Publications by authors named "Peyman Adibi"

206 Publications

The relationship between fruit and vegetable intake with functional dyspepsia in adults.

Neurogastroenterol Motil 2021 Apr 2:e14129. Epub 2021 Apr 2.

Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Introduction: The association of fruit and vegetables with functional dyspepsia (FD) has been less studied, especially in Middle Eastern populations. This study investigated the relationship between fruit and vegetable consumption with FD and its related symptoms among a large group of Iranian adults.

Methods And Materials: This cross-sectional research was conducted on 3362 middle-age participants. Usual dietary intakes, including fruit and vegetable intake, during the last year were assessed using a validated 106-item dish-based food frequency questionnaire (FFQ). A modified Persian version of the Rome III questionnaire was used for assessment of FD.

Results: The prevalence of FD among study participants was 14.5%. After adjustment for confounders, the highest energy-adjusted tertile of fruit consumption was related to 32% lower risk of FD, compared to the lowest intake (OR = 0.68, 95% CI:0.51-0.90). Fruit consumption was also significantly related to lower risk of early satiation (OR = 0.67, 95% CI:0.54-0.85) and post-prandial fullness (OR = 0.75, 95% CI:0.61-0.92). Vegetable consumption was not related to the risk of FD in all models. Men who were in the third tertile of fruit and the third tertile vegetable consumption had lower risk of FD compared to the first tertile; but, in women, just fruit consumption was related to the reduced risk of FD, after adjustment for all confounders.

Conclusion: We found an inverse association between fruit intake and dyspepsia symptoms. In addition, high consumption of fruit was related to lower odds of early satiation and post-prandial fullness. Higher intake of vegetables was associated with lower risk of FD, only in men.
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http://dx.doi.org/10.1111/nmo.14129DOI Listing
April 2021

Challenges and strategies of clinical rounds from the perspective of medical students: A qualitative research.

J Educ Health Promot 2021 28;10. Epub 2021 Jan 28.

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

Introduction: Clinical rounds provide opportunities for medical students to acquire essential skills to practice medicine in the real world. Although this kind of training is one of the most important components of medical education, it is replete with barriers in its effective implementation. This study aimed to investigate medical students' experiences concerning the barriers and strategies of clinical rounds in Kerman University of Medical Sciences (KMU).

Materials And Methods: This qualitative research was conducted on 12 medical students in KMU in 2017. Purposive sampling was used and participants in three grades (stagers, interns, and residents) were selected, and individual semi-structured interviews were conducted until data saturation. The average of the interview time differed among the three batches (stagers, 51 min; interns, 38 min; and residents, 31 min). Content analysis using deductive approach was used for data analysis. MAXQDA version 10 was used for data analysis.

Results: Data analysis yielded the identification of six themes related to the system of clinical education, fields of clinical education, clinical environment, educational program, medical teachers, and medical students concerning the barriers and five themes related to the strategies for clinical rounds.

Conclusions: Findings revealed a deeper understanding of medical students' experiences. Our investigation identified multiple challenges embedded in our context and strategies to overcome them. As teaching in clinical rounds is invaluable, there is a need to take into account the identified challenges and overcome them. Thus, more effective rounds with higher efficacy toward students' professional development can be implemented.
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http://dx.doi.org/10.4103/jehp.jehp_104_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7933671PMC
January 2021

Association Between Inflammatory Potential of the Diet and Ulcerative Colitis: A Case-Control Study.

Front Nutr 2020 10;7:602090. Epub 2021 Feb 10.

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

Despite the inflammatory nature of inflammatory bowel disease (IBD), limited data are available on the association of inflammatory potential of the diet and risk of ulcerative colitis (UC). We aimed to investigate the association of inflammatory potential of the diet (IPD) score and odds of UC in a case-control study. Patients with UC were enrolled from Iranian IBD registry, whose disease was confirmed by a gastroenterologist. Controls were selected randomly from the Study of the Epidemiology of Psycho Alimentary Health and Nutrition (SEPAHAN) study, a large population-based study on more than 8,000 apparently healthy individuals. Dietary intakes of 28 food items obtained from a validated dish-based food frequency questionnaire (FFQ), were used to compute IPD score. This case-control study was carried out among 109 cases and 218 randomly chosen controls. Mean age of cases and controls was 39.5 ± 10.0 and 41.5 ± 11.8 y, respectively. Totally, 52% of study participants were female and 48% were male. After controlling for age, sex, and body mass index (BMI), we found that the patients with UC were more likely to be in the highest quartile of IPD score compared with controls (OR: 2.83; 95% CI: 1.41-5.69, -trend < 0.001). This association strengthened after additional adjustment for education, smoking, medical history, and physical activity (OR: 3.48; 95% CI: 1.32-9.10, -trend = 0.003). When we took dietary habits into account, the association was slightly attenuated (OR: 3.33; 95% CI: 1.20-9.20, -trend = 0.005). We found that adherence to a pro-inflammatory diet was positively associated with greater odds of UC. Further studies are required to confirm these findings.
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http://dx.doi.org/10.3389/fnut.2020.602090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7928336PMC
February 2021

Dietary intake of branched-chain amino acids in relation to depression, anxiety and psychological distress.

Nutr J 2021 01 29;20(1):11. Epub 2021 Jan 29.

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

Background: There is no previous study that examined the association between branched-chain amino acids (BCAAs) intake and odds of psychological disorders. The aim of this study was to investigate the association between dietary BCAAs and odds of psychological disorders including depression, anxiety, and psychological distress in a large sample of Iranian adults.

Methods: In this cross-sectional study on 3175 Iranian adults aged 18-55 years, a validated food frequency questionnaire was used to assess dietary intakes. BCAAs intake was computed by summing up the amount of valine, leucine, and isoleucine intake from all food items in the questionnaire. Psychological health was examined through the use of Iranian validated version of the Hospital Anxiety and Depression Scale (HADS). Psychological distress was assessed using General Health Questionnaire (GHQ). For depression and anxiety, scores of 8 or more on either subscale were considered as psychological disorders and scores of 0-7 were defined as "normal". In terms of psychological distress, the score of 4 or more was defined as psychological distress.

Results: Mean age of study participants was 36.2 ± 7.8 years. Overall, 26.4% (n = 837) of study subjects had depression, 11.9% (n = 378) had anxiety and 20.9% (n = 665) were affected by psychological distress. After controlling for potential confounders, participants in the highest tertile of total BCAAs intake had lower odds of depression (OR: 0.76; 95% CI: 0.60-0.96) and anxiety (OR: 0.66; 95% CI: 0.47-0.91) compared with those in the lowest tertile. Participants in the top tertile of valine intake had a lower odds of depression (OR: 0.76; 95% CI: 0.60-0.96) and anxiety (OR: 0.65; 95% CI: 0.47-0.90) compared with those in the bottom tertile. A significant inverse association was also seen between leucine intake and depression (OR: 0.77; 95% CI: 0.61-0.98) and anxiety (OR: 0.66; 95% CI: 0.47-0.91). In addition, a significant inverse association was observed between isoleucine intake and odds of depression (OR: 0.75; 95% CI: 0.59-0.95) and anxiety (OR: 0.62; 95% CI: 0.45-0.86). There was no significant association between isoleucine intake and odds of psychological distress.

Conclusion: Evidence indicating an inverse association between dietary intake of BCAAs and odds of depression and anxiety was found. Prospective studies are required to confirm these findings.
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http://dx.doi.org/10.1186/s12937-021-00670-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847030PMC
January 2021

Patterning of Food Preferences Among Iranian Adults: Results from SEPAHAN Study.

Int J Prev Med 2020 26;11:176. Epub 2020 Nov 26.

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

Background: The present study was conducted to evaluate the pattern of food preference among a large sample of Iranian adults.

Methods: In a cross-sectional study within the study on the epidemiology of psychological alimentary health and nutrition (SEPAHAN) projects, a total of 6239 of 8694 subjects completed a 106-item food preference questionnaire. Subjects indicated whether they liked, disliked or had gastrointestinal symptoms for each food item separately. They also reported the frequency of consumption for each food item.

Results: We observed that presence of some foods such as yogurt, fruits and vegetables in the list of the most preferred food items and presence of kalbas, sausages and chips in the list of the most disliked food items, were representative of healthy dietary pattern in this population. Results also revealed that women liked unhealthy foods more than men ( value <0.05 for all significant food items). Moreover, in most of the food items, men reported less gastrointestinal symptoms than women ( value <0.05 for all significant food items). Our findings revealed that smokers disliked most of the healthy food items. We also observed that pregnant women regardless of the trimesters, reported dislike for sweet-tasting food items.

Conclusions: More researches are suggested in order to indicate the origins of preferences and recommend some practical alternatives to improve the dietary pattern in society.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_138_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804878PMC
November 2020

A core competency model for clinical informationists.

J Med Libr Assoc 2021 Jan;109(1):33-43

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

Objectives: Access to high-quality information improves the quality of patient care, but lack of time and sufficient skills in information seeking can prevent access to information by clinicians. To solve this problem, clinical informationists can provide high-quality, filtered information for clinical team members. This study identified the core competencies that clinical informationists need to effectively fulfill their roles on clinical teams.

Methods: Participants were selected purposefully from clinicians and medical librarians. Data were collected through semi-structured interviews and analyzed using qualitative content analysis.

Results: The authors identified six competencies-communication, research, education and training, domain knowledge, information services, and technology-which together were used to develop a "CREDIT" model of core competencies for clinical informationists.

Conclusions: The CREDIT model can be used as criteria for evaluating the performance of clinical informationists as well as for developing and assessing clinical informationist educational programs and curriculums.
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http://dx.doi.org/10.5195/jmla.2021.1065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7772977PMC
January 2021

Nutritional challenges of gastric cancer patients from the perspectives of patients, family caregivers, and health professionals: a qualitative study.

Support Care Cancer 2021 Jan 3. Epub 2021 Jan 3.

Omid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Purpose: This study aims to explore the perceptions of gastric cancer patients, their family caregivers, physicians, and nurses of nutritional challenges.

Methods: Using a descriptive qualitative method, this study was conducted in 2019-2020. Twenty participants (6 patients, 6 family caregivers, 3 physicians, and 5 nurses) were selected through purposive sampling. Data was collected through in-depth semi-structured interviews and examined using qualitative content analysis.

Results: Data analysis revealed three categories, each with two subcategories: eating, an unpleasant experience that contains "a feeling like hyperemesis gravidarum" and "childish food excuses"; flexibility while adhering to a proper diet, which consists of "dietary dos and don'ts" and "nutritional leniency"; and nutrition with distress that contains "patient's sense of being an extra burden" and "provision of nutrition with suffering in caregivers."

Conclusion: Because of the significant physical and psychological impact of nutritional problems on patients and their caregivers, the need to provide care and education to these patients and their families using a multidisciplinary team is becoming more important.
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http://dx.doi.org/10.1007/s00520-020-05951-7DOI Listing
January 2021

Adherence to Dietary Approaches to Stop Hypertension Eating Plan and Prevalence of Irritable Bowel Syndrome in Adults.

J Neurogastroenterol Motil 2021 Jan;27(1):78-86

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

Background/aims: Despite huge evidence on the link between adherence to dietary approaches to stop hypertension (DASH) eating pattern and several metabolic abnormalities, the association of this diet with irritable bowel syndrome (IBS) has not been investigated so far. We aim to examine the association between adherence to the DASH diet and prevalence of IBS symptoms and subtypes in adults.

Methods: This cross-sectional study was done among 3362 adult people in Isfahan, Iran. Usual dietary intakes were assessed using a validated 106-item dish-based semi-quantitative food frequency questionnaire. To investigate participants' adherence to DASH-style diet, we created DASH score based on 8 main foods and nutrients emphasized or minimized in the DASH diet. Participants were classified into 3 categories according to their DASH-style diet scores. A validated modified Persian version of the Rome III questionnaire was applied for assessment of IBS.

Results: Totally, 22.2% of study participants were affected by IBS. After adjustment for potential confounding factors, we found that participants in the highest tertile of DASH score had lower odds of IBS (OR, 0.65; 95% CI, 0.50-0.83) compared with those in the lowest tertile. The same findings were also reached for IBS with constipation (OR for the highest vs the lowest tertile of DASH-style diet = 0.56; 95% CI, 0.38-0.85). No significant association was seen between adherence to DASH-style diet and IBS with diarrhea (OR, 1.31; 95% CI, 0.83-2.06).

Conclusions: We found a significant inverse association between adherence to DASH dietary pattern and odds of IBS and IBS with constipation. Further prospective studies are required to confirm these findings.
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http://dx.doi.org/10.5056/jnm20007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786080PMC
January 2021

The effects of sumac (Rhus coriaria L.) powder supplementation in patients with non-alcoholic fatty liver disease: A randomized controlled trial.

Complement Ther Clin Pract 2020 Nov 10;41:101259. Epub 2020 Nov 10.

Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Background: In recent years, great attention has been paid to the role of herbal medicine in the management of non-alcoholic fatty liver disease (NAFLD). Sumac (Rhus coriaria L.) is a popular herb which contains major bioactive compounds known for a variety of health benefits. This study aimed to assess the effects of sumac powder supplementation on hepatic fibrosis and some metabolic markers in patients with NAFLD.

Methods: Eighty-four patients diagnosed with NAFLD were included in this randomized double-blind placebo-controlled clinical trial. They were randomly assigned to receive 2000 mg per day sumac powder (n = 42) or placebo (n = 42) for 12 weeks. Also, both groups received a 500-calories deficit diet plan. Hepatic fibrosis and liver enzymes (ALT and AST) as well as fasting blood sugar (FBS), serum insulin, HbA1c, HOMA-IR (insulin resistance index), QUICKI (insulin sensitivity index), malondialdehyde (MDA), and high sensitivity C-reactive protein (hs-CRP) were measured at baseline and the end of trial.

Results: Eighty patients completed the trial. After 12-weeks of intervention, subjects in the sumac group showed a greater decrease in hepatic fibrosis and liver enzymes as well as FBS, serum insulin, HbA1c, HOMA-IR, MDA, and hs-CRP, compared to the placebo (P-value < 0.05); while the QUICKI was significantly higher in the sumac group at the end of intervention.

Conclusion: Daily intake of 2000 mg sumac powder along with a low-calorie diet for 12 weeks was beneficial for the management of NAFLD.
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http://dx.doi.org/10.1016/j.ctcp.2020.101259DOI Listing
November 2020

Breakfast skipping and prevalence of heartburn syndrome among Iranian adults.

Eat Weight Disord 2020 Nov 12. Epub 2020 Nov 12.

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

Purpose: Limited data are available linking breakfast consumption to Heart Burn Syndrome (HBS). This study was done to investigate to find whether breakfast consumption is associated with HBS. This cross-sectional study was done to investigate the association between breakfast consumption and HBS among Iranian adults.

Methods: This cross-sectional study was performed among 4763 general adults of Isfahan, Iran. Participants' patterns of breakfast eating were assessed by asking two questions from them. How often do you eat breakfast in a week?" Participants were able to respond as: "never or 1 day/wk", "2-4 days/wk", "5-6 days/wk", "every day". HBS was defined as the presence of HBS at sometimes, often or always using a Persian version of validated self-administered modified ROME III questionnaire.

Results: Totally, 4763 patients with HBS completed this cross-sectional study, where about 32.4% of them intake breakfast less than one time per week. After controlling for potential confounders, participants who consumed breakfast every day had a 43% lower risk for having HBS as compared with those who had breakfast ≤ 1 times/wk (OR 0.57; 95% CI 0.41-0.80). A significant inverse relationship was found between breakfast consumption and frequent than scare HBS (OR 0.57; 95% CI 0.40-0.77) among the whole population, not in patients with HBS. No significant association was observed between breakfast intake and severity of HBS (OR 0.56; 95% CI 0.31-1.04).

Conclusion: We found an inverse association between frequency of breakfast consumption and odds of HBS as well as the frequency of HBS among the adult population. Prospective studies are required to confirm these findings.

Level Of Evidence: Level V, cross-sectional descriptive study.
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http://dx.doi.org/10.1007/s40519-020-01065-5DOI Listing
November 2020

A one-year hospital-based prospective COVID-19 open-cohort in the Eastern Mediterranean region: The Khorshid COVID Cohort (KCC) study.

PLoS One 2020 5;15(11):e0241537. Epub 2020 Nov 5.

Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

The COVID-19 is rapidly scattering worldwide, and the number of cases in the Eastern Mediterranean Region is rising. Thus, there is a need for immediate targeted actions. We designed a longitudinal study in a hot outbreak zone to analyze the serial findings between infected patients for detecting temporal changes from February 2020. In a hospital-based open-cohort study, patients are followed from admission until one year from their discharge (the 1st, 4th, 12th weeks, and the first year). The patient recruitment phase finished at the end of August 2020, and the follow-up continues by the end of August 2021. The measurements included demographic, socio-economics, symptoms, health service diagnosis and treatment, contact history, and psychological variables. The signs improvement, death, length of stay in hospital were considered primary, and impaired pulmonary function and psychotic disorders were considered main secondary outcomes. Moreover, clinical symptoms and respiratory functions are being determined in such follow-ups. Among the first 600 COVID-19 cases, 490 patients with complete information (39% female; the average age of 57±15 years) were analyzed. Seven percent of these patients died. The three main leading causes of admission were: fever (77%), dry cough (73%), and fatigue (69%). The most prevalent comorbidities between COVID-19 patients were hypertension (35%), diabetes (28%), and ischemic heart disease (14%). The percentage of primary composite endpoints (PCEP), defined as death, the use of mechanical ventilation, or admission to an intensive care unit was 18%. The Cox Proportional-Hazards Model for PCEP indicated the following significant risk factors: Oxygen saturation < 80% (HR = 6.3; [CI 95%: 2.5,15.5]), lymphopenia (HR = 3.5; [CI 95%: 2.2,5.5]), Oxygen saturation 80%-90% (HR = 2.5; [CI 95%: 1.1,5.8]), and thrombocytopenia (HR = 1.6; [CI 95%: 1.1,2.5]). This long-term prospective Cohort may support healthcare professionals in the management of resources following this pandemic.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241537PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7644058PMC
November 2020

Predictors of Nonalcoholic Fatty Liver Disease Among Middle-Aged Iranians.

Int J Prev Med 2020 6;11:113. Epub 2020 Aug 6.

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

Background: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. Therefore, we sought to determine the most important predictors of NAFLD among middle-aged men and women in Isfahan, Iran.

Methods: A total of 413 individuals (163 men and 250 women) aged 30-60 years were selected by stratified random sampling. The participants had safe alcohol consumption habits (<2 drinks/day) and no symptoms of hepatitis B and C. NAFLD was diagnosed through ultrasound. Blood pressure, anthropometric, and body composition measurements were made and liver function tests were conducted. Biochemical assessments, including the measurement of fasting blood sugar (FBS) and ferritin levels, as well as lipid profile tests were also performed. Metabolic syndrome was evaluated according to the International Diabetes Federation (IDF) criteria.

Results: The overall prevalence of ultrasound-diagnosed NAFLD was 39.3%. The results indicated a significantly higher prevalence of NAFLD in men than in women (42.3% vs 30.4%; < 0.05). Binary logistic regression analysis was performed to determine the significant variables as NAFLD predictors. Overall, male gender, high body mass index (BMI), high alanine aminotransferase (ALT), high FBS, and high ferritin were identified as the predictors of NAFLD. The only significant predictors of NAFLD among men were high BMI and high FBS. These predictors were high BMI, high FBS, and high ferritin in women ( < 0.05 for all variables).

Conclusions: The metabolic profile can be used for predicting NAFLD among men and women. BMI, FBS, ALT, and ferritin are the efficient predictors of NAFLD and can be used for NAFLD screening before liver biopsy.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_274_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7554566PMC
August 2020

The clinical informationist as a new member of clinical team.

J Res Med Sci 2020 31;25:83. Epub 2020 Aug 31.

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

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http://dx.doi.org/10.4103/jrms.JRMS_578_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7554447PMC
August 2020

Clinical informationist educational needs and goals: A scoping review.

J Educ Health Promot 2020 28;9:193. Epub 2020 Jul 28.

Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Clinical informationist (CI) is one of the current trends in the field of medical librarianship and information science. CIs are members of clinical care teams, and their main duty is to fill the gap in the information needs of health-care workers and patients using information sources. They need an official and standard education. This study aims to identify the educational goals and needs of CIs. To this end, a scoping review was conducted using the Preferred Reporting Item for Systematic Reviews and Meta-analyses guidelines. The ISI Web of Science, Scopus, Proquest (MEDLINE), Science Direct, Emerald, ERIC, Cochrane, and Library, Information Science and Technology Abstracts were searched. was hand searched for relevant studies. A total of 1026 studies were extracted, and 38 studies were selected for the final review. The review resulted in identifying 18 goals in cognitive, emotional, and psychomotor areas. Furthermore, the educational needs were identified in eight educational needs including research method and statistics, education, medical knowledge, information and librarianship science, clinical environment knowledge, evidence-based knowledge, information technologies and systems, management, and leadership. Although part of these educational needs can be met through general medical librarianship and information science education, further specialized education for CIs requires specific aims and curriculum. Thus, the results of this study can be the basis for future studies regarding the competencies of CI in order to provide a more precise and detailed curriculum based on these educational needs.
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http://dx.doi.org/10.4103/jehp.jehp_272_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482706PMC
July 2020

The association between meal and snack frequency and irritable bowel syndrome.

Public Health Nutr 2020 Sep 4:1-12. Epub 2020 Sep 4.

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

Objective: The relationship between daily meal and snack frequency with irritable bowel syndrome (IBS) was less investigated in the literature. We aimed to evaluate this association with IBS symptoms.

Design: A cross-sectional study.

Setting: This investigation was performed in Isfahan, a large province in the centre of Iran. Individuals were asked to complete a self-administered questionnaire to quantify the numbers of daily main meals (one, two or three), snacks (never, 1-2, 3-5 or >5) and the total of them (<3, 3-5, 6-7 or ≥8). IBS and its subtypes were diagnosed according to Rome Ш criteria.

Participants: General adults (n 4669, 2063 men and 2606 women).

Results: The prevalence of IBS was 18·6 % in males and 24·1 % in females. Individuals consuming three main meals had 30 % decreased risk of IBS (OR 0·70, 95 % CI 0·52, 0·94) compared with those with one main meal in the crude model. After adjustments for all potential confounders this relation disappeared (OR 0·67, 95 % CI 0·43, 1·03). Gender-specified analysis revealed that women consuming three main meals per day had 32 % decreased likelihood of having IBS symptoms compared with one daily main meal takers (OR 0·68, 95 % CI 0·47, 0·99). This relation remained significant after adjustment for potential confounders (OR 0·56, 95 % CI 0·36, 0·89). A decreased likelihood of IBS in the highest category of main meal consumption compared with the lowest one was found in obese or overweight subjects (OR 0·54, 95 % CI 0·32, 0·91), after adjustment for all confounders.

Conclusions: Our findings suggested that there was no significant relation between main meal or snack frequency and IBS in Iranian adults, but a small inverse association was found among females and overweight/obese individuals in subgroup analysis. Further prospective studies are needed confirming these associations.
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http://dx.doi.org/10.1017/S1368980020002967DOI Listing
September 2020

Effects of soy milk consumption on gut microbiota, inflammatory markers, and disease severity in patients with ulcerative colitis: a study protocol for a randomized clinical trial.

Trials 2020 Jun 23;21(1):565. Epub 2020 Jun 23.

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

Background: Several strategies are recommended to alleviate clinical symptoms of ulcerative colitis (UC). Soy milk may affect UC through its anti-inflammatory properties. However, no study has examined the effects of soy milk consumption on gut microbiota and inflammatory biomarkers in patients with UC. The current study will be done to examine the effects of soy milk consumption on UC symptoms, inflammation, and gut microbiota in patients with UC.

Methods: This study is a randomized clinical trial, in which thirty patients with mild to moderate severity of UC will be randomly allocated to receive either 250 mL/day soy milk plus routine treatments (n = 15) or only routine treatments (n = 15) for 4 weeks. Assessment of anthropometric measures and biochemical indicators including serum concentrations of high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interferon gamma (IFN-γ) will be done at the study baseline and end of trial. In addition, the quantity of butyrate-producing bacteria including Clostridium cluster IV, Faecalibacterium prausnitzii, and Roseburia spp.; prebiotic bacteria including Lactobacillus spp. and Bifidobacteria spp.; and mucus-degrading bacteria including Akkermansia muciniphila, Bacteroides fragilis, and Ruminococcus spp., as well as calprotectin and lactoferrin levels, will be explored in fecal samples. Also, the Firmicutes to Bacteroidetes ratio which is of significant relevance in human gut microbiota composition will be assessed.

Discussion: Altered gut microbiota has been reported as an important contributing factor to inflammation in patients with inflammatory bowel disease (IBD). Soy milk contains several components such as phytoestrogens with potential anti-inflammatory properties. This product might affect gut microbiota through its protein and fiber content. Therefore, soy milk might beneficially affect systemic inflammation, gut microbiota, and then clinical symptoms in patients with UC.

Trial Registration: Iranian Registry of Clinical Trials (www.irct.ir) IRCT20181205041859N1. Registered on 27 January 2019.
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http://dx.doi.org/10.1186/s13063-020-04523-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310397PMC
June 2020

Combined Healthy Lifestyle Is Inversely Associated with Upper Gastrointestinal Disorders among Iranian Adults.

Dig Dis 2021 8;39(1):77-88. Epub 2020 Jun 8.

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

Objective: Although lifestyle-related factors have separately been examined in relation to functional gastrointestinal disorders (FGIDs), there is no epidemiological data on the combined association of lifestyle factors with these conditions. We aimed to examine how combinations of several lifestyle factors were associated with functional dyspepsia (FD), its symptoms, and gastroesophageal reflux disease (GERD) in a large group of Iranian adults.

Design, Setting, And Subjects: In a cross-sectional study on 3,363 Iranian adults, we calculated the "healthy lifestyle score" for each participant by summing up the binary score given for 5 lifestyle factors, including dietary habits, dietary intakes, psychological distress, smoking, and physical activity. A dish-based 106-item semi-quantitative validated food frequency questionnaire, General Practice Physical Activity Questionnaire, General Health Questionnaire, and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. To assess FGIDs, a validated Persian version of ROME III questionnaire was used.

Results: After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle had 79 and 74% lower odds of FD (OR: 0.21; 95% CI: 0.05-0.92) and GERD (OR: 0.26; 95% CI: 0.09-0.69), respectively, compared with those with the lowest score. They were also less likely to have early satiation (OR: 0.28; 95% CI: 0.11-0.73), postprandial fullness (OR: 0.22; 95% CI: 0.09-0.50), and epigastric pain (OR: 0.44; 95% CI: 0.21-0.92). In addition to the combined healthy lifestyle score, low levels of psychological distress, a healthy diet, healthy dietary habits, and nonsmoking were separately and protectively associated with FGIDs.

Conclusion: We found that adherence to a healthy lifestyle was associated with lower odds of GERD, FD, and its symptoms in this group of Iranian adults, in a dose-response manner. Individual lifestyle-related factors were also associated with these conditions.
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http://dx.doi.org/10.1159/000509208DOI Listing
February 2021

Strengths of Iran for internationalization of medical sciences education.

J Educ Health Promot 2020 28;9:92. Epub 2020 Apr 28.

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

Introduction: Internationalization of higher education involves mutual exchanges as well as a consensus based. Political, economic, sociocultural, and scientific reasons recommend the need to move toward the internationalization of higher education. The current study highlights the strengths of the internationalization of Iran's medical sciences education.

Materials And Methods: This descriptive exploratory study was carried out in 2016-2017 in Iran. The techniques used for data collection included review of articles, interview with subject experts, and the focus group and the nominal technique group to explore the views of various stakeholders. The data were analyzed with the qualitative content analysis method.

Results: The inductive qualitative content analysis of all data generated 13 categories and 88 subcategories. The categories were geographical and geostrategic position of Iran; the historical, cultural, religious, and tourist attractions of Iran; the security of Iran; priority to internationalization policies and programs in Iran's macro plans; the existence of regulations, laws, and approvals for international activities; same language with neighboring and regional countries; the low cost of studying and living in Iran; the ability of Iranian faculty members and experts for internationalization; the background, reputation, and the progress of medical education, health, and care in Iran; the cheaper forces of Iran and their welcome to foreigners; the existence of motivation, zeal, and belief for internationalization; the existence of proper infrastructure; and the existence of a suitable capacity for internationalization.

Conclusions: Iran has some positive points that can be used to promote international activities, provided it does some good advertising in this regard. It is suggested that the challenges, opportunities, and threats to Iran's internationalization should be collated from the perspective of the various stakeholders.
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http://dx.doi.org/10.4103/jehp.jehp_488_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271916PMC
April 2020

Water intake and intra-meal fluid consumption in relation to general and abdominal obesity of Iranian adults.

Nutr J 2020 05 2;19(1):39. Epub 2020 May 2.

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

Objective: The aim of this study was to examine the association between whole-day water intake and intra-meal fluid consumption and odds of general and abdominal obesity among adults.

Methods: This cross-sectional study was conducted among 7958 adults in Isfahan, Iran. Daily water consumption was assessed through the use of a pre-tested questionnaire by asking questions about the average number of glasses of water consumed in a day. Intra-meal fluid consumption was also analysed. Data regarding height, weight and waist circumference were collected using a validated self-administered questionnaire. Obesity was defined as body mass index ≥30 kg/m, and abdominal obesity was defined as waist circumference >88 cm for women and >102 cm for men.

Results: After taking potential confounders into account, individuals who were taking more than eight glasses of water in a day had 78% greater odds of general obesity (OR: 1.78; 95% CI: 1.08-2.94) compared with those who were taking less than two glasses of water. Individuals with much water intake had no significant greater odds of abdominal obesity. Compared with those who were consuming less than a glass of intra-meal fluids, subjects with 1-2 glasses of fluids between meals had 34% greater odds of general obesity (OR: 1.34; 95% CI: 1.04-1.59). Although subjects with greater intra-meal fluid intake had greater odds of abdominal obesity in crude model, this association became non-significant after adjustment for potential confounders (comparing > 4 glasses vs. ≤1 glass: OR: 1.65; 95% CI: 0.81-3.34).

Conclusions: We observed that taking more than eight glasses of water in a day and consuming 1-2 glasses of fluids between meals was associated with greater odds of general obesity.
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http://dx.doi.org/10.1186/s12937-020-00551-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196236PMC
May 2020

The educational role of clinical informationist on improving clinical education among medical students: Based on Kirkpatrick model.

J Educ Health Promot 2020 28;9:28. Epub 2020 Feb 28.

Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Introduction: Due to time constraints and a significant increase in medical information, one of the ways to keep physicians and medical teams up to date is to use evidence-based medicine. The current research focused on the effects of the educational role of clinical informationist (CI) on improving clinical education among medical students based on the Kirkpatrick (KP) model.

Methods: The method was semiexperimental research in two group designed with pretest and posttest. The research population included thirty medical students for each group that was selected by the convenience time-based sequential sampling method. The study data were collected using a researcher-made two questionnaires and a checklist. Data were analyzed by the descriptive statistics and inferential statistics using SPSS version 20 software.

Results: Based on the first level of the KP model, the total mean of medical students' satisfaction in the experimental group was 4.06 from 5. Based on the second, third, and fourth levels of the model, the independent -test showed that before the intervention, the mean scores of attitude, knowledge, information-seeking skills and behaviors, and also clinical skills were not significantly different in both the intervention and control groups ( > 0.05). After the intervention, the results of covariance test showed that attitude, knowledge, information-seeking skills and behaviors, and also clinical skills of the intervention group are significantly better than that of the control group ( < 0.001).

Conclusion: Training and the presence of the CIs in the clinical round had resulted in the improved satisfaction, attitude, knowledge, and information-seeking skills while also improving information-seeking behaviors and clinical skills of medical students.
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http://dx.doi.org/10.4103/jehp.jehp_439_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161676PMC
February 2020

Legume and nut consumption in relation to depression, anxiety and psychological distress in Iranian adults.

Eur J Nutr 2020 Dec 12;59(8):3635-3645. Epub 2020 Mar 12.

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

Purpose: Although considerable research has been devoted to the link between consumption of legume and nuts and metabolic abnormalities, few studies have examined legume and nut consumption in relation to psychological disorders. The current study aimed to examine the association of legume and nut consumption with depression, anxiety and psychological distress in Iranian adults.

Methods: This cross-sectional study was carried out among 3172 adult participants aged 18-55 years. Assessment of legume and nut consumption was conducted using a validated dish-based 106-item semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used to examine psychological health. Scores of 8 or more on either subscale in the questionnaire were considered to indicate the presence of depression or anxiety. Data on psychological distress were collected using the General Health Questionnaire (GHQ), in which the score of 4 or more was considered as having psychological distress.

Results: The mean age of participants was 36.5 ± 7.9 years. In the fully adjusted model, men in the top quintile of legume and nut consumption were 66% less likely to be anxious than those in the bottom quintile (OR 0.34; 95% CI 0.14-0.82). However, such significant relationship was not observed among women (OR 1.06; 95% CI 0.63-1.77). We failed to find any other significant association between legume and nut consumption and depression or psychological distress after adjustment for potential confounders either in men or women.

Conclusions: We found that consumption of legume and nuts was associated with lower odds of anxiety in men, but not in women. No other significant association was seen among participants. Legume and nut consumption might be promising and, along with medications, could be used to prevent, control or delay psychological disorders.
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http://dx.doi.org/10.1007/s00394-020-02197-1DOI Listing
December 2020

A randomized controlled trial investigating the effect of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols on the intestinal microbiome and inflammation in patients with ulcerative colitis: study protocol for a randomized controlled trial.

Trials 2020 Feb 18;21(1):201. Epub 2020 Feb 18.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box 81745, Tehran, Iran.

Background: No conclusive treatment is available for irritable bowel disease (IBD). Adherence to a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) might alleviate clinical symptoms of IBD. However, no study has investigated the effect of low FODMAPs diet on the intestinal microbiota and inflammatory biomarkers in patients with IBD. The aim of current study is to examine the effect a low FODMAP diet on IBD symptoms, inflammation, and the intestinal microbiota in patients with ulcerative colitis.

Methods And Analysis: This study is a randomized clinical trial. Thirty patients with mild to moderate ulcerative colitis will be randomly allocated to receive a low FODMAP diet (n = 15) or to continue their usual diet as control (n = 15), for 4 weeks. The quantity of intestinal microbiota including Clostridium cluster IV, Faecalibacterium prausnitzii, Rosburia spp., Lactobacillus spp., Bifidobacteria spp., Akkermansia muciniphila, Bacteroides fragilis, and Ruminococcus spp., and the Firmicutes to Bacteroidetes ratio and calprotectin and lactoferrin levels will be explored in fecal samples from patients. In addition, anthropometric measures and biochemical assessments including serum concentrations of highly sensitive-C reactive protein (hs-CRP), tumour necrosis factor-α (TNF-α) and IL-1β will be taken from patients at baseline and end of the study. The study has been registered in IRCT (IRCT20181126041763N1; registration date: 2019-01-18).

Discussion: Consumption of a low-FODMAP diet might decrease systemic and intestinal inflammation, change the bacterial population in the gut, and modulate clinical symptoms in patients with ulcerative colitis. Further studies investigating the effect of such a diet on other variables, including other bacterial species and inflammatory cytokines, are required to confirm future findings of this trial.
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http://dx.doi.org/10.1186/s13063-020-4108-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029518PMC
February 2020

Association between adherence to MIND diet and general and abdominal obesity: a cross-sectional study.

Nutr J 2020 02 17;19(1):15. Epub 2020 Feb 17.

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

Background: Recently, a new eating pattern called as "Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)" has been coined. Emerging studies are examining this dietary pattern with chronic conditions. We aimed to investigate the association between the MIND diet score and general and central obesity among adults.

Methods: This cross-sectional study was conducted in a framework of the Study on the Epidemiology of Psychological Alimentary Health and Nutrition (SEPAHAN). Dietary information was collected using a validated self-administered 106-item Willett-format dish-based semi-quantitative food frequency questionnaire (DS-FFQ) in 6724 adults. Adherence to the MIND diet was examined based on components suggested in this eating pattern. Anthropometrics data were collected using a validated self-reported questionnaire. General obesity was defined as body mass index ≥30 kg/m, and abdominal obesity as waist circumference > 102 cm for men and > 88 cm for women.

Results: Mean age, BMI and WC in the study population was 36.8 ± 8.08 y, 24.9 ± 3.8 kg/m and 83.7 ± 16.02 cm, respectively. Overall, 9.5% of subjects were generally obese and 24.4 were abdominally obese. Examining the whole study population, we found no significant association between the MIND diet score and odds of general obesity, either before (ORs for comparing T3 vs. T1: 1.03; 95% CI: 0.83, 1.27; P-trend = 0.74) or after controlling for potential confounders (ORs for T3 vs. T1: 0.91; 95% CI: 0.67, 1.25; P-trend = 0.58). This was also the case for men and women when analyzed separately. We also failed to find any significant association between the MIND diet score and odds of abdominal obesity after controlling for potential confounders in the whole study population (ORs for T3 vs. T1: 1.00, 95% CI: 0.79, 1.27; P-trend = 0.87). However, women with the greatest adherence to the MIND diet were 19% less likely to be abdominally obese than those with the lowest adherence in crude model (OR = 0.81; 95% CIs: 0.67, 0.98; P-trend = 0.03). This association disappeared after controlling for potential confounders (OR = 0.87; 95% CIs: 0.66, 1.14; P-trend = 0.55).

Conclusion: No significant association was observed between adherence to the MIND diet and odds of general and central obesity.
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http://dx.doi.org/10.1186/s12937-020-00531-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026971PMC
February 2020

NOX1 Regulates Collective and Planktonic Cell Migration: Insights From Patients With Pediatric-Onset IBD and NOX1 Deficiency.

Inflamm Bowel Dis 2020 07;26(8):1166-1176

Dr. von Hauner Children's Hospital, Department of Pediatrics, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.

Background: Genetic defects of pediatric-onset inflammatory bowel disease (IBD) provide critical insights into molecular factors controlling intestinal homeostasis. NOX1 has been recently recognized as a major source of reactive oxygen species (ROS) in human colonic epithelial cells. Here we assessed the functional consequences of human NOX1 deficiency with respect to wound healing and epithelial migration by studying pediatric IBD patients presenting with a stop-gain mutation in NOX1.

Methods: Functional characterization of the NOX1 variant included ROS generation, wound healing, 2-dimensional collective chemotactic migration, single-cell planktonic migration in heterologous cell lines, and RNA scope and immunohistochemistry of paraffin-embedded patient tissue samples.

Results: Using exome sequencing, we identified a stop-gain mutation in NOX1 (c.160C>T, p.54R>*) in patients with pediatric-onset IBD. Our studies confirmed that loss-of-function of NOX1 causes abrogated ROS activity, but they also provided novel mechanistic insights into human NOX1 deficiency. Cells that were NOX1-mutant showed impaired wound healing and attenuated 2-dimensional collective chemotactic migration. High-resolution microscopy of the migrating cell edge revealed a reduced density of filopodial protrusions with altered focal adhesions in NOX1-deficient cells, accompanied by reduced phosphorylation of p190A. Assessment of single-cell planktonic migration toward an epidermal growth factor gradient showed that NOX1 deficiency is associated with altered migration dynamics with loss of directionality and altered cell-cell interactions.

Conclusions: Our studies on pediatric-onset IBD patients with a rare sequence variant in NOX1 highlight that human NOX1 is involved in regulating wound healing by altering epithelial cytoskeletal dynamics at the leading edge and directing cell migration.
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http://dx.doi.org/10.1093/ibd/izaa017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365810PMC
July 2020

Water consumption and prevalence of irritable bowel syndrome among adults.

PLoS One 2020 24;15(1):e0228205. Epub 2020 Jan 24.

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

Background And Aim: No previous study examined the association between whole-day water intake and odds of irritable bowel syndrome (IBS). We examined the association between whole-day water intake and odds of IBS in a large sample of Iranian adults.

Methods: This cross-sectional study was conducted among 4763 adults in Isfahan, Iran. Daily water intake was assessed using a pre-tested questionnaire by asking questions about the average number of glasses of water consumed in a day. IBS was assessed and defined using a modified Persian version of Rome III questionnaire.

Results: After taking potential confounders into account, no significant association between water consumption and odds of IBS was seen (OR: 1.14; 95% CI: 0.74-1.78). We observed that participants who were taking >8 glasses/d of water had greater odds of IBS-M in comparison to those who consumed <2 glasses daily (OR: 2.07; 95% CI: 1.01-4.22). No significant association was observed between water intake and odds of IBS in either gender as well [for men: OR: 1.15; 95% CI: 0.59-2.24 and for women: OR: 1.15; 95% CI: 0.62-2.12]. By BMI status, no significant association was observed between whole day water intake and odds of IBS among normal weight (BMI<25 kg/m2) or overweight and obese people (BMI≥25 kg/m2).

Conclusion: We found that whole-day water intake was not associated with odds of IBS. A significant association between consumption of >8 glasses of water per day and odds of IBS-M was observed.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0228205PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6980581PMC
April 2020

Healthy lifestyle score and irritable bowel syndrome: A cross-sectional study in adults.

Neurogastroenterol Motil 2020 05 7;32(5):e13793. Epub 2020 Jan 7.

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

Background: Lifestyle modifications play an important role in the management of irritable bowel syndrome (IBS), but there is limited information on any associations of combined lifestyle-related factors with IBS in Middle Eastern populations. We, therefore, assessed the associations of a "lifestyle score," in analogy to lifestyle scores applied in studies of other disorders, with IBS in adults.

Methods: In a cross-sectional study on 3363 Iranian adults, a healthy lifestyle score (HLS) was constructed using information about dietary habits, dietary intake, physical activity, smoking status, and psychological distress, which was collected using validated questionnaires. A modified version of the Rome III questionnaire (in Persian) was used to diagnose IBS and its subtypes.

Key Results: Individuals with the highest HLS had a 65% lower odds of having IBS compared with those in the lowest category (OR: 0.35; 95% CI: 0.26-0.48). Participants with healthy dietary habits, including regular meal pattern, slow/moderate eating rate, moderate intra-meal fluid consumption, moderate/long meal-to-sleep interval, and low/moderate consumption of fatty foods, had significantly lower odds of having IBS compared with those with unhealthy dietary habits (OR: 0.81; 95% CI: 0.69-0.96). Moreover, individuals with lower levels of psychological distress, compared with those with higher levels of distress, had significantly lower odds of IBS (OR: 0.49; 95% CI: 0.40-0.60).

Conclusions And Inferences: Our data suggest that having an overall "healthy lifestyle" is related to substantially reduced odds of IBS, suggesting that adhering to a healthy lifestyle pattern, including dietary habits, diet quality, physical activity, smoking, and psychological distress, can be considered as a key management strategy for IBS.
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http://dx.doi.org/10.1111/nmo.13793DOI Listing
May 2020

Personality traits are related to functional dyspepsia in a large sample of Iranian adults.

J Psychosom Res 2020 02 27;129:109912. Epub 2019 Dec 27.

Gastroentrology and Hepatology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background And Objective: Few studies have evaluated the association of personality traits with functional dyspepsia (FD). In the present study, we aimed to explore the relationship between different personality traits and FD in a sample of Iranian adults.

Methods: This cross-sectional study was conducted on 4763 adults. FD was evaluated using a modified and validated Persian version of the Rome III questionnaire for the diagnosis of functional gastrointestinal disorders. Personality traits were assessed using the five-factor model. Logistic regression was used for data analysis.

Results: After controlling for various potential confounders, neuroticism (OR = 1.043; 95% CI: 1.028, 1.059), agreeableness (OR = 0.965; 95% CI: 0.952, 0.978), extraversion (OR = 0.985; 95% CI: 0.970, 0.990), openness (OR = 0.981; 95% CI: 0.966, 0.996), and conscientious (OR = 0.980; 95% CI: 0.968, 0.991) scores were associated with risk of FD. Similar significant associations were observed in stratified analyses by sex, except for openness which tended to decrease the risk of FD marginally in women (OR = 0.983, 95% CI: 0.966, 1.001) and in men (OR = 0.979, 95% CI: 0.955, 1.003) after adjusting for multiple confounding variables.

Conclusion: Our study showed that the higher scores of extraversion, conscientiousness, openness, and agreeableness are independently associated with a lower risk of FD in Iranian general population while higher scores of neuroticism increase the risk of FD.
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http://dx.doi.org/10.1016/j.jpsychores.2019.109912DOI Listing
February 2020

Adherence to low carbohydrate diet and prevalence of psychological disorders in adults.

Nutr J 2019 12 23;18(1):87. Epub 2019 Dec 23.

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

Background: Although individual macronutrients were studied in relation to mental health, no information exist about the association between adherence to low carbohydrate diet and psychological disorders. This study was conducted to investigate the association between adherence to a low carbohydrate diet and prevalence of psychological disorders among Iranian adults.

Methods: In this cross-sectional study on 3362 adult men and women, dietary intakes were examined by the use of a validated semi-quantitative food frequency questionnaire. Low carbohydrate diet (LCD) score was computed for each participant based on deciles of percentages of energy from macronutrients. Then the scores of carbohydrate, protein and fat intake for each participant were summed up to achieve the overall LCD score, which ranged from 3 (highest carbohydrate intake and lowest fat and protein intakes) to 30 (lowest carbohydrate intake and highest fat and protein intakes). Anxiety, depression, and psychological distress were assessed by validated Iranian versions of the Hospital Anxiety and Depression Scale and General Health Questionnaire-12.

Results: Prevalence of depression, anxiety and psychological distress in the whole population were 28.0, 13.3 and 22.6%, respectively. No significant differences were observed in the distribution of depression, anxiety and psychological distress across different quartiles of LCD score. After controlling for potential confounders, no significant association was seen between LCD score and prevalence of depression (OR for the highest vs. the lowest quartile of LCD score: (1.15; 95% CI: 0.93, 1.39). Consumption of LCD was not also associated with increased risk of anxiety (0.82; 95% CI: 0.59, 1.14) and psychological distress (0.92; 95% CI: 0.72, 1.16). These associations did not alter when the analyses were done stratified by gender or BMI status.

Conclusion: Adherence to the low carbohydrate diet, which contains high amount of fat and proteins but low amounts of carbohydrates, was not associated with increased odds of psychological disorders including depression, anxiety and psychological distress. Given the cross-sectional nature of the study which cannot reflect causal relationships, longitudinal studies, focusing on types of macronutrients, are required to clarify this association.
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http://dx.doi.org/10.1186/s12937-019-0513-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6929485PMC
December 2019

Inflammatory Bowel Disease Registry and Monitoring: Feasibility Study and Application (Isfahan Inflammatory Bowel Disease Surveillance Project).

Int J Prev Med 2019 17;10:190. Epub 2019 Oct 17.

Gastrointestinal and Hepatobiliary Diseases Research Center, Poursina Hakim Research Institute for Health Care Development, Isfahan, Iran.

Background: Inflammatory bowel disease (IBD) incidence has been increased in Iran as a developing country. Surveillance is a standard method for accessing valid data about disease epidemiology to make relevant decisions for disease control, prevention, and management. We designed Isfahan IBD Surveillance Project (IISP) to make a surveillance system in this area.

Methods: The project is designed in 3 phases. At the first phase, a model of step-wise approach (core, expanded core, and optional variables) for IBD surveillance was designed and implemented among IBD patients registered at a major referral gastrointestinal diseases clinic in Isfahan. Data bank program and its software were designed with suitable and multifunctional features. A total of 352 IBD cases were registered to data bank and analyzed as a pilot study of IISP.

Results: A total of 352 IBD patients, including 245 ulcerative colitis (UC), 80 Crohn's disease (CD), and 27 indeterminate colitis, were registered to the data bank. Bloody stool and abdominal cramp were the most common presentation symptom among UC and CD, respectively. Extensive pancolitis was the most prevalent phenotype (40%) of UC. Over two-thirds of our IBD patients were in remission states. Biologic agents had been prescribed in about 10% of patients during disease. Primary sclerosing cholangitis was detected in about 7% and 10% of CD and UC patients, respectively.

Conclusions: Valid data from a standard surveillance system are a relevant, trustworthy tool for making decision by health policy-makers. Integrated comprehensive interventional programs for disease control and management is the second phase of IISP.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_316_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852201PMC
October 2019

The relationship between dietary inflammatory index and psychosomatic complaints profiles: results from SEPAHAN cross-sectional study.

Biopsychosoc Med 2019 6;13:27. Epub 2019 Nov 6.

8Department of Medicine, University of Alberta, Edmonton, Canada.

Background: Although the dietary inflammatory index (DII) has been evaluated in relation to psychological disorders risk, the association between DII and psychosomatic complaints is unclear. This study aimed to determine the association between DII, as a proxy measure of the inflammatory potential of the diet, and psychosomatic complaints.

Methods: This cross-sectional study included 2818 people from the general population, aged 19 to 69 years, of Isfahan province in Iran. Dietary intake was assessed using a validated dish-based food-frequency questionnaire. Psychosomatic complaints were assessed using a self-administered validated Persian questionnaire. Twenty-seven nutrients or foods were included in the calculation of DII. Each of them received a score based on their inflammatory ability, thus, a higher DII score indicated a more pro-inflammatory diet. The risk of being in the top median of a psychosomatic complaints profile across the tertiles of DII was assessed using logistic regression.

Results: Four psychosomatic complaints profiles (psychological, gastrointestinal, neuro-skeletal and pharyngeal- respiratory) were identified. After controlling for potential confounders, individuals in the top tertile of DII had higher odds for experiencing high somatic complaints scores for the psychological (odds ratio (OR) = 1.44, 95% confidence interval (CI): 1.10, 1.89; P trend = 0.009), gastrointestinal (OR = 1.22, 95% CI: 0.99, 1.75;  = 0.058) or neuro-skeletal (OR = 1.56, 95% CI: 1.10, 2.22;  = 0.013) profile. The association for pharyngeal-respiratory complaints did not remain significant after adjustment for stressful life events, medical condition, and anti-psychotropic medicine use.

Conclusion: The significant positive link between DII and the various psychosomatic complaints profiles suggests that a diet with anti-inflammatory potential might be favourably related to psychosomatic complaints. Further studies, particularly clinical trials and longitudinal studies, are warranted to investigate the inflammatory potential of diet in relation to psychosomatic complaints.
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http://dx.doi.org/10.1186/s13030-019-0169-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836464PMC
November 2019