Associations of plant-based dietary patterns with cardiovascular risk factors in women.

Introduction: Given that some plant-based foods, such as potatoes, adversely affect cardiovascular disease (CVD) risk factors, this study was performed to assess the association between plant dietary patterns and these risk factors. Methods: This cross-sectional study was conducted among 371 healthy 18 to 50 year-old Iranian women. Participant dietary intake was assessed using a validated food frequency questionnaire. Nineteen food groups were ranked in deciles and received scores from 1 to 10. An overall plant-based dietary index (PDI), a healthy plant-based dietary index (hPDI), and an unhealthy plant-based dietary index (uPDI) were calculated. Results: Participants who scored in the top tertile of the PDI or uPDI consumed less fat and protein and more carbohydrates, compared to women in the lowest tertile (P < 0.05). There was no significant variation in macronutrient consumption between the highest and lowest tertiles of hPDI. Participants who scored in the highest tertile of PDI had lower low density cholesterol level (LDL) (79.61 ± 14.36 mg dL-1 vs. 83.01 ± 14.96 mg/dL-1, P = 0.021). In addition, higher adherence to uPDI was associated with higher triglyceride (TG) levels compared to participants with lower adherence (101.5 ± 56.55 mg/dL-1 vs. 97.70 ± 56.46 mg dL-1, P < 0.0001). Here was no significant association between PDI, hPDI and uPDI and CVD risk factors in regression model. Conclusion: We found no significant association between plant-based dietary indices and CVD risk factors in women, except for LDL-C and TG. Future cohort studies are needed to confirm these findings.

The association of serum levels of zinc and vitamin D with wasting among Iranian pre-school children.

PURPOSE: Wasting is a main indicator of Child's undernutrition that is associated with several non-communicable diseases and child mortality. This is the first population-based study which evaluated the association of serum zinc and vitamin D levels with wasting in a Middle East region. We also reported the prevalence of vitamin D and zinc deficiencies among Iranian pre-school children aged 6 years. METHODS: This was a multicenter cross-sectional study that included 425 children aged between 5 and 7 years (on average 6 years) with BMI-for-age Z-scores of < - 1 SD resident in urban and rural areas of Iran in the spring of 2012 as part of the National Integrated Micronutrient Survey 2 (NIMS-2). Anthropometric measurements and blood sampling were obtained. The prevalence of vitamin D and zinc deficiencies together with the correlations of these variables with the increase of BMI-for-age Z-scores were evaluated. RESULTS: The prevalence of vitamin D and zinc deficiencies was 18.8% and 12.7%, respectively. In addition, 31.1% of children were wasted. Children in the second tertile of 25(OH)D levels were less likely to have wasting compared with those in the first tertile in both crude and adjusted models (OR 0.47, 95% CI 0.27-0.83). A significant inverse association was found between serum levels of zinc and wasting (OR 0.57, 95% CI 0.34-0.96); such that after adjusting for confounders, children in the highest tertile of serum zinc had 47% less odds of wasting compared with those in the first tertile (OR 0.53, 95% CI 0.31-0.91). CONCLUSION: The prevalence of vitamin D and zinc deficiencies among Iranian pre-school children aged 6 years was 18.8 and 12.7%, respectively. Serum levels of vitamin D and zinc were inversely associated with wasting either before or after controlling for confounders. LEVEL OF EVIDENCE: Level III, case-control analytic studies.

Serum Levels of Vitamin D, Retinol and Zinc in Relation to overweight among Toddlers: Findings from a National Study in Iran.

BACKGROUND: Some studies have examined the association between micronutrient deficiencies and overweight in children, but data in this regard are conflicting. This study was done to investigate the association between serum levels of vitamin D, A and zinc with overweight in a large sample of Iranian toddlers. METHODS: A total of 4261 toddlers, aged 15-23 months, who had an Iranian birth certificate and attended primary health care, were included in the current cross-sectional study. Weight and height were measured by experts based on standard protocols and body mass index (BMI) was calculated. Based on WHO criteria, overweight was defined as BMI-z-score of ≥1SD. Serum levels of 25(OH)D3 , retinol and zinc were measured for each toddler. Binary logistic regression was applied to assess the association of 25(OH)D3 , retinol and zinc levels with overweight. RESULTS: Mean age of study participants was 19.2 ± 8.4 months. After controlling for potential confounders, children in the highest quartile of serum 25(OH)D3 levels had lower odds of overweight compared with those in the lowest quartile (OR: 0.79, 95% CI: 0.63-0.99). Furthermore, a marginally significant inverse association was found between serum levels of 25(OH)D3 and overweight among urban toddlers (OR: 0.75, 95%CI: 0.56-1.00). Such a relationship was not seen for rural children. No other significant association was seen between serum levels of retinol and zinc and overweight either before or after controlling for covariates. CONCLUSION: In conclusion, we found a significant inverse association between serum levels of vitamin D and overweight among toddlers. Further studies, particularly of prospective nature, are required to confirm our findings.

An Explanation for Variation in Age at Menopause in Developing Countries Based on the Second National Integrated Micronutrient Survey in Iran.

BACKGROUND: It is reported that women in developing countries reach menopause earlier compared to developed countries. This seems to be due to underestimation of age at menopause as pre-menopause women who will reach menopause at older ages are commonly excluded in cross-sectional settings. In this study, we propose an estimation method which can deal with this bias. We also assessed major determinants of menopause. METHODS: The second national integrated micronutrient survey in Iran completed in 2015 is a population-based study with a nationally representative sample of 4,898 Iranian women aged 50 to 60 years. We used data on menopause status and menopausal age (asked retrospectively) to estimate the median survival time. We also used Logistic regression to model menopausal status on the current age and to estimate the median age, at which 50% of women will experience menopause. Demographic, lifestyle, and anthropometric determinants were also examined. RESULTS: The estimated age at menopause was 51.2 (51.0-51.3) years in the logistic model and 50.5 (48.1, 53.7) years in survival analysis. In both models, the age at menopause was significantly lower among rural and underweight women. In addition, survival analysis showed that smokers and women with smaller family size had significantly lower age at menopause. CONCLUSION: While many studies stress a gap in age at menopause between developed and developing countries, this study with a reliable estimation method showed that such a gap might originate from an underestimation of age at menopause in developing countries rather than a real difference.

Prevalence of Sarcopenia and Its Association with Socioeconomic Status among the Elderly in Tehran.

BACKGROUND: Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It imposes significant costs on health care systems. Socioeconomic status is also the root cause of healthy challenges among the elderly. Therefore, investigating the association between sarcopenia and socioeconomic status is very important to improve healthy ageing of the elderly. The aim of this study was to investigate the prevalence of sarcopenia and its association with socioeconomic status among the elderly in Tehran. METHODS: Cross-sectional and case-control studies were conducted from August 2014-July 2015 among 310 men and 334 women elderly (60 and over years old) in Tehran health centers. Randomization, restriction and matching were setting during study design to minimize selection bias. Then study participants were recruited via phone call. Participants' phone numbers were already recorded in a telephone book electronically. When there were two elderly people in the same house, only one person was invited randomly. Association between sarcopenia and socio-economic status was analyzed by SPSS version 22. RESULTS: The overall prevalence of sarcopenia in the elderly was 16.5%. Prevalenceamong the low-income elderly was relatively higher than (20.5%) that among those with middle income status (18.2%) while in the higher income, the proportion of sarcopenia was very low (12.8%). The findings indicated that 339(52.6%) were in low-income status, 304(47.1%) were in middle-income status and 1(.2%) in high-income class. CONCLUSION: There was a significant association between socioeconomic status and sarcopenia (P-value <0.001). The odd risk of sarcopenia was 0.97 times more likely higher in low socioeconomic class than those who were in middle and high income classes.

Pre-pregnancy body size dissatisfaction and excessive gestational weight gain.

Body size dissatisfaction has been documented as a risk factor for obesity, but little is known about the effect of body size dissatisfaction on excessive gestational weight gain. The objective of the study was to determine the association of pre-pregnancy body size dissatisfaction with excessive gestational weight gain in Iranian pregnant women. This case-control study compared pre-gravid body satisfaction status in 182 women with excessive gestational weight gain and 180 women who gained weight within the guidelines of the Institute of Medicine. All the participants of the study were 35-41 weeks gestational age and received prenatal care in Shahid Akbarabadi Hospital. The women were asked to think back to their pre-pregnant state and report their body size satisfaction status measured by the Body Image Assessment for Obesity (BIA-O). According to this measurement, the women were divided into three categories: dissatisfied women with a thinner body size preference, dissatisfied women with a heavier body size preference and satisfied women. Among women with excessive gestational weight gain, 56.6% preferred a thinner body size, while 53.9% of those with adequate gestational weight gain were satisfied with their pre-gravid body sizes. After adjusting for cofounders, those with a thinner body size preference were more likely to gain weight excessively during pregnancy when compared to satisfied women (OR: 2.17, 95% CI: 1.17-4.02). Our result showed that thinner body size preference was associated with excessive gestational weight gain. Further studies are needed to investigate whether changes in women's feelings about their body sizes will decrease the proportion of women with excessive gestational weight gain.

Household food security status and associated factors among high-school students in Esfahan, Iran.

OBJECTIVE: The present study was designed to determine household food security status and factors associated with food insecurity among high-school students in Esfahan, Iran. DESIGN: Cross-sectional surveys. SETTING: The present study was conducted in autumn 2008 in Esfahan, Iran. The samples were selected using systematic cluster sampling. Socio-economic questionnaires, food security questionnaires and FFQ were filled out during face-to-face interviews. In addition, data on participants' weights and heights were collected. SUBJECTS: A total of 580 students (261 boys and 319 girls) aged 14-17 years from forty high schools in Esfahan, Iran, were selected. RESULTS: The prevalence of household food insecurity according to the US Department of Agriculture food security questionnaire was 36.6 % (95 % CI 0.33, 0.40). Food insecurity was positively associated with number of members in the household (P < 0.05) and negatively associated with parental education level and job status and household economic status (P < 0.05). Moreover, students living in food-insecure households more frequently consumed bread, macaroni, potato and egg (P < 0.05), while they less frequently consumed rice, red meat, sausage and hamburger, poultry, fish, green vegetables, root and bulb (coloured) vegetables, melons, apples and oranges, milk and yoghurt (P < 0.05). CONCLUSIONS: Food insecurity was prevalent among households in Esfahan, Iran, and food security status was associated with socio-economic factors. Students who belonged to food-secure households more frequently consumed healthy foods (except sausage and hamburger), whereas those living in food-insecure households more frequently consumed cheap foods containing high energy per kilogram. The present study suggests that intervention programmes be designed and carried out.