Diet Quality Indices and Their Correlation with Glycemic Status and Lipid Profile in Patients with Type 2 Diabetes.

BACKGROUND: The study aimed to determine the correlation between different diet quality indices and glycemic status and lipid profile in patients with diabetes. METHODS: This study was carried out on 235 patients with type 2 diabetes referred to Martyr Motahari Diabetes Clinic of Shiraz city so as to investigate the relationship between glycemic status and lipid profile and the diet quality using Healthy Eating Index (HEI-2010), phytochemical index (PI), and Diet Quality Index-International (DQI_I). RESULTS: A positive correlation was indicated between the serum levels of LDL-C and HEI-2010 scores (p=0.026). Furthermore, there was a positive correlation between the patients' age and scores of PI (p=0.006) and between PI and DQI_I (p < 0.001). There was no significant relationship between the scores for all three indicators and biochemical parameters. CONCLUSION: The results of this study indicated that there was a significant correlation between the serum LDL-C levels and the HEI-2010 scores. Moreover, the age of the patients had a direct correlation with the PI scores.

Improving diet quality among adolescents, using health belief model in a collaborative learning context: a randomized field trial study.

This study aimed to assess the impact of educational intervention, based on health belief model (HBM) and collaborative learning techniques on diet quality in adolescents. In this field trial study, 311 students aged 13-15 years old were included, of which 163 and 148 allocated in the experimental and comparison groups, respectively. They were selected through a stratified random sampling from 16 urban, secondary schools in 4 educational districts of Shiraz, the largest city in southern Iran. The revised children diet quality index was used to assess their diet quality. Using HBM as a framework for targeting determinants of dietary behavior, the intervention was performed in a collaborative learning context during the educational year (2015-16). Constructs of HBM and diet quality were measured before and after the intervention. All HBM's constructs and knowledge had significantly improved in the experimental group and mean differences were increased after the intervention. Diet quality improved in the experimental group (P < 0.001), which was significantly different from the comparison group (P = 0.001). The findings support the integration of appropriate models/theories into the context of collaborative learning methods to target large number of behavioral determinants, and ultimately increase the effectiveness of the educational interventions amongst adolescents.

The Healing Effect of Grape Seed Oil Enema with or without Sesame Oil in Acetic Acid Induced Ulcerative Colitis of Rats.

BACKGROUND: Inflammatory bowel diseases contain two digestive system diseases, ulcerative colitis (UC) and Crohn's disease with unclear causes. The aim of present study was to investigate the therapeutic effects of administration of the Sesame oil (SO) and grape seed oil (GSO) as enema route in rats suffering from experimental acetic acid induced UC. METHODS: Eighty male rats were randomly allocated into 8 equal groups as health control (HC1) without any disease treated with 1 ml of normal saline as enema; HC2 received SO; HC3 received GSO; negative control (NC) with induced UC receiving 1 ml of normal saline as enema; and positive control (PC) with induced UC treated by asacol. All treatments were performed identically with 4 mg/kg of medication except for asacol that was 100 mg/kg for 7 days. The weight changes was recorded after seven days. The serum levels of malondialdehyde (MDA), total antioxidant capacity (TAC), interleukin-6, and c-reactive protein (CRP) were measured. Colon macroscopic and microscopic histological changes were also measured at the end of 7th day. RESULTS: No significant changes were detected in weight in neither groups on day 0 nor at the end of study. No beneficial effects were seen for all treatments regarding healing process and the decrease in inflammation. Between treatment groups, the lowest MDA (7.40±0.98 U/ml), CRP (83.20±10.01 mg/l) and IL-6 levels (130.86±10.70 mU/ml) and highest TAC (1.91±0.43 mmol/l) belonged to GSO group. CONCLUSION: GSO enema alone can be considered as a treatment of choice for UC due to its antioxidant properties.

The effects of 6 isocaloric meals pattern on blood lipid profile, glucose, hemoglobin a1c, insulin and malondialdehyde in type 2 diabetic patients: a randomized clinical trial.

BACKGROUND: The present clinical trial study aims at investigating the effect of daily energy intake in 6 isocaloric meals in comparison with the current meal pattern (3 meals and 2 small snacks per day) on type 2 diabetes risk markers in diabetes during 3-month period. METHODS: Eighty four type 2 diabetes patients were randomly divided into 6 isocaloric meal diet or a balanced diet (3 meals and 2 snacks previous meal pattern). The planned reduced calorie diets for both groups were identical except for the meal pattern. Blood samples were analyzed before and after the investigation for fasting blood sugar (FBS), two-hour post-prandial glucose (2hPP), insulin, hemoglobin A1c (HbA1c), total cholesterol, triglyceride, HDL-C, LDL-C, and molondialdehyde (MDA) concentrations. RESULTS: HbA1c (P=0.00) and body mass index (BMI) (P=0.04) values decreased significantly in the 6 isocaloric meal pattern compared with the controls. There were no significant differences in fasting serum glucose (P=0.09), insulin (P=0.65), total cholesterol (P=0.32), LDL-C (P=0.43), HDL-C (P=0.40) cholesterol, triglyceride (P=0.40), MDA (P=0.13) and 2hPP serum glucose (P=0.30) concentrations between the 6 isocaloric meal and tradition meal pattern. CONCLUSION: Six isocaloric meal pattern in comparison with the current meal pattern led to weight loss and improved glycemic control. Serum lipid profile and MDA did not change significantly. TRIAL REGISTRATION NUMBER: IRCT201205179780N1.

The Effects of 6 Isocaloric Meals on Body Weight, Lipid Profiles, Leptin, and Adiponectin in Overweight Subjects (BMI > 25).

BACKGROUND: It seems that meal frequency is negatively related to body weight, but the relationship between meal frequency and weight loss is not clearly known yet. OBJECTIVES: The present study aimed to investigate whether 6 isocaloric meals affected body weight, lipid profiles, leptin, and adiponectin in overweight subjects. METHODS: The present randomized controlled trial was conducted on 90 overweight subjects in 3 months. The subjects were randomly divided into two groups. The control group continued their normal diet, while the intervention group was required to follow a 6 isocaloric meal diet instead of their previous meal pattern (3 meals and 2 snacks). The planned reduced calorie diets for both groups were identical, except for meal pattern. Blood samples were analyzed prior to and at the end of the study for total cholesterol, triglyceride, HDL-C, LDL-C, leptin, and adiponectinn concentrations. Paired t-test was used for comparison of the measurements before and after the study in each group. Besides, independent t-test was used for comparison of the measurements between the groups. P value less than 0.05 was considered as statistically significant. RESULTS: The mean age of the participants was 36.38 ± 9.7 in the intervention group and 37.6 ± 10.9 in the control group. In comparison to the control group, the intervention group showed a significant decrease in total cholesterol (P < 0.001), LDL-C (P < 0.001), BMI (P < 0.001), triglyceride (P < 0.001), and leptin (P = 0.002) and a significant increase in HDL (P < 0.001) and adiponectin (P = 0.031). CONCLUSIONS: The 6 isocaloric meal pattern led to a reduction in BMI, lipid profiles (total cholesterol, LDL-C, triglyceride), and leptin concentrations and an increase in HDL and adiponectin compared to the normal diet.

Adiponectin as a novel indicator of malnutrition and inflammation in hemodialysis patients.

INTRODUCTION: Protein-energy malnutrition and inflammation are common and overlapping conditions in hemodialysis patients, which are associated with increased risk of morbidity and mortality. Adiponectin is an adipocytokine exclusively produced by adipose tissue. The aim of this study was to further elucidate the association between serum adiponectin levels and the nutritional status of hemodialysis patients. MATERIALS AND METHODS: Seventy-three patients on hemodialysis for at least 3 months, three times weekly, without any acute illness, were divided into 2 groups of well-nourished (n = 25) and malnourished (n = 48) based on their nutritional status, measured by the subjective global assessment. Serum levels of adiponectin, albumin, blood urea nitrogen, and creatinine; body mass index; and the malnutrition-inflammation score were measured in all patients. These values were compared between well-nourished and malnourished patients. The correlations of nutritional variables with serum levels of adiponectin were determined, as well. RESULTS: Except for the malnutrition-inflammation score, which was significantly higher in the malnourished patients compared to the well-nourished ones (11.1 +/- 3.6 versus 4.2 +/- 2.0, P < .001), no other significant differences were found between the two groups. A weak but significant positive correlation was found between the serum levels of adiponectin and subjective global assessment scores (r = 0.25, P = .03). CONCLUSIONS: The results of our study point to potential utility of serum adiponectin level as an indicator of nutritional status in hemodialysis patients. Further studies are needed to clarify the role of adiponectin in the pathogenesis of malnutrition in hemodialysis patients.

Selenium supplementation improves the nutritional status of hemodialysis patients: a randomized, double-blind, placebo-controlled trial.

BACKGROUND: Malnutrition is highly prevalent in hemodialysis (HD) patients. These patients have high levels of oxidative stress and inflammation which can subsequently induce malnutrition. Selenium levels have been found to be decreased in HD patients. As selenium deficiency leads to oxidative stress and inflammatory response, the aim of this study was to evaluate the effects of selenium supplementation on oxidative and inflammatory markers and the nutritional status of HD patients. METHODS: In this randomized double-blind placebo-controlled trial, 80 patients on stable HD for at least 3 months without any acute illness or active infections were randomly allocated to two equal groups to receive one selenium (200 µg) or placebo capsule daily for 12 weeks. Serum levels of lipoproteins, malondialdehyde (MDA), interleukin-6 (IL-6), high-sensitivity C-reactive protein (HSCRP), homocysteine, ferritin and transferrin as well as the subjective global assessment (SGA) score, malnutrition-inflammation score (MIS) and hemoglobin (Hb) levels were measured at the baseline and at the end of the treatment phase. The primary outcome was a change in the nutritional status measured by the SGA score from the baseline towards the end of the treatment phase of the study. RESULTS: The SGA score and MIS decreased significantly in the selenium group compared to the placebo group (P < 0.001 for both). Moreover, serum levels of MDA decreased significantly in the selenium group compared with increasing levels in the placebo group (P < 0.001). Selenium supplementation also hindered an increase in IL-6 levels compared with the placebo group (P = 0.016). There were no significant differences between the selenium and placebo groups in terms of changes in serum levels of lipoproteins, HSCRP, homocysteine, ferritin and transferrin or Hb levels. CONCLUSIONS: This study shows that selenium may be an effective complementary supplement for reducing the severity of malnutrition in HD patients through alleviating oxidative stress and inflammation.

Irritable bowel syndrome in adults over 35 years in Shiraz, southern Iran: prevalence and associated factors.

BACKGROUND: The symptoms of irritable bowel syndrome (IBS) are common in the general population. The aim of this population-based study was to determine the prevalence of IBS and describe the associated factors including demographic, life style and health-seeking behaviors in Shiraz city, southern Iran. METHODS: From April to September 2004, 1978 subjects aged > 35 years old completed a validated and reliable questionnaire on IBS. RESULTS: The prevalence rate of IBS was 10.9%, higher in females, in 35-44 years old age group and among subjects eating fast food (14.1%) but was lower in those taking more fruits and vegetables (10.5%). The occurrence of anxiety, nightmare and restlessness was also significantly higher in subjects with IBS. It had an association with psychological distress and recurrent headaches but not with drinking tea/coffee, smoking or physical activity. CONCLUSIONS: In our area, IBS was correlated with gender, age, psychological distress, recurrent headaches and consumption of fast foods that necessitate health planning programs by health policy makers.

Nutritional knowledge and attitudes in athletes with physical disabilities.

CONTEXT: Little is known about sport nutritional problems and requirements of athletes with physical disabilities. OBJECTIVE: To compare the nutritional knowledge and attitudes of Iranian athletes with physical disabilities (APDs) after nutrition education. Because proper nutrition is important for both performance and injury healing, learning about the nutritional areas in which APDs are deficient may assist professionals in educating them. DESIGN: Nested case-control study. SETTING: Sport camp. PATIENTS OR OTHER PARTICIPANTS: Seventy-two APDs (42 APDs in the intervention group and 30 age-matched and sex-matched control APDs) and 10 coaches completed the study. INTERVENTION(S): The APDs in the intervention group and their coaches were given nutrition education, which included a booklet with a simplified food guide pyramid, simple concepts about nutrition and weight loss, and four 3-hour courses. The APDs in the control group and their coaches were not given nutrition education. MAIN OUTCOME MEASURE(S): Subjects completed 2 nutritional questionnaires with both quantitative and qualitative components. Nutritional questionnaires were administered at 2 consecutive camps, 30 days apart, before and after nutrition education. Our questionnaires included a demographics section; 88 Likert scale and true-false questions; and 18 open-ended questions, 13 of which were specifically designed for APDs. Each APD completed two 3-day food records. RESULTS: The APDs in the intervention group scored significantly higher after nutrition education and higher than the control group on the knowledge subscales and interest in nutrition. Although the nutrition knowledge score in this study was moderate, several specific areas of deficient nutritional knowledge were identified that are critical for the health of APDs. Our model of nutrition education was more effective than the usual instructions presented irregularly by coaches. CONCLUSIONS: Our findings suggest that Iranian APDs lack nutritional knowledge in areas critical to preventing nutrition-related health problems, especially components related to nutrition for athletes with disabilities.

Nutritional status of schoolchildren in rural Iran.

The present study compared the nutritional status of schoolchildren from recently settled, ethnic minority tribespeople with those from a Persian village in southern Iran. Height and weight were measured and blood was collected from school children at three time points over 1.5 years. Supplemental Fe was provided to children with low Hb after the first screening. Twenty-one per cent of the children were wasted, 57 % were stunted and 23 % were anaemic. No statistically significant difference in the prevalence of wasting, stunting and anaemia was found between gender or ethnic groups. Children over the age of 12 years had a higher prevalence of wasting than children aged below 12 years. In a sub-sample of forty-one children the average BMI-for-age decreased. Fe supplementation increased Hb levels to normal in most children, but did not increase Fe level in a few children. Dietary deficiency of micronutrients, especially Zn and Fe, probably accounts for the high prevalence of stunting and anaemia in these children. Infection with Helicobacter pylori is another possible explanation for the Fe-deficiency anaemia. Further investigation is in progress to determine the cause(s) of the observed deficiencies.