The association between dietary inflammatory index and risk of neuromyelitis optica spectrum disorder: a case-control study.

BACKGROUND AND AIM: Neuromyelitis optica spectrum disorder (NMOSD) is a severe and rare inflammatory disease affecting the central nervous system through optic neuritis and transverse myelitis. Present study aimed to investigate the association between dietary inflammatory index (DII) and risk of NMOSD. METHODS: In this case-control study, 30 NMOSD cases and 90 aged matched healthy individuals were recruited. Habitual dietary intakes were assessed by a validated 168-item food frequency questionnaire to calculate the DII score. A multiple adjusted regression was used to determine the odd ratio (OR) of NMOSD across DII tertiles. The Residual method was applied to adjust the energy intake. RESULTS: Participants in the top of DII tertile were more likely to have NMOSD in the crude model compared to those with the lowest one (OR: 4.18; 95%CI: 1.43-12.21). It was the case when multivariable confounders were considered in adjustment model I (OR: 3.98; 95%CI: 1.34-11.82) and II (OR: 4.43; 95%CI: 1.36-14.38), such that, individuals with a greater DII score had 3.98 and 4.43-time higher risk of NMOSD in model I and II, respectively. CONCLUSION: The Present study suggests that greater adherence to a pro-inflammatory diet may be associated with an increased risk of NMOSD.

The association between dietary diversity score and general and abdominal obesity in Iranian children and adolescents.

BACKGROUND: To evaluate the association between diet and disease, the consideration of a whole diet has appeared to be more effective than the examination of single-nutrient intake. This study aimed to examine the relationship between dietary diversity score (DDS) and obesity in Iranian children. METHODS: A cross-sectional study was conducted on 456 children aged 11-18 years, who were selected by random cluster sampling. The usual food intake for each participant assessed using a validated Food frequency questionnaire (FFQ). To calculate the dietary diversity score, food items were categorized into 5 broad groups and 23 subgroups based on the US Department of Agriculture Food Guide Pyramid. Participants were categorized based on the DDS tertile cut-off points. Anthropometric measurements were conducted based on standard protocols. Overweight and obesity were defined as 85th ≤ BMI < 95th, and ≥ 95th percentiles of BMI, respectively. Additionally, abdominal obesity was considered as WC ≥ 85th percentile. RESULTS: Mean and standard deviation (SD) of subjects' Body Mass Index (BMI) and waist circumference were 20.88 (SD 4.22) kg/m2 and 74.27 (SD 10.31) cm, respectively. The probability of overweight and obesity was increased as tertiles of DDS increased (OR among tertiles: 1.00, 1.82 and 2.13 for overweight and 1.00, 2.60 and 3.45 for obesity; this was the same for abdominal obesity: 1.00, 2.22 and 3.45, P <  0.001 for all). However, no statistically significant results were found after adjustment for energy intake. CONCLUSION: Dietary diversity positively affected obesity through higher energy intake. Despite the wide recommendation of having high dietary diversity, public health programs should emphasize to improve dietary diversity only in selective food items.

The effect of okra (Abelmoschus esculentus) on lipid profiles and glycemic indices in Type 2 diabetic adults: Randomized double blinded trials.

The aim of the present study was to investigate the effect of okra consumption on serum levels of lipid profiles and glycemic indices in Type 2 diabetic (T2D) patients. The present study was a randomized, double-blinded clinical trial, carried out in Kerman, Iran. Sixty T2D patients were randomized into intervention and control groups and received 10 g okra powder blended in 150 g conventional yogurt or conventional yogurt alone, along with dinner and lunch, for 8 weeks. Glycemic markers and lipid profile were assessed, as well as anthropometric measures, at the beginning and end of study. The findings showed that 8 weeks okra consumption resulted in a significant decrease in fasting plasma glucose (-15.61 ± 19.44 vs. -3.40 ± 24.78; p = .02), homeostatic model of assessment for insulin resistance (-1.17 ± 1.61 vs. -0.14 ± 1.64; p = .01), quantitative insulin sensitivity check index (0.01 ± 0.007 vs. 0.00 ± 0.01; p = .004), triacylglycerol (-22.30 ± 32.46 vs. -3.86 ± 30.57; p = .001), total cholesterol (-10.23 ± 10.36 vs. -2.03 ± 13.94; p = .004), low-density lipoprotein cholesterol (LDL-C; -8.15 ± 10.01 vs. -2.31 ± 9.37; p = .02), and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (-0.28 ± 0.37 vs. -0.08 ± 0.24; p = .01). No significant difference was observed between groups in HDL-C, glycated hemoglobin, fasting insulin levels, and anthropometric measures. The present study suggests that okra consumption can elicit improvements in lipid profile, as well as glycemic markers, among T2D patients.

24-h urinary sodium to potassium ratio and its association with obesity in children and adolescents.

PURPOSE: There are epidemiologic studies indicating a positive correlation between high sodium and low potassium intake and body mass index. Therefore, this study was conducted in a cross-sectional sample of Iranian children and adolescents to evaluate the link between 24-h urinary Na:K ratio and risk of obesity. METHODS: In this cross-sectional study, 374 participants aged 11-18 years were included. One 24-h urine sample was collected by each participant to estimate Na:K ratio. Anthropometric measurements were carried out and overweight/obesity was defined as a BMI ≥ 85th percentile and abdominal obesity as a waist:height ratio (WHtR) of more than 0.5. RESULTS: As expected, 24-h urinary Na:K ratio showed significant associations with risk of overweight/obesity. Risk of adiposity assessed by WC and PBF was significantly associated with Na:K ratio after adjusting for SSBs consumption and calorie intake. Urinary Na:K ratio showed significant association with risk of adiposity assessed by WC only in girls in the highest tertile group with OR of 2.71 (95% CI 1.14-6.43), only after the addition of calorie intake. Adiposity assessed by PBF was only associated with Na:K ratio among boys with OR of 4.47 (95% CI 1.44-9.87) and 3.87 (95% CI 1.20-8.48), after adjusting for SSBs consumption and calorie intake, respectively. CONCLUSION: Our findings suggest that reducing Na and increasing K intake could be used as a useful approach to lower the risk of obesity and associated burden of disease in Iran. However, more studies are warranted.

Prevalence of Primary Dysmenorrhea and Factors Associated with Its Intensity Among Undergraduate Students: A Cross-Sectional Study.

Primary dysmenorrhea is a womanhood problem around the world and negatively affects quality of life. This study was designed to investigate the prevalence of primary dysmenorrhea and to determine the factors associated with its intensity. A cross-sectional study was carried out among 311 undergraduate female students aged 18 to 27 years in Isfahan University of Medical Sciences, Iran. Socio-demographic characteristics and menstrual factors were obtained through interviews with the help of a pretested questionnaire. The prevalence of primary dysmenorrhea was 89.1%. Residing at home, younger age, lower number of years of formal education for the mother, positive family history of dysmenorrhea, higher severity of bleeding, and shorter menstrual period intervals were significantly associated with the higher intensity of primary dysmenorrhea. Primary dysmenorrhea is a common health concern among young women. Being aware of the factors that are associated with its intensity makes it possible for health professionals to organize better focused programs to reduce the adverse effects of dysmenorrhea.

Association of plant-based diets with adropin, atherogenic index of plasma, and metabolic syndrome and its components: A cross-sectional study on adults.

Background: Little is known about the association of plant-based diet indices with metabolic syndrome (MetS) and its novel predictive biomarkers, including the atherogenic index of plasma (AIP) and adropin. We aimed to investigate the association of plant-based diets with adropin, atherogenic index of plasma, and MetS and its components in adults. Methods: The present population-based cross-sectional study was conducted on a representative sample of adults aged 20-60 years in Isfahan, Iran. Dietary intake was obtained through a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Peripheral blood was obtained after an overnight fast of at least 12 h from each participant. MetS was identified based on the Joint Interim Statement (JIS). AIP was calculated as a logarithmically transformed ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-c), and serum levels of adropin were measured by an ELISA kit. Results: A total of 28.7% of subjects had MetS. No significant association was found between the overall plant-based diet index (PDI) and the healthful plant-based diet index (hPDI) with MetS. However, a non-linear association was observed between hPDI and MetS. Subjects in the third quartile of the unhealthful plant-based diet index (uPDI) had higher odds of MetS compared to the first quartile (OR: 2.39; 95% CI: 1.01, 5.66). The highest quartile of PDI (OR: 0.46; 95% CI: 0.21, 0.97) and the third quartile of hPDI (OR: 0.40; 95% CI: 0.18, 0.89) were associated with decreased odds of having high-risk AIP compared to the first quartile, after adjusting for potential confounders. No linear association was found between quartiles of plant-based diet indices and serum levels of adropin. Conclusion: Plant-based diet index (PDI) and hPDI were not associated with the prevalence of MetS in adults, while moderate adherence to uPDI increased the prevalence of MetS. In addition, high adherence to PDI and moderate adherence to hPDI were associated with decreased odds of high-risk AIP. No significant association was found between plant-based diet indices and serum adropin levels. To confirm these findings, further studies with prospective designs are warranted.

Modified alternate-day fasting vs. calorie restriction in the treatment of patients with metabolic syndrome: A randomized clinical trial.

OBJECTIVE: The aim of present study was to compare the effect of calorie restriction and modified alternate-day fasting diet on treatment of adults with metabolic syndrome. DESIGN: This randomized clinical trial was conducted on 70 participants diagnosed with metabolic syndrome. SETTING: Patients were randomly allocated into 2 groups to follow either calorie restriction or a modified alternate-day fasting diet for 8 weeks. Diets was prescribed by dietitians and specialized for each participant. Anthropometric parameters, blood pressure, fasting plasma glucose, fasting insulin, HOMA-IR and lipid profile were measured at baseline and after trial conclusion. RESULTS: 69, out of 70, participants completed the study and were included in the final analysis. The results showed that, compared with calorie restriction, following the modified alternate-day fasting diet significantly reduced body weight (P = 0.003), waist circumference (P = 0.026), systolic blood pressure (P = 0.029) and fasting plasma glucose (P = 0.009). However, no significant difference was observed between the 2 groups in triglyceride (P = 0.614), total cholesterol (P = 0.759), LDL-C (P = 0.289), HDL-C (P = 0.909), diastolic blood pressure (P = 0.262), HOMA- IR (P = 0.425) and fasting insulin concentrations (P = 0.496). In addition, the participants did not report any complaint due to difficulties with diet adherence when following calorie restriction or modified alternate-day fasting diet. CONCLUSIONS: the present study suggests that modified alternate-day fasting diet may be a more effective option in managing body weight, waist circumference, systolic blood pressure, and fasting plasma glucose, compared with common calorie restriction. Further studies are needed to confirm the veracity of our results.

Zinc status of Iranian preschool children.

BACKGROUND: Zinc deficiency is one of the most prevalent micronutrient deficiencies in developing countries, including Iran. The main direct causes of zinc deficiency are insufficient zinc intake, absorption or metabolic disorder, and increase in need during acute growth periods. OBJECTIVE: To determine the prevalence of zinc deficiency in preschool boys and girls in urban and rural populations in order to assist policy makers. Children of preschool age (i.e., 6 years old in Iran) were studied because interventions in this age group are believed to result in greater improvement in learning skills once these children enter school. METHODS: A national cross-sectional study was carried out on 4,374 randomly selected healthy preschool children from Iranian families in 2001. Serum zinc concentration was measured by atomic absorption spectrometry. The cutoff point for zinc deficiency was set at a serum level of 10 micromol/L (65 microg/dL). RESULTS: The prevalence of zinc deficiency was estimated at approximately 19.3%. The highest prevalence was seen in the region that includes Sistan and Baluchistan, South Khorasan, and the southeast area of Kerman and the lowest in the region of Boushehr, Hormozgan, and South Khoozestan. The prevalence of zinc deficiency was significantly higher in rural areas than in urban areas. No significant difference in prevalence was seen between boys and girls. CONCLUSIONS: In the long run, nutritional security and increased access to and intake of foods with high levels of zinc are the most sustainable strategies to overcome zinc deficiency. Fortification of staple foods, improved quality of traditional bread, and supplementation for at-risk population groups are considered short- and mid-term interventions. Nutrition education and behavioral change may be long-term strategies.

Relationship of sodium intake with obesity among Iranian children and adolescents.

BACKGROUND: Emerging evidence suggests a relationship between sodium (Na) intake and obesity risk. The aim of this study was to investigate the link between 24-hour (24-h) urinary Na excretion and adiposity measures in a sample of Iranian children and adolescents. METHODS: This cross-sectional study was performed among 374 healthy individuals aged 11-18 years old. Random cluster sampling method was used to select the participants from 4 districts in Isfahan, Iran. Na excretion was estimated using a 24-h urinary sample. Creatinine (Cr) level was used to confirm the completeness of samples. Anthropometric measures including weight, height and waist circumference (WC) were obtained based on standard protocols. RESULTS: The odds ratio (OR) for overweight/obesity in subjects with the highest tertile of Na excretion compared with the lowest tertile was 8.01 [95% confidence interval (CI) 4.20-15.3] in crude model and 8.33 (95% CI 4.14-16.8) after adjusting for potential confounders. The association was independent of intake of energy and sugar-sweetened beverages (SSBs). The OR for abdominal obesity in the highest tertile of Na excretion compared with the lowest tertile was 9.12 (95% CI 4.78- 17.4) in crude model and 9.75 (95% CI 4.88-19.5) after controlling for potential confounders. The association was independent of energy intake or SSBs consumption. CONCLUSION: Our study showed a positive association between Na excretion and obesity among children and adolescents. Further investigation through longitudinal studies using a more representative sample of children and adolescents is suggested to determine whether this is a causal relationship.

Dietary approaches to stop hypertension diet and obesity: A cross-sectional study of Iranian children and adolescents.

BACKGROUND: Few studies have investigated the effects of dietary approaches to stop hypertension (DASH) diet on obesity in children. The present study was conducted to examine adherence to the DASH diet in relation to obesity in children and adolescents, Isfahan, Iran. METHODS: A cross-sectional study was carried out among 456 children aged 11-18 years who were selected by random cluster sampling method. Dietary intakes were assessed using a validated Food Frequency Questionnaire (FFQ). The DASH score was constructed based on food items emphasized or minimized in the DASH diet. Anthropometric measurements were conducted based on standard protocols. General and abdominal obesity were defined based on body mass index ≥ 95th percentiles and waist: height ratio of more than 0.5, respectively. RESULTS: Higher adherence to DASH diet was inversely associated with general obesity (odds ratioT1 vs. T3 3.34, 95% confidence interval 1.28-8.75); however, after controlling for confounding factors, this association disappeared. Furthermore, higher adherence to DASH diet was negatively associated with central obesity in children, but the relation was not statistically significant. CONCLUSION: We concluded that there was an inverse nonsignificant association between adherence to DASH diet and general obesity indices after adjustment for potential confounders. Further, well-designed randomized clinical trial studies are suggested to find out the effect of DASH diet on obesity obviously.

Effect of Brown Rice Consumption on Inflammatory Marker and Cardiovascular Risk Factors among Overweight and Obese Non-menopausal Female Adults.

BACKGROUND: Brown rice (BR) is unpolished rice with various beneficial compounds such as vitamins, magnesium and other minerals, dietary fiber, essential fatty acids, γ-oryzanol and γ-aminobutyric acid. In the present study, we compared the effects of white rice (WR) and BR on inflammatory marker high-sensitivity C-reactive protein (hs-CRP) and cardiovascular risk factors among non-menopausal overweight or obese female. METHODS: In a randomized cross-over clinical trial, 40 overweight or obese (body mass index (BMI) >25) women were randomly allocated to group 1 (n = 20): Treatment with BR diet and group 2 (n = 20): Treatment with WR diet for 6 weeks (first intervention period). Two participants in group 2 dropped out during this period. After a 2-week washout period, individuals were switched to the alternate diet for an additional 6 weeks (second intervention period) and three subjects in group 2 did not follow this period and eliminated, finally this study was completed with 35 subjects (group 1 = 20 and group 2 = 15). Each one was instructed to consume 150 g cooked WR or BR daily in each intervention period. Cardiovascular risk factors including BMI, waist and hip circumference, blood pressure, serum lipid profiles, fasting blood glucose (FBG) and hs-CRP as an inflammatory marker, were measured 4 times (in study week 0, 6, 8, 14). RESULTS: BR diet in comparison with WR diet could significantly reduce weight, waist and hip circumference, BMI, Diastole blood pressure and hs-CRP. No significant differences between the two diets were found regarding lipid profiles and FBG. CONCLUSIONS: The present results suggest that BR replacement in the diet may be useful to decrease inflammatory marker level and several cardiovascular risk factors among non-menopausal overweight or obese female.