The predictive role of the total potassium intake and odds of breast cancer: a case-control study.

BACKGROUNDS: Dietary potassium can play an important role in decreasing inflammatory factors as a protective factor for cancers. In this case-control study, we aimed to assess the possible association between dietary potassium intake and the risk of breast cancer (BC) among Iranian adult women. METHODS: The present case-control study was conducted at Shohada and Imam Hossain hospitals, in Tehran. The study included 134 newly diagnosed cases of BC and 267 controls. A validated semi-quantitative 168-item food frequency questionnaire was used to compute the potassium intake. Logistic regression, adjusted for potential confounders, was used to estimate odds ratios(ORs) and 95% confidence intervals(CI) of BC according to tertiles of potassium intake. RESULTS: The mean(M) ± standard deviation(SD) of age and body mass index (BMI) were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m2, respectively. Also, the M ± SD of potassium intake for the control and case groups was 1616 ± 293 and 1542 ± 338 (mg/1000 Kcal), respectively. In the multivariable-adjusted model for potential confounders, the higher total potassium intake was associated with decreased odds of BC (OR: 0.35, 95%CI: 0.19-0.62, P for trend < 0.001). Moreover, an inverse relationship was observed between potassium from plant sources (OR: 0.39, 95%CI: 0.22-0.69, P for trend = 0.001) and fruit and vegetable sources (OR: 0.49, 95%CI: 0.28-0.87, P for trend = 0.016) and odds of BC. CONCLUSIONS: Our findings suggested that diet rich in potassium may have a predictive role to reduce the odds of BC.

Effects of Hesperidin Supplementation on Cardiometabolic Markers: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

CONTEXT: Hesperidin is a naturally occurring bioactive compound that may influence cardiometabolic markers, but the existing evidence is inconclusive. OBJECTIVE: This study aims to further investigate the effects of hesperidin supplementation on cardiometabolic markers in adults. DATA SOURCES: A comprehensive search was conducted up to August 2023, utilizing relevant key words in databases such as PubMed, Scopus, Embase, and the Cochrane Central Register of Controlled Trials, focusing on randomized controlled trials (RCTs). DATA EXTRACTION: RCTs that examined the impact of hesperidin on fasting blood sugar (FBS), insulin, quantitative insulin-sensitivity check index (QUICKI), homeostatic model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) were selected independently by 2 authors. The GRADE assessment was used to ascertain the certainty of the evidence. Results were pooled using a random-effects model as weighted mean differences and 95% CIs. DATA ANALYSIS: The results of this study demonstrate that hesperidin supplementation had a significant impact on reducing FBS, TG, TC, LDL-C, SBP, and TNF-α. However, there was no significant effect observed on insulin, HOMA-IR, QUICKI, HDL-C, DBP, and hs-CRP. The study's subgroup analyses also revealed that interventions lasting more than 12 weeks were effective in reducing FBS, TG, TC, and LDL-C. Moreover, hesperidin dosage exceeding 500 mg/day showed significance in reducing FBS, TC, and LDL-C levels. CONCLUSION: In conclusion, this research suggests that hesperidin can be consumed as an effective dietary approach to enhance cardiometabolic markers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42022325775.

Creatine supplementation protocols with or without training interventions on body composition: a GRADE-assessed systematic review and dose-response meta-analysis.

BACKGROUND: Despite the robust evidence demonstrating positive effects from creatine supplementation (primarily when associated with resistance training) on measures of body composition, there is a lack of a comprehensive evaluation regarding the influence of creatine protocol parameters (including dose and form) on body mass and estimates of fat-free and fat mass. METHODS: Randomized controlled trials (RCTs) evaluating the effect of creatine supplementation on body composition were included. Electronic databases, including PubMed, Web of Science, and Scopus were searched up to July 2023. Heterogeneity tests were performed. Random effect models were assessed based on the heterogeneity tests, and pooled data were examined to determine the weighted mean difference (WMD) with a 95% confidence interval (CI). RESULTS: From 4831 initial records, a total of 143 studies met the inclusion criteria. Creatine supplementation increased body mass (WMD: 0.86 kg; 95% CI: 0.76 to 0.96, I2 = 0%) and fat-free mass (WMD: 0.82 kg; 95% CI: 0.57 to 1.06, I2 = 0%) while reducing body fat percentage (WMD: -0.28 %; 95% CI: -0.47 to -0.09; I2 = 0%). Studies that incorporated a maintenance dose of creatine or performed resistance training in conjunction with supplementation had greater effects on body composition. CONCLUSION: Creatine supplementation has a small effect on body mass and estimates of fat-free mass and body fat percentage. These findings were more robust when combined with resistance training.

Assessing the predictive value of insulin resistance indices for metabolic syndrome risk in type 2 diabetes mellitus patients.

Limited research has explored the effectiveness of insulin resistance (IR) in forecasting metabolic syndrome (MetS) risk, especially within the Iranian population afflicted with type 2 diabetes mellitus (T2DM). The present investigation aimed to assess the efficacy of IR indices in predicting the risk of MetS among T2DM patients. Convenient sampling was utilized to select four hundred subjects with T2DM. Metabolic factors and IR indices, including the Waist Circumference-Triglyceride Index (WTI), Triglyceride and Glucose Index (TyG index), the product of TyG index and abdominal obesity indices, and the Metabolic Score for Insulin Resistance (METS-IR), were evaluated. Logistic regression, coupled with modeling, was employed to explore the risk of MetS. The predictive performance of the indices for MetS stratified by sex was evaluated via receiver operating characteristic (ROC) curve analysis and estimation of the area under the curve (AUC) values. The TyG-Waist Circumference (TyG-WC) index exhibited the largest AUCs in both males (0.91) and females (0.93), while the TyG-Body Mass Index (TyG-BMI) demonstrated the smallest AUCs (0.77 in males and 0.74 in females). All indices significantly predicted the risk of MetS in all subjects before and after adjustment (p < 0.001 for all). The TyG-WC index demonstrated the highest odds ratios for MetS (8.06, 95% CI 5.41-12.00). In conclusion, all IR indices assessed in this study effectively predicted the risk of MetS among Iranian patients with T2DM, with the TyG-WC index emerging as the most robust predictor across both genders.

Pro-vegetarian dietary pattern and risk of breast cancer: a case-control study.

BACKGROUND: There are a few conflicting results from studies assessing the association between plant-based diets, particularly pro-vegetarian dietary pattern (PDP), and breast cancer (BC) incidence. Therefore, this study aimed to investigate the association between PDP and BC odds in the Iranian population. METHODS: This case-control study was conducted on 134 women with BC and 265 without cancer (control). Participants were selected from two referral hospitals in Tehran, Iran. Also, a validated food frequency questionnaire was used to collect food information. Logistic regression was used to assess the association between PDP and BC and the association between PDP and BC by menopausal status. RESULTS: It was observed that in two models of logistic regression, the chance of BC was lower in the second and last tertile (T) than in the first tertile of PDP (model 1-T2: odds ratio (OR) = 0.39; 95% confidence interval (CI): 0.23-0.67; P = 0.001, and T3: OR = 0.43; 95% CI: 0.26-0.73; P = 0.002-model 2: T2: OR = 0.42; 95% CI: 0.24-0.74; P = 0.003, and T3: OR = 0.49; 95% CI: 0.27-0.88; P = 0.017). Also, according to menopausal status, the odds of developing BC in post-menopausal women in the second and last tertile of PDP was significantly lower than the first tertile in both logistic regression models. CONCLUSIONS: The findings revealed that Iranian women who followed PDP had a lower chance of developing BC. Also, we found that a diet high in plant-based foods and low in animal products is beneficial for reducing BC odds, particularly for post-menopausal women.

Dietary acid load and cirrhosis-related mortality: a prospective cohort study.

As a global health concern, cirrhosis contributes significantly to morbidity and mortality. This prospective cohort study aimed to investigate the association between dietary acid load (DAL) and cirrhosis-related mortality. Present study was conducted on 121 patients with newly diagnosed cirrhosis who were followed up for 48 months. Anthropometric measures, nutritional status and dietary intakes were assessed and DAL was estimated based on potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. Crude and multivariable-adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox proportional hazard analyses. Participants in the high PRAL and NEAP scores had significantly higher intakes of grains and lower intakes of fruits and vegetables. Also, the intake of dairy products and legumes, nuts and seeds decreased significantly with increasing NEAP score. After adjustment of all the confounders, the risk of mortality in the second and third tertiles of PRAL was 5.9 times and 10.97 higher than those in the first tertile, respectively (P trend: 0.006). Similarly, comparing the risk of mortality in the second and third tertiles with the first tertile of NEAP showed a 4.46-fold and 12.3-fold increased risk, respectively (P trend: 0.010). Our findings suggested that DAL was significantly associated with cirrhosis-related mortality and highlight the need for further research to understand the underlying mechanisms and establish optimal DAL levels in cirrhotic patients.

High-protein diet scores, macronutrient substitution, and breast cancer risk: insights from substitution analysis.

BACKGROUND: Evidence from recent studies suggested that variation in the quantity and quality of macronutrients in the diet may potentially play a role in predicting the risk of breast cancer (BC). In the current study, we aimed to assess the association of different high-protein diet scores and replacing fats and carbohydrate (CHO) with protein in the diet with the BC risk among Iranian women. METHODS: The current hospital-based case-control study was conducted on 401 participants, aged ≥ 30 years old, including 134 women in the case group who had been diagnosed with histologically confirmed BC and 267 women in the control group. Dietary intake data was collected using a validated food frequency questionnaire, and high protein diet scores were determined. Logistic regression models were used to determine the odds ratios (OR) and 95% confidence interval (CI) of BC across tertiles of high protein diet scores. Also, we assessed how substituting protein with other macronutrients affected BC odds while adjusting for the various confounding variables. RESULTS: Participants' mean ± SD of age and body mass index were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m2, respectively. The scores of high-protein-low-CHO and fat diet, high-protein and CHO-low-fat diet, and high-protein and fat-low-CHO diet in participants were 16.5 ± 3.8, 16.5 ± 6.7, and 16.4 ± 5.9, respectively. In the multivariable model, individuals in the highest tertile of high-protein-low-CHO and fat diet score (OR:0.71;95%CI:0.56-0.90) and high-protein and CHO-low-fat diet (OR:0.76;95%CI:0.60-0.97) had lower odds of BC compared to those in the lowest tertile (P < 0.05). However, no significant association was found between high-protein and fat-low-CHO diet and BC risk. Our results showed that replacing fat by protein (ORdifferences:-0.40;95%CI:-0.73,-0.07) and also replacing refined-CHO by plant protein (ORdifferences:-0.66;95%CI:-1.26,-0.07) in the diet are associated inversely with risk of BC(P < 0.05). CONCLUSIONS: The results of our study suggested that higher adherence to a high-protein-low-CHO and fat diet, characterized by a higher intake of plant proteins and a lower intake of refined grains and saturated fat can play a protective role against the odds of BC.

Dietary Diabetes Risk Reduction Score (DDRRS) and Breast Cancer Risk: A Case-Control Study in Iran.

INTRODUCTION: Given the role of type 2 diabetes and insulin resistance in tumor initiation, we hypothesized that following a diet that reduces the risk of type 2 diabetes could also reduce the risk of breast cancer. Herein, we conducted a case-control study to investigate the association between dietary diabetes risk reduction score and breast cancer risk in Iranian women. METHOD: We recruited 136 newly diagnosed cases and 272 age-matched hospitalized controls from referral hospitals. A valid and reliable 168-item food frequency questionnaire (FFQ) was used to collect the data on dietary intake. We used Multivariate Logistic regression to assess the odds ratio (OR) with 95% confidence interval (CI) of breast cancer by the dietary diabetes risk reduction score tertiles. RESULTS: After adjusting for confounding variables, no association was seen between dietary diabetes risk reduction score and breast cancer risk (OR = 0.65, 95% CI: 0.37-1.14). However, after stratification by menopausal status, a decreased risk was observed between adherence to dietary diabetes risk reduction score and breast cancer risk in postmenopausal individuals (OR = 0.43, 95% CI: 0.19-0.99). CONCLUSION: The present study states that there is no significant relationship between the dietary diabetes risk reduction score and the risk of breast cancer. However, adherence to dietary diabetes risk reduction score could have a preventive role for breast cancer among postmenopausal women.

Dietary advanced glycation end products are associated with an increased risk of breast cancer in Iranian adults.

BACKGROUND: Dietary advanced glycation end products (AGEs) can play an important role in increasing inflammatory factors and oxidative stress as risk factors for cancers. In the present study, we aimed to assess the relationship between dietary AGEs and the risk of breast cancer (BC) in Iranian adult women. METHODS: This hospital-based case-control study includes 401 participants aged ≥ 30 years old. The cases group consisted of 134 women diagnosed with histologically confirmed BC. The control group included 267 women enrolled randomly from patients admitted to the same hospitals. Dietary intake information was determined using a validated food frequency questionnaire, and dietary AGEs intake was computed for all participants. Logistic regression models, adjusted for potential confounders, were used to determine the odds ratios (OR) and 95% confidence interval (CI) of BC across tertiles of dietary AGEs. RESULTS: The mean ± SD age and body mass index of the study population were 47.92 ± 10.33 years and 29.43 ± 5.51 kg/m2, respectively. The median (interquartile) of dietary AGEs in all individuals was 9251(7450, 11,818) kU/day. After adjusting for age, first pregnancy age, and energy intake, participants in the highest tertile of dietary AGEs intakes had higher odds of BC compared to those in the lowest tertile of dietary AGEs (OR:2.29;95%CI:1.19-4.39, Ptrend:0.012). Additionally, in the multivariable model, after adjusting for age, age at first pregnancy, energy, menopausal status, family history of cancer, anti-inflammatory drug use, Vitamin D supplementation, physical activity, body mass index, number of childbirths, and history of abortion, breastfeeding, and oral contraceptive pills use, the odds of BC were increased across tertiles of dietary AGEs intake (OR: 2.33; 95%CI: 1.18-4.60, Ptrend: 0.017). CONCLUSION: The present findings suggest that a diet with high AGEs is associated with a higher likelihood of BC in adult women.

Dietary quality index and the risk of breast cancer: a case-control study.

BACKGROUND: Diet quality is a significant determinant in the etiology of breast cancer (BrCa), but further studies are required to explore this relationship. Therefore, we tried to assess if diet quality, assessed using the Diet Quality Index-International (DQI-I), was related to BrCa among the Iranian population. METHODS: In the present case-control research, 134 women with a recent diagnosis of BrCa and 267 without BrCa were selected as case and control groups. Individual food intake data from a food frequency questionnaire was used to compute DQI-I. Also, the multivariable logistic regression models were utilized to evaluate the association between DQI-I and BrCa odds . RESULTS: We found a significant association between the last tertile of DQI-I and BrCa odds in the fully adjusted model (odds ratio (OR) = 0.30; 95% confidence interval (CI): 0.15-0.56). The subgroup analysis based on menopausal status also showed a significant decrease in BrCa odds in pre-and post-menopausal women (pre-menopausal: OR = 0.27; 95% CI: 0.10-0.70 - post-menopausal status: OR = 0.35; 95% CI: 0.13-0.92). CONCLUSIONS: Our findings indicated that a higher DQI-I score was related to a lower chance of BrCa. According to our research, a healthy diet pattern is crucial for BrCa prevention.

Diet-dependent acid load and the risk of breast cancer: A case-control study.

BACKGROUND & AIMS: Dietary acid load causes metabolic acidosis, which leads to inflammation and cell change, both of which are related to cancer development. Even though a high acid load has been associated with an increased risk of breast cancer (BC), epidemiologic evidence correlating diet-dependent acid load and cancer risk, particularly for BC, is still lacking. As a result, we intend to investigate its potential role. METHODS: The potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were calculated in this case-control study using the dietary intake of individuals as determined by a verified FFQ. Logistic regression was used to calculate odds ratios (ORs), which were adjusted for probable confounders. RESULTS: Using multivariate logistic regression models, the odds ratios (OR) of BC according to quartiles of PRAL and NEAP scores revealed that neither PRAL (P-trend = 0.53) nor NEAP (P-trend = 0.19) scores were significantly associated with BC risk. Multiple logistic regressions remained non-significant after controlling for covariates, indicating no significant relationships between PRAL (P-trend = 0.96) and NEAP (trend = 0.45) scores and the odds of BC. CONCLUSION: According to the findings of our study, there is no relation between DAL and the risk of BC in Iranian women.

Relationships between spiritual health and perceived stress with breastfeeding adequacy in mothers with infants aged 1-6 months.

BACKGROUND: Previous studies have shown that psycho-spiritual state of mothers may have significant effects on their breastfeeding. The most common cause of nonexclusive breastfeeding is inadequate breastfeeding; therefore, this study examined the relationship between spiritual health and perceived stress with breastfeeding adequacy in mothers with infants aged 1-6 months. MATERIALS AND METHODS: This cross-sectional, descriptive, correlational study was performed on 186 mothers with infants aged 1-6 months, who referred to the health centers in Dorud city of Lorestan province, Iran, in 2021, which were selected based on cluster sampling. Data were collected through four questionnaires including demographic-fertility, spiritual health, perceived stress, and breastfeeding adequacy. Data was analyzed by Statistical Package for the Social Sciences (SPSS) software version 22 using descriptive and analytical statistics. RESULTS: The mean ± standard deviation (SD) values of spiritual health, perceived stress, and breastfeeding adequacy were 99.59 ± 12.96, 23.8 ± 72.19, and 55.67 ± 7.67, respectively. There was a significant positive relationship between spiritual health and breastfeeding adequacy (P < 0.001, r = 0.268). In addition, there was a significant negative relationship between perceived stress and breastfeeding adequacy (P = 0.002, r = -0.231). CONCLUSION: Breastfeeding adequacy has a significant positive relationship with spiritual health and a significant negative relationship with perceived stress. Since infants are one of the most vulnerable groups and breastfeeding is the best way to support their health and reduce infant mortality rates, breastfeeding adequacy can be improved by reducing stress and promoting spiritual health.

Nursing students and faculty perception of academic incivility: A descriptive qualitative study.

BACKGROUND: Incivility is one of the significant challenges that affect nursing education. Uncivil behaviors have a significant upward trend compared to the past in nursing education. This study was conducted to explore academic incivility from the perspective of nursing students and faculty. MATERIALS AND METHODS: This study was conducted in 2021 using a descriptive qualitative method. Fifteen baccalaureate nursing students and six faculty were selected using purposeful sampling method. Data was collected through in-depth semi-structured interviews, and a qualitative content analysis was applied for data analysis. RESULTS: Data analysis revealed four categories, namely, ineffective teaching-learning, inapposite/unreasonable requests, behaviors disrupting mutually respectful environment, and academic dishonesty, and 14 subcategories. CONCLUSION: To reduce incivility, closer attention needs to be paid to the admission of faculty as well as training them to use effective communication techniques and interactive teaching methods. In addition, nursing students must be provided with the training about uncivil behaviors. Furthermore, clear and precise rules and regulations concerning incivility incidence should be developed and implemented in the universities.

The relationship between women's breastfeeding empowerment and conformity to feminine norms.

BACKGROUND: Women empowerment is effective in successful breastfeeding. Hence,identifying the relationship between psychosocial factors, such as acceptance of feminine norms, and empowerment can be beneficial in designing interventions.. Therefore, this study aimed to determine the relationship between breastfeeding empowerment and conformity to feminine norms. METHODS: This cross-sectional study was conducted on 288 primiparous mothers in the postpartum period using validated questionnaires of conformity to gender norms and breastfeeding empowerment in the following domains: "sufficient knowledge and skills for breastfeeding," "a sense of breastfeeding competence," "conscious belief in the value of breastfeeding," "overcoming breastfeeding problems," "negotiation and obtaining family support" and "self-efficacy in breastfeeding" which were completed through the self-report method. Data were analyzed using the multivariate linear regression test. RESULTS: The mean score of 'conformity to feminine norms' and 'breastfeeding empowerment' were 142.39 and 144.14, respectively. The score of breastfeeding empowerment was positively related to conformity to feminine norms (p = 0.003). Among the dimensions of breastfeeding empowerment, 'mothers' adequate knowledge and skills for breastfeeding' (p = 0.001), 'belief in the value of breastfeeding' (p = 0.008), and 'negotiation and obtaining family support' (p = 0.01) were positively related to conformity to feminine norms. CONCLUSIONS: The results indicate a positive relationship between the level of conformity to feminine norms and breastfeeding empowerment. Accordingly, it is recommended that supporting breastfeeding as a valuable role of women be considered in programs designed to improve breastfeeding empowerment.

The relationship between sexual self-concept and contraception sexual behavior in 15 to 49 years old women covered by community health centers.

BACKGROUND: One of the most important goals of sexual intercourse is to arouse the psychological effects of intercourse and to increase sexual self-concept, which changes following sexual behaviors such as the use of contraception methods. This study was performed to investigate the relationship between sexual self-concept and contraception sexual behavior in 15-49-year-old women covered by community health centers. MATERIALS AND METHODS: The present descriptive correlational study was performed on 297 married women referring to Isfahan community health centers in 2020 who were selected as cluster that randomly classified. The tools included demographic information and the Snell's Multidimensional Sexual Self-Concept Questionnaire, the data of which were analyzed via SPSS version 22 software by Mann-Whitney U test and Pearson correlation. RESULTS: Among a total of 297 women, 5.4% of the samples used hormonal methods and 94.6% used non-hormonal methods, which was the most common intermittent method. The results also showed that the mean score of negative sexual self-concept in women using the hormonal level method was significantly higher (P = 0.012). Positive and positive sexual self-concept score was significantly higher in women using non-hormonal methods (P = 0.048 and P = 0.002). Therefore, there was a significant relationship between sexual self-concept and contraception method. CONCLUSION: Due to the relationship between contraception and sexual self-concept, it is recommended to pay attention to the aspects of sexual self-concept and contraception during reproductive health counselling sessions so that if there is a disorder, useful advice can be provided or referred, if necessary.

Dietary Total Antioxidant Capacity and Odds of Breast Cancer: A Case-Control Study.

Breast cancer (BC) is the most frequently diagnosed female cancer worldwide. It has been shown that oxidative stress can contribute to cancer development. Therefore, we investigated the association between dietary total antioxidant capacity (TAC) and breast cancer risk in a case-control study. This study was conducted on 136 newly diagnosed breast cancer patients and 272 hospitalized controls in Tehran, Iran. Participant habitual diet was obtained using a 168-item validated food frequency questionnaire. Dietary TAC scores were computed using two different methods: the dietary ferric reducing antioxidant potential (FRAP) method and oxygen radical scavenging capacity (ORAC). The association between dietary TAC and breast cancer risk was estimated by logistic regression. The score of DTAC calculated by ORAC method was associated with lower odds of BC, especially among premenopausal women. However, this association was not significant after controlling potential confounders (ORAC: OR Q4-Q1 = 1.01, 95% CI = 0.42-2.44, p-trend = 0.96). Estimation of DTAC by FRAP method was not associated with the risk of BC (FRAP: OR Q4-Q1 = 1.04, 95% CI = 0.53-2.05, p-trend = 0.8). There were no association detected based on menopausal status. In this study, dietary TAC was not significantly related to the odds of breast cancer.

A reproductive health-care program for surrogate mothers: A mixed methods study.

BACKGROUND: Surrogacy has become an alternative family formation option for women who are unable to carry a pregnancy. There is no comprehensive care program despite the different nature of this pregnancy. The present study aimed to develop a reproductive health-care program for surrogate mothers within the cultural and social context of Iran. MATERIALS AND METHODS: In the present sequential exploratory mixed methods study, first through a qualitative approach surrogate mothers, care providers, and policy makers of reproductive health services were selected purposefully. Data were collected by using the in-depth semi-structured interviews and analyzed. A care program draft was designed by integrating results of the qualitative study and reviewing the literature and guidelines, then appropriateness of each proposed care was assessed by a two-Rounds Delphi technique (RAM), and the final reproductive health-care program for surrogate mothers was developed. RESULTS: The surrogate mothers' reproductive health needs were summarized in four main categories: surrogate mothers' extra care, educational training, psychological support, and protecting against surrogacy's social and familial consequences. The reproductive health-care program for surrogate mothers were developed in four sections: prepregnancy health screenings and legal counseling; special care during embryo transfer until pregnancy confirmation; psychological support and prenatal care of surrogacy until delivery and follow-up postpartum care. CONCLUSION: Women face many challenges in surrogacy and need special care such as legal counseling, reproductive health care, and psychological support. Implementation of this care program seems to help improve the reproductive health of these mothers.

The relationship between Mediterranean-DASH diet intervention for the neurodegenerative delay (MIND) Diet and risk of breast Cancer: a case-control study among iranian adult women.

BACKGROUND: choosing a healthier lifestyle and modifying dietary habits could prevent four million new people from developing cancer. Recently, a new index called the Mediterranean-dietary approach to stop hypertension (DASH) diet intervention for the neurodegenerative delay (MIND) diet has been developed. In the current study, we aimed to assess the relationship between the MIND diet and the risk of breast cancer (BC) among Tehranian adult women. METHOD: In this hospital-based, case-control study, 134 Tehranian women ≥ 30 years old with recently (< 6 months) diagnosed BC, confirmed histologically and 272 women of the same age as control were included. Dietary intakes were assessed in a personal interview using a valid and reliable semi-quantitative 168-item food frequency questionnaire. The odds ratio (OR) and 95% confidence intervals (CI) of breast cancer across tertiles of the MIND diet were determined using multivariable-adjusted logistic regression analysis. RESULTS: In the crude model, participants in the highest tertiles had lower odds of BC [(OR = 0.57; 95% CI,0.34-0.95), P for trend = 0.020)] than those with the lowest scores on the MIND diet. After controlling for potential confounding variables, individuals in the highest tertile of the MIND diet had a 45% lower risk of BC [(OR = 0.55; 95% CI, 0.32-0.96), P for trend = 0.021)] compared with those in the lowest tertile. Also, in women with an abortion history, higher adherence to the MIND diet was associated with a lower risk of BC [(OR = 0.15; 95% CI, 0.04-0.52, P for trend = 0.002)]. CONCLUSION: Our findings revealed that higher adherence to the MIND diet was associated with decreased BC risk, which was strongly observed among women with a history of abortion.

Dietary Intake of Polyphenols and the Risk of Breast Cancer: a Case-Control Study.

Despite mounting evidence that dietary polyphenols might have a protective role against the risk of breast cancer (BC), few studies have assessed the relationship between intake of polyphenol classes and subclasses with BC. Thus, we examined the relationship between dietary polyphenol classes and individual polyphenol subclasses and the risk of BC. Overall, 134 newly diagnosed BC patients and 267 healthy hospitalized controls were studied. Dietary intake was assessed using a validated 168-item food frequency questionnaire (FFQ). To estimate dietary intake of polyphenols, polyphenol content (flavonoids, lignans, stilbenes and phenolic acids) of 80 food items were derived from an updated version of the phenol explorer database containing information on the effects of food processing on polyphenol content. The dietary polyphenol intake was calculated by matching the subjects' food consumption data with our polyphenol content database. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Controls had higher intake of total polyphenol (marginally significant; p = 0.07), hydroxycinnamic acid (marginally significant; p = 0.05) and lignan (p = 0.01). After adjusting for potential confounders, high consumption of lignans (highest vs. lowest tertile: OR, 0.51; 95% CI, 0.26-0.97; p for trend = 0.04) associated with decreased risk of BC. There was no significant relationship between intake of other polyphenols and risk of BC. Our findings suggest that high lignan intake is associated with a reduced risk of BC.