Association of white and red meat consumption with general and abdominal obesity: a cross-sectional study among a population of Iranian military families in 2016

Reducing meat and/or dairy consumption in adults: a systematic review and meta-analysis of effects on protein intake, anthropometric values, and body composition

CONTEXT

Consumers are increasingly encouraged to reduce meat and dairy consumption. However, few meta-analyses of randomized controlled trials (RCTs) on the effect of reducing meat and/or dairy on (absolute) protein intake, anthropometric values, and body composition are available.

OBJECTIVE

The aim of this systematic review and meta-analysis was to evaluate the effect of reducing meat and/or dairy consumption on (absolute) protein intake, anthropometric values, and body composition in adults aged ≥ 45 years.

DATA SOURCES

The MEDLINE, Cochrane CENTRAL, Embase, ClinicalTrials.gov, and International Clinical Trials Registry Platform databases were searched up to November 24, 2021.

DATA EXTRACTION

Randomized controlled trials reporting protein intake, anthropometric values, and body composition were included.

DATA ANALYSIS

Data were pooled using random-effects models and expressed as the mean difference (MD) with 95%CI. Heterogeneity was assessed and quantified using Cochran's Q and I2 statistics. In total, 19 RCTs with a median duration of 12 weeks (range, 4-24 weeks) and a total enrollment of 1475 participants were included. Participants who consumed meat- and/or dairy-reduced diets had a significantly lower protein intake than those who consumed control diets (9 RCTs; MD, -14 g/d; 95%CI, -20 to -8; I2 = 81%). Reducing meat and/or dairy consumption had no significant effect on body weight (14 RCTs; MD, -1.2 kg; 95%CI, -3 to 0.7; I2 = 12%), body mass index (13 RCTs; MD, -0.3 kg/m2; 95%CI, -1 to 0.4; I2 = 34%), waist circumference (9 RCTs; MD, -0.5 cm; 95%CI, -2.1 to 1.1; I2 = 26%), amount of body fat (8 RCTs; MD, -1.0 kg; 95%CI, -3.0 to 1.0; I2 = 48%), or lean body mass (9 RCTs; MD, -0.4 kg; 95%CI, -1.5 to 0.7; I2 = 0%).

CONCLUSION

Reduction of meat and/or dairy appears to reduce protein intake. There is no evidence of a significant impact on anthropometric values or body composition. More long-term intervention studies with defined amounts of meat and dairy are needed to investigate the long-term effects on nutrient intakes and health outcomes.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020207325.

Association of combined healthy lifestyle with general and abdominal obesity

Background

Data linking joint healthy lifestyle factors to general and abdominal obesity are scarce, in particular in the Middle East. The aim of this study was to examine the association of combined healthy lifestyle factors with general and abdominal obesity in a large population of Iranian adults.

Methods

This cross-sectional study was done on 3,172 Iranian adults aged ≥18 years. We constructed healthy lifestyle score using information on dietary intakes, physical activity, smoking status, and psychological distress. To evaluate components of healthy lifestyle, we applied a validated 106-item semi-quantitative Food Frequency Questionnaire (FFQ), General Practice Physical Activity Questionnaire (GPPAQ), General Health Questionnaire (GHQ), and other pre-tested questionnaires. General obesity was defined as having a body mass index (BMI) ≥30 kg/m2 and abdominal obesity as a waist circumference (WC) of ≥102 cm in men and ≥88 cm in women.

Results

Mean age of participants was 36.54 ± 7.97 years. General and abdominal obesity were prevalent among 8.7% and 21.5% of study participants, respectively. Linear analysis showed a significant positive relationship between healthy lifestyle score and BMI among men (β: 0.30, 95% CI: 0.05, 0.54). However, no significant association was found between healthy lifestyle and abdominal obesity in men. Among women, one score increase in healthy lifestyle score was associated with a reduction of 0.65 cm in WC. In terms of individual components of healthy lifestyle, we found that low-distressed women had lower odds of abdominal obesity compared with high-distressed women.

Conclusion

We found a significant inverse association between healthy lifestyle and WC among women. However, healthy lifestyle was positively associated with BMI among men.

The prevalence and determinant of overweight and obesity among residents aged 40-69 years in high-risk regions for upper gastrointestinal cancer in southeast China

Being overweight or obese is one of the public health concerns worldwide, and its prevalence is gradually increasing. Obesity has been proven to be associated with some cancers, including upper gastrointestinal cancer (UGC). However, studies on the prevalence of obesity among residents of areas at high risk of UGC in China are minimal. The aim of this study is to assess the prevalence of obesity and its influencing factors among people aged 40-69 years (high-risk population) in high-risk areas for UGC in Jiangsu Province, southeast China. This cross-sectional study involved 45,036 subjects aged 40-69 years identified in the Rural Early Diagnosis and Treatment of UGC Project database in Jiangsu Province from 2017 to 2021. Differences in prevalence across gender and age were assessed using the Chi-square test. Using a multinomial logistic regression model, we examined independent risk factors for overweight/obesity and their gender and age differences. The prevalence of overweight, obesity, and overweight/obesity varied based on the standards used: Chinese standard (42.1%, 11.9%, and 54.0%) and WHO standard (34.7%, 4.7%, and 39.4%), respectively. Being overweight was more common in men than women, while obesity was more common in women than men. Age of 50-59 years, married, household size of 7-9, drinking, soy products, pickled food, and hot food intake were positively associated with overweight/obesity. Females, 60-69 years, higher education level, household size of 4-6, annual family income of more than 60,000 CNY, smoking, and fresh fruit intake were negatively associated with overweight/obesity. Stratified analysis showed that the effects of age, education and meat, egg and dairy products on overweight/obesity were different across gender. The impact of fresh fruit and vegetables on overweight/obesity was also heterogeneous between the younger (40-59 years) and older (60-69 years) groups. In conclusion, the prevalence of overweight and obesity is high among adults aged 40-69 years from high-risk areas for UGC of Jiangsu Province, southeast China. Independent influencing factors of being overweight/obese included gender, age, marital status, education, household size, annual family income, smoking, drinking, fresh fruit, soy products, pickled food and hot food intake, and may vary by gender and age. Screening-based interventions should be considered to control obesity levels among screened participants. Besides, heterogeneity of influencing factors across subgroups could be focused on to improve intervention effectiveness.

Meat consumption and the risk of general and central obesity: the Shahedieh study

Objective

This study aimed to investigate the relations of total meat intake and its subtypes, including red and processed meat, white meat, poultry, fish, and organ meat to the risk of general/central obesity.

Methods

This cross-sectional study included a total of 7312 Iranian adults with the age range of 35–70 years from the Shahedieh cohort study, Yazd, Iran. Dietary intake of subjects was evaluated using a validated 120-item Food Frequency Questionnaire. General obesity was defined as body mass index ≥ 30 kg/m2 and central obesity as waist circumference ≥ 102 cm in men and ≥ 88 cm in women.

Results

After controlling for potential covariates including energy intake, age, marital status, gender, physical activity, supplement use, house possession, education, family size, current smoking, night shift working, history of thyroid disease and depression, and intakes of vegetables, legumes, nuts, fruits, whole grains, and dairy, a significant direct association was found between the higher consumption of white meat (OR = 1.31; 95% CI: 1.06–1.61) and poultry (OR = 1.23; 95% CI: 1.04–1.45) with odds of general obesity. Processed meat was a significant predictor for central obesity in the fully adjusted model, so that individuals in the fourth quartile of processed meat intake, compared with those in the first quartile, had a 22% (OR = 1.22; 95% CI: 1.04–1.43) increased risk to be centrally obese.

Conclusion

This study reveals that higher intakes of white meat and poultry are associated with increased risk of general obesity, while, processed meat consumption was associated with central obesity.

Predictors Of Breakfast Consumption Among Iranian Students: Applying Social Cognitive Theory

Background — Despite the known significance of regular breakfast consumption, skipping or inadequate consumption of breakfast is common among students. Social cognitive theory (SCT) is one of the most effective theories in predicting nutritional behaviors, especially breakfast-related behaviors Objective — This study aimed to determine the factors related to breakfast consumption based on SCT among students of Islamic Azad University Kermanshah Branch. Methods — In this cross-sectional study, 206 students of Islamic Azad University Kermanshah Branch were selected based on availability sampling. An online questionnaire consisting of demographic information scales, SCT variables and breakfast consumption behavior was sent to student groups. Data were analyzed using descriptive statistical tests, chi-square test, linear regression and correlation analysis in SPSS software version 16. Results — On average, students consume breakfast 4.39 times a week. Overall, 17.6% of students had completely ignored breakfast and 42.4% of them ate breakfast irregularly between one and six times a week. Among the components of social cognitive theory, self-efficacy and observational learning predicted 55.7% of changes in breakfast consumption among students (P<0.001). Conclusions — It seems that social cognitive theory is a useful framework for predicting breakfast consumption behavior among young people, and it is possible to improve breakfast consumption behavior by designing and implementing appropriate educational interventions based on this theory.

Dietary glycaemic index and glycaemic load in relation to risk of breast cancer

OBJECTIVE

Previous studies on the association between glycaemic index (GI) and glycaemic load (GL) in relation to breast cancer risk are contradictory. The aim of this study was to examine the association between dietary GI and GL and risk of breast cancer in Iranian women.

DESIGN

Population-based case-control study. Dietary GI and GL were assessed using a validated Willett-format 106-item semi-quantitative FFQ.

SETTING

Isfahan, Iran.

PARTICIPANTS

Cases were 350 patients with newly diagnosed stage I-IV breast cancer, for whom the status of breast cancer was confirmed by physical examination and mammography. Controls were 700 age-matched apparently healthy individuals who were randomly selected from general population.

RESULTS

After controlling for potential confounders, individuals in the highest tertile of dietary GI had 47 % higher odds of breast cancer than women in the lowest tertile (OR: 1·47; (95 % CI 1·02, 2·12)). Stratified analysis by menopausal status showed such association among postmenopausal women (OR: 1·51; (95 % CI 1·02, 2·23)). We found no significant association between dietary GL and odds of breast cancer either before (OR: 1·35; (95 % CI 0·99, 1·84)) or after adjustment for potential confounders (OR: 1·24; (95 % CI 0·86, 1·79)). In addition, stratified analysis by menopausal status revealed no significant association between dietary GL and odds of breast cancer.

CONCLUSIONS

Our findings showed a significant positive association between dietary GI and odds of breast cancer. However, we observed no significant association between dietary GL and odds of breast cancer.

The Effect of Vitamin D Deficiency with Stunting and Overweight: A Meta-analysis Study

Background: Childhood malnutrition such as stunting and obesity is an international public health problem leading to an increased risk of mortality and morbidity. Vitamin D deficiency has also been identified as a worldwide public health issue that is associated with an increase in the prevalence of related-chronic diseases. Aim: The purpose of this study was to investigating the relation between vitamin D deficiency with stunting and  overweight  among children. Methods: This was a systematic review and meta analysis study used articles from online database of PubMed, which published in 2011 to 2021. The dependent variables was stunting and overweight. The independent variable was vitamin D deficiency. The data was analyzed by RevMan. Results: Subjects with below-standard vitamin D levels in the body had 1.86 higher risk of experiencing stunting (OR = 1.86; 95% CI 0.90-3.84; p = 0.09) and 2.76 higher being overweight (OR = 2.76; 95% CI 0.96-7.99 ; p = 0.09) compared with those with normal vitamin D levels, this result was not statistically significant. Conclusion: There is a relation between vitamin D deficiency with stunting and overweight among children under 18 years

Red and Processed Meat Intake in Relation to Non-Alcoholic Fatty Liver Disease Risk: Results from a Case-Control Study

Data on the association between dietary red meat intake and non-alcoholic fatty liver disease (NAFLD) are limited. We designed this case-control study to determine the association between red and processed meat consumption and risk of NAFLD in Iranian adults. A total of 999 eligible subjects, including 196 NAFLD patients and 803 non-NAFLD controls were recruited from hepatology clinics in Tehran, Iran. A reliable and validated food frequency questionnaire was used to evaluate the red and processed meat intakes. The analyzes performed showed that in an age- and gender-adjusted model, patients with the highest quartile of red meat intake had an approximately three-fold higher risk of NAFLD than those with the lowest quartile of intake (odds ratio [OR], 3.42; 95% confidence interval [CI], 2.16–5.43; p value < 0.001). Moreover, patients in the highest quartile of processed meat intake had a 3.28 times higher risk of NAFLD, compared to the lowest quartile(OR, 3.28; 95% CI, 1.97–5.46; p value < 0.001).Both these associations remained significant by implementing additional adjustments for body mass index, energy intake, dietary factors, diabetes, smoking, and physical activity (OR, 3.65; 95% CI, 1.85–7.18; p value < 0.001 and OR, 3.25; 95% CI, 1.57–6.73; p value = 0.002, respectively).Our findings indicate that both red and processed meat intakes are related to the increased odds of NAFLD; however, prospective studies are needed to confirm these results.

The Association of Prepregnancy Body Mass Index with Pregnancy Outcomes in Chinese Women

Our study was to evaluate the association between prepregnancy body mass index (BMI) and pregnancy outcomes. A total of 1546 women who attended prenatal care clinics and delivered at the Peking University International Hospital, Beijing, China, from October 2018 to April 2020 was included. This research explored gestational, perinatal, and postpartum outcomes, including gestational diabetes, anemia, preeclampsia, preterm premature rupture of membranes (PPROM), and postpartum hemorrhage. Participants were divided into underweight (BMI < 18.5 kg/m²), normal weight (18.5 kg/m² ≤ BMI ≤ 23.9 kg/m²), overweight (24 kg/m² ≤ BMI ≤ 27.9 kg/m²), and obese (BMI ≥ 28 kg/m²) groups. Logistic regression analysis was used to analyze the association between prepregnancy BMI and pregnancy outcomes, and odds ratio (OR) with 95% confidence interval (95% CI) was calculated. After adjusting potential confounders, the risk of PPROM was higher in the underweight group than the normal weight group (OR = 1.864, 95% CI: 1.269-2.737, P < 0.01). Prepregnancy obesity was associated with higher odds of gestational diabetes (OR = 2.649, 95% CI: 1.701-4.126, P < 0.001) and preeclampsia (OR = 3.654, 95% CI: 1.420-9.404, P < 0.01) than the normal weight group, whereas it correlated with the lower risk of anemia (OR = 0.300, 95% CI: 0.128-0.704, P < 0.01). Our findings may provide evidence for the importance of keeping normal weight for Chinese women when preparing for pregnancy.

Predicting meat consumption from concurrent, automatic appraisals: Introducing nuance to product appraisals

Research into the relationship between automatic product appraisals and consumer behaviour has largely been limited to measuring generic product evaluations (i.e., positive vs. negative). Especially in the context of meat consumption, this approach seems inadequate, as conflicting evaluative product dimensions may play a role in the preference for a plant-based vs. a meat-based diet (e.g., sustainability vs. taste vs. healthiness). We discuss the limitations of this approach and provide a novel tool that can measure automatic appraisals of several stimulus dimensions simultaneously. Using this tool, we register automatic appraisals (health, taste, price, sustainability, ethicality) of meat and vegetarian stimuli, and compare automatic and explicit appraisals in relation to a range of outcome measures, including self-reported likelihood of purchase and reducing meat consumption, willingness to pay, self-reported frequency of meat consumption, and Body Mass Index. Our findings suggest that the measured automatic appraisals represent unique constructs and vary in the degree to which they inform behaviour. Further, variation in the prediction of the outcome variables suggests that the appraisals captured by the explicit and automatic measures differed. Demonstrating unique contributions of the individual automatic appraisals has crucial implications for future research to understand behaviour and improve existing models.

The association between lunch composition and obesity in Iranian adults

We aimed to assess the dietary composition of lunch meal using a posteriori-derived dietary patterns and to determine the association of lunch composition with obesity in a sample of Iranian adults. This cross-sectional study was conducted on 850 men and women in Tehran (aged 20-59 years). Dietary intakes were assessed using three 24-h dietary recalls, and dietary patterns were identified via principal component factor analysis. For each identified pattern, scores were calculated for each participant and then classified into tertiles. Central obesity was defined WHO criteria. General obesity was defined as a BMI of more than 30 kg/m2. Three major dietary patterns were identified at lunch meal using twelve food groups: 'Bread, grains and fat', 'Western' and 'Potato and eggs'. After adjustment for potential confounders, participants at the top tertile of the 'Bread, grains and fat' dietary pattern had greater odds for a higher waist-to-hip ratio (WHR), compared with those in the lowest tertile (OR: 1·44, 95 % CI 1·01, 2·07). However, we found no association between 'Western' or 'potato and eggs' patterns and WHR (OR: 0·89, 95 % CI 0·62, 1·28 and OR: 1·16, 95 % CI 0·69, 1·42, respectively). None of the identified dietary patterns was associated when defining obesity with waist circumference or BMI. In conclusion, participants had a greater chance of central obesity defined based on WHR following a lunchtime pattern with a higher and positive loading factor for 'Bread, grains and fat'.

Association between dietary phytochemical index and breast cancer: a case-control study

BACKGROUND

Dietary intake of isoflavones has been positively associated with risk of breast cancer (BC) in some earlier studies. In addition, most studies on diet-disease associations came from western countries and limited data are available in the Middle-East.

METHODS

This case-control study was performed on 350 women with BC aged over 30 years who were recruited from hospitals or private clinics in Isfahan, Iran. All patients were diagnosed with BC during the maximum of the last 6 months using physical examination and mammography findings. Using cluster method sampling, 700 apparently healthy age- and socioeconomic status-matched controls were randomly selected from healthy women who had no relationship with BC patients and had no familial history of BC. Data on dietary intakes were collected using a validated food-frequency questionnaire. The DPI was calculated based on dietary energy derived from foods rich in phytochemicals (kcal) divided by total daily energy intake (kcal) of each participant.

RESULTS

Mean ± SD age and BMI in the study participants were 62.4 ± 10.8 years and 24.3 ± 5.2 kg/m², respectively. In the crude model, participants in the highest quartile of DPI had 63% lower odds of breast cancer compared to those in the lowest quartile (95% CI 0.26, 0.54; P-trend < 0.001). After adjustment for potential confounders, this inverse association became strengthened (95% CI 0.22, 0.49; P-trend < 0.001). Further adjustment for BMI did not change the association (OR for the highest quartile vs. the lowest quartile = 0.40, 95% CI 0.26, 0.60; P-trend < 0.001).

CONCLUSION

In conclusion, a protective association was observed between DPI and BC in this case-control study. Therefore, high consumption of foods rich in phytochemicals such as fruits, vegetables, and whole grains might help reducing the odds of BC among women.

Fruit and vegetable consumption in relation to primary headaches: the MEPHASOUS study

BACKGROUND

Fruit and vegetable consumption may beneficially affect the odds of primary headaches due to their antioxidant contents. However, no study has examined the association between fruit and vegetable consumption and primary headaches among university students.

AIM

To assess the relation between fruit and vegetable intakes and primary headaches among Iranian university students.

METHODS

Overall, 83,214 university students with an age range of ≥ 18 years participated in the present study. Dietary intakes and also data on confounding variables were collected using validated questionnaires. Data on dietary intakes were collected using a validated dietary habits questionnaire. We used the International Classification of Headache Disorders-3 (ICHD-3) criteria to define primary headaches.

RESULTS

Fruit consumption was negatively associated with primary headaches; such that after controlling for potential confounders, greater intake of fruits was associated with 30% lower odds of primary headaches (OR: 0.70, 95% CI 0.58-0.84). Such an inverse association was also found for vegetable consumption. In the fully adjusted model, students in the top category of vegetable consumption were 16% less likely to have primary headaches compared with those in the bottom category (OR: 0.84, 95% CI 0.74-0.95). Subgroup analysis revealed that fruit consumption was inversely associated with primary headaches in females, unlike males, and vegetable consumption was inversely associated with these headaches in males, as opposed to females. Moreover, fruit and vegetable consumption was related to lower odds of primary headaches in normal-weight students.

CONCLUSION

Fruit and vegetable intakes were associated with reduced odds of primary headaches.

LEVEL OF EVIDENCE

Level III, cross-sectional analytic studies.

Breakfast consumption is inversely associated with primary headaches in university students: The MEPHASOUS study

OBJECTIVE

This study was conducted to examine the association between breakfast consumption pattern and primary headaches in a large population of university students.

METHODS

This cross-sectional study was done on the MEPHASOUS dataset that contained the information of 83,677 university students, aged ≥18 years, from 28 provinces of Iran. Dietary intakes and breakfast consumption pattern were assessed using a validated self-administered dietary habits questionnaire. Primary headaches were determined according to the International Classification of Headache Disorders-3 (ICHD-3) criteria. Binary logistic regression in different adjusted models was used to assess the association between breakfast consumption and primary headaches.

RESULTS

The mean age of participants was 21.50 ± 4.01. Primary headaches were prevalent among 9% of university students. A significant inverse association was seen between breakfast consumption and odds of primary headaches [odds ratio (OR): 0.57, 95 % confidence interval (CI): 0.51-0.62]. This association remained significant even after taking potential confounders into account; such that students who consumed breakfast frequently had 26 % lower odds of primary headaches compared with those who consumed it <1 day/week (OR: 0.74, 95 % CI: 0.65-0.85). Moreover, such a significant inverse association was observed in female students (OR: 0.54, 95 % CI: 0.49-0.61) as well as those with BMI < 25 kg/m² (OR: 0.68, 95 % CI: 0.58-0.79). However, it became non-significant in male students and those with overweight or obesity.

CONCLUSION

We found that frequent breakfast consumption is associated with a decreased odds of primary headaches in female students and those with BMI < 25 kg/m². Further prospective studies are needed to confirm our findings.

Factors associated with overweight and obesity in adults using structural equation model: mediation effect of physical activity and dietary pattern

PURPOSE

This study aimed to determine the indirect effect of risk factors associated with overweight and obesity through physical activity (PA) and dietary pattern (DP), using structural equation model in the adults' population.

METHODS

This cross-sectional study was conducted on 10,000 adults from baseline data of Ravansar Non Communicable Disease cohort study, in the west region of Iran in 2018. Structural equation modeling was used to assess the causal effects of associated factors on obesity and overweight as the outcome.

RESULTS

In general, the population at higher economic level was significantly more dependent on the healthy DP. The direct effect of socioeconomic status (SES) on overweight and obesity was - 0.070, the indirect effect was 0.127, and the total effect was 0.057. When stratified by gender, in women, SES had a weak direct effect (β = 0.024) and indirectly, through the variables of PA and DP, had a significant effect (β = 0.088) on the outcome. The same situation has been observed in men. That is a weak direct effect of SES (β = 0.070) and a significantly indirect effect, through three variables such as PA, DP, and smoking status, on the outcome.

CONCLUSION

Factors associated with overweight and obesity not only by direct effect, but also can indirectly and through mediators (such as DP and PA as two important mediation variables) cause this outcome. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

The effect of concentrated pomegranate juice consumption on risk factors of cardiovascular diseases in women with polycystic ovary syndrome: A randomized controlled trial

Polycystic ovary syndrome (PCOS) is associated with insulin resistance and dyslipidemia. Pomegranate juice is a rich source of polyphenols that may improve blood pressure, lipid profile, and other risk factors of cardiovascular diseases (CVDs). No study has examined the effects of pomegranate juice consumption on the clinical outcomes of PCOS. This study aimed to examine the effects of concentrated pomegranate juice (CPJ) consumption on risk factors of CVDs in women with PCOS. In this randomized clinical trial, 44 PCOS women with an age range of 18-40 years and body mass index (BMI) of ≥25 kg/m² were recruited. They were randomly allocated to the CPJ (n = 22) and control (n = 22) groups, and followed for 8 weeks. Anthropometric measures, blood pressure, and biochemical parameters were measured at baseline and at the end of the trial. Compared with the control group, CPJ consumption significantly reduced systolic (-9.77 ± 1.46 vs. -1.18 ± 1.46 mmHg, p < .001) and diastolic (-3.87 ± 1.36 vs. 0.30 ± 1.36 mmHg, p = .05) blood pressure, serum triglyceride (TG) levels (-7.82 ± 6.32 vs. 16.63 ± 6.32 mg/dl, p = .01), TG/high-density lipoprotein-cholesterol (HDL-C) ratio (-0.39 ± 0.24 vs. 0.66 ± 0.24, p = .007), and increased serum concentrations of low-density lipoprotein-cholesterol (LDL-C) (6.03 ± 2.47 vs. -1.98 ± 2.47 mg/dl, p = .04) and HDL-C (1.93 ± 1.10 vs. -1.78 ± 1.10 mg/dl, p = .03). These findings were obtained after taking baseline measurements and potential confounders into account. No adverse event or complication was reported due to CPJ consumption throughout the study. We found that CPJ consumption has a beneficial effect on blood pressure, serum concentrations of TG and HDL-C, and TG/HDL-C ratio in women with PCOS. However, this juice could increase serum LDL-C levels in these patients. This trial was registered at www.irct.ir as IRCT20191109045383N1.

Sugar-sweetened beverages consumption in relation to hypertension among Iranian university students: the MEPHASOUS study

PURPOSE

This study aimed to assess the link between sugar-sweetened beverages (SSBs) consumption and hypertension among a large population in the Middle East.

METHODS

In this cross-sectional study (a part of Mental and Physical Health Assessment of University Student: MEPHASOUS study), 66,634 university students from all provinces of Iran, aged ≥ 18 years, were included. A self-administered dietary habits questionnaire was used to assess SSBs consumption as well as other dietary intakes. Participants were categorized based on three levels of SSB consumption: < 1 time/wk, 1-3 times/wk, and ≤ 3 times/wk. Hypertension was defined as systolic blood pressure (SBP) of ≥ 140 and diastolic blood pressure of ≥ 90.

RESULTS

Compared with those in the bottom category, students in the top category of SSBs consumption were more likely to have hypertension (OR 1.71, 95% CI 1.54-1.90). This association remained significant even after adjusting for confounding variables; such that participants in the highest category of SSBs consumption had 2.17 times greater odds of hypertension compared with those in the lowest category (OR 2.17, 95% CI 1.91-2.47). Stratified analysis based on gender and BMI status revealed such significant association in men (OR 2.12, 95% CI 1.79-2.50) and women (OR 2.03, 95% CI 1.67-2.48), and in all categories of BMI including students with underweight (OR 2.53, 95% CI 1.81-3.52), normal-weight (OR 2.13, 95% CI 1.81-2.51), overweight (OR 2.14, 95% CI 1.58-2.89) and obesity (OR 1.59, 95% CI 1.00-2.53).

CONCLUSION

Our results support previous findings indicating a significant positive association between SSBs consumption and hypertension.

LEVEL OF EVIDENCE

Level III, cross-sectional analytic studies.

The association between nutrient patterns and metabolic syndrome among Iranian adults: cross-sectional analysis of Shahedieh cohort study

OBJECTIVE

To assess the association between patterns of nutrient intake and metabolic syndrome (MetS) in a large sample of Iranian adults.

DESIGN

Baseline data from the Shahedieh cohort study were used in the current cross-sectional study. Dietary intakes were assessed through the use of a validated semi-quantitative FFQ. Nutrient patterns (NP) were derived using factor analysis. The MetS was defined according to criteria introduced from the National Cholesterol Education Program Adult Treatment Panel III, modified for Iranian adults.

SETTING

Yazd, Iran.

PARTICIPANTS

A total of 7325 Iranian adults aged between 30 and 75 years.

RESULTS

Three NP were identified. A significant positive association was found between adherence to semi-plant NP (characterised by the high intakes of P; vitamins B1, B3, B6 and B5; Se; Mg; Fe; protein; Cr; Cu; fibre; biotin; Mn; Zn and Na) and odds of MetS (OR 1·68, 95 % CI 1·43, 1·98). However, after adjusting for potential confounders, this association became non-significant. In addition, after taking potential confounders into account, individuals in the highest quintile of the semi-animal NP, rich in Ca; K; vitamins B2, B12, A, D, K and C; SFA; dietary cholesterol and trans-fatty acid, were 26 % more likely to have MetS compared with those in the lowest quintile (OR 1·26, 95 % CI 1·05, 1·51). No significant association was seen between adherence to the high-carbohydrate/low-fat NP and odds of MetS.

CONCLUSIONS

We found that adherence to a semi-animal NP was associated with increased odds of MetS.

Legume and Nuts Consumption in Relation to Odds of Breast Cancer: A Case-Control Study

Previous studies on the association between legume and nuts intake and risk of breast cancer have mainly been focused on individual components of legume or nuts, rather than consumption of the whole food group. This study aimed to investigate the relation between legume and nuts intake in relation to breast cancer in Iranian women. In this population-based case-control study, we enrolled 350 pathologically confirmed new cases of breast cancer and 700 controls which were matched with cases in terms of age and socioeconomic status. Dietary intakes were assessed using a validated block-format 168-item semi-quantitative food frequency questionnaire. Legume intake was computed by summing up the consumption of lentils, peas, chickpeas, and different kinds of beans, including red beans and pinto beans. To calculate nuts consumption, we summed up intake of mixed nuts, almond, peanut, walnut and hazelnut. Data on potential confounding variables were also collected using pre-tested questionnaires. Mean consumption of legume and nuts among cases and controls were 14.7 ± 15.0 and 2.3 ± 5.6, respectively. A significant inverse association was found between legume intake and breast cancer (OR: 0.41, 95% CI: 0.30-0.57); such that after adjusting for confounders, participants in the top tertile of legume intake had 46% lower odds of breast cancer compared with those in the bottom tertile (OR: 0.54, 95% CI: 0.36-0.88). Such inverse association was seen among postmenopausal women (OR: 0.51, 95% CI: 0.31-0.85) and also among normal-weight participants (OR: 0.49, 95% CI: 0.29-0.82). In terms of nuts intake, it was inversely associated with odds of breast cancer (OR: 0.16, 95% CI: 0.11-0.23). This association remained significant even after taking potential confounders into account (OR: 0.15, 95% CI: 0.09-0.26). The same association was also seen in premenopausal women (OR: 0.21, 95% CI: 0.14-0.31), postmenopausal women (OR: 0.23, 95% CI: 0.13-0.42), normal-weight (OR: 0.15, 95% CI: 0.08-0.28), and overweight or obese people (OR: 0.27, 95% CI: 0.10-0.71). Our findings on the inverse association of legume and nuts intake with odds of breast cancer support the current recommendations on these foods. Prospective studies are needed to further examine this link.

The effect of green coffee extract supplementation on anthropometric measures in adults: A comprehensive systematic review and dose-response meta-analysis of randomized clinical trials

BACKGROUND AND AIM

Two meta-analyses summarized data on the effects of green coffee extract (GCE) supplementation on anthropometric measures. However, the accuracy of those meta-analyses is uncertain due to several methodological limitations. Therefore, we aimed to conduct a comprehensive systematic review and dose-response meta-analysis to summarize all available evidence on the effects of GCE supplementation on anthropometric measures by considering the main limitations in the previous meta-analyses.

METHODS

We searched available online databases for relevant publications up to January 2020, using relevant keywords. All randomized clinical trials (RCTs) investigating the effects of GCE supplementation, compared with a control group, on anthropometric measures [including body weight, body mass index (BMI), body fat percentage, waist circumference (WC) and waist-to-hip ratio (WHR)] were included.

RESULTS

After identifying 1871 studies from our initial search, 15 RCTs with a total sample size of 897 participants were included in the systematic review and meta-analysis. We found a significant reducing effect of GCE supplementation on body weight (weighted mean difference (WMD): -1.23, 95 % CI: -1.64, -0.82 kg,P < 0.001), BMI (WMD: -0.48, 95 % CI: -0.78, -0.18 kg/m², P = 0.001), and WC (WMD: -1.00, 95 % CI: -1.70, -0.29 cm, P = 0.006). No significant effect of GCE supplementation on body fat percentage and WHR was seen. In the dose-response analyses, there was no significant association between chlorogenic acid (CGA) dosage, as the main polyphenol in green coffee, and changes in anthropometric measures.

CONCLUSION

We found that GCE supplementation had a beneficial effect on body weight, BMI and WC. It provides a cost-effective and safe alternative for the treatment of obesity. Additional well-designed studies are required to further confirm our findings.

Breakfast consumption pattern and its association with overweight and obesity among university students: a population-based study

PURPOSE

To determine the association between breakfast consumption habit and overweight and obesity in a sample of Iranian university students.

METHODS

A sample of 78,905 university students, aged 18 years or older, was recruited from 28 provinces in Iran to assess breakfast consumption pattern. Breakfast consumption habit was evaluated using a pre-tested questionnaire. Weight and height were measured using standard protocol and then body mass index (BMI) was calculated. Overweight (obesity included) and obesity were defined as BMI ≥ 25 and BMI ≥ 30 kg/m², respectively.

RESULTS

Mean age of participants was 21.50 ± 4.01. After controlling for potential confounders, participants who ate breakfast > 4 days/week had 15% lower risk of overweight compared with those who ate < 1 day/week (OR: 0.85, 95% CI 0.78-0.92). Such significant association was also seen in female students (OR: 0.82, 95% CI 0.72-0.93); however, it was marginally significant in male ones (OR: 0.89, 95% CI 0.79-1.00). In addition, a significant inverse association was found between breakfast consumption and obesity (OR: 0.74, 95% CI 0.64-0.85) such that after adjusting for potential confounders, students who consumed breakfast > 4 days/week were 33% less likely to be obese compared with those who consumed it < 1 day/week (OR: 0.67, 95% CI 0.57-0.78). Such significant inverse association was also seen in either gender.

CONCLUSIONS

Breakfast consumption was inversely associated with odds of overweight and obesity in university students.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive studies.

Dairy Consumption in Relation to Hypertension Among a Large Population of University Students: The MEPHASOUS Study

BACKGROUND

Hypertension is a chronic condition that its prevalence is increasing at an alarming rate. Findings on the association between dairy consumption and hypertension are conflicting and few data are available in the Middle East.

AIM

To assess the association between dairy consumption and hypertension among a large population of university students.

MATERIALS AND METHODS

The current study was performed in the framework of the Mental and Physical Health Assessment of University Student (MEPHASOUS) project. Overall, 67,011 university students with complete information were included in the statistical analysis. To assess dairy consumption, a self-administered dietary habits questionnaire was employed. Blood pressure was measured using a standard protocol. The systolic/diastolic blood pressure of ≥140/90 mmHg was considered hypertension.

RESULTS

Hypertension was prevalent among 6.9% of students. A significant inverse association was found between dairy consumption and the odds of hypertension; such that after taking potential confounders into account, individuals in the highest levels of dairy consumption had 85% lower odds for having hypertension compared with those in the lowest levels (odds ratio (OR): 0.15, 95% confidence interval (CI): 0.13-0.18). Such an inverse association was also seen among males (OR: 0.14, 95% CI: 0.11-0.18) and females (OR: 0.16, 95% CI: 0.12-0.21), normal-weight students (OR: 0.15, 95% CI: 0.12-0.18) and those with overweight or obesity (OR: 0.15, 95% CI: 0.11-0.21), and individuals with (OR: 0.13, 95% CI: 0.11-0.16) and without (OR: 0.24, 95% CI: 0.17-0.35) family history of hypertension.

CONCLUSION

Our results support the previous findings on the inverse association between dairy consumption and hypertension among university students.

Association of vitamin D, retinol and zinc deficiencies with stunting in toddlers: findings from a national study in Iran

OBJECTIVE

The objective of this study was to investigate the association of serum levels of 25(OH)D₃ (vitamin D), retinol (vitamin A) and zinc with stunting in a large sample of Iranian toddlers.

STUDY DESIGN

This was a cross-sectional study.

METHODS

A total of 4261 children, aged 10-36 months, who had Iranian birth certificates were included in the present study. Weight and height were measured by experienced professionals in accordance with standard protocols. Stunting was defined as a height-for-age z-score of <-1 standard deviation (SD) based on the World Health Organization (WHO) criteria (the WHO Child Growth Standards median). Serum levels of 25(OH)D₃, retinol and zinc were examined based on standard methods.

RESULTS

The mean age of the study participants was 19.2 ± 8.4 months. A significant inverse association was found between serum retinol concentrations and the odds of stunting such that after controlling for potential confounders, toddlers in the highest quartile of serum retinol levels had 29% lower odds of stunting than those in the lowest quartile (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.53-0.97). Furthermore, a significant inverse association was found between serum levels of retinol and stunting in girls (OR: 0.57, 95% CI: 0.34-0.94), urban toddlers (OR: 0.66, 95% CI: 0.44-0.99) and those who did not use nutritional supplements (OR: 0.70, 95% CI: 0.52-0.95). Although serum 25(OH)D₃ levels were not significantly associated with stunting in the overall study population, we found a positive association among toddlers who used nutritional supplements. No significant association was found between serum levels of zinc and stunting.

CONCLUSION

We found a significant inverse association between serum levels of retinol and stunting in toddlers aged 10-36 months.

The association of overall diet quality with BMI and waist circumference by education level in Mexican men and women

OBJECTIVE

The present study evaluated the association of two measures of diet quality with BMI and waist circumference (WC), overall and by education level, among Mexican men and women.

DESIGN

We constructed two a priori indices of diet quality, the Mexican Diet Quality Index (MxDQI) and the Mexican Alternate Healthy Eating Index (MxAHEI), which we examined relative to BMI and WC. We computed sex-specific multivariable linear regression models for the total sample and by education level.

SETTING

Mexico.

PARTICIPANTS

Mexican men (n 954) and women (n 1356) participating in the Mexican National Health and Nutrition Survey 2012.

RESULTS

Total dietary scores were not associated with BMI in men and women, but total MxDQI was inversely associated with WC in men (-0·10, 95 % CI -0·20, -0·004 cm). We also found that some results differed by education level in men. For men with the lowest education level, a one-unit increase in total MxDQI and MxAHEI score was associated with a mean reduction in BMI of 0·11 (95 % CI -0·18, 0·04) and 0·18 (95 % CI -0·25, -0·10) kg/m2, respectively. Likewise, a one-unit increase in total MxDQI and MxAHEI score was associated with a mean change in WC of -0·30 (95 % CI -0·49, -0·11) and -0·53 (95 % CI -0·75, -0·30) cm, respectively, in men with the lowest level of education. In women, the association of diet quality scores with BMI and WC was not different by education level.

CONCLUSIONS

Our findings suggest that a higher diet quality in men with low but not high education is associated with lower BMI and WC.

Visceral obesity as a risk factor for colorectal adenoma occurrence in surveillance colonoscopy

BACKGROUND AND AIMS

The aim of this study was to examine the prospective association between visceral obesity and the incidence and recurrence of colorectal adenoma.

METHODS

We conducted a cohort study involving 2244 participants between 2006 and 2007. The study participants were prospectively followed until 2014 according to the initial colonoscopy and histopathology findings. Incident and recurrent colorectal adenoma groups were defined as individuals with a positive follow-up colonoscopy result from the normal results and adenoma groups, respectively, at the baseline colonoscopy.

RESULTS

Among the 1163 patients (51.8%) who received a follow-up colonoscopy, 509 (43.8%) and 654 (56.2%) were grouped into the normal and adenoma cohorts. Colorectal adenomas occurred in 592 patients (50.9%) during the median period of 43 months, with an incident adenoma prevalence of 39.1% and a recurrent adenoma prevalence of 60.1%. An increase in the visceral adipose tissue (VAT) area was associated with a higher incidence of adenoma (highest quintile vs lowest quintile of the VAT hazard ratios [HRs], 2.16; 95% confidence interval [CI], 1.26-3.71; HR 1.32 [per 1-standard deviation]; 95% CI, 1.10-1.60) in the multivariable analysis. Increases in body mass index and waist circumference were associated with recurrent adenomas (HR 1.33 [per 1 kg/m²], 95% CI, 1.18-1.46; HR 1.04 [per 1 cm], 95% CI, 1.01-1.07, respectively) in the multivariate analysis.

CONCLUSION

A higher VAT area was dose-dependently associated with a higher risk of incident adenoma. Furthermore, increases in body mass index and waist circumference as surrogate markers of abdominal obesity were associated with a higher risk of recurrent adenoma.