Development and psychometric analysis of a new tool to assess food literacy in diabetic patients.

BACKGROUND: One of the factors affecting self-care in diabetic patients is food literacy, which helps said patients in following a healthy diet. Thus, it is crucial to analyze food literacy in diabetic patients through suitable and reliable instruments.  OBJECTIVE: The current study aimed to design a questionnaire for food literacy assessment in diabetic patients and analyze its psychometric features. METHOD: The present study was a cross-sectional descriptive analysis carried out in 2021. Firstly, the concepts of food literacy in diabetic patients were identified and the questionnaire was deigned based on them. Secondly, its face and content validities and its reliability were analyzed. Finally, the construct validity was analyzed by exploratory factor analysis. The study was carried out on 300 diabetic participants chosen at random via stratified cluster sampling from Health service centers. The exploratory factor analysis was carried out by extracting the main factors and using varimax rotation with eigenvalue values more than 1. RESULTS: A five-pronged structure accounted for 52.745% of food literacy variance. This included the ability to read food facts, practical ability to group foods, the ability to identify the caloric content of different foods, the ability to understand the effect of food on health, and the ability to prepare a healthy meal. Items with an impact score below 1.5 were discarded. Additionally, items with CVR scores below 0.62 and CVI scores below 0.79 were deleted too. The Kaiser-Meyer-Okin measurement was 0.836 (p < 0.001). Alpha Cronbach Scale dimension was 0.610-0.951. CONCLUSION: The results of this study showed that the exploratory dimensions of the current study were consistent with health literacy measurements, such as functional, interactive, and critical food literacy. This scale has acceptable reliability and validity. Health professionals can use this scale to analyze and improve food literacy in diabetic patients. This is a new instrument and thus far no questionnaire has been made to evaluate food literacy in diabetic patients.

Effect of green coffee bean extract supplementation on liver function and inflammatory biomarkers: A meta-analysis of randomized clinical trials.

Inflammation is considered a major contributor to non-alcoholic fatty liver disease (NAFLD) and several chronic diseases such as, cardiovascular disease and type two diabetes. Green coffee bean extract (GCBE) supplementation has been suggested to enhancing antioxidant capacity in people with obesity but results across studies are mixed. We conducted a meta-analysis of randomized controlled trials of GCBE supplementation in overweight/obese with normal liver function and NAFLD adults with ALT, AST, γ-GTP, ALP, LDH, CRP, IL-6, and TNF-α as outcomes by searching PubMed and other databases. Eight studies were included, totaling 330 participants randomized to GCBE supplementation or placebo ranging from 50 mg/day to 1200 mg/day for 8-12 weeks. GCBE supplementation resulted in lower levels of TNF-α (mean difference = 1.37 pg/mL [95% CI = 0.97-1.76]; p < 0.00001). No significant difference was found in the remaining markers. In conclusion, GCBE supplementation attenuated TNF-α, a circulating inflammatory marker mediator which may be linked with lower systemic inflammation. However, potential cellular and molecular mechanisms by which GCBE exerts this positive effect warrants further investigations in human model studies.

Relationship between breastfeeding and obesity in high school girls.

Objectives Some factors in infancy can play a role in the development of adolescent obesity. Understanding these factors can help prevent early complications in adolescents associated with obesity in adulthood. The aim of this study was to determine the prevalence of overweight and obesity among high school girls in Khorramabad and its relationship with breastfeeding history. Methods This was a cross-sectional study. This study was conducted in 832 high school girls during the academic year 2016-2017. Samples were selected by multi-stage random sampling. General questionnaires, physical activity, and 24-h food questions were completed through interviews with students. Data regarding breastfeeding was obtained by mothers. Results The prevalence of overweight and obesity in the study population was 16.3 and 5.8%, respectively. Overweight and obesity had a significant association with breastfeeding history (p = 0.001), while there was no significant relationship between overweight and obesity with school type, student's age, parental occupation, education Parents, household size, birth rate, physical activity, and energy intake. Conclusions The results of this study showed that breast feeding has a protective effect on overweight and obesity during adolescence. To reduce the incidence of overweight and obesity, necessary education regarding breastfeeding should be provided.

The effect of green coffee extract supplementation on anthropometric measures in adults: A comprehensive systematic review and dose-response meta-analysis of randomized clinical trials.

BACKGROUND AND AIM: Two meta-analyses summarized data on the effects of green coffee extract (GCE) supplementation on anthropometric measures. However, the accuracy of those meta-analyses is uncertain due to several methodological limitations. Therefore, we aimed to conduct a comprehensive systematic review and dose-response meta-analysis to summarize all available evidence on the effects of GCE supplementation on anthropometric measures by considering the main limitations in the previous meta-analyses. METHODS: We searched available online databases for relevant publications up to January 2020, using relevant keywords. All randomized clinical trials (RCTs) investigating the effects of GCE supplementation, compared with a control group, on anthropometric measures [including body weight, body mass index (BMI), body fat percentage, waist circumference (WC) and waist-to-hip ratio (WHR)] were included. RESULTS: After identifying 1871 studies from our initial search, 15 RCTs with a total sample size of 897 participants were included in the systematic review and meta-analysis. We found a significant reducing effect of GCE supplementation on body weight (weighted mean difference (WMD): -1.23, 95 % CI: -1.64, -0.82 kg,P < 0.001), BMI (WMD: -0.48, 95 % CI: -0.78, -0.18 kg/m2, P = 0.001), and WC (WMD: -1.00, 95 % CI: -1.70, -0.29 cm, P = 0.006). No significant effect of GCE supplementation on body fat percentage and WHR was seen. In the dose-response analyses, there was no significant association between chlorogenic acid (CGA) dosage, as the main polyphenol in green coffee, and changes in anthropometric measures. CONCLUSION: We found that GCE supplementation had a beneficial effect on body weight, BMI and WC. It provides a cost-effective and safe alternative for the treatment of obesity. Additional well-designed studies are required to further confirm our findings.

Assessment of Nutritional Status and Related Factors of Lactating Women in the Urban and Rural Areas of Southwestern Iran: A Population-Based Cross-Sectional Study.

BACKGROUND: During the lactation period, mothers are at an increased risk of nutritional deficiencies due to improper dietary patterns, physiological changes, and various socio-demographic factors. The present study aimed to examine the nutritional status, dietary intake, and related factors among lactating women in the urban and rural areas of Khorramabad, Lorestan province in the southwest of Iran. METHODS: The present population-based cross-sectional study was conducted in Khorramabad (Iran) during April-July 2012. The study population included 708 lactating mothers who were referred to the health centers in Khorramabad (10 urban health centers and 30 rural health/community centers). A multi-stage sampling method was used to recruit the participants. The nutritional status and food intake of the participants were assessed over three days using the 24-hour dietary recall (24HDR) and dietary record (DR) questionnaires. The data were analyzed using SPSS software (version 16.0) with the Chi-square test, Fisher's exact test, paired t test, independent t test, and Pearson correlation coefficient. P<0.05 was considered statistically significant. RESULTS: The mean age and body mass index (BMI) of the mothers were 29.78±6.24 years and 26.11±3.70 kg/m2, respectively. There was a significant difference in calorie intake between the different categories of age, BMI, education level, job status (P<0.001) and lactation stage (P=0.034). The energy and nutrient intakes, except iron and phosphor, were statistically lower (P<0.05) than the prescribed Recommended Dietary Allowances (RDA). The intake of vitamins K, B1, B2, B3, and C; protein, magnesium, phosphor, zinc, copper, and iodine by mothers in the rural areas was significantly higher (P<0.05) than those in the rural areas. Higher intakes of energy and macronutrients by the lactating mothers had a significant negative correlation with an increase in age and had a significant positive correlation with a higher BMI (P<0.001). CONCLUSION: Lactating women in the urban and rural areas of Khorramabad (Iran) had a poor nutritional status. Nutrition education and a modified dietary pattern during the lactation period are recommended.

Effects of carnitine supplementation on liver aminotransferase enzymes: A systematic review and meta-analysis of randomized controlled clinical trials.

BACKGROUND AND AIMS: This meta-analysis of the randomized controlled trials was performed to assess effects of carnitine supplementation on serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. METHODS: A comprehensive literature search of PubMed, Cochrane's library, Web of Science, Scopus, and Embase was performed up to May 2018. From a total of 2012 articles identified initially, only 17 articles were included in the final meta-analysis to evaluate the effects of carnitine supplementation on serum levels of ALT and AST enzymes. RESULTS: Random effects model meta-analysis showed that carnitine supplementation led to reduction in serum ALT (weighted mean difference [WMD] - 10.25 IU/L; 95% CI = - 15.73, - 4.77; p < 0.001) and AST levels (WMD - 7.85 IU/L; 95% CI = - 11.85, - 3.86; p < 0.001). The results of subgroup analysis showed that carnitine could reduce serum AST levels at dosages equal to 2000 mg/day (p = 0.014) or more than 2000 mg/day (p < 0.001). However, carnitine supplementation at dosages of ≤ 1000 mg/day (p = 0.035) or equal to 2000 mg/day (p = 0.013) resulted in significant reduction in ALT level, while doses more than 2000 mg/day did not change ALT significantly. Carnitine exerts its reducing effect on serum ALT and AST levels only when these aminotransferases are raised or when the duration of supplementation lasts at least 3 months. CONCLUSION: Results of the current meta-analysis showed that carnitine supplementation can decrease serum AST and ALT levels significantly, especially when supplementation lasts 3 months or more in patients with elevated serum aminotransferase levels.

Prevalence of exclusive breastfeeding practice in the first six months of life and its determinants in Iran: a systematic review and meta-analysis.

BACKGROUND: Exclusive breastfeeding (EBF) in the first 6 months of life is the best and most complete option for an infant, in that supplies the vitamins and minerals the baby needs. Several studies in Iran have been conducted concerning the prevalence of EBF. The aim of this study was to determine the prevalence of EBF in the first 6 months of life and associated factors in Iran synthesizing published studies. METHODS: We searched PubMed/MEDLINE, Embase, Scopus, ISI/Web of Science, the Cochrane Library, Directory of Open Access Journals Directory (DOAJ) and Google Scholar as well as Iranian databases (Barakathns, MagIran and the Scientific Information Database or SID) up to November 2018. The Newcastle-Ottawa Scale was used to assess the quality of studies. Analyses were performed by pooling together studies using DerSimonian-Laird random-effects model with 95% confidence interval. To test for heterogeneity, I2 test was used. The Egger's regression test and funnel plot were used to evaluate the publication bias. The strength of EBF determinants was assessed computing the Odds-ratios (OR) using the Mantel-Haenszel method. RESULTS: In the initial search 725 records were found. Finally, 32 studies were selected based on inclusion/exclusion criteria. The sample size of studies varied between 50 and 63,071 subjects. The overall prevalence of EBF in Iran was 53% (CI 95%; 44-62). The OR for breastfeeding education received before pregnancy was 1.13 (0.94-1.36), for mother's job 1.01 (0.81-1.27), for education level 1.12 (0.89-1.42), for type of delivery 1.16 (0.98-1.37), and for gender of child 1.03 (0.83-1.28). CONCLUSION: In Iran health policy- and decision-makers should try to take interventions that encourage mothers to use their milk to breastfeed the infants.

Effect of Q10 supplementation on body weight and body mass index: A systematic review and meta-analysis of randomized controlled clinical trials.

AIMS: This meta-analysis study was carried out to assess the effects of coenzyme Q10 supplementation on body weight and body mass index of patients in randomized controlled clinical trial studies. MATERIALS AND METHODS: A comprehensive systematic search of literature was performed through ISI web of sciences, PubMed, Scopus and Cochrane library databases up to February 2018 which was supplemented by manual search of the references list of included studies. From a total of 1579 identified articles, only 17 trials with 14 and 14 effect-sizes were included for pooling the effects of co-enzyme Q10 supplementation on body weight and body mass index, respectively. RESULTS: Results of random-effect size meta-analysis showed that supplementation with coenzyme Q10 had no significant decreasing effects on body weight (WMD: 0.28 kg; 95% CI = -0.91, 1.47; P = 0.64) and BMI (WMD: -0.03; 95% CI = -0.4, 0.34; P = 0.86) of study participants. Subgroup analysis revealed that dosage of Q10 and trial duration could not differ the results of Q10 supplementation. CONCLUSION: Results of this meta-analysis study failed to show any beneficial effect of coenzyme Q10 supplementation on body weight and BMI of patients in clinical trial studies.

Reduction of expression of IL-18, IL-1ß genes in the articular joint by sumac fruit extract (Rhus coriaria L.).

BACKGROUND: Osteoarthritis is the most common malignant disease in the world. The disease is caused by changes in the metabolism, the structure and function of multiple joints, and joint tissues. Sumac is one of the indigenous plants of Iran and has traditionally been used as a spice in Iran. The aim of this study was to investigate the reduction of expression of IL-18, IL-1ß genes in the articular joint by sumac fruit extract (Rhus coriaria L.). METHODS: The alcoholic extract of sumac fruit (E.E.R.C.L) was prepared from the Genetic Reserve Center. Bleeding was used to provide synoviocyte cells from the joint and fluid of the anatomical metacarpal limb of the 8-month-old Holstein healthy calf without any signs of inflammation. Using cell-hemocytometer count, their viability was evaluated by trypan blue and after lipopolysaccharide (LPS) proliferation and injection to enhance the level of cytokines. After isolating the RNA and preparing the cDNA, RT-PCR and PCR were performed and then, using the real-time PCR method, the expression of the desired genes was investigated. RESULTS: In this study, after the expression of IL-18 cytokines, IL-1ß increased to 100%, and following the treatment with alcoholic extract, the reduction of expression of these cytokines was 33.61% and 29.01%, respectively. The results of anti-inflammatory effects showed that the alcoholic extract of sumac reduced the IL-1ß, IL-18 expression in LPS-stimulated cells. CONCLUSION: Sumac fruit extract can be an effective medication for reducing pain.

The Lowering of Bilirubin Levels in Full-Term Newborns by the Effect of Combined Massage Therapy and Phototherapy Practice.

OBJECTIVE: Various therapeutic treatments have been prescribed for decreasing the bilirubin level. Massage therapy is one of the neonate treatments for jaundice. The aim of this study is to investigate the effects of combined massage therapy and phototherapy on neonatal jaundice. STUDY DESIGN: This study was performed at Shahid Madani Hospital in the city of Khorramabad in 2016, where 83 healthy full-term infants were enrolled. They were selected through convenience sampling and then were randomly assigned to the intervention and control groups. The control group (n = 43) received phototherapy, whereas infants in the intervention group (n = 40) received 4 days of massage and phototherapy. The serum bilirubin level, frequency of stooling and amount of urination, duration of hospitalization, and feeding frequency were analyzed using SPSS by descriptive and analytical statistics (mixed regression models). RESULTS: Baseline levels of bilirubin were similar between the two groups (p > 0.05). The bilirubin level was measured as 13.4 ± 0.7 mg/dL in the intervention group on day 1. It stood at 14.4 ± 1.5 mg/dL in the control group, which was not statistically significantly different. However, the mean bilirubin level was decreased on day 4 of hospitalization to 7.4 ± 0.56 mg/dL and 9.0 ± 2.3 mg/dL, showing a significant difference decrease in the intervention and control group (p < 0.05), respectively. CONCLUSION: Intervention had a significant role in decreasing the bilirubin level, amount of urination, and duration of hospitalization of full-term infants suffering from hyperbilirubinemia.

Effect of a session of intensive exercise with ginseng supplementation on histone H3 protein methylation of skeletal muscle of nonathlete men.

PURPOSE: The pressure and stress caused by some intense exercises cause changes in histone proteins and gene expression. The aim of this study was to investigate the effect of one session of intensive exercise with supplementation of ginseng, on the methylation of H3K-36 histone protein in skeletal muscle of young nonathlete men. METHODS: After the approval by the ethics committee, 12 untrained male subjects were randomly assigned to either exercise group (six subjects) or exercise and supplement group. First, from both groups, the muscular sample was taken from the broad-lateral muscle of the subjects. Immediately after the muscle biopsy, exercise and exercise + supplement groups completed the exercise protocol. During this period, the exercise + supplement group consumed ginseng supplementation and took placebo group. Immediately after exercise, all subjects were retested. RESULTS: There was no significant increase in histone H3-k36 protein methylation in the intergroup between exercise + supplementation and exercise. There was a significant difference within the training group but there was no difference in the exercise + supplementation group. CONCLUSION: The methylation caused by intense physical pressure, can be reduced by ginseng extract.

The Effect of Self-Care Education on the Quality of Life in Children with Allergic Asthma.

Asthma is a condition where the airways become tiny and swollen producing extra mucus. This can cause breathing difficulty and wheezing, coughing, and shortness of breath. Self-care education affects the quality of life of children. This study examined the effect of self-care education on quality of life for children between 8 and 11 years with allergic asthma. This study was a randomized controlled trial. Study sample included 70 children between 8 and 11 years with asthma allergy referred to Children's Hospital Clinic of Khorramabad, Lorestan Province in 2015; they were selected by possible non-consecutive sampling method. Children were divided by random sampling of blocks, and classified into two groups of 35 patients each in the experimental and control groups. Both groups were matched for age and sex of children's and parents' educational level and initial quality of life scores were analyzed (using covariance analysis). At the beginning, quality of life was calculated by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) for each of the group. The intervention was carried out in four sessions of 45 minutes of self-care education for children in the case group. No intervention was done in the control group. Eight weeks later quality of life was measured in each of the group. There was a significant difference between increase values of PAQLQ in the intervention group and control group (p < 0.001). These results show that self-care education enhances the quality of life in asthmatic children.

Epigenetic changes due to physical activity.

One of the epigenetic-modifying factors is regular and continuous physical activity. This article attempts to investigate the effects of physical activity and exercise on changes in histone proteins and gene expression, as well as the effect of these exercises on the prevention of certain cancers and the ejection of age-related illnesses and cellular oxidation interactions. All of this is due to epigenetic changes and gene expression. Most studies have reported the positive effects of regular exercises on the expression of histone proteins. DNA methylation and the prevention of certain diseases such as cancer and respiratory diseases, caused by antioxidative interactions that occur more often in the elderly, have been studied.

Prevalence of anemia and its risk factors among pregnant women in Khorramabad (Iran) 2010-2014.

PURPOSE: Anemia's adverse effects on physical and behavioral development and on the reduction of efficiency have been proven. The aim of this study was to determine the prevalence of anemia in pregnant women referred to the health care centers of Khorramabad from 2010 to 2014. MATERIALS AND METHODS: In this cross-sectional study, 2821 prenatal care cases of pregnant women referred to health care centers of Khorramabad were studied. Studied variables included the following: hemoglobin, hematocrit, age, parity, trimester of pregnancy status, number of deliveries, number of abortions, number of children, weight, height, time gap from previous delivery, negative RH, history of eclampsia/preeclampsia, coagulation disorder and blood pressure. RESULTS: The mean age of the studied women was 26.7 ± 5.5. The mean levels of hemoglobin and hematocrit from the population was 12 ± 1.1 and 36.1 ± 9.2, respectively. The prevalence of anemia was 16.8%. Prevalence of anemia among pregnant women referred to health care centers of Khorramabad was found to be high. CONCLUSIONS: Staff working at different parts of health care centers were advised to pay more attention to this problem. They should also try to control and treat anemia by regular distribution of iron supplements among women referred to health care centers.

Phenotypic and genotypic characterization of lactic acid bacteria from traditional cheese in Khorramabad city of Iran with probiotic potential.

Lactic acid bacteria (LAB) with proteolitic activity are used as aromatic and antibacterial substances, cholesterol reduces, bile salt hydrolyses, and probiotic. The aims of this project were to isolate and identify natural LAB flora involved in traditional fermentation in cheeses of Khoramabad city and also to survey their probiotic potential. In order to achieve this goal, LAB were isolated and characterized using phenotypic and genotypic methods (PCR-sequencing); in the next stage, they were analyzed lowering cholesterol medium, hydrolysis of the bile, resistance to bile-resistant PH acidic stomach. At the end of the study, 88 cocci and 3 bacill were found: 58 Enterococcus faecium, 16 Enterococcus hirae, 5 Lactococcus lactis, 3 Lactobacillus plantarum, and 9 undetermined. The probiotic results of the bacteria had effects on the reduction of cholesterol, resistance to stomach acid, had relative antibacterial effects, and some strains had effects on hydrolyzing the bile. For further identification, the PCR method and the application of 16s-DNA-ITS genes and its sequencing were found useful. This study showed that lactic acid bacteria in the traditional cheese of the Khorramabad city have relative probiotic effect and that these lactic acid bacteria in fermented milk are suitable.

The influence of a behavior modification interventional program on body mass index in obese adolescents.

BACKGROUND/PURPOSE: The prevalence of obesity and overweight among children and adolescents is increasing rapidly. The present research was performed to determine the influence of a ''behavior modification'' program on body mass index (BMI) in obese public high school students in Iran. METHODS: In this study, 152 adolescence and their parents were selected from 12 high schools of Khorram Abad from 2004 to 2006, and they were randomly assigned to either the intervention or the control groups. The "behavior modification" interventional program consisted of nutritional education, modifying dietary habits, teaching exercise programs, teaching nutritional facts to the parents, and performing exercises 3 days a week. The height and weight as well as waist, hip, and wrist circumferences of the participants were measured before and after implementing the interventional program. BMI and waist to hip ratio (WHR) were calculated. The adolescents and parents completed a nutrition knowledge questionnaire. Adolescents also completed the Beck's Depression Questionnaire. RESULTS: Adolescent's mean weight, BMI, and waist and hip circumferences decreased significantly after implementing the interventional program, in the intervention group (p≤0.001). In addition, the students' and parents' nutrition knowledge increased in the intervention group after implementing the interventional program (p<0.046). The symptoms of depression decreased and the frequency of students without symptoms of depression increased in the case group, but it did not reveal a statistically significant difference between case and control groups. CONCLUSION: The ''behavior modification'' interventional program is effective in reducing BMI in obese students, and therefore, school principals and planners can play an important role in controlling obesity by implementing this program via the students, their parents, and the school staff.

Investigation of the assembly of chylomicrons in hamster enterocytes using pluronic-L81 acid as a probe.

A major function of the enterocytes is absorption, processing, and export of dietary lipids into the lymphatic system. Pluronic L-81 is a non-ionic hydrophobic surfactant, which specifically inhibits lipid absorption in the intestine when administered in vivo. This compound is therefore an attractive probe to perturb and investigate the molecular and intracellular events in chylomicron assembly in the enterocytes. In the present study pluronic acid was administered to hamsters followed by isolation of the enterocytes and cell fractionation to investigate the effect of pluronic acid on intracellular events in lipid absorption. Four types of diet were administered to hamsters for three weeks; low-fat chow, high-fat chow and each diet with or without added pluronic acid. Sub-cellular fractions of freshly isolated enterocytes were prepared. Consistent with morphological observation, the high fat diet resulted in a three-fold increase in the triacylglycerol (TAG) content of the enterocytes and addition of pluronic acid to either the low fat or the high fat diets resulted in a ten-fold increase in cellular TAG levels. Determination of the mass of TAG and the time course of incorporation of 3H-triolein, administered by gavage, showed that the increased TAG was recovered in the microsomal (endoplasmic reticulum) fraction and the cytosol. In microsomes, increased TAG was recovered mainly in the membrane although there was a significant amount in the microsomal luminal contents. Pluronic acid therefore acts at the level of the endoplasmic reticulum and inhibits the assembly of apo-B48 with chylomicron TAG. The excess TAG is transferred to cytosolic stores.