Household food security in isfahan based on current population survey adapted questionnaire.

BACKGROUND: Food security is a state in which all people at every time have physical and economic access to adequate food to obviate nutritional needs and live a healthy and active life. Therefore, this study was performed to quantitatively evaluate the household food security in Esfahan using the localized version of US Household Food Security Survey Module (US HFSSM). METHODS: This descriptive cross-sectional study was performed in year 2006 on 3000 households of Esfahan. The study instrument used in this work is 18-item US food security module, which is developed into a localized 15-item questionnaire. This study is performed in two stages of families with no children (under 18 years old) and families with children over 18 years old. RESULTS: The results showed that item severity coefficient, ratio of responses given by households and item infit and outfit coefficient in adult's and children's questionnaire respectively. According to obtained data, scale score of +3 in adults group is described as determination limit of slight food insecurity and +6 is stated as the limit for severe food insecurity. For children's group, scale score of +2 is defined to be the limit of slight food insecurity and +5 is the determination limit of severe food insecurity. CONCLUSIONS: The main hypothesis of this survey analysis is based on the raw scale score of USFSSM The item of "lack of enough money for buying food" (item 2) and the item of "lack of balanced meal" (3(rd) item) have the lowest severity coefficient. Then, the ascending rate of item severity continues in first item, 4(th) item and keeps increasing into 10(th) item.

Assessing the internal validity of a household survey-based food security measure adapted for use in Iran.

BACKGROUND: The prevalence of food insecurity is an indicator of material well-being in an area of basic need. The U.S. Food Security Module has been adapted for use in a wide variety of cultural and linguistic settings around the world. We assessed the internal validity of the adapted U.S. Household Food Security Survey Module to measure adult and child food insecurity in Isfahan, Iran, using statistical methods based on the Rasch measurement model. METHODS: The U.S. Household Food Security Survey Module was translated into Farsi and after adaptation, administered to a representative sample. Data were provided by 2,004 randomly selected households from all sectors of the population of Isfahan, Iran, during 2005. RESULTS: 53.1 percent reported that their food had run out at some time during the previous 12 months and they did not have money to buy more, while 26.7 percent reported that an adult had cut the size of a meal or skipped a meal because there was not enough money for food, and 7.2 percent reported that an adult did not eat for a whole day because there was not enough money for food. The severity of the items in the adult scale, estimated under Rasch-model assumptions, covered a range of 6.65 logistic units, and those in the child scale 11.68 logistic units. Most Iteminfit statistics were near unity, and none exceeded 1.20. CONCLUSION: The range of severity of items provides measurement coverage across a wide range of severity of food insecurity for both adults and children. Both scales demonstrated acceptable levels of internal validity, although several items should be improved. The similarity of the response patterns in the Isfahan and the U.S. suggests that food insecurity is experienced, managed, and described similarly in the two countries.

Long term effects of oral vitamin E supplement in type II diabetic patients.

This triple-blind, placebo-controlled clinical trial was conducted to determine the effect of the vitamin E on fasting blood sugar (FBS), serum insulin, and glycated hemoglobin (GHb) in type 11 diabetic patients (NIDDM). A total of 100 patients, with no complications, aged 20-60 years old were chosen from those consulting the Isfahan Social Security Service Diabetes Clinic and divided randomly into two treated and placebo groups, and matched for age, sex, level of education, and occupation. The treated and placebo groups were given vitamin E tablets (200 IU/day) and placebo respectively. Serum vitamin E, total cholesterol (TC), triglycerides (TG), FBS, insulin, and GHb were measured at the beginning and at the end of the study (a period of 27 weeks); FBS, GHb and insulin levels were also determined several times during the period. Blood lipids and FBS were measured using the ELAN 2000 autoanalyzer at the Isfahan Cardiovascular Research Center, while for measuring insulin the enzyme-linked immunosorbent assay (ELISA) method was used; GHb was determined calorimetrically (thiobarbituric acid), and for vitamin E measurements the Hansen and Warwick method was used, by which the vitamin E was determined fluorometrically. The findings of this study show no effect of vitamin E supplementation in the patients: GHb did not change appreciably, FBS was reduced nonsignificantly (-4.3% in the treated group vs. -14.0% in the placebo group, p < 0.05). In the case of insulin, no increase was seen; instead, a decrease was observed (slightly more than 17% in the two groups, p = 0.15). No changes were observed in the levels of blood lipids. It was concluded that a daily vitamin E supplement of 200 IU for a period of 27 weeks does not affect insulin, GHb, or FBS in type II diabetic patients. However, since this antioxidant vitamin is beneficial in other ways in these patients, it would seem justified to recommend its use. Certainly, more extensive research is necessary to draw definite conclusions.

Isfahan Healthy Heart Programme: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience.

The Isfahan Healthy Heart Programme (IHHP) is a five to six year comprehensive integrated community-based programme for cardiovascular diseases (CVD) prevention and control via reducing CVD risk factors and improvement of cardiovascular healthy behaviour in a target population. IHHP started late in 1999 and will be finished in 2005-2006. A primary survey was done to collect baseline data from interventional (Isfahan and Najaf-Abad) and reference (Arak) communities. In a two-stage sampling method, we randomly selected 5 to 10 percent of households from randomly selected clusters. Then individuals aged > or = 19 years were selected for the survey. This way, data from 12,600 individuals (6300 in interventional counties and 6300 in the reference county) was collected and stratified according to living area (urban vs. rural) and different age and sex groups. The samples underwent a 30-minute interview to complete validated questionnaires containing questions on demography, socioeconomic status, smoking behaviour, physical activity, nutritional habits and other behaviour regarding CVD. Blood pressure and body mass index (BMI) measurements were done and fasting blood samples were taken for two hours post load plasma glucose (2 hpp), serum (total, HDL and LDL) cholesterol and triglyceride levels. A twelve-lead electrocardiogram was recorded in all persons above 35 years of age. Community-wide surveillance of deaths, hospital discharges, myocardial infarction and stroke registry was carried out in the intervention and control areas. Four to five years of interventions based on different categories such as mass media, community partnerships, health system involvement and policy and legislation have started in the intervention area while Arak will be followed without intervention. Considering the results of the baseline surveys, (assessments needed, the objectives, existing resources and the possibility of national implementation) the interventions were planned. They were set based on specific target groups like school children, women, work-site, health personnel, high-risk persons, and community leaders were actively engaged as decision makers. A series of teams was arranged for planning and implementation of the intervention strategies. Monitoring will be done on small samples to assess the effect of different interventions in the intervention area. While four periodic surveys will be conducted on independent samples to assess health behaviours related to CVD risk factors in the intervention and reference areas, the original pre-intervention subjects aged more than 35 years will be followed in both areas to assess the individual effect of interventions and outcomes like sudden death, fatal and nonfatal MI and stroke. The whole baseline survey will be repeated on the original and an independent sample in both communities at the end of the study.

Vitamin E can reduce blood pressure in mild hypertensives.

This triple-blind placebo-controlled clinical trial was performed to determine the effects of the anti-oxidant vitamin E on blood pressure and heart rate in patients with mild hypertension. A total of 70 new mild hypertensive subjects (systolic blood pressure, SBP: 140-160 mmHg; diastolic blood pressure, DBP: 90-100 mmHg) without secondary hypertension were selected from among people referred to the Hypertension Unit of Isfahan Cardiovascular Research Center and divided randomly into two groups of drug (DG) and placebo (PG). All subjects were aged from 20 to 60 years old, without any other cardiovascular risk factors. The drug group received vitamin E tablets (200 IU/day) and the placebo group received placebo only for 27 weeks. At the beginning and the end of the study, the blood vitamin E level was measured fluorimetrically in all subjects according to the Hansen and Warwick method [14, 15]. Blood pressure and heart rate were measured at the beginning, during, and at the end of the study. Blood pressure was measured by a physician using one random zero mercury sphygmomanometer. Personal information and dietary habits of subjects were collected by separate questionnaire. At the end of the study, it was found that the vitamin E supplement had caused a remarkable decrease in SBP (-24% in DG versus -1.6% in PG) and a less remarkable decrease in DBP (-12.5% in DG versus -6.2% in PG) (p < 0.05). The change in heart rate was -4.3% in DG, and -14.0% in PG (p < 0.05). It is concluded that a vitamin E supplement of 200 IU/day can be effective in mild hypertensive patients in the long term, probably due to nitric oxide, and improve their blood pressure status. Therefore, vitamin E supplement could be recommended to such patients.