The association between daytime sleep and general obesity risk differs by sleep duration in Iranian adults.

BACKGROUND: Sleep duration and daytime napping and obesity are related to adiposity; however, it is not clear whether the association between daytime napping and adiposity measures can differ by sleep duration. AIM: To clarify the association between daytime napping and general and abdominal obesity based on sleep duration of participants. SUBJECTS AND METHODS: This cross-sectional study was conducted on 1,683 individuals (837 men and 846 women) aged ≥ 35 years. Height, weight and waist circumference (WC) were measured according to the standard protocols. Body mass index (BMI) was calculated. Self-reported sleep duration (in a 24-hour cycle) was recorded. The odds of general and abdominal obesity were compared between nappers and non-nappers, stratified by their sleep duration (≤ 6 h, 6-8 h, ≥ 8 h). RESULTS: The mean (SD) age of participants was 47.48 ± 9.35 years. Nappers with a short sleep duration (≤ 6 h) had greater BMI and higher risk for overweight/obesity compared with counterpart non-nappers after adjustment for potential confounders (OR = 1.61, 95% CI = 1.07-2.41). In subjects with moderate sleep duration (6-8 h), nappers had a tendency towards higher BMI in comparison with non-nappers (28.04 ± 0.25 vs. 26.93 ± 0.51 kg/m2; p = 0.05), however, no significant difference was observed for the risk of obesity. Daytime napping was not related to the risk of obesity in long sleepers. No significant association was observed for abdominal obesity measures. CONCLUSIONS: Daytime napping is associated with increased risk of overweight/obesity in short sleepers. However, in subjects with longer sleep duration, it is not related to the risk of overweight/obesity.

Red and processed meat consumption and risk of incident cardiovascular disease and mortality: Isfahan cohort study.

To investigate the cardiovascular risks associated with red and/or processed meat intake in a large population-based cohort study in Iran. A total of 5432 participants from the Isfahan Cohort Study (ICS) were enrolled. Diet was assessed using a validated, 48-item food frequency questionnaire. Cox proportional hazards regression models were applied to calculate hazard ratios (HRs) for the CVD risk associated with red and processed meat intake. Median follow-up was 11.2 years. Compared to the first tertile, the highest tertile of red meat intake, either alone or in combination with processed meat was associated with a 50% reduced risk of stroke (95% CI: 0.31-0.77; 95% CI: 0.33-0.82, respectively), but increased risk of CVD mortality with corresponding HRs of 1.58 (95% CI: 1.06-2.35) and 1.47 (95% CI: 1.02-2.08), respectively. Red meat and red plus processed meat intake were inversely associated with stroke risk, but positively linked with CVD mortality.

The long-term association of different dietary protein sources with metabolic syndrome.

Due to scarce epidemiologic data linking dietary protein intakes and metabolic syndrome (MetS), we aim to determine the longitudinal association of different types of dietary protein with the incidence of MetS among Iranians adults. The study was conducted in the framework of the Isfahan Cohort Study (ICS) on 6504 adults, aged ≥ 35 years, and free of MetS at baseline. A validated food frequency questionnaire was used for assessing usual dietary intakes. MetS was defined according to the Joint Scientific Statement. Mixed-effects logistic regression was applied to examine the associations between changes in weekly frequency consumption of protein and MetS status. After a median follow-up of 11.25 years, in multivariate-adjusted model, each additional frequency consumption of total protein intake (OR 0.83; 95% CI 0.81-0.85), animal protein (OR 0.80; 95% CI 0.77-0.83), plant protein (OR 0.70; 95% CI 0.64-0.76), red meat (OR 0.74; 95% CI 0.70-0.78), poultry (OR 0.73; 95% CI 0.68-0.78), egg (OR 0.79; 95% CI 0.72-0.88) and nuts and seeds (OR 0.77; 95% CI 0.71-0.84) was associated with reduced risk of MetS. No significant association was found for processed meat (OR 0.96; 95% CI 0.87-1.01) and legumes and soy (OR 0.96; 95% CI 0.86-1.07) with MetS. Our results suggest an independent inverse association between total protein, animal and plant protein and the risk of MetS. These associations did not differ by sex. Although our results can be considered to be a strategy to reduce MetS risk by dietary guidelines, randomized clinical trials are required to confirm our findings.

Effects of soy consumption on metabolic parameters in patients with metabolic syndrome: A systematic review and meta-analysis.

Functional foods like soy have unique effects on health status. Although various dietary modifications have been recommended to ameliorate features of metabolic syndrome (MetS), no meta-analysis has summarized the effect of soy consumption in patients with MetS. PubMed, ISI Web of Science, and Scopus were searched for relevant articles until Jun 2020, resulting in six relevant publications that were included in our meta-analysis. Combining a total of 9 comparisons suggested a significant decrease in serum levels of triglyceride (WMD: -0.29; 95 % CI: -0.49, -0.09 mg/dL), total cholesterol (WMD: -1.46; 95 % CI: -1.70, -1.22 mg/dL), LDL-C (WMD: -0.73; 95 % CI: -0.93, -0.52 mg/dL) and no change in serum HDL-c levels. Combining a total of 7 effect sizes examining soy effects on glycemic parameters indicated that subjects who consumed soy products had lower levels of fasting blood sugar (WMD: -0.90; 95 % CI: -1.12, -0.68 mg/dL), insulin (WMD: -1.06; 95 % CI: -1.29, -0.84 pmol/ L) and HOMA-IR (WMD: -1.08; 95 % CI: -1.31, -0.85) compared with those in the control group. Soy consumption could not significantly change anthropometric measures and blood pressure. Consuming soy products in patients with MetS effectively improved lipid profile and glycemic parameters independent of affecting anthropometric measures.

The effect of educational and encouraging interventions on anthropometric characteristics and perilipin-1 levels: TABASSOM Study.

BACKGROUND: Perilipin protein located in lipid droplets is involved in formation and storage of lipid in adipocytes; thus, it is considered as one of the obesity biomarkers. This study was performed to examine the effect of educational and encouragement interventions and lifestyle modifications on anthropometric characteristics and perilipin-1 level. METHODS: This quasi-experimental study was conducted on subsample of TABASSOM Study. Participants were 42 overweight and obese children and adolescents aged 6-18 years old and 80 overweight and obese adults aged 19-65 years old. Anthropometric characteristics including weight, height, waist circumference (WC), body fat percentage (BFP), and perilipin-1 level were measured at the first and the end of study (after one year). RESULTS: After intervention, the mean of perilipin-1 decreased significantly in total children and adolescents (before vs. after: 26.79 ± 13.17 vs. 22.57 ± 8.03; P = 0.006) and girls (27.75 ± 10.51 vs. 22.00 ± 8.15; P = 0.001), but decreasing was not significant in boys. In adults, perilipin-1 levels were significantly reduced in total subjects (before vs. after: 16.19 ± 13.42 vs. 15.34 ± 11.25; P = 0.029) and men (18.02 ± 15.78 vs. 15.44 ± 10.61; P = 0.003). There was no significant difference in mean of body mass index (BMI), WC, and BFP in both groups after 12 months. CONCLUSION: Educational and encouraging interventions and lifestyle modifications could lead to decreasing perilipin-1 level in adults, children, and adolescents.

The effects of aerobic training, resistance training, combined training, and healthy eating recommendations on lipid profile and body mass index in overweight and obese children and adolescents: A randomized clinical trial.

BACKGROUND: The aim of this study was to evaluate the effects of 8 weeks of aerobic training, resistance training (RT), combined training, and nutritional recommendations on lipid profile and body mass index (BMI) in obese and overweight children and adolescents. METHODS: This randomized, clinical trial was conducted on 120 children and adolescents (10-19 years of age) with overweight and obesity. Participants were divided into 4 groups, the 3 intervention groups of high-intensity interval training (HIIT), RT, and combined training, and 1 non-exercising control group with healthy eating recommendations. We considered 24 sessions of training during 8 weeks for the intervention groups. The participants' anthropometric indices and lipid profile were assessed before and after the intervention. RESULTS: There were no significant differences between the groups in terms of anthropometric indices and lipid profiles before the intervention. After the intervention, there was a significant difference between the groups in terms of high-density lipoprotein (HDL) level; the control group (37.70 ± 9.45) and the HIIT group (43.65 ± 9.09) displayed the lowest and highest mean, respectively (P = 0.040). Comparison of physical variables and blood lipid profiles before and after the intervention showed a significant difference in waist circumference (P = 0.030), hip circumference (P ≤ 0.001), and HDL level (P = 0.040) in RT, HIIT, combined, and control groups. CONCLUSION: These results demonstrate that the combined training program and HIIT program with nutritional recommendations in overweight and obese children and adolescents were more effective in reducing BMI and hip circumference, respectively.

The effect of educational and encouragement interventions on anthropometric characteristics, obestatin and adiponectin levels.

BACKGROUND: Lifestyle modification is the most important strategy for control of obesity and overweight. Obestatin and adiponectin are the biomarkers of obesity. Thus, this study was performed to examine the effect of educational and encouragement interventions and lifestyle modifications on obesity anthropometric as well as obestatin and adiponectin levels. METHODS: This semi-experimental study was conducted on a subsample of TABASSOM study. Participants were 41 overweight and obese children and adolescents aged 6-18 years old and 45 overweight and obese adults aged 19-65 years old. Anthropometric characteristics including height, weight, waist and hip circumferences, and body fat percentage (BFP) were measured at the first and after one year at the end of study. We implemented some educational and encouragement interventions regarding dietary modification and physical activity during the study. Obestatin and adiponectin levels were measured at the first and end of study by enzyme-linked immunosorbent assay (ELISA) method. RESULTS: The study did not show significant effect on anthropometric characteristics such as body mass index (BMI) and waist circumference (WC). BFP decreased significantly in boys, total children and adolescent group, and waist-to-hip ratio (WHR) decreased significantly only in adolescent boys after 1 year (P < 0.050). CONCLUSION: Educational and encouraging interventions and lifestyle modifications could lead to decrease of body WHR and BFP in adolescent boys. This is helpful in controlling the increasing rate of obesity.

Improvement of dietary oil consumption following a community trial in a developing country: The role of translational research in health promotion.

BACKGROUND: This study aimed to determine the effects of the interventions of Isfahan Healthy Heart Program (IHHP) on the type of oil consumed at the population level. It also tried to assess how this strategy has been effective as a health policy. METHODS: The IHHP, a six-year community intervention program (2001-07), aimed at health promotion through the modification of cardiovascular disease risk factors. It was performed in Isfahan and Najafabad counties (intervention area) and Arak county (reference area), all in central Iran. This study targeted the whole population of over 2,000,000 in the intervention area. The findings of annual independent sample surveys were compared with the reference area. Dietary interventions were performed as educational, environmental, and/or legislative strategies. RESULTS: From 2001 to 2007, the mean of changes for hydrogenated oil consumption was -3.2 and -3.6, and for liquid oil it was 3.6 and 2.8 times per week in the intervention and reference areas, respectively (P < 0.001). According to Commerce office record, the increase in liquid oil distribution during 2000-2007 was significantly higher in Isfahan than Arak (34% vs. 25%). CONCLUSION: The effects of the simple, comprehensive, and integrated action-oriented interventions of our program could influence policy making and its results at the community level. It can be adopted by other developing countries.

Healthy bread initiative: methods, findings, and theories--Isfahan Healthy Heart Program.

The scientific evidences show that the content, baking methods, and types of bread can make health impacts. Bread, as a major part of Iranian diet, demonstrates a significant potential to be targeted as health promotion subject. Healthy Food for Healthy Communities (HFHC) was a project of Isfahan Healthy Heart Program (IHHP), consisting of a wide variety of strategies, like Healthy Bread (HB) Initiative. The HB Initiative was designed to improve the behaviour of both producers and consumers, mainly aiming at making high-fibre, low-salt bread, eliminating the use of baking soda, providing enough rest time for dough before baking (at least one hour), and enough baking time (at least one minute in oven). A workshop was held for volunteer bakers, and a baker-to-baker training protocol under direct supervision was designed for future volunteers. Cereal Organization was persuaded to provide less refined flour that contained more bran. Health messages in support of new breads were disseminated by media and at bakeries by health professionals. Evaluation of the HB Initiative was done using before-after assessments and population surveys. While HB was baked in 1 (0.01%) bakery at baseline, 402 (41%) bakeries in the intervention area joined the HB Initiative in 2009. Soda was completely eliminated and fibre significantly increased from 4 +/- 0.4 g% before study to 12 +/- 0.6 g% after the intervention (p < 0.001). The preparation and baking times remarkably increased. Wastage of bread decreased from 13 +/- 1.8 g% to 2 +/- 0.5 g% and was expressed as the most important advantage of this initiative by consumers. People who lived in Isfahan city consumed whole bread 6 times more than those who lived in reference area Arak (p < 0.001). The HB Initiative managed to add new breads as a healthy choice that were compatible with local dishes and made a model to solve the longstanding problems of bread. It used various health promotion approaches but was best consistent with Beattie's model.

Comparison of effects of soft margarine, blended, ghee, and unhydrogenated oil with hydrogenated oil on serum lipids: A randomized clinical trail.

BACKGROUND: Trans fatty acids (TFAs) are known as the most harmful type of dietary fats. Therefore, this study was done to compare the effects of some different oils including unhydrogenated, blended, ghee, and soft magazine with hydrogenated oil on serum lipid profile of healthy adults. METHODS: This study was a randomized clinical trial conducted on 206 healthy participants of 20 to 60 years of age. Subjects were randomly divided into 5 groups and each of them was treated with a diet containing unhydrogenated oil, ghee, blended oil, soft margarine, or hydrogenated oil for 40 days. Fasting serum lipids were measured before and after the study. RESULTS: Compared to hydrogenated oil, total cholesterol (TC) and triglyceride (TG) had a significant reduction in all groups, LDL-C declined in unhydrogenated oil and soft margarine groups, and apolipoprotein (Apo) B only in unhydrogenated oil group (all P < 0.05). However, there was a significant enhancement in ApoA of ghee oil (P < 0.001). CONCLUSION: Consuming unhydrogenated oil, ghee, soft margarine, and blended oil had some beneficial effects on serum lipids.

The relation between dietary intake of vegetable oils and serum lipids and apolipoprotein levels in central Iran.

BACKGROUND: The detrimental effects of partially hydrogenated vegetable oils (PHVOs) on apolipoproteins have been reported from several parts of the world. However, little data is available in this regard from the understudied region of the Middle East. The present study therefore tried to evaluate the association between type of vegetable oils and serum lipids and apolipoprotein levels among Iranians. METHODS: In this cross-sectional study, data from 1772 people (795 men and 977 women) aged 19-81 years, who were selected with multistage cluster random sampling method from three cities of Isfahan, Najafabad and Arak in "Isfahan Healthy Heart Program" (IHHP) (Iran), was used. To assess participants' usual dietary intakes, a validated food frequency questionnaire was used. Hydrogenated vegetable oil (commonly consumed for cooking in Iran) and margarine were considered as the category of PHVOs. Soy, sunflower, corn, olive and canola oils were considered as non-HVOs. After an overnight fasting, serum cholesterol (total, low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol) and triglyceride as well as apolipoproteins A and B were measured using standard methods. RESULTS: Participants with the highest intakes of non-HVOs and PHVOs were younger and had lower weight than those with lowest intakes. High consumption of non-HVOs and PHVOs was associated with lower intakes of energy, carbohydrate, dietary fiber, and higher intakes of fruits, vegetables, meat, milk and grains. No overall significant differences were found in serum lipids and apolipoprotein levels across the quartiles of non-HVOs and PHVOs after controlling for potential confounding. CONCLUSION: We did not find any significant associations between hydrogenated or nonhydrogenated vegetable oil and serum lipid and apolipoprotein levels. Thus, further studies are needed in this region to explore this association.

Using factor analysis to identify dietary patterns in Iranian adults: Isfahan Healthy Heart Program.

OBJECTIVE: To identify dietary patterns of a representative sample of Iranian adults using factor analysis. METHODS: This study was conducted in 2000-2001 as the baseline survey of Isfahan Healthy Heart Program (IHHP). We studied 12,514 participants aged ≥19 years who were randomly selected in three counties of Central Iran. A validated 48-item food frequency questionnaire was completed and factor analysis was used to identify dietary patterns. RESULTS: Four major dietary patterns were identified, namely "Western", "animal fat", "traditional" and "Mediterranean". In both men and women, we found a significant positive relationship between age and Mediterranean diet, and a negative relationship between age and the other three dietary patterns (P < 0.001). The Western and traditional dietary patterns showed a significant negative relationship with education in both genders (P < 0.01). The Western dietary pattern correlated positively with being single, widowed, or a divorced man (P < 0.001). CONCLUSIONS: We identified four major dietary patterns. As dietary pattern analysis is useful to identify dietary behaviors in relation to health risks, the results can be practical.

Effect of hydrogenated, liquid and ghee oils on serum lipids profile.

BACKGROUND: Trans fatty acids are known as the most harmful type of dietary fats, so this study was done to compare the effects of hydrogenated, liquid and ghee oils on serum lipids profile of healthy adults. METHODS: This study was a randomized clinical trial conducted on 129 healthy participants aged from 20 to 60 years old who were beneficiaries of Imam-e-Zaman charitable organization. Subjects were randomly divided into 3 groups and each group was treated with a diet containing cooking and frying liquid, ghee, or hydrogenated for 40 days. Fasting serum lipids, including total cholesterol (TC), triglyceride (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), apoprotein A (Apo A), and apoprotein B (Apo B) were measured before and after the study. RESULTS: TC, TG and Apo B had a significant reduction in the liquid oil group compared to the hydrogenated oil group. In the ghee group TG declined and Apo A increased significantly (P < 0.01). Liquid oil group had a significant reduction in HDL-C, compared to the ghee oil group (P < 0.05). CONCLUSION: It was concluded that consuming liquid oil along with frying oil caused to reduce all serum lipid levels. However, ghee oil only reduced TG and increased HDL-C levels.

Effects of 5-year interventions on cardiovascular risk factors of factories and offies employees of isfahan and najafabad: worksite intervention project-isfahan healthy heart program.

BACKGROUND: Effects of 5-year interventions of Worksite Intervention Project from Isfahan Healthy Heart Program on cardiovascular risk factors of factories and offices employees were studied in Isfahan and Najafabad (intervention area) compared to Arak (control area). METHODS: We had especial interventions for nutrition, physical activity and smoking as well as hypertension and obesity screening systems in all offices and factories, and other risk factors screening systems whenever possible. Before and after the interventions, questionnaires containing demographic and other required data were completed for the two populations; height, weight and blood pressure (BP) were measured and a fasting and 2h blood sample was taken for the measurement of blood sugar (BS) and lipid levels. RESULTS: The prevalence of hypercholesterolemia, hypertriglyceridemia and central obesity decreased, but low HDL increased in office staff (P < 0.01). Waist circumference, HDL and total cholesterol mean values decreased, and diastolic BP and fasting and 2h BS increased among the intervention group. In factory workers, the prevalence of hypertriglyceridemia and central obesity decreased, while low HDL prevalence increased in intervention group (P < 0.001). Mean values of waist circumference, HDL and total cholesterol, and triglyceride decreased significantly (P < 0.001), while diastolic BP and fasting BS increased. CONCLUSION: It seems that Worksite Intervention Project has a protective effect on CVD risk factors in factories and offices employees. So, the modifiable project can be used as an applicable tool for health improvement in worksites which creates tangible changes in employees' lifestyle.