chronic diseases" in the demographic information section and "Effects of infertility and food allergy" in the educational section were not confirmed. CONCLUSION: The present findings could not only highlight the patients' roles in managing their disease but also increase the healthcare workers' awareness in designing the hospital information system.

Higher dietary glycemic load is inversely associated with stress prevalence among Iranian adults.

BACKGROUND: Psychological disorders including depression, anxiety, and stress comprise a huge public health problem. The aim of this cross-sectional study is to assess the relationship between dietary glycemic index (DGI) and glycemic load (DGL) and mental disorders. METHOD: Participants (n = 10,000) aged 20-69 were randomly selected from 200 clusters in Yazd from the recruitment phase of Yazd Health Study. The dietary intake of study participants was collected by a reliable and validated food frequency questionnaire consisting of 178 food items. DGI and DGL were calculated from the FFQ data using previously published reference values. To assess psychological disorders an Iranian validated short version of a self-reported questionnaire Depression Anxiety Stress Scales 21 was used. RESULTS: There were no significant associations between DGI and DGL with odds of depression or anxiety in crude and adjusted models. However, individuals in the highest quartiles of DGL had the lowest odds of stress (OR: 0.69; 95% CI 0.47-1, P-trend = 0.023). This association remained significant after adjustment for potential confounding variables in model I (OR: 0.45; 95% CI 0.22-0.9, P-trend = 0.023), model II (OR: 0.46; 95% CI 0.22-0.96, P-trend = 0.039) and model III (OR: 0.46; 95% CI 0.22-0.96, P-trend = 0.042). CONCLUSION: In conclusion, consumption of foods with higher GL was associated with lower odds of stress; however, no significant association was found between DGI or DGL and risk of depression and anxiety. Performing further studies with longitudinal design is suggested to confirm these results.

Effects of Nigella sativa supplementation on blood concentration and mRNA expression of TNF-α, PPAR-γ and adiponectin, as major adipogenesis-related markers, in obese and overweight women: a crossover, randomised-controlled trial.

Adipocyte expansion through adipogenesis can offset the adverse metabolic effects of obesity. Nigella sativa (NS) (black seed) oil is shown to have therapeutic features in the management of obesity. NS oil might have beneficial changes in obese populations through mediating serum levels of adipogenesis-related parameters and relative transcriptional gene-diet interactions (nutrigenomics), though no previous studies assessed this mechanism in overweight/obese participants. This study assessed the effects of NS oil supplements on blood concentration and mRNA expression levels of TNF-α, PPAR-γ and serum adiponectin and expression of AdipoR1, as major adipogenesis and obesity-related parameters, in overweight/obese women using a cross-over design. Eligible women were randomised to receive either NS oil supplements (2000 mg/d) or placebo. Two periods of interventions (8 weeks in each) were cross-changed by a 4-week washout period. An individualised diet plan without calorie deficits was given to participants to match their energy/macronutrient intakes. The Pkcross procedure and intention-to-treat analysis were performed using Stata. Cohen's d(d) was estimated to measure the magnitude of the effects. Forty-six participants were included. NS oil capsules reduced transcription levels ((d = -2·31), P < 0·001) and blood concentrations of TNF-α ((d = -0·29), P < 0·001). AdipoR1 expression (d = 2·24, P < 0·001) and serum adiponectin (d = 0·88, P < 0·001) showed a significant augmentation with a medium-high effect size, as did gene expression (d = 0·69, P < 0·001) and serum levels of PPAR-γ (d = 0·97, P < 0·001). There was a moderate but significant decrease in body weight (d = 0·6, P < 0·001). The present beneficial findings would provide strong information for future nutrigenomics/clinical trial studies assessing the role of NS in the management of obesity and other comorbidities.

The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin and lipid profile in overweight/obese women with polycystic ovary syndrome: a randomized clinical trial.

PURPOSE: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women. Insulin resistance and dyslipidemia are linked to PCOS. L-Carnitine supplementation as a management strategy for women with PCOS has been proposed. The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin (SHBG) and lipid profile in overweight/obese women with PCOS was investigated. METHODS: This randomized, double-blind, controlled clinical trial, was conducted on 62overweight/obese women with PCOS. Participants were randomly assigned into two groups to receive 1000 mg/day L-carnitine or placebo (1000 mg starch) for 12 weeks. RESULTS: L-Carnitine supplementation compared to the placebo showed a significant improvement in insulin [- 0.7 (- 7.3 to 4.0) vs. 0.7 (- 3.0 to 5.2); P = 0.001], homeostatic model assessment for insulin resistance [- 0.4 (- 1.7 to 1.1) vs. 0.0 (- 0.7 to 1.3); P = 0.002], quantitative insulin sensitivity check index (+ 0.01 ± 0.02 vs. - 0.01 ± 0.01; P = 0.02) and a non-significant change toward improvement in SHBG (+ 11.5 ± 40.2 vs. - 3.2 ± 40.2; P = 0.2). However, there was no significant differences between the two groups in serum levels of fasting plasma glucose, total cholesterol, triglyceride, low density lipoprotein-cholesterol and high density lipoprotein cholesterol (P > 0.05). CONCLUSION: 12-week L-carnitine supplementation in overweight or obese women with PCOS ameliorate insulin resistance, but has no effect on SHBG and lipid profile. Studies with higher dosages and duration of L-carnitine intake are required. The trial was registered on 30 December 2019 at Iranian Registry of Clinical Trials IRCT20191016045131N1. TRIAL REGISTRATION: Registered on 30th December 2019 at Iranian Registry of Clinical Trials (IRCT20191016045131N1).

The association between major dietary patterns and severe mental disorders symptoms among a large sample of adults living in central Iran: Baseline data of YaHS-TAMYZ cohort study.

BACKGROUND: The diet's role in developing psychological disorders has been considered by researchers in recent years. OBJECTIVE: To examine the association between major dietary patterns and severe mental disorders symptoms in a large sample of adults living in Yazd city, central Iran. METHODS: This cross-sectional study used the baseline data of a population-based cohort study (Yazd Health study: YaHS). Dietary intakes were assessed by a multiple-choice semi-quantitative food frequency questionnaire (FFQ, Yazd nutrition survey called TAMYZ). Psychological assessments were also done by using the depression, anxiety, and stress scale-21 (DASS-21) questionnaire. Major dietary patterns were identified using principal component analysis (PCA). Analysis of covariance (ANCOVA) and logistic regression analyses were used to evaluate the relationship between dietary patterns and mental disorders symptoms. RESULTS: A total of 7574 adults were included in the current analysis. Four major dietary patterns were identified: "Sugar and Fats", "Processed Meats and Fish", "Fruits" and "Vegetables and Red Meat". After adjustment for all confounding variables, participants in the fifth quintile of "Fruits" dietary pattern which was highly correlated with dried fruits, canned fruits, fruit juice, olive, hydrogenated fats and fruits intake, had a lower odds of severe depression (OR=0.61, 95% CI: 0.45-0.81, p for trend=0.057), anxiety (OR=0.64, 95% CI: 0.50-0.80, p for trend=0.007), and stress, (OR=0.45, 95% CI: 0.30-0.68, p for trend=0.081). CONCLUSIONS: The intake of a dietary pattern high in dried fruits, canned fruits, fruit juice, olive, hydrogenated fats, and fruits might be inversely associated with depression, anxiety, and stress symptoms. Future prospective studies are needed to warrant this finding.

Design and evaluation of a mobile-based nutrition education application for infertile women in Iran.

BACKGROUND: The prevalence of infertility in Iran is higher than the world average. Furthermorte, education and nutrition are among the effective factors in improving the quality of life of women with infertility. According to the significant role of smartphones in people's lives as well as health education, the present study aimed to design and evaluate a mobile-based nutrition education application for infertile women. METHODS: This quantitative research was conducted in two stages. Initially, the educational contents were determined based on a review of the literature. Later, the obtained contents were given to 10 nutritionists and five infertility specialists to determine the necessity of each item. In the next stage, the application prototype was designed based on the results of the first stage and distributed among 220 infertile women. After two months, the Questionnaire of User Interface Satisfaction was administrated to assess the usability of the developed application. The results were analyzed via SPSS software version 20. RESULTS: According to the nutritionists and infertility specialists, the contents determined for the nutrition educational application were categorized under three general sections of user's demographic data, educational contents, required capabilities. The users' mean score of the application usability was calculated as 7.44 out of 9 indicating a good level of satisfaction. CONCLUSIONS: Nutrition education of women with infertility problems can play a significant role in improving their awareness and treatment outcomes. Due to the increasing use of smartphones, designing a mobile-based nutrition educational application can be of great benefit for women with infertility according to the cultural conditions and characteristics of each community.

The effects of preoperative supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine, and glutamine on inflammatory and hematological markers of patients with heart surgery: a randomized controlled trial.

BACKGROUND: Cardiac surgery is associated with a widespread inflammatory response, by an additional release of free radicals. Due to the importance of these patient's nutritional status, the present study was designed to evaluate the effectiveness of supplementation with a combination of glutamine, ß-hydroxy-ß-methylbutyrate (HMB) and arginine in patients undergoing to the heart surgery. METHODS: The experiment was performed in 1 month (30 days) before cardiac surgery. patients were asked to take 2 sachets of Heallagen® (a combination of 7 g L-arginine, 7 g L-glutamine, and 1.5 g daily HMB) or placebo with identical appearance and taste (maltodextrin) with 120 cc of water. Clinical and biochemical factors were evaluated in the baseline and end of the study. RESULTS: Totally, 60 preoperative patients (30 interventions and 30 placeboes) with a mean age of 53.13 ± 14.35 years participated in the study. Subjects in Heallagen® group had a lower serum levels of interleukin-6 (P = 0.023), erythrocyte sedimentation rate (P < 0.01), high sensitivity C-reactive protein (P < 0.01), and lymphocyte number (P = 0.007) compared to the placebo, at end of the study. CONCLUSION: In the patients undergoing heart surgery, Heallagen® significantly improved some of the inflammatory factors and hematological parameters. These results need to be confirmed in a larger trial. TRIAL REGISTRATION: The protocol of the study was registered in the IRCT.ir with registration no. IRCT20120913010826N31 at 13/10/2020.

The effect of Nigella sativa supplementation on cardiovascular risk factors in obese and overweight women: a crossover, double-blind, placebo-controlled randomized clinical trial.

PURPOSE: To assess the effect of Nigella sativa (N.S) oil supplements on CVD risk factors in a crossover design for the first time. METHODS: Obese and overweight healthy women were randomized to receive N.S oil (2000 mg/day) and placebo. This intervention period lasted for 8 weeks and separated by a 4-week washout period. An iso-caloric diet was given to every individual throughout the study. Blood pressure, lipid profile, atherogenic indices and liver enzymes were measured. Pkcross procedure was performed for statistical analyses using Stata software. Cohen's d was estimated as effect size for all outcomes to measure the magnitude of the effects. RESULTS: Thirty-nine participants completed the study. Capsules of N.S increased serum high-density lipoprotein cholesterol (Cohen's d = 0.47, P = 0.009), reduced low-density lipoprotein cholesterol (Cohen's d = - 0.33, P = 0.031), reduced TC/HDL-C ratio (as an atherogenic index, Cohen's d = - 0.9, P < 0.001), reduced serum glutamic-oxaloacetic transaminase (Cohen's d = 0- 0.5, P = 0.038) and reduced systolic blood pressure (Cohen's d = - 0.4, P < 0.001). There was no effect on diastolic blood pressure measures (P = 0.96). CONCLUSION: The overall improvements in cardiovascular disease (CVD) risk factors showed beneficial effects of N.S supplements among adults with obesity to prevent possible cardiovascular diseases. More studies with different designs and in other populations are suggested to clarify the exact effects of N.S as a complementary therapy for modulating CVD risk factors in individuals with overweight and obesity. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20180528039884N1, Registered on February 15th, 2019.

The association between low-carbohydrate diet score and metabolic syndrome among Iranian adults.

OBJECTIVE: Assessing the relationship between low-carbohydrate diet (LCD) score and metabolic syndrome (Mets) in Iranian adults. DESIGN: Cross-sectional study. SETTING: Yazd Health Study and Taghzieh Mardom-e-Yazd study. PARTICIPANTS: Data of 2074 participants were used. Dietary intakes were assessed by a validated semi-quantitative FFQ. LCD score was calculated for each person by summing up the assigned scores to deciles of energy percentages from macronutrients. Mets was evaluated using National Cholesterol Education Program Adult Treatment Panel III. Eventually, association between LCD score and Mets was examined using logistic regression. RESULTS: Total Mets prevalence was approximately 40·5 %. After adjustment for confounders, subjects in the higher quartile of LCD score had a significant lower chance of Mets than lower quartile among all participants (Q4 v. Q1: OR: 0·68, 95 % CI (0·50, 0·92)) and separately in men (Q4 v. Q1: OR: 0·54, 95 % CI (0·34, 0·86)) and women (Q2 v. Q1: OR: 0·53, 95 % CI (0·34, 0·82)). Furthermore, more LCD adherence in men reduced abdominal obesity by 47 % (Q3 v. Q1: OR: 0·53, 95 % CI (0·28, 0·99)). A significant inverse relation was also observed between low HDL cholesterol and LCD score in all participants (Q4 versus Q1 OR: 0·74, 95% CI: 0·56-0·99) and separately in men (Q4 versus Q1 OR: 0·63, 95% CI: 0·40-0·98). CONCLUSIONS: More adherence to LCD might be related to lower chance of Mets and some of its components such as low HDL-cholesterol and abdominal obesity specially in men. Further studies are required to confirm the findings.

The relation between dietary phytochemical index and metabolic syndrome and its components in a large sample of Iranian adults: a population-based study.

BACKGROUND: Despite the protective effects of foods being rich in phytochemicals against chronic diseases, this issue is still poorly understood. The aim of this study was to investigate the association between Dietary Phytochemical Index (DPI) and metabolic syndrome (MetS) and its components. METHODS: This cross-sectional study focused on adults aged between 20 and 70years. The dietary intake was assessed using a validated and reliable food frequency questionnaire. DPI was calculated based on dietary energy, derived from phytochemical-rich food sources (kcal) per total daily energy intake (kcal). The odds ratio of MetS and its components were assessed across DPI quartiles by logistic regression models. RESULTS: After adjustment for all potential confounders, the risk of MetS (OR: 0.63, 95% CI = 0.41-0.96) and elevated blood pressure (OR: 0.62, 95% CI = 0.40-0.96) in the second category of DPI decreased significantly as compared to that in the first category. Subjects in the second and fourth quartiles of DPI with adjusting for age, sex and total energy intake revealed 30 and 25% lower risk of abdominal obesity, respectively. After full adjustment for confounders, the analysis stratified by sex showed women in the highest quartile of DPI had 59% lower risk of MetS (OR: 0.41, 95% CI = 0.22-0.76) as compared to those in the lowest quartile of DPI. CONCLUSIONS: Greater adherence to phytochemical-rich diet could reduce odds of MetS and some components, especially in women. Further studies with intervention approaches are recommended.

The association between serum TSH concentration whithin the normal range and nutritional status in euthyroid pregnant women at the first trimester of gestation.

BACKGROUND: Follow-up studies have shown an increased risk of thyroid dysfunction in individuals with normal serum thyroid-stimulating hormone (TSH) levels. Furthermore, the possible consequences of minor differences in thyroid function (without achieving poor thyroid function) in the risk of weight gain during pregnancy are questionable, too. The production of TSH is under the hypothalamus-pituitary control, and food is one of the most effective environmental agents that control hypothalamic-pituitary-thyroid axis activity. Regarding the few available studies, we assessed the association of minor variations of TSH concentrations and nutritional status in the first trimester of pregnancy. MATERIALS AND METHODS: This cross-sectional descriptive and analytical study was performed on 150 primiparous healthy women. Demographic and family characteristics were collected using a researcher-administered questionnaire. Nutrients intake were extracted from a 72-h recall, and physical activity scores were determined by the pregnancy physical activity scale. RESULTS: The prepregnancy body mass index (BMI) (ß =0.022, P = 0.004) and participants' weight at 6-10 weeks of gestation (ß =0.006, P = 0.024) were positively associated with TSH concentrations, while total physical activity score was negatively correlated (ß = ‒0.006, P = 0.047). We did not find any significant association between TSH values and energy-adjusted nutrients intake (P > 0.05). CONCLUSION: We suggest that differences in TSH concentrations within normal range in the first trimester are correlated with gaining weight, physical activity level, and prepregnancy BMI. TSH concentration and consequently thyroid function may influence on gestational weight gain or vice versa.

Incentives to Reduce Salt Intake Resulting From Women's Experiences: A Qualitative Study.

INTRODUCTION: Over consumption of salt adversely affects health and is associated with some diseases. Salt over consumption has been reported to be higher in Asian countries including Iran. This research aimed to identify the facilitative factors of reduced salt consumption among 20-65 year-old women to develop effective educational interventions. Methods: This research used qualitative content analysis. We included 42 (31 women aged 20-65 years residing in Hamidia, Yazd and 11 healthcare providers) using Purposeful sampling method. Data were collected through focal group discussions (three groups of 6) and in-depth semi-structured individual interviews with 24 Participants. Data analysis was done using Graneheim and Lundman's approach. Results: Motivators and facilitators were extracted. The former consisted of sub-categories: physical fitness and healthcare, obtaining others' approval, family cooperation and support, internal motivators, contextual motivators and healthcare staff support. Sub-categories of the latter were gaining more information from different instructions, willingness to acquire self-protection skills and nutritional advice. These factors affected to reduce the salt intake among women. Conclusion: In the light of the qualitative results of motivating and facilitating factors, it is essential to enhance internal motivators and increase access to information via different communicative channels in community including schools, medical care providers and public associations. It is also necessary to pave the way for more family and medical staff support, provide appropriate educational and advertising programs, raise women's awareness and change their attitude and behavior with this concern.

The effect of Nigella sativa on the measures of liver and kidney parameters: A systematic review and meta-analysis of randomized-controlled trials.

The aim of this systematic review and dose-response meta-analysis was to determine the effect of Nigella sativa (N.S) supplementation on liver and kidney parameters. We searched PubMed, Scopus, ISI Web of Science, Cochrane central register for controlled trials and Google Scholar from database inception to April 2019 for relevant controlled trials. Mean differences and standard deviations for each outcome were pooled using a random-effects model and a dose-response analysis was performed using a fractional polynomial model. Quality of evidence was evaluated using Cochrane Collaboration Risk of Bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Nineteen trials (n = 1295 participants) were included in the meta-analysis. We observed that N.S supplements had significant reducing effects on alkaline-phosphatase (ALP) [9 trials, n = 710 participants, weighted mean difference (WMD)= -10.825; 95 %CI: -19.658, -1.992 U/L; P = 0.016; I2 = 75.7 %; P-heterogeneity = 0.000) and blood urea nitrogen (BUN) (12 trials, n = 821 participants, WMD= -1.016; 95 % CI: -1.760, -0.273 U/L; P = 0.007; I2 = 87.7 %; P-heterogeneity = 0.000) concentrations. Subgroup analysis showed that, an intervention of more than 12 weeks was found to have a reducing effect on aspartate- aminotransferase (AST) measures (2 trials, n = 201 participants, WMD= -11.317; 95 % CI: -15.007, -7.626; P = 0.000; I2 = 0.0 %; P-heterogeneity = 0.977). Creatinine levels increased significantly in studies that considered adjusted analysis based on covariates (3 trials, n = 152 participants, WMD = 0.070; 95 % CI: 0.027, 0.112 U/L; P = 0.001; I2 = 0.0 %; P-heterogeneity = 0.788). A daily dose of 1100-1500 mg of N.S supplements was observed to have a substantial reducing effect on ALP levels (5 trials, n = 340 participants, WMD= -11.323; 95 % CI: -21.418, -1.229 U/L; P = 0.028; I2 = 0.00 %; P-heterogeneity = 0.686), while a dosage of more than 2000 mg per day led to a significant increase in BUN concentrations (2 trials, n = 101 participants, WMD= -1.016; 95 % CI: -1.760, -0.273 U/L; P = 0.007; I2 = 87.7 %; P-heterogeneity = 0.000). Our data suggested that N.S supplementation had significant impacts on liver and kidney parameters leading to a decrease in ALP and BUN levels. Longer duration of intervention and normal daily dosages of N.S supplements led to significant reductions in ALP and AST concentrations, respectively, while higher daily dosages increased BUN levels. Hence, in spite of favorable impacts of N.S supplements on liver and kidney parameters, due to the herbal nature of N.S, more studies with high-quality, large-scale, long-term intervention and precise baseline characteristics are needed to assess the exact effective dose, duration and efficacy of N.S supplementation on kidney and liver parameters.

Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes in Central Iran: results from Yazd health study.

BACKGROUND: Over the past few decades, the prevalence of Diabetes Mellitus (DM) has risen rapidly in Iran and other low and middle-income countries. We investigated the prevalence of DM, pre-diabetes, undiagnosed and uncontrolled diabetes and its relationship with some associated socioeconomic factors in the Yazd Greater Area in Iran. METHODS: Yazd Health Study is a longitudinal study conducted to determine the prevalence of non-communicable disease and related risk factors. In a two-step cluster sampling, 10,000 adults aged 20-69 years (200 clusters) were selected. In the recruitment phase, DM was considered if the patients had been either diagnosed DM by a physician or had fasting blood glucose ≥ 126 mg/dL. Chi square test was used for categorical variables to evaluate the differences and logistic regression model was applied to determine the predictors of diabetes.. P-value < 0.05 considered statistically significant. RESULTS: Of the 9965 individuals recruited, the crude self-reported prevalence of DM was 14.1% (95% CI: 13.4-14.7). The prevalence was higher in women than men (15.6 vs.12.4%), significantly. The age-standardized prevalence of DM was 8%. The prevalence was 14.9% in Yazd local people and 8.6% in those residents migrated from other provinces (P < 0.0001). We showed a significant association between DM prevalence and age, education, marital status, unemployment, insurance status, and positive family history (P < 0.0001). The prevalence of DM diagnosed by phycisians was 16.1% in participants (age-standardized prevalence: 8.3%). The subset analysis showed that 4.8% of patients were not aware of their disease. The prevalence of pre-diabetes was 25.8%. Of those with diabetes, 58.3% were not adequately controlled, which is not statistically significant with socio-economic status. CONCLUSION: The current study showed a high prevalence of DM in Yazd Greater Area which is closely related to some socio-demographic factors. The high prevalence of pre-diabetes is alarming. Effective strategies for DM prevention should be introduced. The majority of people with diabetes are aware, but half of them are not controlled. The ineffective care plan currently in use, should be reviewed. Patients needs to be encouraged to improve their lifestyle. Active follow-up of patients is recommended to ensure continuity of care.

The effect of vitamin D supplementation on the androgenic profile in men: A systematic review and meta-analysis of clinical trials.

The aim of this systematic review and meta-analysis was to evaluate the effect of vitamin D supplementation on total testosterone (TT) and sex hormone-binding globulin (SHBG) in men. We searched PubMed, Scopus and Web of Science for randomized, controlled trials of vitamin D supplementation in men ≥18 years old up to September 2018, without language restrictions. Meta-analysis was based on a random effects model. The systematic review was registered as CRD42018094498. We identified 3,402 articles, of which eight studies with 10 effect sizes met the inclusion criteria. Vitamin D daily dose equivalents ranged from 600 to 4,000 per day to 60,000 IU per week; duration was 6 weeks to 36 months. In general, vitamin D supplementation had no significant effect on TT (MD = 0.20, 95% CI: -0.20, 0.60, p = 0.336) and SHBG (MD = 1.56, 95% CI: -0.85, 3.97, p = 0.204). Subgroup analysis conducted with duration of prescription, type (daily or weekly), dosing frequency and baseline vitamin D and TT concentration showed that vitamin D did not significantly affect TT. The present study did not find any evidence to support beneficial effect of vitamin D supplementation on TT and SHBG in men. Thus, further large-scale randomised controlled trials are required to evaluate the effects of vitamin D supplementation on androgen in men.