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Zhong L, Li M. Response to "Sleep and modifiable dietary factors in adolescents: A letter to the editor". Sleep Med 2024; 119:596-597. [PMID: 38744637 DOI: 10.1016/j.sleep.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Ling Zhong
- Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ming Li
- Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Zhou R, Chen Z, Yang T, Gu H, Yang X, Cheng S. Vitamin D Deficiency Exacerbates Poor Sleep Outcomes with Endocrine-Disrupting Chemicals Exposure: A Large American Population Study. Nutrients 2024; 16:1291. [PMID: 38732537 PMCID: PMC11085561 DOI: 10.3390/nu16091291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Phthalates and bisphenol A are recognized as the predominant endocrine-disrupting substances (EDCs) in the environment, but their impact on sleep health remains unclear. Vitamin D has often been reported to play a role in sleep health and may be affected by endocrine-disrupting compounds. The study utilized data from 5476 individuals in the NHANES project to investigate the correlation between combined exposure to environmental EDCs and sleep duration through modeling various exposures. Furthermore, it emphasizes the importance of vitamin D in the present scenario. Preliminary analyses suggested that vitamin D-deficient individuals generally slept shorter than individuals with normal vitamin D (p < 0.05). Exposure to Mono-ethyl phthalate (MEP), triclosan (TRS), and Mono-benzyl phthalate (MZP), either alone or in combination, was associated with reduced sleep duration and a greater risk of vitamin D deficiency. Individuals with low vitamin D levels exposed to TRS experienced shorter sleep duration than those with normal vitamin D levels (p < 0.05). TRS and MZP were identified as crucial factors in patient outcomes when evaluating mixed exposures (p < 0.05). The results provide new data supporting a link between exposure to EDCs and insufficient sleep length. Additionally, they imply that a vitamin D shortage may worsen the sleep problems induced by EDCs.
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Affiliation(s)
| | | | | | | | | | - Shuqun Cheng
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing 400016, China; (R.Z.); (Z.C.); (T.Y.); (H.G.); (X.Y.)
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Jin Y, Li J, Ye J, Luo X, Wilson A, Mu L, Zhou P, Lv Y, Wang Y. Mapping associations between anxiety and sleep problems among outpatients in high-altitude areas: a network analysis. BMC Psychiatry 2023; 23:341. [PMID: 37189050 PMCID: PMC10184966 DOI: 10.1186/s12888-023-04767-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Anxiety and sleep problems are common comorbidities among outpatients living in high-altitude areas. Network analysis is a novel method to investigate the interaction and the association between symptoms across diverse disorders. This study used network analysis to investigate the network structure symptoms of anxiety and sleep problems among outpatients in high-altitude areas, and to explore the differences in symptom associations in various sex, age, educational levels and employment groups. METHODS The data was collected from the Sleep Medicine Center of The First People's Hospital of Yunnan Province from November 2017 to January 2021 with consecutive recruitment (N = 11,194). Anxiety and sleep problems were measured by the Chinese version of the seven-item Generalized Anxiety Disorder Scale (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI) respectively. Central symptoms were identified based on centrality indices and bridge symptoms were identified with bridge indices. The difference of network structures in various sex, age, educational levels and employment groups were also explored. RESULTS Among all the cases, 6,534 (58.37%; 95% CI: 57.45-59.29%) reported experiencing anxiety (GAD-7 total scores ≥ 5), and 7,718 (68.94%; 95% CI: 68.08-69.80%) reported experiencing sleep problems (PSQI total scores ≥ 10). Based on the results of network analysis, among participants, "Nervousness", "Trouble relaxing", "Uncontrollable worry" were the most critical central symptoms and bridge symptoms within the anxiety and sleep problems network structure. The adjusted network model after controlling for covariates was significantly correlated with the original (r = 0.75, P = 0.46). Additionally, there were significant differences in edge weights in the comparisons between sex, age and educational levels groups (P < 0.001), while the employed and unemployed groups did not show significant differences in edge weights (P > 0.05). CONCLUSIONS In the anxiety and sleep problems network model, among outpatients living in high-altitude areas, nervousness, uncontrollable worry, and trouble relaxing were the most central symptoms and bridge symptoms. Moreover, there were significant differences between various sex, age and educational levels. These findings can be used to provide clinical suggestions for psychological interventions and measures targeting to reduce symptoms that exacerbate mental health.
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Affiliation(s)
- Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Jing Ye
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xianyu Luo
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Lanxue Mu
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Pinyi Zhou
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Yunhui Lv
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Maurya C, Muhammad T, Maurya P, Dhillon P. The association of smartphone screen time with sleep problems among adolescents and young adults: cross-sectional findings from India. BMC Public Health 2022; 22:1686. [PMID: 36064373 PMCID: PMC9444278 DOI: 10.1186/s12889-022-14076-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background Although sleep problem is a growing public health issue with the advancement of technology, especially among adolescents and young adults, it received little attention. The study aimed to examine the association of screen time on smartphone with sleep problems among adolescents and young-adults in India. Methods We used data from the “Understanding the lives of adolescents and young-adults” (UDAYA, 2018). The effective sample size for the study was 16,292 adolescents and young adults (males-4428 and females-11,864). Descriptive statistics and bivariate analysis with percentages and chi-square test were used to report the preliminary results. Multivariable logistic regression analysis was conducted to examine the association between smartphone screen time and sleep problems, separately for adolescents and young adults. Results Nearly 15.6% of males and 23.5% of females had sleep problems in their adolescence in the last 15 days, while these percentage were high among young-adults (18.4% males and 33.24% females). Adolescents [AOR: 1.55; CI: 1.21-1.99] and young adults [AOR: 1.48; CI: 1.24-1.75], who spent more than 2 h on smartphone had higher odds of reporting sleep problems than those who did not use smartphone in the last 24 hours. Adolescent females who used smartphone for less or equal to 2 h and three or more hours respectively, had 2.11 [AOR: 2.11; CI: 1.63-2.73] and 2.94 times [AOR: 2.94; CI: 1.97-4.38] higher odds of reporting sleep problems than adolescent males who did not use smartphones. Additionally, among the young adult females, the odds of sleep problems were 1.66 times [AOR: 1.66; CI: 1.55-2.38] and 2.36 times [AOR: 2.36; CI: 1.59-3.51] greater than the non-users young adult males. Conclusion The increased time spent on mobile phones’s screen among adolescents and young-adults, particularly in females is associated with a higher likelihood of reporting sleeping problems. The current findings have important implications for adolescence and young-adults’ mental health programmes. The findings can also be used to further inform how different strategies need to be developed for better sleep outcome during adolescence and young-adults.
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Affiliation(s)
- Chanda Maurya
- Department of Survey Reseach and Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - T Muhammad
- International Institute for Population Sciences, Mumbai, India.
| | - Priya Maurya
- International Institute for Population Sciences, Mumbai, India
| | - Preeti Dhillon
- Department of Survey Reseach and Data Analytics, International Institute for Population Sciences, Mumbai, India
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Li B, Dong H, Wang Y, Li F, Gao X, Ma H, Gao L. Effects of sleep insufficiency on spatial working memory in low-pressure and hypoxic environments. Medicine (Baltimore) 2022; 101:e30210. [PMID: 36107513 PMCID: PMC9439777 DOI: 10.1097/md.0000000000030210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND This study aimed to investigate the effects of sleep insufficiency on spatial working memory in low-pressure and hypoxic environments. METHODS We selected 58 insufficient sleepers and 27 normal sleepers among the college students living in high-altitude areas for a long time to receive a spatial 2-back working memory task, while collecting behavioral and electroencephalograph data. We adopted an independent sample t-test and repeated measures analysis of variance to compare the differences in response time and accuracy, P2 and late positive potential components, and theta band energy values in the spatial working memory task between insufficient and normal sleepers. RESULTS We found no significant differences in response time and accuracy between the insufficient sleep group and the normal sleep group; however, the P2 peak value and the early theta band energy value were higher in the insufficient sleep group than in the normal sleep group. CONCLUSIONS These results suggest that the spatial working memory ability of individuals with sleep insufficiency was weakened under low-pressure and low-oxygen environment.
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Affiliation(s)
- Bingqi Li
- Plateau Brain Science Research Center, Tibet University/South China Normal University, Lhasa, China
| | - Haotian Dong
- Plateau Brain Science Research Center, Tibet University/South China Normal University, Lhasa, China
| | - Yanxiang Wang
- Plateau Brain Science Research Center, Tibet University/South China Normal University, Lhasa, China
| | - Fangming Li
- Plateau Brain Science Research Center, Tibet University/South China Normal University, Lhasa, China
| | - Xiaolei Gao
- Plateau Brain Science Research Center, Tibet University/South China Normal University, Lhasa, China
| | - Hailin Ma
- Plateau Brain Science Research Center, Tibet University/South China Normal University, Lhasa, China
| | - Lei Gao
- Plateau Brain Science Research Center, Tibet University/South China Normal University, Lhasa, China
- *Correspondence: Lei Gao, Plateau Brain Science Research Center, Tibet University, Jiangsu Road No. 36, Chengguan District, Lhasa 850000, China (e-mail: )
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Yoshino Y, Wakabayashi Y, Kitazawa T. Relationship of sleep disorders with long-term complications and health-related quality of life in people with well-controlled human immunodeficiency virus. Medicine (Baltimore) 2022; 101:e29070. [PMID: 35356931 PMCID: PMC10684212 DOI: 10.1097/md.0000000000029070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/24/2022] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT Although sleep disorders are common in patients with human immunodeficiency virus (HIV) infection, they have not been adequately evaluated under currently advanced treatments, mainly with integrase strand transfer inhibitors. However, the relationship of sleep disorders with long-term complications and quality of life (QOL) status in patients infected with HIV is still poorly understood. Such associations are important in the management of outpatients with HIV. Hence, this study aimed to evaluate these associations.This cross-sectional observational study assessed the QOL changes of patients with HIV before and after the treatment regimen change. Male patients with well-controlled HIV who attended our hospital and changed HIV medications for reasons other than treatment failure between October 2019 and September 2021 were included. At the time of regimen change, sleep disorder status was assessed according to the Pittsburgh sleep quality index (PSQI), and health-related QOL (HRQOL) was assessed using the medical outcomes study 8-item short form health survey. In addition, we collected information on age, blood tests, and long-term comorbid conditions present during the evaluation. The HIV treatment regimen was also reviewed.Out of 45 male Japanese patients with HIV that were included in this study, 24 (53.3%) and 21 (46.7%) were classified into the sleep disorder group and nonsleep disorder group, respectively, according to their PSQI scores. The sleep disorder group had a significantly lower HRQOL mental component summary (P = .0222) than the nonsleep disorder group. The prevalence rates of hypertension, dyslipidemia, and diabetes mellitus were not significantly different between the 2 groups. In addition, a significant correlation was observed between PSQI scores and the HRQOL status (mental component summary, P = .0450; physical component summary, P = .0350).Sleep disorders remain common in patients with well-controlled HIV infection receiving current treatment. Sleep disorder is significantly associated with a low HRQOL in these patients. Hence, sleep status evaluation is necessary to improve HIV management.
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Affiliation(s)
- Yusuke Yoshino
- Department of Microbiology, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, Japan,Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, Japan
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Zhang T, Lu L, Ren YM, Liu YY, Hynek KA, Gao J, Chen HR, Shen HY, Gai XY, Dang ZC, Liu S. Sleep disturbance and quality of life among university freshmen in Qinghai-Tibet Plateau of China. Front Psychiatry 2022; 13:996996. [PMID: 36424991 PMCID: PMC9680160 DOI: 10.3389/fpsyt.2022.996996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022] Open
Abstract
PURPOSE University freshmen are particularly vulnerable as they are undergoing the transition from high school to university with a range of changes. Sleep problems among this group in the Qinghai-Tibet Plateau of China were barely studied. This study aimed to explore sleep disturbance, and its association with quality of life (QoL) and demographic and clinical characteristics among university freshmen in Qinghai-Tibet Plateau, China. METHODS A multistage stratified cluster random sampling method was performed to recruit student participants with a structured questionnaire to collect sociodemographic and clinical characteristics, and lifestyle behaviors. Sleep disturbance including three aspects of sleep disturbance (i.e., difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA)) was assessed using standardized measurement. Multiple logistic regression models were applied to analyze the data. RESULTS Among included 2,769 freshmen, the prevalence of sleep disturbance was 14.8% (95% CI: 14.2-15.5%), and corresponding prevalence of DIS, DMS, and EMA was 8.2% (95% CI: 7.7-8.7%), 8.3% (95% CI: 7.8-8.8%), and 4.2% (95% CI: 3.8-4.6%), respectively. Freshmen with sleeping disturbance had significantly lower QoL in physical [F (1, 2769) = 60.23, p < 0.001], psychological [F (1, 2769) = 46.18, p < 0.001], social [F (1, 2769) = 23.04, p < 0.001], and environment [F (1, 2769) = 6.07, p = 0.01] domains. Multiple logistic regression analyses revealed that having breakfast five times a week or less (less than three times, OR = 1.79, 95% CI: 1.34-2.40; 3-5 times, OR = 1.40, 95% CI: 1.09-1.79), self-perceived severe Internet dependence (OR = 1.71, 95% CI: 1.11-2.65), self-perceived poor health status (OR = 3.44, 95% CI: 2.06-5.74), high academic stress (OR = 1.42, 95% CI: 1.13-1.78), poor relationship with classmates (OR = 3.44, 95% CI: 1.53-7.71), and severe ADHD symptoms (OR = 1.08, 95% CI: 1.05-1.12) were positively associated with sleeping disturbance. CONCLUSION Sleep disturbance was common among freshmen and is associated with poorer QoL. Prevention and intervention strategies should be developed and implemented, especially among the vulnerable university freshman groups.
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Affiliation(s)
- Tiantian Zhang
- Department of Nosocomial Infection Management, Xi'an Central Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Li Lu
- Health Management and Policy Institute, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Yan-Ming Ren
- Department of Public Health, Medical College, Qinghai University, Xining, China
| | - Yu-Ying Liu
- Department of Public Health, Medical College, Qinghai University, Xining, China
| | - Kamila Angelika Hynek
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jie Gao
- Department of Clinical Medicine, Qinghai Institute of Health Sciences, Xining, China
| | - Hong-Ru Chen
- Department of Public Health, Medical College, Qinghai University, Xining, China
| | - Hong-Yi Shen
- Department of Public Education, Xining Urban Vocational & Technical College, Xining, China
| | - Xiang-Yun Gai
- School of Pharmacy, Qinghai Nationalities University, Xining, China
| | - Zhan-Cui Dang
- Department of Public Health, Medical College, Qinghai University, Xining, China
| | - Shou Liu
- Department of Public Health, Medical College, Qinghai University, Xining, China
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Oh TK, Song IA. Five-year mortality trends associated with sleep disorders in South Korea: a population-based cohort study. Sleep Biol Rhythms 2021. [DOI: 10.1007/s41105-021-00319-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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The onset of sleep disturbances and their associations with anxiety after acute high-altitude exposure at 3700 m. Transl Psychiatry 2019; 9:175. [PMID: 31332159 PMCID: PMC6646382 DOI: 10.1038/s41398-019-0510-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/30/2019] [Accepted: 05/31/2019] [Indexed: 11/22/2022] Open
Abstract
Sleep disturbances and psychiatric repercussions pose great challenges at high altitude; however, few studies have investigated sleep disturbance and anxiety profiles and their associations after acute exposure in consecutive patients. Thus, we aimed to study the profiles of sleep disturbances in consecutive patients after high-altitude exposure and the association of such disturbances with anxiety. A total of 668 participants were recruited at sea level and 3700 m. The trials were performed at sea level (1 week prior to a 2-h flight to a high-altitude destination) and at 3700 m (24, 72, and 168 h). Sleep disturbances were assessed by self-reported sleep patterns and scores on the Athens Insomnia Scale (AIS). State anxiety was assessed using the Self-Rating Anxiety Scale (SAS). In our study, the incidence of sleep disturbances increased significantly after acute high-altitude exposure (65.3%, 434/668) and then gradually decreased after 72 h (50%, 141/282) and 168 h (44%, 124/282). The sleep assessments AIS [2.0 (4.0) vs. 4.0 (5.0)] and ESS [4.0 (4.0) vs. 5.0 (5.0)] increased significantly (p < 0.05). Also, the SAS increased significantly from 26.25 (3.75) to 28.75 (7.5). The SAS was significantly high in sleep disturbance group [31.25 (7.5) vs. 27.5 (5), p < 0.001] than in the non-sleep- disturbance group. The baseline SAS and AIS scores were significantly higher in participants with sleep disturbances than in those without (p < 0.01). Age, baseline insomnia, sleepiness, fatigue, and higher SAS were predictors of sleep disturbances in univariate regression (all p values < 0.05). However, only an older age (p = 0.045) and a higher baseline SAS (p = 0.018) remained independent predictors of sleep disturbances. Our findings indicated that acute high-altitude exposure triggers the onset of sleep disturbances, which are closely associated with anxiety. Furthermore, baseline state anxiety and age are independent predictors of sleep disturbances at high altitude.
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Milajerdi A, Jazayeri S, Shirzadi E, Hashemzadeh N, Azizgol A, Djazayery A, Esmaillzadeh A, Akhondzadeh S. The effects of alcoholic extract of saffron (Crocus satious L.) on mild to moderate comorbid depression-anxiety, sleep quality, and life satisfaction in type 2 diabetes mellitus: A double-blind, randomized and placebo-controlled clinical trial. Complement Ther Med 2018; 41:196-202. [PMID: 30477839 DOI: 10.1016/j.ctim.2018.09.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Depression and anxiety are major health problems throughout the world. Metabolic changes in type 2 diabetes mellitus induces and aggravates mental disorders, such as depression and anxiety. Saffron as a therapeutic herb may attenuate Comorbid Depression- Anxiety (CDA). So, this trial is designed to investigate the effect of saffron alcoholic extract on symptoms of CDA in type 2 diabetic patients. METHODS Fifty-four outpatients suffered from mild to moderate CDA diagnosed by using Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV), were assessed by Hamilton Depression and anxiety measurements, the Pittsburgh Sleep Quality Index (PSQI), and the Satisfaction with Life Scale (SWLS). The participants of this double-blind, placebo-controlled, single center and randomized trial were randomly assigned to intake 30 mg/day saffron or placebo capsules for 8 weeks. RESULTS After the intervention, mild to moderate CDA, anxiety and sleep disturbance, but not depression alone, were relieved significantly in the saffron group (P < 0.05), whereas, the changes were not significant in the placebo group. Anthropometric measures and blood pressure parameters of the patients in either groups did not change significantly (P > 0.05) during the intervention. Moreover, dietary intake and physical activity did not differ during the study in the two groups. Changes in the life satisfaction were not significant. CONCLUSION The results indicate the beneficial effect of saffron on the mild to moderate CDA in type 2 diabetic patients.
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Affiliation(s)
- Alireza Milajerdi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Shima Jazayeri
- Department of Nutrition, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Abolghassem Djazayery
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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