Publications by authors named "Fereydoun Siassi"

69 Publications

Dietary Fat Quality and Pre-diabetes: A Case-control Study.

Int J Prev Med 2020 5;11:160. Epub 2020 Oct 5.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Background: The relationship between dietary fat quality (DFQ) indices and pre-diabetes has not been well studied. This study aimed to determine the association of DFQ indices and fatty acid intake with pre-diabetes.

Methods: This case-control study included 150 subjects with normal fasting blood glucose (FBG) and 147 pre-diabetic subjects. Dietary intake was assessed by a validated food-frequency questionnaire. DFQ indices including atherogenicity (AI) and thrombogenicity (TI), the ratios of hypo- and hypercholesterolemic (h:H), polyunsaturated:saturated (P:S) and n-3:n-6 polyunsaturated fatty acids were calculated. FBG test and 2-hour oral glucose tolerance test (OGTT) were measured.

Results: After adjustment for some confounding variables, a positive association was found between intake of total saturated fatty acids (SFA), myristic acid, palmitic acid, and pre-diabetes, and a negative association was observed among -3 polyunsaturated fatty acids, eicosapentaenoic, docosahexaenoic and arachidonic acids intake and pre-diabetes. AI was found to be positively associated with pre-diabetes (OR 6.68, 95% CI 2.57-17.34). An inverse relationship was observed between -3:-6 (OR 0.37, 95% CI 0.14-0.93) and h:H (OR 0.20, 95% CI 0.07-0.52) ratios with pre-diabetes.

Conclusions: Higher intake of dietary -3 fatty acids was adversely, whereas SFA intake was positively related to pre-diabetes morbidity. DFQ indices may be a useful measure to investigate fat intakes and blood glucose disturbances.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_243_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716603PMC
October 2020

The association of food quality index with mental health in women: a cross-sectional study.

BMC Res Notes 2020 Dec 9;13(1):557. Epub 2020 Dec 9.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Objective: Diet is a fundamental modifiable risk factor for the development of depression and anxiety. However, no evidence currently exists regarding the association of food quality score (FQS) and mental health in Iranian women. This study investigated the relationship between food quality score, depression, anxiety and stress in Iranian women.

Results: Results showed that 35%, 41% and 42% of participants had depression, anxiety and stress, respectively. The average age of participants was 31.40 ± 7.47 years. A significant association was indicated between FQS and symptoms of depression (OR: 0.36; 95% CI 0.21, 0.63), anxiety (OR: 0.31; 95% CI 0.18, 0.53), and stress (OR: 0.39; 95% CI 0.23, 0.66) in both crude and adjusted models.
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http://dx.doi.org/10.1186/s13104-020-05401-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726882PMC
December 2020

Association of dietary acid-base load and psychological disorders among Iranian women: A cross-sectional study.

Complement Ther Med 2020 Sep 4;53:102503. Epub 2020 Jul 4.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Science, Isfahan, Iran. Electronic address:

Metabolic acidosis, which can be affected by dietary acid-base load, seems to be associated with psychological disorders through different pathways. Given limited evidence on dietary acid-base load, we aimed to examine the association of dietary acid-base load with psychological disorders in Iranian women. This cross-sectional study was performed on 447 female subjects (20-50 years old). Dietary intake was assessed using a valid food frequency questionnaire for Iran. Dietary acid-base load was calculated through different indices including potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL). To assess psychological disorders, an Iranian validated version of depression, anxiety, and stress scale (DASS-21) was used. The mean value of PRAL, NEAP, and DAL were -8.87mEq/da, 37.94mEq/day, and 30.77mEq/day, respectively. Considering a wide range of confounding variables, compared with the first tertile, a significant positive association was observed between dietary acid-base load and depression (OR: 3.63; 95 %CI:1.97, 6.71; P = 0.0001) (OR:3.42; 95 %CI: 1.87, 6.23; P = 0.0001) (OR: 3.02; 95 %CI: 1.64, 5.58; P = 0.0001). Women in the high dietary acid-base load category had higher anxiety (OR: 3.31; 95 %CI: 1.81, 6.06; P = 0.0001) (OR:3.47; 95 %CI: 1.90, 6.33; P = 0.0001) (OR: 3.25; 95 %CI: 1.76, 5.98; P = 0.0001). Moreover, there was a strong positive relationship between dietary acid-base load and psychologicaldistress (OR: 3.79; 95 %CI: 2.09, 6.90; P = 0.0001) (OR: 3.67; 95 %CI: 2.04, 6.58; P = 0.0001) (OR: 3.00; 95 %CI: 1.66, 5.43; P = 0.0001). Women with higher dietary acid-base load score had greater odds for depression, anxiety, and psychological distress compared to lower ones.
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http://dx.doi.org/10.1016/j.ctim.2020.102503DOI Listing
September 2020

The effects of green cardamom supplementation on blood pressure and endothelium function in type 2 diabetic patients: A study protocol for a randomized controlled clinical trial.

Medicine (Baltimore) 2020 May;99(18):e11005

Department of Community Nutrition.

Introduction: Cardamom possesses antioxidant, anti-inflammation, and blood pressure lowering properties, which might improve endothelial function in type 2 diabetic patients. However, no study has examined the effect of cardamom on diabetic patients. The present study aimed to examine the effects of 10-week green cardamom intake on blood pressure, concentrations of inflammatory and endothelial function biomarkers in type 2 diabetes mellitus patients, and its potential mechanisms.

Methods And Analysis Design: Eighty overweight or obese patients with type 2 diabetes mellitus (aged 30-60 years) will be recruited into the trial and will assign to receive either cardamom (3 g/day, 6 capsules) or placebo (rusk powder, 6 capsules) for a period of 10 weeks. Systolic blood pressure and diastolic blood pressure, asymmetric dimethylarginine, and nitric oxide will be measured. Serum inflammatory markers namely interleukin 6, tumor necrosis factor-α, high-sensitivity C-reactive protein, and factors related to endothelial function including intercellular adhesion molecule-1, vascular cell adhesion molecule 1, CD62 antigen-like family member E, and cluster of differentiation 163 will be measured at baseline and at the end of the trial. Sociodemographic, International Physical Activity Questionnaire, and three 24-hour dietary recall questionnaires will be collected for each participant.

Ethics And Dissemination: The study has been approved by The Ethics Committee of Tehran University of Medical Sciences (IR.TUMS.REC.1395.2700). Each participant will sign a written informed consent at the beginning of the study. At the end of the study, results will be published timely manner.

Trial Registration Number: (http://www.irct.ir, identifier: IRCT-2016042717254N5) Date of registration: 2016-11-23.
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http://dx.doi.org/10.1097/MD.0000000000011005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7440108PMC
May 2020

Dietary fat quantity and quality in relation to general and abdominal obesity in women: a cross-sectional study from Ghana.

Lipids Health Dis 2020 Apr 11;19(1):67. Epub 2020 Apr 11.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost street, Naderi street, Keshavarz Blv, Tehran, Iran.

Background: Although relationships between obesity and total fat and fat types have been widely examined, the associations between the relative proportions of fatty acids calculated in the form of indices and obesity/overweight are lacking. The objective of this study was to assess associations between dietary fat quality indices and odds of obesity/overweight in women from Ghana.

Methods: In this cross-sectional study, dietary information was obtained using 24-h dietary recall. The odds of obesity were evaluated across quintiles of specific DFQ indices [atherogenicity index (AI), thrombogenic index (TI), hypo- and hypercholesterolemic fatty acids ratio (h/H), omega-3 to omega-6 polyunsaturated fatty acids ratio (∑ω-3/∑ω-6), polyunsaturated fatty acids/saturated fatty acids ratio (PSR), dietary lipophilic index (LI) and percentage of energy from total fat (TF)].

Results: After adjustment for covariates, general obesity and overweight were inversely associated with ∑ω-3/∑ω-6 ratio (OR: 0.63; 95% CI: 0.24-1.63; P for trend (P) = 0.005) and positively with TI (4.14; 95% CI: 1.78-9.66; P = 0.01) and LI (2.49; 95% CI: 1.14-5.43; P = 0.01). The odds of abdominal obesity based on waist circumference (WC) were significantly higher among participants in the fifth quintile (Q) compared with those in the first Q of AI (1.24; 95% CI: 0.56-2.74; P = 0.01), TI (4.14; 95% CI: 1.78-9.66; P = 0.009), LI (2.11; 95% CI: 0.98-4.55; P = 0.02) and TF (1.59; 95% CI: (0.73-3.46; P = 0.003). Similarly, waist to height ratio (WHtR) was positively associated with AI (2.89; 95% CI: 1.32-6.31; P = 0.04), TI (2.65; 95% CI: 1.22-5.76; P = 0.03), LI (3.32; 95% CI: 1.52-7.28; P = 0.007) and TF (1.83; 95% CI: 0.85-3.93; P = 0.009).

Conclusion: There was an inverse association between ∑ω-3/∑ω-6 ratio and general obesity and WC. We also found positive associations between abdominal obesity and AI and TF. Furthermore, TI and LI showed positive relationships with both general and abdominal obesity. Therefore, intake of dietary fatty acids in favor of higher ratios of ∑ω-3/∑ω-6 may be important in obesity prevention.
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http://dx.doi.org/10.1186/s12944-020-01227-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7149837PMC
April 2020

Higher dietary fat quality is associated with lower anxiety score in women: a cross-sectional study.

Ann Gen Psychiatry 2020 26;19:14. Epub 2020 Feb 26.

1Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost street, Naderi street, Keshavarz Blv., Tehran, Iran.

Background: The relationship between anxiety and dietary fat quality (DFQ) has not been well studied. The aim of this study was to investigate the relationship between anxiety disorder and fatty acids' intake in women.

Methods: This cross-sectional study included 300 women aged 18-49 attending healthcare centers. Dietary exposure was measured by a 168-item semi-quantitative food frequency questionnaire (FFQ). To determine the status of anxiety, the Depression, Anxiety, and Stress Scale (DASS) questionnaire was used. Based on the total score of anxiety, the participants were divided into two groups of without anxiety (< 8) and with anxiety (≥ 8). The relationship between fatty acids intake and odd ratio (OR) for anxiety was analyzed by simple logistic regression.

Results: About 37.7% of individuals reported anxiety. After adjustment for covariates, an increase in the OR for anxiety was observed across the quintuples of saturated fatty acids (SFAs) (OR 3.17; 95% CI 1.43-7.00; -trend = 0.005). In addition, higher intakes of monounsaturated fatty acids (MUFAs) (OR 0.15; 95% CI 0.05-0.44; -trend = 0.001), oleic acid (OR 0.25; 95% CI 0.09-0.67; -trend = 0.002), alpha-linolenic acid (ALA) (OR 0.07; 95% CI 0.02-0.23; -trend < 0.001), and -3:-6 poly unsaturated fatty acids (PUFAs) (OR 0.56; 95% CI 0.24-1.03; -trend = 0.02) were found to be related with lower OR of anxiety.

Conclusion: Intake of SFAs was positively related to anxiety disorder, whereas MUFAs, oleic acid, ALA, and -3: -6 PUFAs intake were inversely related to anxiety score. For investigating the association of fat intake and anxiety disorder, DFQ may be a useful measure.
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http://dx.doi.org/10.1186/s12991-020-00264-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045483PMC
February 2020

Dietary inflammatory index and dietary energy density are associated with menopausal symptoms in postmenopausal women: a cross-sectional study.

Menopause 2020 05;27(5):568-578

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: No previous study has evaluated the association of the dietary inflammatory index (DII) and dietary energy density (DED) with menopausal symptoms and its subclasses in postmenopausal women. The aim of this study was to evaluate the association of DII score and DED with menopausal symptoms and its subtypes in Iranian postmenopausal women.

Methods: This cross-sectional study was conducted on 393 postmenopausal women who attended health centers in the south of Tehran, Iran. The DII score was calculated using dietary factors obtained by a validated food frequency questionnaire. DED was defined as average daily energy intake (kcal) per gram of food. The Menopause Rating Scale questionnaire was used to evaluate the menopausal symptoms. The total Menopause Rating Scale score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score. Linear regression analysis was used to assess the association of the DII score and DED with menopausal symptoms.

Results: After adjusting for covariates, participants in the highest tertile of DII score had greater SS compared to those in the lowest tertile (βDIIt3vs1= 0.032, 95% confidence interval (CI): 0.004-0.068, P = 0.04). No significant relationship was found between DII score and PS, urogenital score or TMRSS. Furthermore, higher DED was associated with greater SS (βDIIt3vs1 = 0.071, 95% CI: 0.028-0.115, P = 0.001), PS (βDIIt3vs1 = 0.065, 95% CI: 0.012-0.121, P = 0.01) and TMRSS (βDIIt3vs1 = 0.053, 95% CI: 0.017-0.088, P = 0.004).

Conclusion: A proinflammatory diet was associated with higher menopause-specific somatic symptoms and higher DED was positively associated with menopausal symptoms.
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http://dx.doi.org/10.1097/GME.0000000000001502DOI Listing
May 2020

Higher intakes of fruits and vegetables are related to fewer menopausal symptoms: a cross-sectional study.

Menopause 2020 05;27(5):593-604

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: The aim of this study was to explore the associations between fruit and vegetable (FV) intake, and its subgroups and menopausal symptoms along with its subtypes in postmenopausal women.

Methods: This cross-sectional study included 393 postmenopausal women in municipality health centers in the south of Tehran, Iran. Sociodemographic data, dietary intakes, and anthropometric measures were obtained from individuals. Menopause rating scale (MRS) questionnaire was employed to measure menopausal symptoms. The total MRS score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score (US). Participants were divided into low and high total MRS and its domain scores.

Results: After adjustment for confounding variables, an inverse relationship was found between total FV with TMRSS (odds ratio [OR] 0.23, 95% confidence interval [CI] 0.06-0.81) and SS (OR 0.30, 95% CI 0.11-0.82). In addition, the consumption of total fruits was significantly related to lower SS (OR 0.27, 95% CI 0.10-0.71). Only intake of citrus fruits was inversely associated with TMRSS (OR 0.23, 95% CI 0.07-0.71) and SS (OR 0.28, 95% CI 0.11-0.70). Likewise, intakes of total FV (OR 2.46, 95% CI 1.37-4.41), total vegetables (OR 2.54, 95% CI 1.10-5.88), green leafy vegetables (OR 3.59, 95% CI 1.47-8.75), dark yellow vegetables (OR 2.28, 95% CI 1.00-5.18), other vegetables (OR 5.23, 95% CI 1.17-15.39), and citrus fruits were linked to higher US (OR 4.35, 95% CI 1.77-10.71).

Conclusion: The results of the present study showed that some FV subgroups had inverse associations with climacteric symptoms, whereas higher intake of some subgroups of FV appeared to be associated with more urogenital symptoms in postmenopausal women.
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http://dx.doi.org/10.1097/GME.0000000000001511DOI Listing
May 2020

The association of serum levels of zinc and vitamin D with wasting among Iranian pre-school children.

Eat Weight Disord 2021 Feb 3;26(1):211-218. Epub 2020 Jan 3.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.

Purpose: Wasting is a main indicator of Child's undernutrition that is associated with several non-communicable diseases and child mortality. This is the first population-based study which evaluated the association of serum zinc and vitamin D levels with wasting in a Middle East region. We also reported the prevalence of vitamin D and zinc deficiencies among Iranian pre-school children aged 6 years.

Methods: This was a multicenter cross-sectional study that included 425 children aged between 5 and 7 years (on average 6 years) with BMI-for-age Z-scores of < - 1 SD resident in urban and rural areas of Iran in the spring of 2012 as part of the National Integrated Micronutrient Survey 2 (NIMS-2). Anthropometric measurements and blood sampling were obtained. The prevalence of vitamin D and zinc deficiencies together with the correlations of these variables with the increase of BMI-for-age Z-scores were evaluated.

Results: The prevalence of vitamin D and zinc deficiencies was 18.8% and 12.7%, respectively. In addition, 31.1% of children were wasted. Children in the second tertile of 25(OH)D levels were less likely to have wasting compared with those in the first tertile in both crude and adjusted models (OR 0.47, 95% CI 0.27-0.83). A significant inverse association was found between serum levels of zinc and wasting (OR 0.57, 95% CI 0.34-0.96); such that after adjusting for confounders, children in the highest tertile of serum zinc had 47% less odds of wasting compared with those in the first tertile (OR 0.53, 95% CI 0.31-0.91).

Conclusion: The prevalence of vitamin D and zinc deficiencies among Iranian pre-school children aged 6 years was 18.8 and 12.7%, respectively. Serum levels of vitamin D and zinc were inversely associated with wasting either before or after controlling for confounders.

Level Of Evidence: Level III, case-control analytic studies.
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http://dx.doi.org/10.1007/s40519-019-00834-1DOI Listing
February 2021

Association between Carbohydrate Quality Index and general and abdominal obesity in women: a cross-sectional study from Ghana.

BMJ Open 2019 12 23;9(12):e033038. Epub 2019 Dec 23.

Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran, Iran (the Islamic Republic of)

Objectives: The relationships between carbohydrate intake and risk of obesity have been widely investigated. However, there are limited data on the associations between their relative proportions and quality contained in the same diet on risk of obesity, especially in low-income and middle-income countries. The aim of this study was to assess the relationship between an overall Carbohydrate Quality Index (CQI) and general and abdominal obesity in women.

Setting And Participants: In this cross-sectional study, data from 277 women in Ghana were analysed. Dietary information was obtained from 2-day 24 hours dietary recalls. CQI was calculated from the four indices dietary fibre, Glycaemic Index, whole grains/total grains ratio and solid carbohydrates/total carbohydrates ratio.

Outcome Measures: Body mass index, waist circumference (WC), waist-to-height ratio (WHtR) and Conicity Index were measured.

Results: After adjusting for covariates, the chance for general obesity (OR 0.25, 95% CI 0.10 to 0.65) and abdominal obesity measured by WC (OR 0.22, 95% CI 0.08 to 0.58) were significantly lower in the topmost quintile of CQI in comparison with the lowest quintile. In addition, the OR for higher WHtR (OR 0.27, 95% CI 0.11 to 0.69) was significantly lower among participants in the fifth quintile of CQI compared with those in the first quintile.

Conclusions: The present study demonstrates that there is an inverse association between dietary CQI and both general and abdominal obesity. These findings suggest that CQI may be used for the improvement of dietary intake to prevent obesity.
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http://dx.doi.org/10.1136/bmjopen-2019-033038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008417PMC
December 2019

Beneficial effects of nano-curcumin supplement on depression and anxiety in diabetic patients with peripheral neuropathy: A randomized, double-blind, placebo-controlled clinical trial.

Phytother Res 2020 Apr 1;34(4):896-903. Epub 2019 Dec 1.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Depression in patients with diabetes is associated with poor glycemic control and linked to an increased risk for diabetes complications such as neuropathy. Curcumin has shown potential antidepressant-like activities in some studies. The present study is the first randomized controlled trial to test the efficacy of nano-curcumin supplementation on depression, anxiety, and stress in patients with diabetic polyneuropathy. Eighty patients with diabetes were enrolled in this parallel, double-blind, randomized, placebo-controlled clinical trial. The participants were allocated randomly to the intervention (n = 40) and control (n = 40) groups. They received 80 mg of nano-curcumin or placebo capsules daily for 8 weeks. At baseline and end of study, anthropometric measurements, dietary intake, physical activity, glycemic indices, and severity of neuropathy were assessed. The depression, anxiety, and stress level were measured by Depression, Anxiety, Stress Scale (DASS-21-items) questionnaire before and after the intervention. After intervention, there was a significant reduction in the mean score of depression in the nano-curcumin group (from 16.7 [3.1] to 15.3 [2.6]) compared with placebo group (17.5 [3.2] to 17.3 [3.1]; p = .02). In addition, a significant fall was found in the mean score of anxiety in the nano-curcumin group (from 22.4 [4.03] to 20.6 [3.4]) compared with the placebo group (21.9 [3.5] to 21.2 [3.5]; p = .009). Changes in stress score were not statistically significant between the two groups. These findings suggested that nano-curcumin supplementation for 8 weeks was effective in reducing depression and anxiety scores in patients with diabetic polyneuropathy.
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http://dx.doi.org/10.1002/ptr.6571DOI Listing
April 2020

The effect of different amounts of vitamin D supplementation on serum calcidiol, anthropometric status, and body composition in overweight or obese nursing women: a study protocol for a randomized placebo-controlled clinical trial.

Trials 2019 Aug 30;20(1):542. Epub 2019 Aug 30.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost street, Naderi street, Keshavarz Blvd, Tehran, Iran.

Background: The optimal vitamin D intake for nursing mothers with overweight or obesity has not been defined. Vitamin D concentrations are associated with body composition indices, particularly body fat mass. Few studies have investigated the relationship between hypovitaminosis D, obesity, anthropometric status, and body composition in nursing women. Thus, the present study aims to investigate whether vitamin D supplementation during lactation will improve vitamin D status, reduce body fat mass, and improve body composition.

Methods/design: In a double-blind, randomized, placebo-controlled, parallel-group trial, after term delivery, 90 healthy women with overweight or obesity will be selected and randomly allocated into three groups to receive 2000 IU/d cholecalciferol (vitamin D3), 4000 IU/d cholecalciferol, or placebo (lactose) for 12 weeks while nursing. Measurements of height, weight, waist circumference, and body composition (fat mass (kg), lean mass (kg), body fat (%), fat mass index, and relative fat mass index) will be taken for all subjects at baseline and after 12 weeks of intervention. In addition, serum 25-hydroxyvitamin D (25(OH)D), parathyroid hormone, calcium, and phosphorus will be measured.

Discussion: This study is the first investigating the effect of different amounts of vitamin D supplementation on serum calcidiol, anthropometric status, and body composition in nursing women with overweight or obesity. Our findings will contribute to the growing body of knowledge regarding the role of vitamin D supplementation in obesity, anthropometric status, and body composition in nursing women.

Trial Registration: Iranian Registry of Clinical Trials IRCT20140413017254N6 . Registered on 11 April 2018.
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http://dx.doi.org/10.1186/s13063-019-3622-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716881PMC
August 2019

Association of plant-based dietary patterns with psychological profile and obesity in Iranian women.

Clin Nutr 2020 Jun 26;39(6):1799-1808. Epub 2019 Jul 26.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Science, Isfahan, Iran. Electronic address:

Background: A bidirectional association exists between psychological disorders and obesity. Also, diet could impact on both of these disorders. The aim of this study was to evaluate the association between plant-based dietary patterns and psychological profile and obesity.

Methods: This cross-sectional study was performed in a sample of 435 Iranian women. A validated and reliable semi-quantitative food-frequency questionnaire was used to collect dietary data. Three dietary indices including an overall plant-based diet (PDI), healthful plant-based diet (hPDI), and unhealthful plant-based diet (uPDI) were determined. Body mass index (BMI) and waist circumference (WC) were used to define general and abdominal obesity, respectively. Psychological profile status was determined from the DASS-21 questionnaire.

Results: We found that higher uPDI scores increased the odds of overall (PDI: 2.62; 95% CI 1.28-5.35, P = 0.01) and abdominal (PDI: 2.36; 95% CI 1.11-5.02, P = 0.03) obesity in comparison with lower scores. Moreover, an inverse association was observed between higher PDI and hPDI scores and depression (PDI: 0.41; 95% CI 0.23-0.71, P = 0.001, hPDI: 0.44; 95% CI 0.25-0.76, P = 0.003), anxiety (PDI: 0.56; 95% CI 0.33-0.94, P = 0.03, hPDI: 0.55; 95% CI 0.33-0.94, P = 0.03), and psychological distress (PDI: 0.44; 95% CI 0.26-0.75, P = 0.003, hPDI: 0.49; 95% CI 0.29-0.82, P = 0.009). For uPDI, higher scores were associated with depression (uPDI: 1.91; 95% CI 1.03-3.55, P = 0.03).

Conclusions: A plant-based diet, particularly healthful-rich plant foods were inversely associated with psychological disorders. Furthermore, unhealthy plant foods were associated with increased risk of obesity as well as depression.
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http://dx.doi.org/10.1016/j.clnu.2019.07.019DOI Listing
June 2020

The dietary acid load is higher in subjects with prediabetes who are at greater risk of diabetes: a case-control study.

Diabetol Metab Syndr 2019 1;11:52. Epub 2019 Jul 1.

1Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, KeshavarzBlv, Tehran, Iran.

Background: We aimed to examine the association of dietary acid load and prediabetes in a case-control study.

Methods: This study recruited 297 subjects including 147 prediabetic subjects and 150 controls referred to diabetes screening center in Shahreza, Iran. Participants were frequency-matched by sex and age. Blood pressure, anthropometric measures and blood glucose levels were measured. Dietary intake was assessed using a validated 168-items food frequency questionnaire (FFQ). The dietary acid load scores including the potential renal acid load (PRAL) and net endogenous acid production (NEAP) were calculated based on nutrients intake. NEAP and PRAL scores were categorized by quartiles based on the distribution of controls. Logistic regression models were used to estimate multivariable odds ratio (OR) of prediabetes across the energy-adjusted and sex-specific quartiles of NEAP and PRAL scores.

Results: Participants of control group in the higher quartiles of NEAP and PRAL tended to have higher body weight compared to the lower quartiles (P-trend < 0.04). After adjustment for multiple confounding variables, participants in the highest quartiles of NEAP and PRAL had increased OR for prediabetes (OR = 14.48 95% CI 5.64-37.19), and (OR = 25.61 95% CI 9.63-68.08) (P-trend < 0.001), respectively.

Conclusion: Our data indicated subjects with prediabetes had diets with more acid-forming potential than control group. Our findings suggest that higher dietary acid load was associated with increased prediabetes morbidity. Interventional studies are warranted to elucidate the role of acidogenic diets in the development of prediabetes.
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http://dx.doi.org/10.1186/s13098-019-0447-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6604202PMC
July 2019

Dietary insulin index and insulin load in relation to glioma: findings from a case-control study.

Nutr Neurosci 2019 Jun 26:1-9. Epub 2019 Jun 26.

b Department of Community Nutrition, School of Nutritional Sciences and Dietetics , Tehran University of Medical Sciences , Tehran , Iran.

Although hyperinsulinemia is assumed to be involved in brain carcinogenesis, data on the link between dietary insulin index (DII) and dietary insulin load (DIL) and risk of glioma are lacking. The current study aimed to investigate the relation between DII and DIL and risk of glioma in a case-control study among Iranian adults. In this hospital-based case-control study, 128 pathologically confirmed cases of glioma and 256 age and sex-matched controls were enrolled. Dietary intakes of study participants were assessed using a validated Block-format 123-item semi-quantitative FFQ. DII and DIL were computed using a published food insulin index (FII) data. A significant positive association was found between DIL and glioma (OR: 3.56; 95% CI: 1.85-6.58,  < 0.001); such that after controlling for potential confounders, participants in the highest quartile of DIL had 2.95 times greater odds of glioma than those in the lowest quartile (OR: 2.95; 95% CI: 1.40-6.24, =0.006). Furthermore, we observed a significant positive association between DII and glioma (OR: 2.65; 95% CI: 1.43-4.93, = 0.001). This association remained significant even after considering energy intake (OR: 2.66; 95% CI: 1.43-4.95,  = 0.001). However, when further potential confounders were taken into account, this relationship became non-significant (OR: 1.87; 95% CI: 0.92-3.80,  = 0.03), despite a significant trend of increased odds ratios ( = 0.03). In conclusion, we found a significant positive association between DIL and odds of glioma. DII was not significantly associated with odds of glioma after controlling for confounders. FII, Food insulin index; GI, Glycemic index; DIL, Dietary insulin load; DII, Dietary insulin index; ICD-O-2, International Classification of Diseases for Oncology 2nd; FFQ, Food frequency questionnaire; MRI, Magnetic resonance imaging; CT scan, Computerized tomography scan; IPAQ, International physical activity questionnaire; MET, Metabolic equivalent of task; BMI, Body mass index; ANOVA, Analysis of variance; RR, Relative risk; OR, Odds ratio; CI, Confidence interval.
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http://dx.doi.org/10.1080/1028415X.2019.1631594DOI Listing
June 2019

Serum Levels of Vitamin D, Retinol and Zinc in Relation to overweight among Toddlers: Findings from a National Study in Iran.

Arch Iran Med 2019 04 1;22(4):174-181. Epub 2019 Apr 1.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Background: Some studies have examined the association between micronutrient deficiencies and overweight in children, but data in this regard are conflicting. This study was done to investigate the association between serum levels of vitamin D, A and zinc with overweight in a large sample of Iranian toddlers.

Methods: A total of 4261 toddlers, aged 15-23 months, who had an Iranian birth certificate and attended primary health care, were included in the current cross-sectional study. Weight and height were measured by experts based on standard protocols and body mass index (BMI) was calculated. Based on WHO criteria, overweight was defined as BMI-z-score of ≥1SD. Serum levels of 25(OH)D3 , retinol and zinc were measured for each toddler. Binary logistic regression was applied to assess the association of 25(OH)D3 , retinol and zinc levels with overweight.

Results: Mean age of study participants was 19.2 ± 8.4 months. After controlling for potential confounders, children in the highest quartile of serum 25(OH)D3 levels had lower odds of overweight compared with those in the lowest quartile (OR: 0.79, 95% CI: 0.63-0.99). Furthermore, a marginally significant inverse association was found between serum levels of 25(OH)D3 and overweight among urban toddlers (OR: 0.75, 95%CI: 0.56-1.00). Such a relationship was not seen for rural children. No other significant association was seen between serum levels of retinol and zinc and overweight either before or after controlling for covariates.

Conclusion: In conclusion, we found a significant inverse association between serum levels of vitamin D and overweight among toddlers. Further studies, particularly of prospective nature, are required to confirm our findings.
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April 2019

Nano curcumin supplementation reduced the severity of diabetic sensorimotor polyneuropathy in patients with type 2 diabetes mellitus: A randomized double-blind placebo- controlled clinical trial.

Complement Ther Med 2019 Apr 28;43:253-260. Epub 2019 Feb 28.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Diabetic Sensorimotor Polyneuropathy (DSPN) is a common complication of diabetes mellitus. Curcumin is the most important ingredient found in turmeric which has a very high potential for eliminating free radicals and inhibiting oxidative stress as an antioxidant agent. The aim of this study was to determine the effect of Nano-curcumin supplementation on the severity of sensorimotor polyneuropathy in patients with Type 2 diabetes mellitus (T2DM).

Method: This parallel, double-blind randomized, placebo-controlled clinical trial was conducted on 80 diabetic patients. Participants were allocated randomly to the intervention (n = 40) and the control group (n = 40). They received 80 mg of nano-curcumin or placebo capsules for 8 weeks. Anthropometric measurements, dietary intake, physical activity, glycemic indices and the severity of DSPN were measured before and after the intervention.

Result: Supplementation of nano curcumin was accounted for a significant reduction in Glycated hemoglobin(HbA1c) (p < 0.001) and Fast Blood Sugar(FBS) (p = 0.004), total score of neuropathy (p < 0.001), total reflex score (p = 0.04) and temperature (p = 0.01) compared to placebo group.

Conclusion: Our findings indicated that curcumin supplementation for 2 months improved and reduced the severity of DSPN in patients with T2DM.
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http://dx.doi.org/10.1016/j.ctim.2019.02.014DOI Listing
April 2019

Dietary total antioxidant capacity is inversely associated with depression, anxiety and some oxidative stress biomarkers in postmenopausal women: a cross-sectional study.

Ann Gen Psychiatry 2019 19;18. Epub 2019 Mar 19.

1Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran.

Background: Postmenopausal women are at higher risk of mental disorders. Oxidative stress has implication in the development of these disorders. Dietary total antioxidant capacity (DTAC) has been proposed as a tool for assessing dietary antioxidants intake. The relationship between DTAC with depression, anxiety and stress has not been investigated in postmenopausal women. Thus, we aimed to assess the association between DTAC and depression, stress and anxiety as well as oxidative stress biomarkers.

Methods: This cross-sectional study was carried out on 175 postmenopausal women. Data on dietary intake and mental health were collected by 147-item semi-quantitative food frequency questionnaires (FFQ) and Depression Anxiety Stress Scales (DASS-42), respectively. Dietary and serum total antioxidant capacity (TAC), malondialdehyde (MDA), oxidized-LDL, and superoxide dismutase (SOD) were measured. ANOVA test was applied to compare the mean of variables across the tertiles of DTAC. The relationship between DTAC and oxidative stress biomarkers was determined through ANCOVA method. Simple and multivariate linear regression tests were performed to measure the relationship between DTAC and mental health.

Results: Serum MDA level was significantly lower in the subjects at the highest tertiles of DTAC (-value < 0.001). In addition, serum TAC level was significantly higher in subjects at the second tertile of DTAC (-value = 0.04). DTAC was inversely and independently related to depression (β = - 0.16, -value = 0.03) and anxiety scores (β = - 0.21, -value = 0.007). There was no significant association between DTAC and stress score (β = - 0.10, -value = 0.1).

Conclusion: An inverse relationship was found between DTAC with depression, anxiety scores and some oxidative stress biomarkers in postmenopausal women. These findings indicate DTAC may be used for developing effective dietary measures for reducing depression and anxiety in these women.
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http://dx.doi.org/10.1186/s12991-019-0225-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423824PMC
March 2019

Association of dietary phytochemical index and mental health in women: a cross-sectional study.

Br J Nutr 2019 05 4;121(9):1049-1056. Epub 2019 Feb 4.

1Department of Community Nutrition,School of Nutritional Sciences and Dietetics,Tehran University of Medical Sciences,PO Box 1416643931,Tehran,Iran.

Previous studies have shown that unhealthy dietary patterns are among the most important modifiable risk factors in the development of mental health disorders. We examined the association of dietary phytochemical index (DPI) with symptoms of depression, anxiety and psychological distress in Iranian women. In this cross-sectional study, a total of 488 women aged 20-50 years old attending health centres in the south of Tehran in 2018 were included. A validated and reliable FFQ was used for dietary assessment. Symptoms of depression, anxiety and psychological distress were assessed using a validated depression, anxiety, stress scales questionnaires with twenty-one-items. DPI was estimated using the following formula: (daily energy derived from phytochemical-rich foods (kJ)/total daily energy intake (kJ))×100. The mean age of the study participants was 31·9 (sd 7·7) years. The prevalence of depressive symptoms, anxiety and psychological distress among study participants was 34·6, 40·6 and 42·4 %, respectively. After controlling for potential confounders, women in the highest tertile of DPI had a lower prevalence of depressive symptoms (OR 0·22; 95 % CI 0·12, 0·38) and anxiety (OR 0·33; 95 % CI 0·20, 0·55), as well as psychological distress (OR 0·30; 95 % CI 0·18, 0·49) compared with those in the lowest tertile. In conclusion, we found a significant association between DPI and mental health in women. Prospective studies are needed to confirm these findings.
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http://dx.doi.org/10.1017/S0007114519000229DOI Listing
May 2019

Fruits and vegetables intake and its subgroups are related to depression: a cross-sectional study from a developing country.

Ann Gen Psychiatry 2018 1;17:46. Epub 2018 Nov 1.

1Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, KeshavarzBlv., Tehran, Iran.

Background: The association of fruits and vegetables (FV) specific subgroups consumption and depression has not been investigated in healthy adult populations. Therefore, the aim of our study was to determine the relationship between intake of FV as well as their subgroups and depression.

Methods: This cross-sectional study was conducted on 400 women attending healthcare centers. The scores of depression, anxiety, and stress were measured using the 21-item depression, anxiety and stress scales questionnaire. The participants' anthropometric and physical activity data were collected and the 147-item semi-quantitative FFQ was used for estimating the FV intake.

Results: After adjustment for confounding variables, the participants in the lower quartiles of total FV, total vegetables, total fruits, citrus, other fruits and green leafy vegetables intake were more likely to experience depression compared to those in the higher quartiles ( trend < 0.03).

Conclusion: Our findings suggest that higher intake of total FV and some of its specific subgroups might be associated with depression.
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http://dx.doi.org/10.1186/s12991-018-0216-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211514PMC
November 2018

Dietary patterns and their association with menopausal symptoms: a cross-sectional study.

Menopause 2019 04;26(4):365-372

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Objective: Although menopause is a natural event in a woman's life, some of its symptoms can be severe enough to adversely affect her health. There is some evidence to suggest that diet has an influence on menopausal symptoms, but less attention has been paid to dietary patterns. The purpose of this study is to determine the association of dietary patterns with physical, mental, and genitourinary menopausal symptoms.

Methods: A cross-sectional study design was applied using a sample of 400 postmenopausal women who attended health centers in the south of Tehran, Iran. The menopausal symptoms were assessed by a Menopause Rating Scale (MRS) questionnaire; a 147-item, semi-quantitative food-frequency questionnaire was used to collect dietary information, and major dietary patterns were identified by principal component analysis. Linear regression was used to evaluate the relationship between menopausal symptoms and dietary patterns.

Results: Three major dietary patterns were identified: vegetables and fruits (VF); mayonnaise, liquid oils, sweets, and desserts (MLSD); and solid fats and snacks (SFS). It has been found that the VF dietary pattern is inversely associated with general (β = -1.37; SE = 1.08; P for trend <0.001), physical (β = -1.54; SE = 1.09; P for trend <0.001), and mental (β = -1.58; SE = 1.11; P for trend <0.001) symptoms. A stronger adherence to the MLSD dietary pattern was directly associated with general (β = 1.15; SE = 1.08; P for trend <0.001) and genitourinary symptoms (β = 1.54; SE = 1.1; P for trend <0.001). Moreover, the SFS dietary pattern was directly related to the general (β = 1.23; SE = 1.09; P for trend = 0.01), physical (β = 1.24; SE = 1.09; P for trend = 0.04), and mental (β = 1.29; SE = 1.12; P for trend < 0.001) symptoms.

Conclusion: The present study demonstrated that there is an inverse association between VF dietary pattern and menopausal symptoms. In contrast, the MLSD and SFS dietary patterns were correlated to an increased risk of these symptoms.
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http://dx.doi.org/10.1097/GME.0000000000001245DOI Listing
April 2019

Higher Intake of Phytochemical-Rich Foods is Inversely Related to Prediabetes: A Case-Control Study.

Int J Prev Med 2018 30;9:64. Epub 2018 Jul 30.

Department of Community Nutrition, Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Background: Dietary phytochemical index (DPI) has introduced as an inexpensive method for quantifying the phytochemicals in foods. For the first time, this study was conducted to investigate the relationship between DPI and the risk of prediabetes.

Methods: Three hundred participants were assigned to 150 prediabetics (cases) and 150 healthy (controls) groups. Anthropometric values, fasting blood glucose, and 2-h oral glucose tolerance test (OGTT) were measured. The DPI was calculated based on data collected from 168-item validated food frequency questionnaire.

Results: The sex-specific energy-adjusted DPI was inversely related to fasting blood glucose (FBG) and OGTT ( < 0.001). The odds ratio (OR) of prediabetes was assessed across sex-specific energy-adjusted DPI quartiles. After adjusting for body mass index, physical activity, education, dietary intake of energy, fiber, carbohydrate (% of energy), fat (% of energy), and protein (% of energy), the OR of prediabetes across the sex-specific energy-adjusted DPI quartiles decreased significantly (-trend < 0.001).

Conclusions: We found that higher DPI score is related to lower prediabetes OR. This simple method may be used for the improvement of dietary intake to prevent prediabetes.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_145_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6085832PMC
July 2018

Dietary total antioxidant capacity is inversely related to menopausal symptoms: a cross-sectional study among Iranian postmenopausal women.

Nutrition 2018 11 7;55-56:161-167. Epub 2018 Jun 7.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Objective: The aim of this study was to assess the association between dietary total antioxidant capacity (DTAC) and menopausal symptoms (MS) in postmenopausal middle-aged women.

Methods: A cross-sectional study was conducted with 400 postmenopausal women who referred to municipality health houses and health centers in south Tehran, Iran. Sociodemographic data and anthropometric measures such as body weight, height, and waist circumference were determined. Dietary intake was assessed using a 147-item validated food frequency questionnaire. Energy-adjusted DTAC was calculated using the US Department of Agriculture database. Individual MS was measured by the Menopause Rating Scale questionnaire.

Results: Multivariable linear regression analyses indicated that DTAC was negatively associated with total Menopause Rating Scale score, somatic and psychological score, which was independent of confounding variables such as age, education, waist circumference, total physical activity, dietary intake of fiber, tea and coffee intake, total energy intake, and dietary supplement use (P < 0.001). Additionally, in logistic regression, a negative association between MS and DTAC was observed, which was independent of confounding variables (P = 0.002). Logistic regression for each symptom indicated that higher DTAC was associated with reduction in hot flashes and sweating, sleep problems, anxiety, exhaustion, and difficulty concentrating. However, a significant positive association was observed between DTAC and sexual problems.

Conclusion: DTAC is inversely associated with MS, which could be of particular significance for somatic and psychological symptoms. These findings indicate that DTAC could be an important basis for developing an effective dietary measure for reducing MS.
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http://dx.doi.org/10.1016/j.nut.2018.04.014DOI Listing
November 2018

Reply to ZT Lopez-Ixta.

Eur J Nutr 2018 Sep;57(6):2309-2310

Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1007/s00394-018-1697-yDOI Listing
September 2018

Second National Integrated Micronutrient Survey in Iran: Study Design and Preliminary Findings.

Arch Iran Med 2018 04 1;21(4):137-144. Epub 2018 Apr 1.

School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Background: The main objective of the Second National Integrated Micronutrient Survey (NIMS-II) was to assess the nutritional status of four micronutrients, namely iron, zinc, and vitamins A and D, and also to conduct an anthropometric assessment of selected groups of children, adolescents, pregnant women, and adults, disaggregated by sex and residential area in nationally representative samples. This paper reports the design of the study along with preliminary findings.

Methods: In this study, 32 770 individuals were selected by using single-stage cluster sampling. Venous blood samples were collected on site for laboratory analysis; interviews were conducted, and anthropometric measurements were performed.

Results: The prevalence of anemia was highest (17.1%) among 15- to 23-month-old children; vitamin A deficiency was 18.3% in this age group. As regards iron deficiency anemia, the prevalence in all age/sex groups was less than 5%, ranging from 0.5% in 6-year-old children to 4.2% in 15- to 23-month-old children. Zinc and vitamin D deficiencies were highest among pregnant women (8% and 85.3%, respectively). Finally, the prevalence of overweight and obesity among adults was 40.3% and 29.2%, respectively.

Conclusion: Results of this study can help in designing nutritional intervention programs for nationwide implementation. Of all micronutrient deficiencies, vitamin D deficiency was the most prevalent in all study groups. Thus, appropriate actions should be taken in our community.
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April 2018

Consumption of fruit and vegetables in relation with psychological disorders in Iranian adults.

Eur J Nutr 2018 Sep 5;57(6):2295-2306. Epub 2018 Mar 5.

Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Objective: Findings from observational studies on the relationship between fruit and vegetables consumption and risk of mental disorders are contradictory. We aimed to examine the association between fruit and vegetables intake and prevalence of depression, anxiety, and psychological distress in a large group of Iranian adults.

Methods: This cross-sectional study was conducted on 3362 people of Iranian adults working in 50 health centers. Dietary data were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire (FFQ). The Iranian-validated version of Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depression. The General Health Questionnaire (GHQ) was used to assess psychological distress.

Results: The prevalence of depression, anxiety, and high psychological distress among the study population was 30.0, 15.2, and 25.0%, respectively. Women in the top quintile of fruit intake, compared with those in the bottom quintile, had 57, 50, and 60% lower odds of depression, anxiety, and psychological distress. Consumption of vegetables was significantly associated with lower odds of depression (OR 0.65; 95% CI 0.46, 0.93) in women and lower odds of anxiety (OR 0.43; 95% CI 0.22, 0.87) in men. In addition, after adjustment for potential confounders, women in the highest quintile of fruit and vegetables intake, compared with those in the bottom quintile, had significantly lower odds of depression (OR 0.55; 95% CI 0.37, 0.80) and psychological distress (OR 0.60; 95% CI 0.40, 0.90). Furthermore, high intake of total fruit and vegetables was associated with lower odds of psychological distress (OR 0.42; 95% CI 0.21, 0.81) in men.

Conclusion: We found significant inverse associations between high intake of fruit with depression, anxiety, and psychological distress in Iranian women. High consumption of vegetables was also associated with lower risk of depression and anxiety, respectively, in women and men. In addition, high intake of total fruit and vegetable was associated with lower odds of depression and psychological distress in women and men.
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http://dx.doi.org/10.1007/s00394-018-1652-yDOI Listing
September 2018

The effects of green cardamom supplementation on blood glucose, lipids profile, oxidative stress, sirtuin-1 and irisin in type 2 diabetic patients: a study protocol for a randomized placebo-controlled clinical trial.

BMC Complement Altern Med 2018 Jan 17;18(1):18. Epub 2018 Jan 17.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Background: It has been suggested that the antioxidant, anti-inflammatory and hypolipidemic activities of cardamom may improve diabetes. However, the effect of this spice has not been investigated in diabetic subjects. This study was planned to determine the effects of green cardamom on blood glucose, lipids and oxidative stress status in type 2 diabetic patients.

Methods/design: Eighty overweight or obese patients with type 2 diabetes will be selected. They will be randomly assigned to receive 3 g/d green cardamom or placebo for 10 weeks. The socio demographic, physical activity and 24-h food recall questionnaires will be collected for each subject. Weight, height and waist circumference will be measured. Determination of blood glucose, lipid profile, and oxidative stress biomarkers including serum levels of total antioxidant capacity (TAC), malondialdehyde (MDA), and glutathione peroxidase (GPx) and superoxide dismutase (SOD) in red blood cells will be performed. The homeostasis model assessment-estimated insulin resistance (HOMA-IR) index and the quantitative insulin-sensitivity check index (QUICKI) will be calculated. Also, serum levels of irisin, and Sirtuin1 (SIRT1) will be measured.

Discussion: This trial will be the first study to explore the effects of green cardamom supplementation on glycemic control, lipid profile and oxidative stress in patients with type 2 diabetes mellitus. The results from this trial will provide evidence on the efficacy of green cardamom in type 2 diabetes mellitus.

Trial Registration Number: ( http://www.irct.ir , identifier: IRCT2016042717254N5), Registration date: 23.11.2016.
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http://dx.doi.org/10.1186/s12906-017-2068-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772716PMC
January 2018

Higher dietary total antioxidant capacity is inversely related to prediabetes: A case-control study.

Nutrition 2018 02 10;46:20-25. Epub 2017 Aug 10.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: Dietary total antioxidant capacity (DTAC) has been proposed as a tool for assessing the intake of antioxidants. The relationship between DTAC and blood glucose levels has been investigated mostly in healthy people. The aim of this study was to evaluate the association between DTAC and prediabetes morbidity in a case-control study.

Methods: We examined 300 individuals with and without prediabetes (n = 150/group) who attended a Diabetes Screening Center in Shahreza, Iran. The anthropometric measures, physical activity, and blood glucose levels of all participants were measured. Food intake over the previous year was determined using a semiquantitative food frequency questionnaire, and sex-specific, energy-adjusted DTAC was calculated using the U.S. Department of Agriculture's database. Logistic reg/ression was used to model the relationship between DTAC and prediabetes morbidity.

Results: The mean DTAC was significantly lower in individuals with prediabetes than in the control group (P < 0.001). Across increasing DTAC quartiles, the participants had lower fasting blood glucose and 2-h postchallenge plasma glucose (P < 0.02). After adjustment for body mass index; physical activity; education; dietary intake of fiber, fat, energy, and coffee; participants in the fourth quartile of DTAC were less likely to experience prediabetes compared with those in the first quartile (odds ratio, 0.18; 95% confidence interval, 0.07-0.49).

Conclusion: The DTAC score appears useful when assessing the antioxidant capacity of diet and to better understand the relationship between diet and prediabetes morbidity. Future studies are needed to confirm the findings from the present study in other populations.
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http://dx.doi.org/10.1016/j.nut.2017.08.005DOI Listing
February 2018

Fruit and vegetable intake and pre-diabetes: a case-control study.

Eur J Nutr 2018 Dec 4;57(8):2953-2962. Epub 2017 Dec 4.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran.

Purpose: Few studies have evaluated the association of fruit and vegetable (FV) intake and pre-diabetes. However, these studies are very limited and incomplete. Therefore, the aim of our study was to compare FV consumption and their subgroups between pre-diabetic and control subjects.

Methods: This case-control study included 300 individuals, 150 subjects with normal fasting blood glucose (FBG), and 150 pre-diabetic subjects who were matched for sex and age. We collected the participants' anthropometric and physical activity data and measured their blood glucose level. A 168 items semi-quantitative food frequency questionnaire (FFQ) was used for estimating the FV intake.

Results: After adjustment for confounding variables, participants in the lower quartiles of FV and total fruit intake were more likely to experience pre-diabetes compared with those in the higher quartiles (p trend < 0.007). In addition, cruciferous vegetables, other vegetables, and berries were inversely associated with pre-diabetes (p < 0.05), although a distinct dose-response relationship was not found. Unexpectedly, higher intake of dark yellow vegetables was significantly associated with a higher chance of pre-diabetes (p trend = 0.006). Other vegetable and fruit subgroups did not show any significant relationship with this disorder.

Conclusion: Our findings suggest that higher intake of total FV and total fruits might be associated with lower odds ratio of pre-diabetes.
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http://dx.doi.org/10.1007/s00394-017-1569-xDOI Listing
December 2018

Depression is related to dietary diversity score in women: a cross-sectional study from a developing country.

Ann Gen Psychiatry 2017 16;16:39. Epub 2017 Nov 16.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran.

Background: Substantial evidence provides support for the role of diet in the prevention and control of mental disorders. However, since there is no study regarding the relationship between dietary diversity and stress or depression, we aimed to determine the relationship between the dietary diversity score (DDS) and stress and depression in women.

Methods: This descriptive-analytical cross-sectional study was performed on 360 women aged 20-49 years attending health centers in the south of Tehran. The dietary intake and score of depression, anxiety, and stress were measured using a 24-h dietary recall and the 42-item depression, anxiety, stress scales questionnaire, respectively. The DDS was calculated based on the FAO 2013 guidelines. Data were analyzed using Chi-square, analysis of variance, Spearman correlation coefficient, and multivariable logistic regression tests.

Results: In total, 31.4 and 25.8% of the subjects suffered from depression and stress, respectively. After adjusting for confounders, a one-unit increase in DDS was associated with a 39% reduction in the risk of severe depression. The DDS was not significantly associated with mild or moderate depression, and no significant relationship was observed between the DDS and stress.

Conclusions: The DDS could be inversely associated with depression in women. Since we observed no significant relationship between stress and DDS, further studies are needed in this regard.
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http://dx.doi.org/10.1186/s12991-017-0162-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5689184PMC
November 2017