[Show abstract][Hide abstract] ABSTRACT: Background:
Dietary assessment is the first step of dietary modification in community-based interventional programs. This study was performed to validate a simple food frequency questionnaire (SFFQ) for assessment of selected food items in epidemiological studies with a large sample size as well as community trails.
This validation study was carried out on 264 healthy adults aged ≥ 41 years old living in 3 district central of Iran, including Isfahan, Najafabad, and Arak. Selected food intakes were assessed using a 48-item food frequency questionnaire (FFQ). The FFQ was interviewer-administered, which was completed twice; at the beginning of the study and 2 weeks thereafter. The validity of this SFFQ was examined compared to estimated amount by single 24 h dietary recall and 2 days dietary record. Validation of the FFQ was determined using Spearman correlation coefficients between daily frequency consumption of food groups as assessed by the FFQ and the qualitative amount of daily food groups intake accessed by dietary reference method was applied to evaluate validity. Intraclass correlation coefficients (ICC) were used to determine the reproducibility.
Spearman correlation coefficient between the estimated amount of food groups intake by examined and reference methods ranged from 0.105 (P = 0.378) in pickles to 0.48 (P < 0.001) in plant protein. ICC for reproducibility of FFQ were between 0.47-0.69 in different food groups (P < 0.001).
The designed SFFQ has a good relative validity and reproducibility for assessment of selected food groups intake. Thus, it can serve as a valid tool in epidemiological studies and clinical trial with large participants.
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND
Epidemiologic studies have shown an inverse association between dietary fiber and metabolic syndrome (MetS). Therefore, the purpose of this study was to investigate the association between MetS and consumption of legumes in adults in Isfahan, Iran.
This cross-sectional study was carried out on 2027 individuals who were a subsample of the 3rd phase of the Isfahan Healthy Heart Program (IHHP). Basic characteristics information such as age, sex, smoking status, and physical activity were collected using a questionnaire. A validated 48-item food frequency questionnaire was used to assess dietary behaviors. Blood pressure, waist circumference (WC), glucose, triacylglycerols, and high-density lipoprotein cholesterol were measured, and MetS was defined based on Adult Treatment Panel III guidelines. Multiple logistic regression models examined associations of frequency consumption of legumes with MetS occurrence and its components.
All MetS components were less prevalent among subjects with regular legume intake (P < 0.01). Legume intake was inversely associated with the risk of MetS, after adjustment for confounding factors in women. Life style adjusted odds ratio of Mets between highest and lowest tertile and no consumption (as reference category) of legume intake were 0.31 (0.13, 0.70), 0.38 (0.17, 0.87), respectively, in women (P = 0.01).
This study showed that age has a crucial role in MetS incidence; therefore, after further age adjustment to lifestyle adjusted model there was no significant difference in lower and higher tertile of legume intake and MetS.
Full-text · Article · Jun 2014 · ARYA Atherosclerosis
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND/OBJECTIVE
It is expected that dairy products such as cheeses, which are the main source of cholesterol and saturated fat, may lead to the development or increase the risk of cardiovascular and metabolic diseases; however, the results of different studies are inconsistent. This study was conducted to assess the association between cheese consumption and cardiovascular risk factors in an Iranian adult population.
Information from the Isfahan Healthy Heart Program (IHHP) was used for this cross-sectional study with a total of 1,752 participants (782 men and 970 women). Weight, height, waist and hip circumference measurement, as well as fasting blood samples were gathered and biochemical assessments were done. To evaluate the dietary intakes of participants a validated food frequency questionnaire, consists of 49 items, was completed by expert technicians. Consumption of cheese was classified as less than 7 times per week and 7-14 times per week.
Higher consumption of cheese was associated with higher C-Reactive Protein (CRP), apolipoprotein A and high density lipoprotein cholesterol (HDL-C) level but not with fasting blood sugar (FBS), total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and apolipoprotein B. Higher consumption of cheese was positively associated with consumption of liquid and solid oil, grain, pulses, fruit, vegetable, meat and dairy, and negatively associated with Global Dietary Index. After control for other potential confounders the association between cheese intake and metabolic syndrome (OR: 0.81; 96%CI: 0.71-0.94), low HDL-C level (OR: 0.87; 96%CI: 0.79-0.96) and dyslipidemia (OR: 0.88; 96%CI: 0.79-0.98) became negatively significant.
This study found an inverse association between the frequency of cheese intake and cardiovascular risk factors; however, further prospective studies are required to confirm the present results and to illustrate its mechanisms.
Full-text · Article · Jun 2014 · Nutrition research and practice
[Show abstract][Hide abstract] ABSTRACT: Considering the main effect of obesity on chronic non-communicable diseases, this study was performed to assess the association between body mass index (BMI), waist-circumference (WC), cardio-metabolic risk factors and to corroborate whether either or both BMI and WC are independently associated with the risk factors in a sample of Iranian adults. This cross-sectional study was performed on data from baseline survey of Isfahan Healthy Heart Program (IHHP). The study was done on 12,514 randomly-selected adults in Isfahan, Najafabad and Arak counties in 2000-2001. Ages of the subjects were recorded. Fasting blood glucose (FBG), 2-hour post-load glucose (2hpp), serum lipids, systolic and diastolic blood pressure (SBP and DBP), BMI, WC, smoking status, and total daily physical activity were determined. Increase in BMI and WC had a significant positive relation with the mean of FBG, 2hpp, SBP, DBP, serum lipids, except for HDL-C (p<0.001 for all). After adjustment for age, smoking, physical activity, socioeconomic status (SES), and BMI, the highest odds ratio (OR) (95% CI) for diabetes mellitus (DM) according to WC was 3.13 (1.93-5.08) and 1.99 (1.15-3.44) in women and men respectively. Moreover, the highest ORs based on BMI with adjustment for age, smoking, physical activity, SES, and WC were for dyslipidaemia (DLP) [1.97 (1.58-2.45) in women and 2.96 (2.41-3.63) in men]. The use of BMI or WC alone in the models caused to enhance all ORs. When both BMI and WC were entered in the model, the ORs for all risk factors, in men, according to BMI, were more compared to WC. However, in women, ORs for DM and hypertension (HTN) in WC quartiles were more than in BMI quartiles. BMI is the better predictor of DM, HTN, and DLP in men compared to WC. Conversely, in women, WC is a superior predictor than BMI, particularly for DM and HTN. Furthermore, the measurement of both WC and BMI in Iranian adults may be a better predictor of traditional risk factors of CVDs compared to BMI or WC alone.
Full-text · Article · Sep 2013 · Journal of Health Population and Nutrition
[Show abstract][Hide abstract] ABSTRACT: Association between white rice intake and risk factors of cardiovascular diseases remained uncertain. Most of the previous published studies have been done in western countries with different lifestyles, and scant data are available from the Middle East region, including Iran. This cross-sectional study was conducted in the structure of Isfahan Healthy Heart Program (IHHP) to assess the association between white rice consumption and risk factors of cardiovascular diseases. In the present study, 3,006 men were included from three counties of Isfahan, Najafabad, and Arak by multistage cluster random-sampling method. Dietary intake was assessed with a 49-item food frequency questionnaire (FFQ). Laboratory assessment was done in a standardized central laboratory. Outcome variables were fasting blood glucose, serum lipid levels, and anthropometric variables. Socioeconomic and demographic data, physical activity, and body mass index (BMI) were considered covariates and were adjusted in analysis. In this study, Student's t-test, chi-square test, and logistic regression were used for statistical analyses. Means of BMI among those subjects who consumed white rice less than 7 times per week and people who consumed 7-14 times per week were almost similar--24.8 +/- 4.3 vs 24.5 +/- 4.7 kg/m2. There was no significant association between white rice consumption and risk factors of cardiovascular diseases, such as fasting blood sugar arid serum lipid profiles. Although whole grain consumption has undeniable effect on preventing cardiovascular disease risk, white rice consumption was not associated with cardiovascular risks among Iranian men in the present study. Further prospective studies with a semi-quantitative FFQ or dietary record questionnaire, representing type and portion-size of rice intake as well as cooking methods and other foods consumed with rice that affect glycaemic index (GI) of rice, are required to support our finding and to illustrate the probable mechanism.
Full-text · Article · Jun 2013 · Journal of Health Population and Nutrition
[Show abstract][Hide abstract] ABSTRACT: Stress has been considered as a highly common disorder that has a complicated relation with dietary intake and has been linked with both increased and decreased dietary intake.
This study was conducted to assess the association between food consumption and stress levels in an Iranian adult population.
In this cross-sectional study, data from the third phase of Isfahan Healthy Heart Program (IHHP) that was conducted for cardiovascular diseases prevention and health promotion were used. Nine thousand five hundred forty-nine adults aged ≥ 18 years participated in the study. Dietary habits were assessed by a 49- item Food Frequency Questionnaire (FFQ). Stress levels were assessed by General Health Questionnaire-12 (GHQ-12). The participants were separated on the basis of their stress levels into two groups as the low- and high- stress groups.
Individuals in the low- stress group were significantly younger and tended to have higher physical activity and education level, lower LDL cholesterol, and were less likely to be current smokers. Dietary intake of unsaturated oils, grains, fruits, vegetables, meat, and dairy products was significantly higher in the low- stress group whereas dietary intake of saturated oils was significantly lower; moreover, Global Dietary Index (GDI) was lower in the low- stress group. We found a significant positive association between stress level, GDI (OR: 1.24; 95% CI: 1.14 - 1.35), and saturated oils (OR: 1.17; 95% CI: 1.08 - 1.28) and inverse association between stress level and intake of unsaturated oils (OR: 0.84 ; 95% CI: 0.77 - 0.91), fruits and vegetables (OR: 0.83; 95% CI: 0.76 - 0.90), meat (OR: 0.88; 95%CI: 0.82 - 0.97),and dairy products (OR: 0.88 ; 95% CI: 0.81 - 0.96) after adjustments based on sex, age, smoking, and physical activity.
Our results showed a significant positive association between dietary intake and stress. We must have a special attention to dietary intake in stress management program of high- stress individuals, and in dietary recommendations, psychologic aspects should be considered. However, prospective longitudinal studies are needed to assess the causal relationship between stress and dietary factors.
Full-text · Article · Mar 2013 · Archives of Iranian medicine
[Show abstract][Hide abstract] ABSTRACT: Background: Previous studies investigated the effects of dietary glycaemic index and glycaemic load on cardiovascular risk factors. Little evidence is available regarding the association between potato intake and cardiovascular risk factors in Iran. Objective: This cross-sectional study was conducted in the first stage of Isfahan Healthy Heart Programme. Methods: A total of 4774 subjects were included in the present study. Dietary intake was assessed with a 49-item food frequency questionnaire. Biochemical assessments were done according to the standard protocol. Results: There were significant associations between potato consumption and diabetes mellitus (odds ratio (OR): 1.38; 95% CI: 1.14-1.67; p < 0.001), high fasting blood sugar level (OR: 1.40; 95% CI: 1.17-1.68; p < 0.001) and low serum high density lipoprotein level (OR: 1.10; 95% CI: 1.01-1.20; p = 0.02) remained after adjustments for possible confounding factors. Conclusion: We found a positive relation between potato consumption, high fasting blood glucose level and diabetes mellitus.
No preview · Article · May 2012 · International Journal of Food Sciences and Nutrition
[Show abstract][Hide abstract] ABSTRACT: This study investigated the gender differences in association of some behavioural and socioeconomic factors with obesity indices in a population-based sample of 12,514 Iranian adults. The mean body mass index (BMI), waist circumference (WC), and the waist-to-hip ratio (WHR) were significantly higher in women than in men. Current and passive smoking had an inverse association with BMI among males whereas current smoking, transportation by a private car, and longer duration of watching television (TV) had a positive association with BMI among females. Current and passive smoking, cycling, and Global Dietary Index (GDI) had an inverse association with WC among males. Higher consumption of fruits and vegetables, current and passive smoking, duration of daily sleep, and GDI had an inverse association with WC among females. Using a private car for transportation had a significant positive association with WHR among both males and females. Living in an urban area, being married, and having a higher education level increased the odds ratio of obesity among both the genders. Non-manual work also increased this risk among males whereas watching TV and current smoking increased this risk among females. Such gender differences should be considered for culturally-appropriate interventional strategies to be implemented at the population level for tackling obesity and associated cardiometabolic risk factors.
Full-text · Article · Dec 2010 · Journal of Health Population and Nutrition
[Show abstract][Hide abstract] ABSTRACT: This study aimed to assess the effects of a 2-month lifestyle modification trial on cardio-metabolic abnormalities and C-reactive protein (CRP) among obese adolescents with metabolic syndrome [phenotypically obese metabolically abnormal (POMA)] and obese adolescents without a cardio-metabolic disorder [phenotypically obese metabolically normal (POMN)], as well as in normal-weight adolescents with at least one cardio-metabolic disorder [phenotypically normal metabolically obese (PNMO)]. The study comprised 360 adolescents assigned in three groups of equal number of POMN, POMA and PNMO. They were enrolled in a trial consisting of aerobic activity classes, diet and behaviour modification, and were recalled after 6 months. Overall, 94.7% of participants completed the 2-month trial, and 87.3% of them returned after 6 months. The mean CRP was not significantly different between the POMA and PNMO groups, but was higher than in the POMN group. After the trial, body mass index (BMI) and waist circumference (WC) decreased in obese participants, and the mean body fat mass decreased in all groups. At 2 months, the mean total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and CRP decreased in the POMA and PNMO groups. After 2 and 6 months, the decrease in mean TC, LDL-C, TG, CRP and systolic blood pressure was greater in the POMA than in the POMN group. The magnitude of decrease in CRP correlated with that of BMI, WC, fat mass, TG, TC and LDL-C. Lifestyle modification programmes for primordial/primary prevention of chronic diseases would be beneficial at the population level and should not be limited to obese children.
No preview · Article · Jul 2010 · Maternal and Child Nutrition
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Family-based interventions are the most well-established way for the treat-ment of childhood obesity.For being applicable and sustainable; these interventions should be assessed in different community settings. The aim of this study was to compare the effects of two methods of nutritional intervention on weight loss of of obese children-parents pairs.