Association of vitamin D, retinol and zinc deficiencies with stunting in toddlers: findings from a national study in Iran.

OBJECTIVE: The objective of this study was to investigate the association of serum levels of 25(OH)D3 (vitamin D), retinol (vitamin A) and zinc with stunting in a large sample of Iranian toddlers. STUDY DESIGN: This was a cross-sectional study. METHODS: A total of 4261 children, aged 10-36 months, who had Iranian birth certificates were included in the present study. Weight and height were measured by experienced professionals in accordance with standard protocols. Stunting was defined as a height-for-age z-score of <-1 standard deviation (SD) based on the World Health Organization (WHO) criteria (the WHO Child Growth Standards median). Serum levels of 25(OH)D3, retinol and zinc were examined based on standard methods. RESULTS: The mean age of the study participants was 19.2 ± 8.4 months. A significant inverse association was found between serum retinol concentrations and the odds of stunting such that after controlling for potential confounders, toddlers in the highest quartile of serum retinol levels had 29% lower odds of stunting than those in the lowest quartile (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.53-0.97). Furthermore, a significant inverse association was found between serum levels of retinol and stunting in girls (OR: 0.57, 95% CI: 0.34-0.94), urban toddlers (OR: 0.66, 95% CI: 0.44-0.99) and those who did not use nutritional supplements (OR: 0.70, 95% CI: 0.52-0.95). Although serum 25(OH)D3 levels were not significantly associated with stunting in the overall study population, we found a positive association among toddlers who used nutritional supplements. No significant association was found between serum levels of zinc and stunting. CONCLUSION: We found a significant inverse association between serum levels of retinol and stunting in toddlers aged 10-36 months.

Unhealthy dietary patterns are related to low ceruloplasmin in female nurses.

BACKGROUND AND OBJECTIVE: Few studies have examined the relationship between dietary patterns and antioxidant status. We aimed to explore the association between major dietary patterns and oxidative stress biomarkers including serum protein carbonyl (PC), ceruloplasmin and total antioxidant capacity (TAC). METHOD: In this cross-sectional study, we randomly selected 320 female nurses aged 20-45 years. General information of participants was collected by trained interviewers. Their weight and height were measured and dietary intakes were determined by the 147-food-item semiquantitative food frequency questionnaire. Dietary patterns were derived by principal component analysis of yielding 25 food groups. In this study, 90 subjects were randomly selected from all participants with serum levels of PC, ceruloplasmin and TAC measured further. To determine the association between dietary patterns' score and oxidative stress biomarkers, multiple linear regression analysis was conducted. RESULTS: Three dietary patterns were derived: healthy, unhealthy and traditional. After adjusting for several confounding factors, the unhealthy dietary pattern was inversely related to the serum concentration of ceruloplasmin and PC (p<0.05). The relationship between other dietary patterns and antioxidant biomarkers was not significant. CONCLUSIONS: According to the results of this study, unhealthy dietary patterns may have an adverse effect on serum ceruloplasmin.

Dietary patterns in relation to inflammation in shift workers.

INTRODUCTION: Rotational shift work has a considerable effect on immune function and cause inflammation. In addition, it may lead to unhealthy dietary intake. No earlier study has examined the association between dietary patterns and inflammation in rotational shift workers. Therefore, this study was conducted to investigate the association between dietary patterns and circulating proinflammatory cytokines among shift workers. METHODS: This cross-sectional study was conducted among 257 male shift workers. Dietary intake of participants was examined using the semiquantitative Food Frequency Questionnaire. Serum concentrations of interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and high sensitivity C-reactive protein (hs-CRP) were measured using suitable commercial kits. RESULTS: Three main dietary patterns included green vegetables, yellow vegetables and cruciferous vegetables (VEG), liquid oils and mayonnaise, fast food and eggs (LFE), as well as tea and coffee, refined grains and spice (TRS). Subjects with the highest adherence to VEG dietary pattern had a significantly lower concentration of IL-6 (p<0.01) and TNF-α (p<0.001) as compared with those with the lowest adherence. On the other hand, a significant negative association was found between LFE dietary pattern and serum concentrations of IL-6 (p=0.01) and TNF-α (p=0.02). However, no significant association was found between adherence to VEG (p=0.34) or LFE (p=0.99) dietary patterns and levels of hs-CRP and between adherence to TRS dietary pattern and any of the inflammatory cytokines. CONCLUSION: Adherence to VEG and LFE dietary patterns was inversely and directly associated to serum IL-6 and TNF-α concentrations in shift workers, respectively. However, no significant association was found between adherence to these two dietary patterns and serum hs-CRP concentrations and between TRS dietary pattern and any of the inflammatory cytokines.

Higher intake of dietary n-3 PUFA and lower MUFA are associated with fewer menopausal symptoms.

OBJECTIVE: This study aimed to investigate the association between dietary fat quality and menopausal symptoms. METHODS: We carried out a cross-sectional study with 393 Iranian postmenopausal women. Dietary intakes and menopausal symptoms were assessed, using a validated food frequency questionnaire and a menopausal rating scale (MRS) questionnaire, respectively. Participants were divided into low and high total MRS and its domain scores. RESULTS: Women in the highest quartiles of monounsaturated fatty acids (MUFA) had higher somatic symptoms compared with women in the lowest quartile (odds ratio [OR] 3.41; 95% confidence interval [CI] 1.17-9.95). Women in the highest quartiles of n-3 polyunsaturated fatty acids (PUFA) (OR 0.58; 95% CI 0.32-1.05), eicosapentaenoic acid (EPA) (OR 0.66; 95% CI 0.37-1.20), and n-3:n-6 PUFA ratio (OR 0.49; 95% CI 0.25-0.97) had lower somatic symptoms compared to the lowest quartiles. The OR for psychological symptoms decreased from the lowest to the highest quartiles of n-3 PUFA (OR 0.47; 95% CI 0.20-1.11) and n-3:n-6 PUFA ratio (OR 0.46; 95% CI 0.24-0.86). Higher intakes of EPA (OR 0.53; 95% CI 0.29-0.99) and docosahexaenoic acid (OR 0.51; 95% CI 0.27-0.95) were found to be related with fewer urogenital symptoms. CONCLUSION: Consuming diets low in MUFA intake, but high in n-3 PUFA, and with a more favorable ratio of n-3:n-6 PUFA may be helpful for improving menopausal symptoms.

Rice Bran Oil Decreases Total and LDL Cholesterol in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.

Cardiovascular disease (CVD) has become a concerning health problem because of its increasing prevalence. Vegetable oils such as rice bran oil may improve blood lipids, risk factors for CVD. We performed a systematic review and meta-analysis to identify and quantify the effects of rice bran oil on lipid profiles in humans. Literature databases (Pubmed, Scopus, Science Direct, Proquest, Ovid, and Google Scholar) were systematically searched until the end of November 2015, with no restrictions regarding study design, time, or language. The variables extracted for the meta-analysis included low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triacylglycerol (TAG), VLDL-C, apoA, apoB, Lp(a), TC/HDL-C, and LDL-C/HDL-C. From 415 identified articles, 11 randomized controlled trials met the eligibility criteria and were included in our review. Rice bran oil consumption resulted in a significant decrease in concentrations of LDL-C (-6.91 mg/dl, 95% CI, -10.24 to -3.57; p<0.001) and TC (-12.65 mg/dl; 95% CI, -18.04 to -7.27; p<0.001). The increase in HDL-C levels were considerable only in men (6.65 mg/dl; 95% CI, 2.38-10.92; p=0.002). Results of our meta-analysis provided no evidence of a significant effekt of rice bran oil on other lipid profile components. In conclusion, consumption of rice bran oil can reduce LDL-C and TC concentrations, which may lead to prevention and control of CVD. It also has favorable effects on HDL-C concentrations in men. However, changes related to other lipid profile components are not considerable.

Effect of breastfeeding on cognitive performance in a British birth cohort.

This cohort study investigated the effect of early life nutrition on later performance in developmental milestones and cognitive tests. Structural equation modelling was carried out on follow-up data from a national birth cohort of 5362 children born in 1 week of 1946 in Britain. Children who were breastfed longer showed earlier developmental milestones. After adjusting for sex, social group and milestones, those children scored higher in verbal tests. Path analysis showed that breastfeeding may have an effect even into adult life. The chain of path coefficients from breastfeeding to developmental milestones at early ages, to cognitive scores at ages 8-15 years, to reading tests at age 26 years and to memory and visual tests at age 43 years were significant in females but not in males.

The effects of vitamins e and d supplementation on erythrocyte superoxide dismutase and catalase in atopic dermatitis.

BACKGROUND: Atopic dermatitis is a public health problem worldwide. Increment of reactive oxygen species (ROS) production may be one of the contributing factors of tissue damage in atopic dermatitis. The present study was designed to determine the effect of vitamins E and/or D on erythrocyte superoxide dismutase and catalase activities in patients with atopic dermatitis. METHODS: In a randomized, double blind, placebo controlled clinical trial 45 atopic dermatitis patients were divided into four groups. Each group received one of the following supplements for 60 days: group A (n=11) vitamins E and D placebos; group B (n= 12) 1600 international unit (IU) vitamin D3 plus vitamin E placebo; group C (n=11) 600 IU synthetic all-rac-α tocopherol plus vitamin D placebo; group D (n=11) 1600 IU vitamin D3 plus 600 IU synthetic all-rac-α tocopherol. Erythrocyte superoxide dismutase (SOD) and catalase activities, serum 25 (OH) D, plasma α-tocopherol were determined. The data were analyzed by analysis of variance (ANOVA) and paired t-test. RESULTS: After 60 days vitamin D and E supplementation, erythrocyte SOD activities increased in groups B, C and D (P= 0.002, P= 0.016 and P= 0.015, respectively). Erythrocyte catalase activities increased in groups B and D (P= 0.026 and P= 0.004, respectively). The increment of erythrocyte catalase activity was not significant in group C. There was a positive significant correlation between SOD activity and serum 25 (OH) D (r= 0.378, P= 0.01). CONCLUSIONS: It is concluded that vitamin D is as potent as vitamin E in increasing the activities of erythrocyte SOD and catalase in atopic dermatitis patients.

Effect of breastfeeding on cognitive performance in a British birth cohort

This cohort study investigated the effect of early life nutrition on later performance in developmental milestones and cognitive tests. Structural equation modelling was carried out on follow-up data from a national birth cohort of 5362 children born in 1 week of 1946 in Britain. Children who were breastfed longer showed earlier developmental milestones. After adjusting for sex, social group and milestones, those children scored higher in verbal tests. Path analysis showed that breastfeeding may have an effect even into adult life. The chain of path coefficients from breastfeeding to developmental milestones at early ages, to cognitive scores at ages 8-15 years, to reading tests at age 26 years and to memory and visual tests at age 43 years were significant in females but not in males

Association of glomerular and tubular dysfunction with glycaemic control, lipid, lipoprotein, apolipoprotein and antioxidant status in type 2 diabetes mellitus.

INTRODUCTION: This study was conducted to investigate the relationship of glomerular and tubular dysfunctions with glycaemic control, lipid, lipoprotein, apolipoproteins and antioxidant status in 72 patients with type 2 diabetes mellitus. METHODS: Urine albumin concentration was measured by immunoturbidimetric and urine N-acetyl-beta-D-glucosaminidase (NAG) and alanine aminopeptidase (AAP) activities with colorimetric methods. Glycated haemoglobin was measured using affinity chromatography. Erythrocyte glutathione reductase and glutathione peroxidase activities and serum levels of malondialdehyde, lipids, lipoproteins and apolipoproteins were determined in patients with type 2 diabetes mellitus. RESULTS: In univariate regression, urinary albumin excretion, and activities of NAG and AAP were associated with glycaemic control. These glycaemic factors included serum glucose concentrations and glycated haemoglobin. Urinary albumin excretion was also inversely correlated with erythrocyte glutathione peroxidase activity, and positively correlated with erythrocyte glutathione reductase activity. No significant associations were found with serum levels of insulin, lipids, lipoproteins, apolipoproteins, malondialdehyde or blood pressure. In multivariate regression, glycated haemoglobin was the most significant predictor of urinary albumin concentration and with erythrocyte glutathione reductase, whereas only glycated haemoglobin was the independent predictor of tubular dysfunctions. Erythrocyte glutathione peroxidase was not an independent predictor of urinary albumin excretion, after adjusting for glycated haemoglobin, glutathione reductase, systolic blood pressure, diastolic blood pressure and apolipoprotein B. CONCLUSION: In type 2 diabetes mellitus, both glomerular and tubular dysfunctions are dependent on glycaemic control. Glomerular, but not tubular, dysfunction is also significantly associated with increased glutathione reductase activity.

Serum antibodies to the major proteins found in cow's milk of Iranian patients with Type 1 diabetes mellitus.

The purpose of this study was to assess the humoral immune response to cow's milk proteins in Iranian children with Type 1 diabetes mellitus (T1DM). Eighty children aged 4-17 yr with T1DM from two centres in Iran (the Iranian Association of Diabetes in Tehran and Center for Diabetes Research in Hamedan), 37 apparently healthy siblings of diabetic patients (related controls), 82 apparently healthy age- and sex- matched controls (unrelated controls), and 32 patients aged 11-15 yr with auto-immune thyroiditis were examined for specific whole antibodies (Igs), IgG, and IgM to the major proteins found in cow's milk or to ovo-albumin by enzyme-linked immunosorbent assay (ELISA). A crude extract was made from 2.5% fat pasteurized cow's milk. This extract, together with individual commercial major proteins of cow's milk, was then used as antigen to evaluate the humoral immune response of the subjects to the individual proteins found in cow's milk or to cow's milk as a whole. A questionnaire on medical history, duration of exclusive and non-exclusive breast-feeding and daily intake of dairy products was completed before blood sampling. Diabetic children had significantly higher serum levels of Igs, IgG and IgM to the proteins found in cow's milk than unrelated healthy controls (p<0.001). Healthy siblings of diabetic patients, compared to unrelated controls, had significantly higher levels of serum Igs and IgG to cow's milk proteins (p<0.05 and p<0.01, respectively). Serum levels of Igs and IgG to the cow's milk proteins showed a significantly negative correlation with duration of non-exclusive breast-feeding but positive correlation with daily intake of dairy products. These correlations were stronger when calculated just within the T1DM group. In this group, serum levels of IgM to cow's milk proteins also showed a positive correlation with daily intake of dairy products. Though serum levels of IgG to casein were insignificantly higher in diabetic children than in healthy controls, there was a significant negative correlation between serum levels of IgG to casein and duration of non-exclusive breast-feeding. Again in the T1DM group, this correlation was stronger. There was no significant difference in serum levels of Igs, IgG or IgM to other major proteins of cow's milk or to ovo-albumin between groups. It was concluded that though high levels of Igs or IgG were found to cow's milk proteins, especially casein, it seems unrelated to the early introduction of cow's milk into an infant diet and the onset of T1DM in Iranian subjects.

Glycemic optimization may reduce lipid peroxidation independent of weight and blood lipid changes in Type 2 diabetes mellitus.

The aim of this study was to determine the effect of diet-therapy on lipid peroxidation in patients with Type 2 diabetes mellitus (T2DM). Fifteen T2DM patients of both sexes, aged between 35-70 years, were given the diet suggested for patients with diabetes by the American Diabetic Association. This diet comprised 50-60% carbohydrate, 10-15% protein, 20-30% fat and about 35 g fiber was given for weight maintenance. Weight and body mass index did not change significantly during 8 weeks of study. Also, no statistically significant difference was observed in serum total cholesterol, triglycerides, LDL- and HDL-cholesterol from before to after dietary intervention. However, the levels of fasting blood sugar, HbA1c and malondialdehyde were lowered significantly after dietary intervention. It was concluded that glycemic optimization, independent of weight and blood lipid profile, through a well-designed diet is likely to be the most effective factor in reducing the process of oxidative stress in T2DM. This may have preventive implications for such diabetic complications as atherosclerosis.

Obesity in Iranian children.

We surveyed 4315 2-5 year olds in Iran. Prevalence of obesity (BMI >95th centile, Iranian reference data) was compared with the recent "IOTF" approach. Prevalence was significantly higher than expected, and increased with age, but contradictory trends were obtained from the two approaches. Monitoring of childhood obesity using the BMI in developing countries is indicated, but differences associated with obesity definition should be considered.

Nutrient intake and esophageal cancer in the Caspian littoral of Iran: a case-control study.

The purpose of this study was to investigate the possible contribution of different dietary nutrients in the development of esophageal cancer (EC) in the Caspian littoral of Iran. Forty-one cases and 145 members of their households were matched for age and gender with 40 non-blood-relative controls and 130 members of their households for their nutrient intake. A standard 24-hour dietary recall questionnaire was used to estimate the daily intake of energy, protein, P, Fe, Na, K, vitamins C and A, thiamin, riboflavin, and niacin. Dietary nutrient deficiency was defined as less than 75% of the World Health Organization human nutritional requirements, except for P, Na, and K, for which the United States Recommended Dietary Allowances were followed. The results indicate the following: (1) The mean daily intake of all nutrients, except for riboflavin, was significantly lower in cases than in control subjects (P < .05); (2) with the exception of protein, riboflavin, and phosphorus, significant correlation was observed between the pattern of nutrient intake and health status of the study subjects (P < .05); and (3) dietary deficiency of niacin and phosphorus was associated significantly with the risk of EC development among case and control households (P < .01-.001), indicating that persons living in case households with dietary deficiencies of these nutrients have more than twice the risk of developing EC tumors than those living in control households. In conclusion, apparently some nutrients, such as P and niacin, may play a role in the etiology of esophageal cancer, and the status of these nutrients may be used eventually as an epidemiologic predictive marker for EC in the Caspian littoral of Iran and perhaps other regions.

Plasma tryptophan levels and brain serotonin metabolism in chronically uremic rats.

Plasma tryptophan (Trp) levels and brain concentrations of Trp, serotonin, and 5-hydroxyindoleacetic acid (5-HIAA) were measured in chronically uremic rats fed either 11% or 18% casein diets for 8 to 12 weeks. Uremic rats had increased levels of plasma urea nitrogen and 5-HIAA when compared with sham-operated pair-fed controls. The level of plasma total Trp decreased in both uremic groups and the level of plasma free Trp increased only in those fed an 11% casein diet. Uremic rats fed 11% casein had a higher level of plasma free Trp than those fed 18% casein. The ratio of plasma total Trp to the sum of five amino acids competing for the blood-brain transport system was decreased in both uremic groups, and the ratio of plasma free Trp to the same amino acids was increased only in uremic rats fed 11% casein. The concentration of brain 5-HIAA increased in uremic rats fed 11% casein, and that of Trp and serotonin decreased in uremic rats fed 18% casein. These results indicate that uremic stress and changes in protein intake in chronic uremia alter plasma Trp levels and brain serotonin metabolism.

Brain serotonin turnover in chronically uremic rats.

Brain serotonin turnover was investigated in chronically uremic and sham-operated pair-fed control rats. Animals were injected ip with 100 mg/kg body wt of pargyline HCl, a nonreversible monoamine oxidase inhibitor, and decapitated 0, 30 and 60 min later. The level of total tryptophan in plasma was decreased, and that of free tryptophan was increased in the uremic group. Uremic and control rats had similar concentrations of tryptophan and serotonin at 0 and 30 min after pargyline administration. However, the brain serotonin concentration was elevated in the uremic group 60 min after pargyline treatment. The brain serotonin turnover rate was higher and serotonin turnover time was lower in the uremic group. These results indicate that uremic stress, in addition to altering plasma tryptophan levels, also affects brain serotonin turnover.

Amino acid metabolism in the chronically uremic rat.

The chronically uremic rat has been used as a model to study amino acid metabolism in uremia. Uremic rats fed low protein diets (6% casein) survived longer than uremic rats receiving either higher levels of dietary protein or a low protein diet supplemented with a mixture of nonessential amino acids. Alterations in plasma amino acid levels were observed in the uremic rats and were similar to those found in patients with renal failure. Plasma concentrations of citrulline, free tryptophan, glycine and the methylhistidines were increased and levels of serine, ornithine, lysine, total tryptophan, tyrosine, and the tyrosine-phenylalanine ratio were reduced. The metabolic basis of the altered tyrosine-phenylalanine ratio in plasma was studied. Tyrosine aminotransferase (TAT) and phenylalanine hydroxylase (PHL) activity were normal in the liver, but renal PHL activity of was decreased as compared to control rats. Tissue concentrations of citrulline were also found to be raised in liver and muscle of uremic rats. The activity of ornithine transcarbamoylase, was reduced in the liver and arginine synthetase activity was decreased in the kidneys of uremic rats. Thus elevated citrulline levels in uremic tissue appear to be caused by a decrease conversion of citrulline to arginine in the kidney. Preliminary studies of tryptophan metabolism in uremic rats have shown elevated brain levels of 5-hydroxyindoleacetic acid and increased hepatic tryptophan oxygenase activity. Increased plasma amine levels were associated with altered activities of monoamine oxidase and diamine oxidase in kidney and other tissues.