Zamzam Paknahad

Nutrition and Dietetics, Nutritional Biochemistry

associate professor
15.42

Publications

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    ABSTRACT: Lifestyle factors such as weight, salt intake, and physical activity have shown to be important in treating hypertension. The object of this study was to describe feasibility and to assess the effectiveness of a multicomponent lifestyle intervention on high blood pressure (BP) of Iranian women. This randomized controlled trial was conducted in four health centers by recruiting 161 women aged 35-65 years with high BP and randomizing them to a 4-week lifestyle modification (n = 80) or control group (n = 81). BP level and other health behavioral factors were assessed before and after the 4-week intervention and also after 6 months. The mean systolic BP changed from 158.8 (±8.1) mmHg to 153.2 (±6.4) mmHg during 4-week and to 145.5 (±4.6)) mmHg after 6 months in the intervention group (P < 0.001). There was a significant difference between two groups of study after 4-week mean = 5.6 (confidence interval [CI] = 5.1-6.6) and 6 months follow mean (CI = 12.3-14.6).(P < 0.001) A significant correlation was detected between systolic BP (SBP) and diastolic BP (DBP) with weight, body mass index, waist circumference, salt intake, and physical activity level (P < 0.001). Stepwise regression analyses indicated that the weight, dietary salt intake, and physical activity level were significant predictors of SBP and DBP. The results of this study suggest that lifestyle modification program is associated with improvements in BP level in Iranian women.
    Journal of research in medical sciences 01/2015; 20(1):54-61.
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    ABSTRACT: Background:Atherosclerosis, with its major manifestation, coronary artery disease (CAD) is a chronic inflammatory disease. Dietary fatty acids intakes favorably effect on inflammatory responses. This study was conducted to examine the association between dietary fatty acid intakes and inflammatory markers, interleukin 6 (IL-6) and high sensitivity C-reactive protein (hs-CRP), in CAD patients among Iranian population.Materials and Methods:This hospital-based, cross-sectional study was conducted in Chamran Heart Hospital, Isfahan, Iran in 2012. Patients aged ≥45 years with first ever symptomatic CAD confirmed by angiography were included. A semi-quantitative food frequency questionnaire (FFQ) was used to assess the usual intakes of dietary fatty acids.Results:The energy-adjusted daily intakes (mean ± SD) of saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), linoleic acid, α-linolenic acid, and eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) were 27 ± 9, 22 ± 6, 21 ± 5, 0.4 ± 0.32, and 0.85 ± 0.82 g/d; respectively. After adjustment for potential confounders, SFA was directly related to hs-CRP (P = 0.01) and IL-6 (P < 0.001) concentrations. Intakes of EPA + DHA and MUFA, were significantly adversely related to plasma hs-CRP concentration (P = 0.002 and 0.001, respectively) but not IL-6, albeit MUFA was modestly inversely related to IL-6 (P = 0.08). No significant relationships were observed for other fatty acids, α-linolenic acid, and linoleic acid.Conclusions:These findings suggest that saturated fatty acids, EPA + DHA and MUFA were significantly related to plasma inflammatory markers in CAD patients.
    09/2014; 3:148. DOI:10.4103/2277-9175.137818
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    ABSTRACT: Background Dietary intervention for improving serum lipids emphasizes on dietary fiber, plant protein and flavonoids. This study was performed to examine whether regular legume consumption could alter serum lipids level and prevalence of dyslipidemia. Materials and Methods This cross-sectional study was performed among 9660 randomly selected Iranian adults in three districts in the central part of Iran, using data collected in the Isfahan Healthy Heart Program in 2007. Dietary behavior including frequency of legume consumption was assessed by 48-item food frequency questionnaire. Fasting serum lipids were measured by standard enzymatic methods. We applied analysis covariance test to compare adjusted mean of serum lipids across legume consumption quartile and logistic regression test was utilized to determine odds ratio (OR) 95% CI of dyslipidemia based on legume consumption in unadjusted and four-adjusted models. Results adjusted mean TG significantly reduced and HDL-C enhanced by increasing legume consumption (p=0.04). The frequency of legume consumption associated with occurrence of all kinds of dyslipidemia except for hypercholesterolemia, especially for those who had consumed legume more than 1 time per day in adjusted models [hypertriglyceridemia: 0.82(0.68-0.98); high LDL-C: 0.76(0.60-0.97) and low HDL-C: 0.81(0.71-0.92)]. Conclusion We found an inverse dose-response association between the frequency of legume consumption and the risk of hypertriglyceridemia, high LDL-C and low HDL-C. Therefore it is suggested that increasing legume intake may be an importantpart of a dietary approach for primary prevention of CVD.
    Journal of Clinical Lipidology 08/2014; DOI:10.1016/j.jacl.2014.08.006
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    ABSTRACT: Osteoporosis is a serious public health. Since the majority of bone mass occurs during adolescence, primary prevention is important. Probably mother's participation in health education interventions leads to promote health behaviors in children. To assess a lifestyle modification intervention focused on mothers and students has an impact on osteoporosis preventive behaviors in adolescent girls. It is a randomized field trial in female high schools. 210 girls aged between 11 and 15 were randomly selected. Students in groups A and C and mothers in group B were selected Through the sampling frame. Our lifestyle modification was based on group based education in the public girls' high schools. Subjects in the intervention groups participated in three educational sessions. Students' osteoporosis preventive behaviors were measured by using a lifestyle questionnaire consisting of items assessing nutrition, physical activity and sun exposure. Repeated measure ANOVA at baseline, 4 week, 2 months and 6 months and were used to analyze the data. After 1 month, diet and sun exposure scores increased significantly (P < 0.001) but it was higher in group B compared with group A. (About diet P < 0.001 and sun exposure = 0. 001). After 6 months, diet and sun exposure status in the group A approximately decreased to baseline, while in group B, diet components were significantly different compared to baseline (P < 0.001). There was no change in physical activity. Osteoporosis prevention intervention of adolescent can be effective when parents or girls participate in training sessions, but education is associated with better outcomes when focused on mothers.
    Journal of research in medical sciences 08/2014; 19(8):746-752.
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    ABSTRACT: Introduction: Osteoporosis is a multifactorial disease and one of the most important modifiable factors in the development and maintenance of bone mass are nutrition nutritional status and its relationship with Bone Mass Density (BMD) in postmenopausal women admitted in osteodensitometry Center, Isfahan, Iran. Materials and Methods: Seventy-two postmenopausal osteoporotic women were studied. BMD of the lumbar spine and total hip were measured using dual-energy X-ray absorptiometry. Demographic and dietary intakes were collected by interview and using a validated food frequency questionnaires. T-scores, Pearson correlation and one way analysis of variance tests were conducted to analyze the data. Results: Mean of age and duration of menopause was nearly 57.5 ± 7.2 and 10.6 ± 7.1 years, respectively. The mean t-scores for BMD of spine and hip were 0.877 ± 0.179 and 0.997 ± 0.21, respectively. The mean of calcium (Ca), phosphorous (P), fluoride (F), Vitamin D, K and Zn were less than DRI and Na more than it (all P value less than 0.0001). BMD of hip was significantly correlated with dietary Ca, animal protein, Zn (P < 0.05), but BMD of spine did not show any significant correlation with nutrients (P > 0.05). Conclusion: Most of the postmenopausal osteoporotic women in this study had a considerable deficiency in terms of micronutrients such as Ca, vitamin D and P, which can be deleterious for bone health.
    International Journal of Health Promotion and Education 05/2014; 3:48. DOI:10.4103/2277-9531.131937
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    ABSTRACT: Nutrition in childhood has a significant role in current and adulthood health. Recent studies have shown that the mother's life-style has an important role in the methods used by mother to feed child, child's diet and body mass index (BMI). This study paper aimed to investigate the association between mother's weight efficacy life-style (WEL) with feeding practices and diet in children aged 3-6 years. In this cross-sectional study, which was carried out in 18 Primary Schools of Rasht (Iran) in 2012, 165 mothers with children aged 3-6 years were participated. Mothers reported their own and their child's demographics. Aspects of mother's WEL and mother's control practices were assessed using WEL questionnaire and Comprehensive Feeding Practices Questionnaire respectively. Height and weight of mothers participated in the study were measured. Child's dietary intake was measured using Food Frequency Questionnaire (FFQ). The role of mother's weight efficacy in predicting child's feeding practices and child's diet was assessed using the linear regression. Statistical significance for all P values was set at 0.003. The results were showed that mother's weight efficacy was related to child feeding practices and child's dietary intake. The mothers with similar WEL applied similar methods in child nutrition. Mothers with better weight efficacy used more encourage balance and variety (β = 1.860), environmental control (β = 0.437), child involvement (β = 0.203) and less emotion regulation using foods (β = -0.213) and their children eat fewer snacks (β = -0.318) (PV= 0.003). The result of this study showed that maternal life-style was associated with feeding practices and child's intake. There was no significant relation between the maternal self-efficacy and child BMI.
    International journal of preventive medicine 01/2014; 5(1):21-28.
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    ABSTRACT: Poor vitamin D status and low serum insulin-like growth factor-1(IGF-1) are associated with metabolic syndrome (MetS) and its components. But, there is no adequate evidence about this. The aim of this study was to examine relationship of factors with MetS features.
    01/2014; 3:159. DOI:10.4103/2277-9175.137873
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    Hossein Hajianfar, Zamzam Paknahad, Ahmad Bahonar
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    ABSTRACT: Diabetes is one of the most common chronic diseases in which antioxidant capacity changes. Omega-3 fatty acids have extensive biological effects including their advantage on lipoprotein metabolism, platelet function, cytokine production, clotting, fibrinolysis, and inflammatory factors. This study aimed to investigate the effect of omega-3 fatty acid supplements on antioxidant capacity in patients with type 2 diabetes. This clinical trial enrolled 71 women with type 2 diabetes in two case (treated with omega-3 capsules) and control (treated with placebo) groups. In the first stage, participants filled out a demographics questionnaire including age, height, weight, waist circumference, and hip circumference.Their blood sample was taken to evaluate glycosylated hemoglobin and antioxidant capacity. Then the case group received intervention for 8 weeks and weight, waist circumference, and hip circumference were measured and a blood sample was taken again. The data were analyzed using SPSS 18 software. The mean difference of antioxidant capacity before and after intervention was significant (P < 0.001). Antioxidant capacity increased in the case group and reduced in the control group. With regard to the results of the present study, patients with type 2 diabetes increase their antioxidant capacity, enhance their antioxidant defense system, and probably prevent diabetes complications and related disease progress by taking omega-3 supplements.
    International journal of preventive medicine 05/2013; 4(Suppl 2):S234-8.
  • Tina Jafari, Zamzam Paknahad
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    ABSTRACT: Nowadays, hypertension is one of the most important causes of death all over the world because of its adverse effects on cardiovascular system. For this reason its study is very valuable. Vitamin D is one of the important factors that may influence blood pressure. Many studies have shown the modulatory effect of this vitamin on rennin-angiotensin system as well as its inhibitory effect on vascular smooth muscle hypertrophy. According to the fact that vitamin receptors are distributed in almost all organs of human body, we can't consider its role just as factor in calcium homeostasis. Therefore many other important roles could be attributed to it. So vitamin D deficiency could arise many problems. There are many causes for vitamin D deficiency. The most important is insufficient exposure to UV-B. In epidemiological studies the vitamin D deficiency is considered to be associated with high blood pressure, as emphasized in many cross-sectional studies. Concerning the cohort prospective studies, the relationship between vitamin D deficiency and hypertension is reported in some cases. The interventional studies about the association between vitamin D and hypertension are not many and the results are different or contradictory. Controversial results might be due to differences in dose of supplements or duration of supplement therapy. The aim of this systematic review is to assess the researches about the association between vitamin D deficiency and hypertension and discuss the power of them. This can be helpful to lighten the path to prospective investigations. Copyright © 2013 Zahedan University of Medical Sciences. All rights reserved.
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    ABSTRACT: Increasing prevalence of obesity is a major health concern. Lifestyle behaviors and diet play an important role in developing childhood obesity. The aim of this study was to determine the association between major dietary patterns and overweight/obesity in a group of Iranian school-aged children. This cross-sectional study was conducted in Isfahan, Iran with 637 elementary school-aged children. A semi-quantitative food-frequency questionnaire was used to assess usual dietary intakes. Data on socio-demographic, physical activity and other lifestyle habits were collected using standard questionnaires. Obesity was determined based on national cut-offs. Factor analysis was used for identifying major dietary patterns. Three major dietary patterns were extracted; "Healthy," "Western," and "Sweet-Dairy." After adjusting for confounders, girls in the second quartile of healthy pattern, were more likely to be overweight (odds ratio [OR] =2.23, Confidence intervals [CI] =1.003, 4.96) compared to those in the highest quartile. Likelihood of being overweight was lower for girls in the second quartile of western dietary pattern versus the fourth quartile (OR = 0.46, CI = 0.21, 1.01). Accordingly, lower adherence to sweet and dairy pattern was associated with lower body mass index (BMI) among girls (OR = 0.42, CI = 0.21, 0.85). There was no significant relationship between western and sweet-dairy pattern with BMI among boys, however, significant association was observed between lowest and highest quartiles of healthy pattern (OR = 0.36, CI = 0.15, 0.84). We found significant associations between the three dietary patterns and obesity among girls. Only healthy pattern was related to weight status of schoolboys. Longitudinal studies will be needed to confirm these associations.
    International journal of preventive medicine 04/2013; 4(4):448-58.
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    ABSTRACT: Designing an intervention based on healthcare settings resources and patient acceptability is potentially important in the prevention of high blood pressure(BP) and other risk factors of cardiovascular disease. To explain a multicenter randomized controlled trial that is designed to examine the effects of the multicomponent lifestyle modification program on BP. The effectiveness of the lifestyle modification program versus usual care in health-care centers is evaluated in a randomized controlled trial. Patients aged 30years or older having a systolic blood pressure(SBP) of 140-179mmHg or a diastolic blood pressure(DBP) of 90-109 mm Hg or patients taking antihypertensive medications are eligible for the study. -The primary outcomes measured are SBP and DBP levels. Mediator outcomes include physical activity level, stress scale, dietary composition, and weight measurements. All measurements will be conducted after the 4weeks of intervention and also at 6months. Outcomes of the study will present the effects of implementing multicomponent lifestyle intervention programs to control BP in health-care centers settings.
    Journal of research in medical sciences 04/2013; 18(4):308-313.
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    Hossein Hajianfar, Zamzam Paknahad, Ahmad Bahonar
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    ABSTRACT: ABSTRACT Background: Diabetes is one of the most common chronic diseases in which antioxidant capacity changes. Omega‑3 fatty acids have extensive biological effects including their advantage on lipoprotein metabolism, platelet function, cytokine production, clotting, fibrinolysis, and inflammatory factors. This study aimed to investigate the effect of omega‑3 fatty acid supplements on antioxidant capacity in patients with type 2 diabetes. Methods: This clinical trial enrolled 71 women with type 2 diabetes in two case (treated with omega‑3 capsules) and control (treated with placebo) groups. In the first stage, participants filled out a demographics questionnaire including age, height, weight, waist circumference, and hip circumference.Their blood sample was taken to evaluate glycosylated hemoglobin and antioxidant capacity. Then the case group received intervention for 8 weeks and weight, waist circumference, and hip circumference were measured and a blood sample was taken again. The data were analyzed using SPSS 18 software. Results: The mean difference of antioxidant capacity before and after intervention was significant (P < 0.001). Antioxidant capacity increased in the case group and reduced in the control group. Conclusions: With regard to the results of the present study, patients with type 2 diabetes increase their antioxidant capacity, enhance their antioxidant defense system, and probably prevent diabetes complications and related disease progress by taking omega‑3 supplements
    International journal of preventive medicine 03/2013; 14(sup):s234-s238.
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    ABSTRACT: Flavonoids comprise a large group of plant metabolites, 6,000 of which have been identified to date. Some studies have shown the increased aerobic performance and maximal oxygen consumption (VO(2max)) and therefore fitness following quercetin intake as a result of elevated number of intracellular mitochondria caused by the flavonoid. This double-blind clinical trial comprised 60 male students having an athletic history of at least 3 years. Body composition, exercise performance, and some blood biomarkers were analyzed. The individuals were selected by convenient sampling, and then were assigned into four groups of equal number by using permuted block randomization. The first to fourth groups received a 500 mg supplemental quercetin capsule plus a 250 mg vitamin C pill, a 500 mg supplemental quercetin capsule plus a 250 mg placebo vitamin C pill, a 500 mg placebo quercetin capsule plus a 250 mg vitamin C pill, and a 500 mg placebo quercetin capsule plus a 250 mg placebo vitamin C pill, respectively, daily for 8 weeks. The participants were asked to continue their routine diet and physical activity during the study and they were monitored through phone calls or text messages. Lean body mass, total body water, basal metabolic rate, and total energy expenditure increased significantly in the quercetin group after intervention. On the other hand, VO(2max) increased in the "quercetin" and "quercetin + vitamin C" groups following the intervention, non-significantly. Our findings suggest that supplementation with quercetin in athletes may improve some indices of performance.
    International journal of preventive medicine 01/2013; 4(1):21-6.
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    ABSTRACT: Background: The health promoting effects of green tea including anti-obesity and anti-inflammatory effects, decreasing heart attack risk and oxidative stress status has been widely demonstrated during the past decade. The purpose of this study was to determine the possible effects of green tea on the anthropometric indices, systolic and diastolic blood pressure in overweight and obese women. Methods: A before-after, randomized clinical trial was conducted during 45 days on 41 overweight and obese women. The randomly selected participants forming a treatment group consumed 3 to 5 cups of green tea (125 cc) daily for 45 days. Demographic information, anthropometric indices including height, weight, body mass index (BMI), waist hip ratio (WHR), percent body fat and systolic/diastolic blood pressure were recorded at the beginning and the end of the study. Findings: Mean of age, BMI and body fat were 38.1 ± 1.7 years, 28.8 ± 3.5 Kg/m2 and 35.8 ± 3.51 percent, respectively. The mean of systolic and diastolic blood pressure were 84.8 ± 12.9 mmHg and 130.1 ± 20 mmHg, respectively. There was a non-significant reduction in anthropometric indices such as weight, BMI, and body fat percent; and a significant reduction in systolic blood pressure (P = 0.009); however, reduction in diastolic blood pressure was not statistically significant (P = 0.05). Conclusion: Daily intake of green tea was associated with a significant reduction in systolic blood pressure; however, reduction in anthropometric indices and diastolic blood pressure was not significant. Key words: Green Tea, Anthropometric Indices, Blood Pressure, Overweight, Percent Body Fat
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    ABSTRACT: Quercetin is a bioflavonoid occurs in many food items. Some previous studies on quercetin showed the inconsistent results on exercise performance and muscle damage in athletes. The aim of this study was to determine the effects of 8 weeks of quercetin supplementation on exercise performance and muscle damage indices in student athletes. This placebo-controlled, double-blind clinical trial was conducted on 60 male students for 8 weeks. The subjects were randomly assigned to one of the four groups: a) quercetin (500 mg/day quercetin + 200 mg/day placebo), b) quercetin+ vitamin C (500 mg/day quercetin + 200 mg/day vitamin C), vitamin C (500 mg/day placebo + 200 mg/day vitamin C), and placebo (500 mg/day placebo + 200 mg/day placebo). Time to exhaustion (TTE) for measuring performance, aspartate transaminase (AST), and creatine kinase (CK) for measuring muscle damage and body fat percent (BFP) were measured before and after intervention. CK levels reduced in group 1 significantly (P=0.045) and BFP reduced in group 1, 3, and 4, significantly, too (P=0.018, P=0.013, and P=0.043, respectively). Whereas statistically significant changes between groups were not observed for TTE, AST, CK, and BFP after 8 weeks of intervention. Supplementation with quercetin and vitamin C for 8 weeks did not improve exercise performance but reduced muscle damage and body fat percent in healthy subjects.
    Journal of research in medical sciences 04/2012; 17(4):328-31.
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    ABSTRACT: Elevated total plasma homocysteine has been established as an independent risk factor for CVD. A strong relationship between plasma homocysteine levels and mortality has been reported in patients with CAD. Interference with folate and homocysteine metabolism by some drugs, may lead to increased plasma homocysteine levels. The object of the study was to examine the effect of AEDs on the serum concentrations of folic acid. A total of 22, older than 18-year-old, epileptic patients, admitted in the Neurology Clinic, who were treated with AED at least for one year were selected. Twenty-two sex- and age-range-matched controls were enrolled in the study. Concentrations of total homocysteine and folic acid in the serum were measured in a fasted status. Demographic and medicine information was collected via a questionnaire. Data were analyzed by spss(16) software. Mean of serum Hcy concentration in the patients was significantly higher compared to that in the controls (p = 0.04). Serum folic acid had a nonsignificant negative correlation with the dose of drug used (p = 0.2). Serum homocysteine was not significantly correlated with the dose and duration of drug consumption (p values were 0.4, 0.24, respectively). Serum homocysteine was not significantly correlated with the kind of drug (p = 0.4), but folic acid concentration was significantly lower in the monotherapy group than in the poly therapy group (p = 0.02). Homocysteine (Hcy) was not different between the epileptic and nonepileptic groups, although the means of the serum folic acid were similar. Possible mechanisms by which AEDs could cause hyper-homocysteinemia might be through the dysfunction of homocysteine metabolism, the acceleration of vitamin metabolism, and the interference in the metabolism of folic acid coenzymes.
    International journal of preventive medicine 03/2012; 3(Suppl 1):S186-90. DOI:10.1016/j.clinbiochem.2011.08.297
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    ABSTRACT: In a cross sectional study, 75 patients (42 males and 33 females) on continuous ambulatory peritoneal dialysis (CAPD) were enrolled from October 2007 to February 2008. Serum levels of leptin, albumin, triglyceride, dialysis adequacy (total KT/V), renal creatinine clearance (Cr Cl), mid arm circumference and demographic findings were measured in all patients. The mean age of patients was 53±14.76. The history of hemodialysis was seen in 23 patients. Mean serum leptin level in women and men were 27±23µg/l and 16±13µg/l, respectively. A significant correlation of serum leptin level with body mass index (BMI) (p<0.001) and renal Cr Cl (p<0.001) was found. There was no significant correlation of serum leptin level with KT/V, duration of renal failure, serum triglycerides (TG), serum low density lipoprotein (LDL) cholesterol and mid arm circumference (p>0.05). To our knowledge, this is probably the first study to report that serum leptin level has a direct positive correlation with renal Cr Cl in CAPD patients. This may explain the increase in mortality in patients with lower serum leptin levels (Tab. 2, Fig. 2, Ref. 25).
    Bratislavske lekarske listy 01/2012; 113(8):486-9. DOI:10.4149/BLL_2012_107
  • Clinical Biochemistry 09/2011; 44(13). DOI:10.1016/j.clinbiochem.2011.08.181
  • Clinical Nutrition Supplements 01/2011; 6(1):204-204. DOI:10.1016/S1744-1161(11)70529-4
  • Zamzam Paknahad
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    ABSTRACT: seleium and health
    The 1 st International Applied Geological Congress, , Mashad; 04/2010

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