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AkbarySedigh A, Asghari G, Mahdavi M, Mirmiran P, Valizadeh M, Azizi F. The association of long-term calcium and dairy products intake in adolescence with carotid intima media thickness and metabolic syndrome in early adulthood: Tehran Lipid and Glucose Study. Nutr Metab (Lond) 2023; 20:21. [PMID: 37013579 PMCID: PMC10069023 DOI: 10.1186/s12986-023-00725-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 01/01/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Calcium could impact on vascular functions and structures and cause atherosclerosis. Thus, we aimed to examine the association of long-term calcium and dairy products intake in adolescence with cIMT and MetS in early adulthood. METHODS We considered 217 adolescents aged 12-18 years in the frame work of the Tehran Lipid and Glucose Study (2006-2009) and follow-up them to early adulthood (2015-2017). The valid food frequency questionnaire was used to assess dietary intake. Ultrasound examination was used to measure common carotid artery. The joint interim statement and cook et al. criteria were used for adults and adolescents to consider MetS, respectively. RESULTS Adolescents' average calcium intake from dairy and non-dairy sources were 395 mg/d and 1088 mg/d, respectively while adults had 212 mg/d and 1191 mg/d. In addition, the mean of cIMT in adults was 0.54 mm. There was no relationship of non-dairy (β: - 0.03; P = 0.804), and total calcium (β: - 0.001; P = 0.591) intake with cIMT and TG. None of the dairy products had link with cIMT, MetS and its components, except cream with cIMT after full adjustment of potential confounders (β: 0.245; P = 0.009). Also, we found that the intake of non-dairy products could increase DBP after controlling for potential confounders (β: 0.365; P = 0.012). Adolescence with higher quartiles of total calcium intake had no odds ratio of MetS in early adulthood (β: 2.05, P = 0.371). CONCLUSIONS Adolescence calcium and dairy products intake, with the exception of cream did not increase early adulthood cIMT and MetS and its components.
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Affiliation(s)
- Assa AkbarySedigh
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Reference growth curves to identify weight status (underweight, overweight or obesity) in children and adolescents: systematic review. Br J Nutr 2023:1-13. [PMID: 36695353 DOI: 10.1017/s0007114522003786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The identification of somatic growth, through reference curves, can be used to create strategies and public policies to reduce public health problems such as malnutrition and obesity and to identify underweight, overweight and obesity. The purpose of this systematic review was to identify studies providing reference growth curves for weight status in children and adolescents. A systematic search was conducted in eight databases and in gray literature (Google scholar). To assess the risk of bias/methodological quality of studies, the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-sectional Studies (NHLBI) was used. Overall, 86 studies that met the inclusion criteria were included. Through the values of reference growth curves for the identification of underweight, overweight and obesity, it was possible to verify that there is great variability among percentiles for the identification of underweight, overweight and obesity. The most prevalent percentiles for underweight were P3 and P5; for overweight, the most prevalent was P85 and the most prevalent percentiles for obesity were P95 and P97. The most prevalent anthropometric indicators were Body Mass Index (BMI), Waist Circumference (WC), Body Mass (BM) for age and height for age. Conclusion: Such data can demonstrate that the optimal growth must be reached, through the standard growth curves, but that the reference curves demonstrate a cut of the population growth, raising possible variables that can influence the optimal growth, such as an increase in the practice of physical activities and an awareness of proper nutrition.
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Yaghoubpour K, Tasdighi E, Abdi H, Barzin M, Mahdavi M, Valizadeh M, Azizi F, Hosseinpanah F. Association of obesity phenotypes in adolescents and incidence of early adulthood type 2 diabetes mellitus: Tehran lipid and glucose study. Pediatr Diabetes 2021; 22:937-945. [PMID: 34173705 DOI: 10.1111/pedi.13243] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 03/14/2021] [Accepted: 06/16/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Obesity and metabolic syndrome, which has an increasing prevalence among adolescence, are associated with metabolic abnormalities. This study investigates the role of adolescent obesity phenotypes in predicting the incidence of early adulthood type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS Participants were divided into four obesity phenotypes: Metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). Multivariate-adjusted hazard ratios (HRs) were calculated for T2DM incidence. RESULTS In this cohort study, 2306 Tehranian adolescents with an average age of 15.1 ± 2.4 years were included. The median (IQ 25-75) follow-up was 15.5 (12.8-17.1) years and the median (IQ 25-75) age of participants at the end of follow-up was 30 (26-32) years old. The incidence rate of T2DM during the early adulthood was [1.37 (95% CI: 0.89-2.10)] and [3.18 (95% CI: 2.44-4.16)] per 1000 person per year in boys and girls, respectively. MHO phenotype was not associated with an increased risk of T2DM for both sexes. Adjusted HRs for MUO were [4.30 95% CI (1.48-12.43)] and [3.39 95% CI (1.78-6.45)] in boys and girls, respectively. MUNW phenotype was associated with an increased risk of T2DM only in boys. After adjustment for adulthood BMI, all the phenotypes for both sexes lost their significance, except for boys with MUNW phenotype [HR = 3.46 95% CI (1.15-10.45)]. CONCLUSIONS Unhealthy obesity phenotypes; in contrast with MHO; had an increased risk of T2DM incidence, apart from girls with MUNW. After adjusting the adulthood BMI, all phenotypes turn insignificant, except for boys with MUNW.
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Affiliation(s)
- Kamran Yaghoubpour
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Erfan Tasdighi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hengameh Abdi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Anthropometric and body composition parameters in adolescents with the metabolically obese normal-weight phenotype. Br J Nutr 2021; 127:1458-1466. [PMID: 34196268 DOI: 10.1017/s0007114521002427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We aimed to investigate the anthropometric and body composition parameters associated with the metabolically obese normal-weight (MONW) phenotype. This cross-sectional study was conducted with 506 adolescents in Brazil (aged 10-19 y). The MONW phenotype was defined as normal-weight, according to BMI/age, and at least one metabolic alteration. Anthropometric measurements were obtained and the DEXA was used for body composition analysis. Crude and adjusted Poisson regression models with robust variance were used to estimate the associations. The phenotype was positively associated with waist circumference (male: prevalence ratio (PR) = 1·05; 95% CI 1·01, 1·09; female: PR = 1·06; 95% CI 1·02, 1·09), waist:height ratio (male: PR = 1·26; 95% CI 1·07, 1·49; female: PR = 1·29; 95% CI 1·07, 1·56) and android:gynoid fat ratio (male: PR = 1·25; 95% CI 1·03, 1·51; female: PR = 1·39; 95% CI 1·20, 1·62), in both sexes. Furthermore, there was a positive association of phenotype with waist:hip ratio (PR = 1·32; 95% CI 1·06, 1·65) and trunk:arm fat ratio (PR = 1·13; 95% CI 1·02, 1·24) only in males and with trunk:leg fat ratio (PR = 2·84; 95% CI 1·46, 5·53), BAIp (PR = 1·06; 95% CI 1·01, 1·12), fat mass index (PR = 1·24; 95% CI 1·10, 1·41) and regional indices of metabolic load and capacity (PR = 1·29; 95% CI 1·09, 1·53), in females. Anthropometric and body composition parameters indicative of central and total fat are associated with the MONW phenotype.
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Yuzbashian E, Nosrati-Oskouie M, Asghari G, Chan CB, Mirmiran P, Azizi F. Associations of dairy intake with risk of incident metabolic syndrome in children and adolescents: Tehran Lipid and Glucose Study. Acta Diabetol 2021; 58:447-457. [PMID: 33387028 DOI: 10.1007/s00592-020-01651-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/01/2020] [Indexed: 01/27/2023]
Abstract
AIMS This cohort study examined the association of total and individual dairy products with the risk of incident MetS and its components in children and adolescents. METHODS We prospectively assessed 531 participants aged 6-18 years without the MetS at baseline during an average 6.6-year follow-up period. Dairy consumption was estimated with a valid and reliable food frequency questionnaire. The MetS was defined according to the Cook criteria. The multivariable regression model was used to calculate the odds ratio (OR) for incident MetS associated with the consumption of dairy products. RESULTS The incidence of MetS was 9.8% after an average 6.6-year follow-up. After adjusting for potential confounders, OR (95% confidence interval) for incident MetS was 0.48 (0.23-1.00) for total dairy, 0.44 (0.21-0.92) for low-fat dairy, 0.46 (0.22-0.98) for low-fat milk, and 0.45 (0.21-0.97) for low-fat yogurt when comparing participants in the highest versus lowest tertile. A moderate intake of regular cheese was associated with decreased risk of MetS (OR = 0.43, 95% CI: 0.19-0.97). Replacing one serving/day of total dairy with nuts was associated with a lower (OR: 0.63, 95% CI: 0.42-0.95), whereas replacement by red and processed meat was associated with higher (OR: 1.55, 95%CI: 1.21-1.97) MetS risk. No significant association was found between high-fat dairy and MetS risk. CONCLUSIONS Higher consumption of dairy products, particularly low-fat milk and yogurt, was associated with reduced risk of incident MetS, suggesting the capability of low-fat dairy products in the primary prevention of MetS in children and adolescents.
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Affiliation(s)
- Emad Yuzbashian
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Nosrati-Oskouie
- Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Catherine B Chan
- Department of Agricultural, Food and Nutritional Science and Department of Physiology, University of Alberta, Edmonton, AB, Canada
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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Behrooz M, Vaghef-Mehrabany E, Moludi J, Ostadrahimi A. Are spexin levels associated with metabolic syndrome, dietary intakes and body composition in children? Diabetes Res Clin Pract 2021; 172:108634. [PMID: 33347897 DOI: 10.1016/j.diabres.2020.108634] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 11/23/2020] [Accepted: 12/15/2020] [Indexed: 12/21/2022]
Abstract
AIMS The aim of the present study was to investigate whether circulating levels of spexin is related to metabolic syndrome, some dietary intakes (Total energyintake, Macronutrient intakes) and body composition in children. METHODS 90 children were recruited in the present cross sectional study. Anthropometric measures, body composition, blood pressure, dietary intakes, resting metabolic rate, physical activity level, appetite status, pubertal stage, serum spexin, fasting blood glucose, high-sensitivity C-reactive protein, insulin and lipid profile were measured using standard techniques. RESULTS 14 children met the criteria for metabolic syndrome. Median (IQR) of spexin levels were significantly lower in children with high fat mass and children with higher systolic blood pressure (SBP), compared to children with normal fat mass and normal SBP: (P < 0.05). A protective independent effect was detected for the highest tertile of serum spexin on metabolic syndrome in adjusted models; Crude OR (CI): 0.23 (0.04-1.2), P-trend = 0.08; Model 1: OR (CI): 0.15(0.02-1.01), P-trend = 0.05; Model 2: OR (CI): 0.10 (0.01-0.90), P-trend = 0.03. There was a significant negative association between spexin and total dietary fat intake (r= - 0.21; P < 0.04). CONCLUSION This findings can further highlight the importance of the relationship between spexin, adipose tissue and adipose tissue metabolism.
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Affiliation(s)
- Maryam Behrooz
- Student Research Committee, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Maraghe University of Medical Sciences, Department of Nutrition and Food Sciences, Department of Nutrition and Food Sciences, Iran
| | | | - Jalal Moludi
- School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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The effects of whole grain intake on anthropometric measures in overweight and obese children: a crossover randomised clinical trial. Br J Nutr 2021; 126:1459-1465. [DOI: 10.1017/s000711452100026x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Abstract
Whole-grain foods have been reported to affect body weight and satiety. However, we are aware of no study in this regard among children. The present study aimed to determine the effects of whole grain consumption on anthropometric measures in overweight or obese children. In this randomised crossover clinical trial, forty-four overweight or obese girls participated. After a 2-week run-in period, subjects were randomly assigned to either intervention (n 44) or non-intervention (n 44) groups. Subjects in the intervention group were given a list of whole-grain foods and were asked to obtain half of their grain servings from these foods each day for 6 weeks. Individuals in the non-intervention group were asked not to consume any of these foods. A 4-week washout period was applied. Then, participants were crossed over to the alternate arm. The measurements were done before and after each phase. Mean age, weight and BMI of participants were 11·2 (sd 1·49) years, 51·2 (sd 10·2) kg and 23·5 (sd 2·5) kg/m2, respectively. Despite the slight reduction in weight and BMI, there were no significant differences in changes in these anthropometric measures. We found a significant effect of whole grain intake on waist circumference (−2·7 v. 0·3 cm, P = 0·04). No significant changes in hip circumference were observed. Changes in the prevalence of overweight, obesity and abdominal obesity were not significantly different. This study indicated a beneficial effect of whole-grain foods on waist circumference in overweight children; however, these foods did not influence weight and BMI.
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Asghari G, Hasheminia M, Heidari A, Mirmiran P, Guity K, Shahrzad MK, Azizi F, Hadaegh F. Adolescent metabolic syndrome and its components associations with incidence of type 2 diabetes in early adulthood: Tehran lipid and glucose study. Diabetol Metab Syndr 2021; 13:1. [PMID: 33388084 PMCID: PMC7778813 DOI: 10.1186/s13098-020-00608-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/01/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022] Open
Abstract
AIM To investigate the association of youth metabolic syndrome (MetS) and its components, individually and in combination with early adulthood incident type 2 diabetes (T2DM). METHODS A total of 2798 adolescents aged 11-19 years enrolled in the study. At baseline, MetS, its components including blood pressure (BP), waist circumference (WC), triglycerides (TGs), fasting plasma glucose, and low HDL-C, and different combinations of MetS components were defined. After a mean 11.3 years of follow-up, T2DM was determined. Multivariable Cox proportional hazard regression analysis adjusted for age, sex, family history of T2DM, and adult BMI was used for data analysis. The hazard ratio (HR) and 95% confidence interval (CI) were reported. RESULTS During the follow-up, 44 incidents T2DM were developed. Among different individual components, only high WC [HR = 2.63, 95% CI (1.39-4.97)] and high TGs [HR = 1.82, 95% CI (1.00-3.34)] remained as significant predictors only in the age and sex adjusted model. Regarding combinations of MetS components, 'high TGs and high WC' [HR = 2.70, 95% CI (1.27-5.77)], 'high BP and high WC' [HR = 2.52, 95% CI (1.00-6.33)], 'high TGs and high BP' [HR = 2.27, 95% CI (1.02-5.05)] as well as MetS per se [HR = 2.82, 95% CI (1.41-5.64)] had a significant relationship with incident T2DM in the multivariable adjusted model. Among different confounders, being female and having family history of T2DM were consistently associated with higher risk of T2DM, in different combinations of MetS components. CONCLUSIONS Adolescence MetS and some combinations of MetS components predicted early adulthood T2DM. Thus, adolescents, particularly female ones, with combinations of MetS components as well as those with family history of T2DM could be targeted for lifestyle intervention.
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Affiliation(s)
- Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abolfazl Heidari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamran Guity
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Karim Shahrzad
- Internal Medicine and Endocrinology, Shohada Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Golpour-Hamedani S, Rafie N, Pourmasoumi M, Saneei P, Safavi SM. The association between dietary diversity score and general and abdominal obesity in Iranian children and adolescents. BMC Endocr Disord 2020; 20:181. [PMID: 33308202 PMCID: PMC7733278 DOI: 10.1186/s12902-020-00662-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 12/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the association between diet and disease, the consideration of a whole diet has appeared to be more effective than the examination of single-nutrient intake. This study aimed to examine the relationship between dietary diversity score (DDS) and obesity in Iranian children. METHODS A cross-sectional study was conducted on 456 children aged 11-18 years, who were selected by random cluster sampling. The usual food intake for each participant assessed using a validated Food frequency questionnaire (FFQ). To calculate the dietary diversity score, food items were categorized into 5 broad groups and 23 subgroups based on the US Department of Agriculture Food Guide Pyramid. Participants were categorized based on the DDS tertile cut-off points. Anthropometric measurements were conducted based on standard protocols. Overweight and obesity were defined as 85th ≤ BMI < 95th, and ≥ 95th percentiles of BMI, respectively. Additionally, abdominal obesity was considered as WC ≥ 85th percentile. RESULTS Mean and standard deviation (SD) of subjects' Body Mass Index (BMI) and waist circumference were 20.88 (SD 4.22) kg/m2 and 74.27 (SD 10.31) cm, respectively. The probability of overweight and obesity was increased as tertiles of DDS increased (OR among tertiles: 1.00, 1.82 and 2.13 for overweight and 1.00, 2.60 and 3.45 for obesity; this was the same for abdominal obesity: 1.00, 2.22 and 3.45, P < 0.001 for all). However, no statistically significant results were found after adjustment for energy intake. CONCLUSION Dietary diversity positively affected obesity through higher energy intake. Despite the wide recommendation of having high dietary diversity, public health programs should emphasize to improve dietary diversity only in selective food items.
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Affiliation(s)
- Sahar Golpour-Hamedani
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, PO Box: 81746-73461, Isfahan, Iran
| | - Nahid Rafie
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, PO Box: 81746-73461, Isfahan, Iran
| | - Makan Pourmasoumi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Parvane Saneei
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, PO Box: 81746-73461, Isfahan, Iran.
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Sayyed Morteza Safavi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, PO Box: 81746-73461, Isfahan, Iran.
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Cardiometabolic risk and health behaviours in adolescents with normal-weight obesity: a systematic review. Public Health Nutr 2020; 24:870-881. [PMID: 33256881 DOI: 10.1017/s1368980020004863] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyse the presence of cardiometabolic risk factors in adolescents with normal-weight obesity (NWO), as well as to investigate health behaviours related to the phenotype. DESIGN The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and the bibliographic search was carried out in the PubMed, Scielo and ScienceDirect databases. SETTING School, university and population. PARTICIPANTS Adolescents between 10 and 19 years old. RESULTS A total of eight papers were included. Most studies have found a relationship between NWO and the presence of cardiometabolic risk factors, such as high waist circumference, unfavourable lipid and glycid profile. As for health behaviours, three of the eight studies included evaluated eating habits; however, the results were not conclusive. In addition, four studies analysed the practice of physical activity or physical fitness, which was lower in NWO. CONCLUSIONS The available evidence indicates that NWO is related to the early development of cardiometabolic changes, physical inactivity and less physical fitness in adolescents. The results also reveal the importance of early detection of the phenotype, as well as the need for further research on the associated factors to prevent future diseases. Registration (PROSPERO: CRD42020161204).
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Rahimi H, Yuzbashian E, Zareie R, Asghari G, Djazayery A, Movahedi A, Mirmiran P. Dietary approaches to stop hypertension (DASH) score and obesity phenotypes in children and adolescents. Nutr J 2020; 19:112. [PMID: 33012284 PMCID: PMC7534156 DOI: 10.1186/s12937-020-00631-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 09/30/2020] [Indexed: 12/12/2022] Open
Abstract
Background The prevalence of obesity and its two important phenotypes, the metabolically healthy obese (MHO) and the metabolically unhealthy obese (MUO) are 10.9, 9.1, and 1.8%, respectively, among children and adolescents in Iran. Data on the link between diet quality indices and obesity phenotypes in children and adolescents is scarce. The present study aimed to assess the association of the Dietary Approaches to Stop Hypertension (DASH) score with MHO and MUO, as well as with cardiometabolic risk factors (RFs) in children and adolescents with excess weight. Methods This cross-sectional study was conducted on 341 children and adolescents with excess weight aged 6–13 years, selected from primary schools of Tehran. The DASH score was determined based on eight components using a valid and reliable food frequency questionnaire. Anthropometric measures, insulin, fasting plasma glucose, lipid profile, and physical activity levels were collected. MUO was classified based on two definitions: having 2 or more cardiometabolic RFs, or being insulin resistant determined by a homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 3.16. Multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for MUO phenotypes and cardiometabolic RFs in each tertile of the DASH score after adjustment for confounders. Results The mean ± SD for age and DASH score was 9.3 ± 1.7 years and 24.0 ± 4.9, respectively. The prevalence of MUO was 62.2% based on RFs, and 43.4% based on HOMA-IR. Participants in the highest tertile of the DASH score had significantly decreased odds for MUO based on HOMA-IR (OR = 0.49; 95% CI: 0.28–0.87) compared with those in the lowest tertile, after adjustment for confounders. However, there were no associations between the DASH score and any of cardiometabolic RFs, or MUO based on RFs (OR = 0.68; 95% CI: 0.38–1.20). Conclusion The DASH score was inversely associated with MUO based on HOMA-IR, but not associated with MUO based on cardiometabolic RFs in this sample of children and adolescents. A DASH-style diet may have favourable effects on insulin sensitivity among children and adolescents with excess weight. Universal definitions for MHO/MUO are required, and longitudinal studies recommended to shed light upon this subject.
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Affiliation(s)
- Hamed Rahimi
- Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413, Iran
| | - Emad Yuzbashian
- Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413, Iran
| | - Rahim Zareie
- Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413, Iran.
| | - Abolghassem Djazayery
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ariyo Movahedi
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran.
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413, Iran
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Santos JLF, Valério VP, Fernandes RN, Duarte L, Assumpção AC, Guerreiro J, Sickler AL, Lemos ÁAR, Goulart Filho JG, Cesar LAM, Pinto IM, Magalhães C, Hussid MF, Camacho C, Avezum A, Sangaleti CT, Consolim-Colombo FM. Waist Circumference Percentiles and Cut-Off Values for Obesity in a Large Sample of Students from 6 To 10 Years Old Of The São Paulo State, Brazil. Arq Bras Cardiol 2020; 114:530-537. [PMID: 32267326 PMCID: PMC7792724 DOI: 10.36660/abc.20190043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023] Open
Abstract
Fundamento A prevalência da obesidade vem aumentando sistematicamente na população, inclusive nas crianças e adolescentes, ao redor do mundo. Objetivos Descrever curvas percentílicas de referência para a circunferência abdominal (CA) nas crianças brasileiras e fornecer pontos de corte da CA para identificar crianças com risco de obesidade. Métodos Um estudo multicêntrico, prospectivo, tranversal foi realizado em crianças com idades entre 6 e 10 anos, matriculadas no ensino fundamental de escolas públicas e particulares de 13 cidades do estado de São Paulo. A estatura, o peso e a CA foram medidos em duplicata em 22.000 crianças (11.199 meninos). Para estabelecer o melhor ponto de corte da CA para o diagnóstico da obesidade, foram calculadas curvas ROC com crianças classificadas como com peso normal e obesas, de acordo com as curvas do IMC, estratificadas por gênero e idade, e o índice Youden foi utilizado como a eficácia potencial máxima desse biomarcador. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados Os valores da CA aumentaram com a idade, tanto nos meninos quanto nas meninas. A prevalência de obesidade em cada grupo variou de 17% (6 anos de idade) a 21,6 % (9 anos de idade), dentre os meninos, e de 14,1% (7 anos de idade) a 17,3 % (9 anos de idade), dentre as meninas. As análises ROC mostraram o percentil 75 como ponto de corte para o risco de obesidade, e o diagnóstico de obesidade está classificado no percentil 85 ou acima. Conclusão Curvas de referência da CA específicas para idade e sexo em crianças brasileiras e pontos de corte para o risco de obesidade podem ser usados em triagem nacional e estudos intervencionais para reduzir a carga da obesidade no Brasil. (Arq Bras Cardiol. 2020; 114(3):530-537)
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Affiliation(s)
| | | | | | - Ligia Duarte
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | | | - Jayme Guerreiro
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Antonio L Sickler
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Álvaro A R Lemos
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | | | | | | | | | | | | | - Alvaro Avezum
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Carine T Sangaleti
- Universidade Estadual do Centro-Oeste - Enfermagem, Guarapuava, PR - Brasil
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Salari-Moghaddam A, Hajihashemi P, Basirat R, Mousavi SM, Salehi-Abargouie A, Larijani B, Esmaillzadeh A. Household socioeconomic status in relation to childhood general and central obesity in Farrokhshahr, Iran. ARYA ATHEROSCLEROSIS 2020; 15:211-217. [PMID: 31949447 PMCID: PMC6954359 DOI: 10.22122/arya.v15i5.1640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although the association between socioeconomic status (SES) and general/central obesity has extensively been examined, limited data are available in this regard among children. The aim of this study was to examine the association between household SES and obesity among children. METHODS This cross-sectional study was done in Farrokhshahr, Iran, among primary school children aged 6-12 years in 2009. SES was examined using participants' and their parents' oral responses to a pretested questionnaire. In the current study, participants were classified based on tertiles of SES score to low, medium, and high SES categories. General as well as central obesity was defined based on age- and sex-specific national cut-off points. RESULTS Comparing individuals in the highest versus lowest tertile of SES, there was no significant difference in mean waist circumference (WC), but those in the middle tertile of SES had greater means of body mass index (BMI) than those in the lowest tertile after controlling for potential confounders (16.19 ± 0.27 vs. 15.27 ± 0.27 kg/m2, P = 0.002). We observed a greater chance of general obesity for those in the highest tertile of SES compared with those in the lowest tertile [odds ratio (OR): 4.00, 95% confidence interval (CI): 1.53-10.59, Ptrend = 0.004]. No significant association was seen between SES and central obesity, either before or after controlling for potential confounders. CONCLUSION We found that children in the highest SES class had a greater chance of general obesity than those in the lowest SES class. There was no significant association between SES and central obesity.
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Affiliation(s)
- Asma Salari-Moghaddam
- PhD Candidate, Students Scientific Research Center AND Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Hajihashemi
- PhD Candidate, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reyhane Basirat
- PhD Candidate, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mohammad Mousavi
- PhD Candidate, Students Scientific Research Center AND Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Salehi-Abargouie
- Assistant Professor, Nutrition and Food Security Research Center AND Department of Nutrition, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Bagher Larijani
- Professor, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Professor, Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute AND Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran AND Food Security Research Center AND Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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14
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Mirmiran P, Ziadlou M, Karimi S, Hosseini-Esfahani F, Azizi F. The association of dietary patterns and adherence to WHO healthy diet with metabolic syndrome in children and adolescents: Tehran lipid and glucose study. BMC Public Health 2019; 19:1457. [PMID: 31694610 PMCID: PMC6833201 DOI: 10.1186/s12889-019-7779-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 10/14/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The optimal dietary pattern for reducing the extent of metabolic syndrome (MetS) has not been well established yet. The aim of this study was to evaluate dietary patterns and adherence to WHO healthy diet in children and adolescents and their associations with MetS. METHODS Subjects of this cohort study were selected from among children and adolescents of the Tehran Lipid and Glucose Study participants, aged 6-18 years (n = 424). Dietary measurements were collected using a valid and reliable food frequency questionnaire. MetS was defined as the existence of at least 3 risk factors according to the Cook criteria. Diet was assessed based on dietary components of the WHO healthy diet. Dietary patterns were defined by principal component analysis. RESULTS The mean ± SD age of participants (42% boys and 57% girls) was 13.5 ± 3.7 years. The most consistency with the WHO healthy diet was observed for cholesterol, free sugar and protein consumption in both genders, and the least was for n-3 poly-unsaturated fatty acid, trans-fatty acid and salt. Intake of SFA up to 12% of energy intake (third quartile) reduced the risk of MetS, compared to the first quartile. Subjects in the third quartile of n-6 poly-unsaturated fatty acid intake (6.2% of energy) showed the lowest odds ratio of MetS compared to the first quartile (OR: 0.18, CI: 0.04-0.66). In the adjusted model, the risk of MetS reduced across quartiles of MUFA intake by 60% (OR: 1, 0.40, 0.40, 0.42; P trend = 0.05). No significant trends were observed in the risk of MetS components across quartiles of the WHO healthy diet components. Three major dietary patterns were identified, the healthy, unhealthy and cereal/meat. An increased risk of MetS was observed in the highest quartile of unhealthy dietary pattern score compared to the lowest quartile (OR: 1, 0.81, 0.93, 2.49; P trend = 0.03). CONCLUSIONS Our results demonstrated that the majority of our population did not meet some components of WHO healthy diet recommendations. The quality and quantity of fatty acid intakes were associated with risk of MetS. Adherence to unhealthy dietary pattern was associated with two-fold increase in MetS risk.
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Affiliation(s)
- Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Ziadlou
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Karimi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Firoozeh Hosseini-Esfahani
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lassek WD, Gaulin SJ. Evidence supporting nubility and reproductive value as the key to human female physical attractiveness. EVOL HUM BEHAV 2019. [DOI: 10.1016/j.evolhumbehav.2019.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Hosseinpour-Niazi S, Bakhshi B, Betru E, Mirmiran P, Darand M, Azizi F. Prospective study of total and various types of vegetables and the risk of metabolic syndrome among children and adolescents. World J Diabetes 2019; 10:362-375. [PMID: 31231459 PMCID: PMC6571485 DOI: 10.4239/wjd.v10.i6.362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/09/2019] [Accepted: 05/14/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Data available on the association between consumption of various types of vegetables and metabolic syndrome (MetS) remain inconsistent.
AIM To investigate the association between the intake of various types of vegetables and MetS among children and adolescents and MetS.
METHODS The Tehran Lipid and Glucose Study cohort included 424 children and adolescents initially free of MetS. At the 3.6 year follow-up, 47 new cases of MetS were identified. A 168-item semi-quantitative food-frequency questionnaire was used to collect information about total and various types of vegetables consumed, including allium-, green leafy-, fruity-, root-, stalk-, starchy-, potatoes, and cabbage. MetS was defined according to the Cook et al[32] criteria.
RESULTS The median (interquartile range) of total vegetable consumption was 217 (146-344) g/d. After adjustment for demographic characteristics and dietary intake, higher total- (≥ 350 g/d) and higher allium vegetable consumption (≥ 30 g/d) in the fourth quartile were significantly and inversely associated with risk of MetS compared to the first quartile. Consumption of green leafy vegetables in the third (21.4-38.3 g/d) versus the first quartile (≤ 13.5 g/d) demonstrated a significant inverse association with lower risk of MetS in children and adolescents; associations for other types of vegetables consumed were not significant.
CONCLUSION Consumption of vegetables, especially allium and green leafy vegetables, in sufficient amounts may be beneficial in reducing the risk of MetS among children and adolescents.
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Affiliation(s)
- Somayeh Hosseinpour-Niazi
- Nutrition and Endocrine Research center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran
| | - Bahar Bakhshi
- Nutrition and Endocrine Research center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran
| | - Ekbal Betru
- Nutrition and Endocrine Research center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran
| | - Mina Darand
- Nutrition and Endocrine Research center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran
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Miri SF, Javadi M, Lin CY, Griffiths MD, Björk M, Pakpour AH. Effectiveness of cognitive-behavioral therapy on nutrition improvement and weight of overweight and obese adolescents: A randomized controlled trial. Diabetes Metab Syndr 2019; 13:2190-2197. [PMID: 31235156 DOI: 10.1016/j.dsx.2019.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/21/2019] [Indexed: 11/26/2022]
Abstract
AIM To assess the effectiveness of a cognitive-behavioral treatment (CBT) program on weight reduction among Iranian adolescents who are overweight. METHODS Using a randomized controlled trial design, 55 adolescents who were overweight (mean [SD] age = 14.64 [1.69] years; zBMI = 2.18 [0.65]) were recruited in the CBT program and 55 in the treatment as usual (TAU; mean age = 14.88 [1.50]; zBMI = 2.09 [0.57]) group. All the participants completed several questionnaires (Child Dietary Self-Efficacy Scale; Weight Efficacy Lifestyle questionnaire; Physical Exercise Self-Efficacy Scale; Pediatric Quality of Life Inventory; and self-reported physical activity and diet) and had their anthropometrics measured (height, weight, waist and hip circumferences, and body fat). RESULTS The CBT group consumed significantly more fruits and juice, vegetables, and dairy in the 6-month follow-up as compared with the TAU group (p-values <0.001). The CBT group consumed significantly less sweet snacks, salty snacks, sweet drinks, sausages/processed meat, and oils in the six-month follow-up compared with the TAU group (p-values<0.001). Additionally, the waist circumference, BMI, waist-hip ratio, and fat mass were significantly decreased in the CBT group in the six-month follow-up compared with the TAU group (p-values<0.005). The CBT group significantly improved their psychosocial health, physical activity, and health-related quality of life (p-values<0.001). CONCLUSION The CBT program showed its effectiveness in reducing weight among Iranian adolescents who were overweight. Healthcare providers may want to adopt this program to treat excess weight problems among adolescents.
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Affiliation(s)
- Seyedeh Fatemeh Miri
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Javadi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Maria Björk
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran; Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
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Ferns GA, Ghayour-Mobarhan M. Metabolic syndrome in Iran: A review. TRANSLATIONAL METABOLIC SYNDROME RESEARCH 2018. [DOI: 10.1016/j.tmsr.2018.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Asghari G, Dehghan P, Mirmiran P, Yuzbashian E, Mahdavi M, Tohidi M, Neyestani TR, Hosseinpanah F, Azizi F. Insulin metabolism markers are predictors of subclinical atherosclerosis among overweight and obese children and adolescents. BMC Pediatr 2018; 18:368. [PMID: 30470212 PMCID: PMC6260656 DOI: 10.1186/s12887-018-1347-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 11/16/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To investigate the association between markers of insulin metabolism and carotid intima-media thickness(cIMT) among overweight and obese children and adolescents. METHODS A total of 378 children and adolescents aged from 6 to 13 years, with WHO body mass index Z-Scores ≥2 were enrolled in this study. We measured fasting serum insulin and glucose, conducted a homeostatic model assessment of insulin resistance(HOMA-IR), and calculated the quantitative insulin sensitivity check index(QUICKI). Carotid intima-media thickness was measured in the common carotid artery with high-resolution ultrasonography. RESULTS The study participants consisted of 198 boys and 180 girls with a mean(±SD) age of 9.3 ± 1.7 years, 18.3% being pre-pubertal. In boys, after controlling for confounders, a one-SD increase in fasting insulin and HOMA-IR were associated with 0.351 mm(P < 0.001) and 0.350 mm(P < 0.001) increases in cIMT, respectively. However, a one-SD increase in QUICKI was associated with a - 0.305 mm(P = 0.001) decrease in cIMT. When categorizing into tertiles, a one-SD increase in fasting insulin and HOMA-IR were associated with 87 and 81% increases in the odds of higher categories of cIMT(both P < 0.05). However, a one-SD increase in QUICKI was associated with 37% lower odds of higher categories of cIMT(P = 0.022). No significant associations were found among girls. CONCLUSION This study demonstrated that insulin resistance and sensitivity markers were independent predictors of cIMT in overweight and obese boys, but not in girls, highlighting the importance of chronically elevated insulin levels for predisposing these boys to alterations in their vascular structure.
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Affiliation(s)
- Golaleh Asghari
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pooneh Dehghan
- Department of Imaging, Research Development Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
| | - Emad Yuzbashian
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tirang R Neyestani
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Jalali-Farahani S, Amiri P, Akbar HM, Cheraghi L, Karimi M, Azizi F. Effects of a Healthy Lifestyle Education on the Incidence of Metabolic Syndrome in Children during a 13-Year Follow-up. Int J Behav Med 2018; 25:131-140. [PMID: 28795355 DOI: 10.1007/s12529-017-9680-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to determine effects of community-based healthy lifestyle education on the incidence of metabolic syndrome (MetS) in Tehranian children considering parental factors during a 13-year follow-up. METHODS This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) on 1603 healthy children, aged 8-18 years, who had complete parental data. Parental factors including MetS, education, age, occupation, and smoking were considered to distinguish parental clusters which could potentially predispose children to MetS. Lifestyle interventions were aimed at achieving healthy dietary patterns and increasing physical activity. Cluster analysis and survival Cox model were used to determine potential low and high risk parental clusters and the effect of intervention on the hazard of MetS in children respectively. RESULTS In a model adjusted for children's age and sex, the hazard of the MetS incidence was 36% higher in children from high-risk parental cluster than those from low-risk parental cluster (HR = 1.36, 95% CI = 1.07-1.73). Moreover, the intervention group showed a 39% lower risk for MetS incidence (HR = 0.61, 95% CI = 0.44-0.85) compared to controls, during the first 6 years after baseline assessment (short term), although the risk lowering effect of the intervention was not maintained long term. CONCLUSION A healthy lifestyle education was successful in reducing the short-term risk of MetS in children. To identify ways of maintaining long-term results, further research is definitely warranted. TRIAL REGISTRATION This study was funded by National Research Council and Planning and Management Organization and has been reviewed and approved by the Iranian registry of clinical trials (ISRCTN52588395).
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Affiliation(s)
- Sara Jalali-Farahani
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
| | - Hasti Masihay Akbar
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Leila Cheraghi
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrdad Karimi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lassek WD, Gaulin SJC. Do the Low WHRs and BMIs Judged Most Attractive Indicate Higher Fertility? EVOLUTIONARY PSYCHOLOGY 2018; 16:1474704918800063. [PMID: 30296846 PMCID: PMC10480809 DOI: 10.1177/1474704918800063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 08/20/2018] [Indexed: 12/30/2022] Open
Abstract
We examine the widely accepted view that very low waist-hip ratios and low body mass indices (BMIs) in women in well-nourished populations are judged attractive by men because these features reliably indicate superior fertility. In both subsistence and well-nourished populations, relevant studies of fertility do not support this view. Rather studies indicate lower fertility in women with anthropometric values associated with high attractiveness. Moreover, low maternal BMI predisposes to conditions that compromise infant survival. Consistent with these findings from the literature, new data from a large U.S. sample of women past reproductive age show that women with lower BMIs in the late teens had fewer live births, controlling for education, marital history, and race. They also had later menarche and earlier menopause compared with women with higher youth BMIs. In addition, data from the 2013 U.S. natality database show that mothers with lower prepregnancy BMIs have an increased risk of producing both low-birth-weight and preterm infants controlling for other relevant variables-conditions that would have adversely affected fitness over almost all of human evolution. Thus, a review of the relevant literature and three new tests fail to support the view that highly attractive women are more fertile.
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Affiliation(s)
- William D. Lassek
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Steven J. C. Gaulin
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA, USA
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Barzin M, Aryannezhad S, Serahati S, Beikyazdi A, Azizi F, Valizadeh M, Ziadlou M, Hosseinpanah F. Incidence of obesity and its predictors in children and adolescents in 10 years of follow up: Tehran lipid and glucose study (TLGS). BMC Pediatr 2018; 18:245. [PMID: 30045707 PMCID: PMC6060527 DOI: 10.1186/s12887-018-1224-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/17/2018] [Indexed: 01/08/2023] Open
Abstract
Background Childhood obesity is one of the most challenging public health issues of twenty-first century. While we know that there is an increase in prevalence of childhood and adolescence obesity, incidence studies must be carried out. The main objective of this study was to determine childhood obesity incidence and its potential predictors in Tehranian urban population. Methods This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS), addressing incidence and risk factors of obesity throughout several phases from 1999–2001 to 2009–2011 among Tehranian urban population. Total study subjects were 1033 non-obese children, aged between 7 to 11 years, with a median 8.7 years of follow-up. Body mass Index (BMI) was used to define obesity and overweight based on World Health Organization (WHO) criteria, and definition of metabolic syndrome (MetS) for children was based on the Cook survey. Cumulative incidence of obesity and obesity incidence rates were calculated for each gender. Cox proportional hazard models was used to estimate potential risk factors of obesity. Results Our Participants had a mean age of 9.2 ± 1.4 years, mean BMI of 16.1 ± 2.2 kg/m2 and mean waist circumference (WC) of 57.2 ± 6.7 at baseline. Total cumulative incidence of obesity was calculated to be 17%, CI =14.1–20.4 for whole population (19.6%, CI =15.4–24.8 for boys and 14.5%,CI = 10.9–19.1 for girls). Participants which were in the age group of 7–9 years at baseline experienced higher rate of cumulative obesity incidence compared to those who were in the age group of 10–11 years at baseline (22% vs 10.8%). In addressing risk factors, 5 parameters were significantly associated with obesity incidence: being overweight at baseline (HR = 14.93 95%CI: 9.82–22.70), having higher WC (HR = 5.05 95%CI: 3.01–8.48), suffering from childhood MetS (HR: 2.77 95%CI: 1.57–4.89) and having a obese father (HR: 2.69 95%CI: 1.61–4.50) or mother (HR: 3.04 95%CI: 1.96–4.72). Conclusion Incidence of obesity is significantly high in Tehranian children, especially the age group 7–9 years. Best predictors of childhood obesity incidence are childhood overweight, WC above 90th percentile, childhood MetS and parental obesity.
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Affiliation(s)
- Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shayan Aryannezhad
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Serahati
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akram Beikyazdi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Ziadlou
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Hooshmand F, Asghari G, Yuzbashian E, Mahdavi M, Mirmiran P, Azizi F. Modified Healthy Eating Index and Incidence of Metabolic Syndrome in Children and Adolescents: Tehran Lipid and Glucose Study. J Pediatr 2018; 197:134-139.e2. [PMID: 29631767 DOI: 10.1016/j.jpeds.2018.01.080] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/29/2017] [Accepted: 01/31/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To assess the relationship between modified healthy eating index (mHEI) with the development of metabolic syndrome (MetS) among children and adolescents. STUDY DESIGN Dietary data were collected using a food frequency questionnaire among 424 healthy subjects, aged 6-18 years. The components of mHEI were grains, vegetables and fruits, dairy, red to white meat ratio, butter, sweet snacks, sweetened beverages, salty snacks, and fast food. Multivariable logistic regression models were used to estimate the incidence of MetS after 3.6 years of follow-up in each quartile of the mHEI score, adjusted for baseline age, sex, total energy intake, physical activity, and body mass index. RESULTS The mean ± SD age and mHEI scores of participants were 13.6 ± 3.7 years and 55.9 ± 10.0, respectively, at baseline. MetS developed in 11% of the participants at the end of follow-up. After adjustment for confounders, the occurrences of MetS decreased in the highest quartile compared with the lowest quartile of the mHEI score (OR = 0.35, 95% CI 0.13-0.98, P for trend = .025). In addition, higher scores of mHEI components including fruits, salty snacks, and fast food were associated with lower risk of MetS. CONCLUSIONS Higher scores of mHEI as an indicator of diet quality may hinder the development of MetS among children and adolescents.
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Affiliation(s)
- Fateme Hooshmand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Golaleh Asghari
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Emad Yuzbashian
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gu DH, Kim MY, Seo YS, Kim SG, Lee HA, Kim TH, Jung YK, Kandemir A, Kim JH, An H, Yim HJ, Yeon JE, Byun KS, Um SH. Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis. Clin Mol Hepatol 2018; 24:319-330. [PMID: 29706058 PMCID: PMC6166111 DOI: 10.3350/cmh.2017.0077] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 02/05/2018] [Indexed: 12/18/2022] Open
Abstract
Background/Aims The most widely used method for diagnosing sarcopenia is the skeletal muscle index (SMI). Several studies have suggested that psoas muscle thickness per height (PMTH) is also effective for detecting sarcopenia and predicting prognosis in patients with cirrhosis. The aim of this study was to evaluate the optimal cutoff values of PMTH for detecting sarcopenia in cirrhotic patients. Methods All cirrhotic patients who underwent abdominal computed tomography (CT) scan including L3 and umbilical levels for measuring SMI and transverse psoas muscle thickness, respectively, were included. Two definitions of sarcopenia were used: (1) sex-specific cutoffs of SMI (≤52.4 cm2 /m2 in men and ≤38.5 cm2 /m2 in women) for SMI-sarcopenia and (2) cutoff of PMTH (<16.8 mm/m) for PMTH-sarcopenia. Results Six hundred fifty-three patients were included. The average age was 53.6 ± 10.2 years, and 499 patients (76.4%) were men. PMTH correlated well with SMI in both men and women (P<0.001). Two hundred forty-one (36.9%) patients met the criteria for SMI-sarcopenia. The best PMTH cutoff values for predicting SMI-sarcopenia were 17.3 mm/m in men and 10.4 mm/m in women, and these were defined as sex-specific cutoffs of PMTH (SsPMTH). The previously published cutoff of PMTH was defined as sex-nonspecific cutoff of PMTH (SnPMTH). Two hundred thirty (35.2%) patients were diagnosed with SsPMTH-sarcopenia, and 280 (44.4%) patients were diagnosed with SnPMTH-sarcopenia. On a multivariate Cox regression analysis, SsPMTH-sarcopenia (hazard ratio [HR], 1.944; 95% confidence interval [CI], 1.144–3.304; P=0.014) was significantly associated with mortality, while SnPMTH-sarcopenia was not (HR, 1.446; 95% CI, 0.861–2.431; P=0.164). Conclusions PMTH was well correlated with SMI in cirrhotic patients. SsPMTH-sarcopenia was an independent predictor of mortality in these patients and more accurately predicted mortality compared to SnPMTH-sarcopenia.
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Affiliation(s)
- Dae Hoe Gu
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Moon Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yeon Seok Seo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Gyune Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Han Ah Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Tae Hyung Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Kul Jung
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Altay Kandemir
- Department of Gastroenterology, Adnan Menderes University Medical School, Aydin, Turkey
| | - Ji Hoon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyunggin An
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Eun Yeon
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kwan Soo Byun
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Soon Ho Um
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Amiri P, Jalali-Farahani S, Akbar HM, Cheraghi L, Khalili D, Momenan A, Mirmiran P, Ghanbarian A, Hedayati M, Hosseini-Esfahani F, Azizi F. The Effects of a Community-Based Lifestyle Intervention on Metabolic Syndrome and Its Components in Adolescents: Findings of a Decade Follow-Up. Metab Syndr Relat Disord 2018; 16:215-223. [PMID: 29648906 DOI: 10.1089/met.2017.0055] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The increasing prevalence of metabolic syndrome (MetS) in childhood makes lifestyle interventions imperative during adolescence. This study aimed to assess the effects of a community-based lifestyle intervention on MetS and its components in adolescents. METHODS Adolescents, based on their residential area were categorized into three groups: complete intervention (residing in the intervention area at baseline and during all follow-ups), incomplete intervention (residing in either the intervention or control areas and were in transition between these two areas), and control group (residing in the control area at baseline and throughout all follow-ups). All measurements were repeated every 3 years for up to 9 years. Lifestyle intervention aimed at achieving healthy dietary patterns and increasing physical activity. Generalized estimating equation models were used to analyze data. RESULTS In boys with incomplete intervention versus controls, the prevalence of MetS was significantly lower in the short term (14.0 vs. 22.9), but not in long term. In boys with complete intervention, the prevalence was significantly lower versus controls (9.0 vs. 23.4) in the long term. In girls, the short-term prevalence of MetS was significantly lower in the complete intervention group compared with controls (2.5 vs. 9.1) and then remained constantly low in all study groups after that. Among MetS components, in boys, triglycerides and fasting plasma glucose in the short term and high-density lipoprotein mid term, and in girls HDL in mid and long term were both significantly improved. The odds of MetS decreased significantly in the complete [odds ratio (OR): 0.516, confidence interval (95% CI): 0.273-0.973] and incomplete (OR: 0.591, 95% CI: 0.358-0.976) intervention groups only in boys. The short- and long-term interventions resulted improvement in some of the MetS components in both genders. CONCLUSIONS The healthy lifestyle intervention reduced the risk of MetS in both genders in short and long term, but with different patterns and improved some of the MetS components.
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Affiliation(s)
- Parisa Amiri
- 1 Research Center for Social Determinants of Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Sara Jalali-Farahani
- 1 Research Center for Social Determinants of Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Hasti Masihay Akbar
- 1 Research Center for Social Determinants of Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Leila Cheraghi
- 1 Research Center for Social Determinants of Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Davood Khalili
- 2 Prevention of Metabolic Disorders Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Amirabbas Momenan
- 2 Prevention of Metabolic Disorders Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Parvin Mirmiran
- 3 Nutrition and Endocrine Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Arash Ghanbarian
- 2 Prevention of Metabolic Disorders Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Mehdi Hedayati
- 4 Cellular and Molecular Endocrine Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Firoozeh Hosseini-Esfahani
- 3 Nutrition and Endocrine Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Fereidoun Azizi
- 5 Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran
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26
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Farhadnejad H, Asghari G, Mirmiran P, Azizi F. Dietary approach to stop hypertension diet and cardiovascular risk factors among 10- to 18-year-old individuals. Pediatr Obes 2018; 13:185-194. [PMID: 29363277 DOI: 10.1111/ijpo.12268] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/10/2017] [Accepted: 12/18/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Current evidence available on the association between Dietary Approach to Stop Hypertension (DASH) diet and cardiovascular risk in adolescents is controversial. OBJECTIVE The aim of the present study was to assess the association between DASH diet and cardiovascular risk factors after 3 years of follow-up among Tehranian adolescents. METHODS A population-based cohort study was conducted on 628 subjects, aged 10-18 years, selected from among participants of the Tehran Lipid and Glucose Study. The DASH score was determined on the basis of eight components using a valid and reliable food-frequency questionnaire at baseline. Anthropometric and lipid profile data were measured at baseline and after a 3-year follow-up. RESULTS Mean (SD) age of the study population (46.6% men) was 14.1 (2.5) years. After adjustment for potential confounding variables, including sex, age, physical activity and total calorie intake, the risk of general obesity (OR = 0.26, 95%CI: 0.15-0.76) and central obesity (OR = 0.32, 95%CI: 0.14-0.84) in the highest quintile of DASH score were significantly lower than in subjects in the lowest quintile. However, DASH score was not associated with risk of incident dyslipidaemia in our study (OR = 0.81, 95%CI: 0.30-1.82). The higher DASH score was inversely associated with 3-year changes in body mass index and waist circumference during the study period (P for trend <0.05). However, there was no significant association between the higher score of this diet with 3-year changes in lipid profiles. CONCLUSION Adherence to the DASH diet was associated with decreased risk of central and general obesity, whereas higher DASH diet score was not associated with risk of dyslipidaemia in adolescents.
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Affiliation(s)
- H Farhadnejad
- Students' Research Committee, Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - G Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - P Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sedaghat F, Naja F, Darand M, Beyzai B, Rashidkhani B. Adherence to a Mediterranean dietary pattern and overweight and obesity among female adolescents in Iran. Int J Adolesc Med Health 2017; 31:/j/ijamh.ahead-of-print/ijamh-2016-0160/ijamh-2016-0160.xml. [PMID: 29168955 DOI: 10.1515/ijamh-2016-0160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 02/21/2017] [Indexed: 01/21/2023]
Abstract
Background Given the high prevalence of overweight and obesity in Iran, identification of a healthy diet is essential. Objective This study aimed to assess the association between adherence to a Mediterranean diet and overweight and obesity in female adolescents. Methods Two hundred and eighty female adolescents from high schools in Tehran were recruited. General information, physical activity and food frequency questionnaires were completed. Adherence to the Mediterranean diet was evaluated using the Mediterranean Style Dietary Pattern Score (MSDPS). Results Under and over reporters of energy intake were excluded from the analysis (n = 37). Results indicated that prevalence of overweight and obesity was 13.3% and 12.5%, respectively. The mean of MSDPS was low in this population (15.99 ± 5.64). The MSDPS was positively associated with mother's education level and energy intake (p < 0.05). No significant relation was observed between MSDPS and overweight and obesity among adolescents. However, there was a negative significant association between MSDPS and WHR just among students who had educated mothers [high: second median v. low: first median, odds ratio (OR) = 0.36, 95% confidence interval (CI) = 0.12-1.03]. Conclusion Adherence to a Mediterranean dietary pattern is low among adolescent females in Tehran, with no association with overweight and obesity.
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Affiliation(s)
- Fatemeh Sedaghat
- Department of Basic Science and Cellular Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farah Naja
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mina Darand
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bita Beyzai
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Rashidkhani
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Phone: (0098) 9127388016, Fax: (0098)(21) 22376467,
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Jafari F, Ehsani S, Nadjarzadeh A, Esmaillzadeh A, Noori-Shadkam M, Salehi-Abargouei A. Household food insecurity is associated with abdominal but not general obesity among Iranian children. BMC Public Health 2017; 17:350. [PMID: 28431549 PMCID: PMC5399801 DOI: 10.1186/s12889-017-4262-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 04/12/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Childhood obesity is increasing all over the world. Food insecurity is mentioned as a possible risk factor; however, previous studies have led to inconsistent results in different societies while data are lacking for the Middle East. We aimed to investigate the relationship between food insecurity and general or abdominal obesity in Iranian children in a cross-sectional study. METHODS Anthropometric data including height, weight, and waist circumference were measured by trained nutritionists. General and abdominal obesity were defined based on world health organization (WHO) and Iranian reference curves for age and gender, respectively. Radimer/Cornell food security questionnaire was filled by parents. Data about the physical activity of participants, family socio-economic status, parental obesity and data about perinatal period were also gathered using self-administered questionnaires. Logistic regression was incorporated to investigate the association between food insecurity and obesity in crude and multi-variable adjusted models. RESULTS A total of 587 children aged 9.30 ± 1.49 years had complete data for analysis. Food insecurity at household level was significantly associated with abdominal obesity (odds ratio (OR) = 1.54; confidence interval (CI):1.01-2.34, p <0.05) and the relationship remained significant after adjusting for all potential confounding variables (OR = 2.02; CI:1.01-4.03, p <0.05). Food insecurity was associated with general obesity neither in crude analysis and multi-variable adjusted models. CONCLUSIONS The slight levels of food insecurity might increase the likelihood of abdominal obesity in Iranian children and macroeconomic policies to improve the food security are necessary. Large-scale prospective studies, particularly in the Middle East, are highly recommended to confirm our results.
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Affiliation(s)
- Fateme Jafari
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Simin Ehsani
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmood Noori-Shadkam
- Department of Pediatrics, Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, PO Code 8915173160, Yazd, Iran.
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Asghari G, Eftekharzadeh A, Hosseinpanah F, Ghareh S, Mirmiran P, Azizi F. Instability of different adolescent metabolic syndrome definitions tracked into early adulthood metabolic syndrome: Tehran Lipid and Glucose Study (TLGS). Pediatr Diabetes 2017; 18:59-66. [PMID: 26825860 DOI: 10.1111/pedi.12349] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/28/2015] [Accepted: 11/16/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVE There are substantial controversies about the clinical utility of adolescent metabolic syndrome (MetS). The current study examined the stability of adolescent MetS by assessing the agreement and discriminative abilities of four different definitions of adolescent MetS and the adult MetS definition during a 10.4-yr follow up. SUBJECTS AND METHODS For this study, 1424 adolescents (55.2% female), who participated in the framework of the Tehran Lipid and Glucose Study were included. Kappa was calculated for agreement between adolescent MetS definitions [Cook, de Ferranti, pediatric National Cholesterol Education Program (NCEP) and pediatric International Diabetes Federation (IDF)] and the adulthood MetS definition defined by the joint interim statement (JIS) criteria. MetS persistence, instability, and incidence were assessed, and for each of the four adolescent definitions, sensitivity, specificity, and area under receiver operating curve (AUC) for the counting of categorical adulthood MetS components was evaluated. RESULTS The agreement between the four adolescent MetS definitions and JIS was poor (κ = 0.094-0.255). All definitions showed low sensitivity and high specificity, except for de Ferranti's, which contrary to other definitions, had higher sensitivity and lower specificity. All four adolescent definitions revealed generally low AUCs (0.601-0.647). Compared with the pubertal group (11-14 yr), the predictive power was slightly higher in the late-pubertal group (15-18 yr). Cook's and de Ferranti's definitions showed fairly better predictive powers (0.647 and 0.644, respectively). Across all definitions, instability ranged between 5.4 and 19.6%. CONCLUSION The adolescent definitions show considerable amount of instability defined as poor agreement and low discriminative abilities tracked into early adulthood.
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Affiliation(s)
- Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anita Eftekharzadeh
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Ghareh
- Faculty of Medicine, Islamic Azad University, Mashhad Medical Branch, Mashhad, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Asghari G, Yuzbashian E, Mirmiran P, Hooshmand F, Najafi R, Azizi F. Dietary Approaches to Stop Hypertension (DASH) Dietary Pattern Is Associated with Reduced Incidence of Metabolic Syndrome in Children and Adolescents. J Pediatr 2016; 174:178-184.e1. [PMID: 27156186 DOI: 10.1016/j.jpeds.2016.03.077] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 03/02/2016] [Accepted: 03/31/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess the association of adherence to Dietary Approaches to Stop Hypertension (DASH)-style diet with development of metabolic syndrome (MetS) in children and adolescents. STUDY DESIGN Dietary data were collected using a valid and reliable food frequency questionnaire among 425 healthy subjects, aged 6-18 years. MetS was defined as the presence of at least 3 of the following according to the Cook criteria: waist circumference ≥90th percentile for sex and age according to national reference curves; systolic blood pressure and/or diastolic blood pressure ≥90th percentile for sex, age, and height; fasting plasma glucose ≥100 mg/dL; triglycerides ≥110 mg/dL; and high-density lipoprotein cholesterol <40 mg/dL. The DASH-style diet score was assessed based on 8 components: high intakes of whole grain, vegetables, fruits, nuts, legumes; moderate amounts of low-fat dairy products; and low intake of red and processed meat, sweetened beverages, and sodium. Multivariable logistic regression models were used to estimate the OR and 95% CI after 3.6 years of follow-up for developing MetS in each quartile of DASH score after adjustment for baseline confounders. RESULTS Mean ± SD for age and DASH score were 13.6 ± 3.7 years and 24.1 ± 4.3, respectively, at baseline. The OR (95% CI) of developing MetS in the highest, compared with the lowest, quartile of DASH score was 0.36 (0.14-0.94) with a linear decreasing trend (P for trend = .023). Also, incidence of hypertension, high fasting plasma glucose, and abdominal obesity decreased with higher adherence to DASH diet (P < .05 for all). CONCLUSIONS Our findings indicate the relationship of adherence to DASH-style diet with MetS and some of its components in both children and adolescents.
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Affiliation(s)
- Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Emad Yuzbashian
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Hooshmand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Najafi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mukherjee S, Leong HF, Wong XX. Waist circumference percentiles for Singaporean children and adolescents aged 6-17 years. Obes Res Clin Pract 2016; 10 Suppl 1:S17-S25. [PMID: 27180165 DOI: 10.1016/j.orcp.2016.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 03/26/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
AIM Population-specific waist circumference (WC) percentiles are crucial for screening children at higher obesity-related metabolic risk. This study aimed to develop age- and gender-specific WC percentile curves for Singaporean children and adolescents. METHODS 3029 participants (boys, 1506; girls, 1523) from different population strata of Singapore were recruited. Stature, weight and WC were measured and BMI calculated. Smoothed WC percentile curves and cut-offs for the 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th, 97th were constructed using the Cole's LMS method. RESULTS WC and BMI increased with age in both sexes and boys had higher WC than girls at every age. Comparison of 50th and 90th percentiles with other populations showed distinct difference in WC curve patterns and values of Singaporean children. CONCLUSIONS We present the first working WC percentile curves and age- and gender-specific cut-offs of Singaporean children and adolescents. These cut-offs and curves can serve as valuable reference for screening and identify children at a higher metabolic risk, for international comparisons and to better understand secular trends in paediatric obesity.
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Prediction of metabolic syndrome by a high intake of energy-dense nutrient-poor snacks in Iranian children and adolescents. Pediatr Res 2016; 79:697-704. [PMID: 26717004 DOI: 10.1038/pr.2015.270] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 10/16/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Our aim was to investigate the relationship between metabolic syndrome (MetS) and energy-dense nutrient-poor solid snacks intakes during 3.6 y of follow-up among children and adolescents. METHOD This population-based longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study, on 424 MetS free subjects, aged 6-18 y. Data on consumption of energy-dense nutrient-poor solid snacks, sweet and salty snacks, were collected at baseline (2006-2008). Logistic regression, adjusted for age, sex, total energy intake, physical activity, dietary fiber, family history of diabetes, and body mass index, was used to assess the relationship between snacks and incident MetS. RESULTS After adjustment for confounders, compared with the lowest quartile of total energy-dense nutrient-poor solid snacks, odds ratio of incident MetS in the highest quartile was 3.04 (95% confidence interval (CI): 1.11-8.49); for sweet snacks this was 2.88 (95% CI: 1.00-8.32), and for salty ones it was 2.85 (95% CI: 1.09-7.43). The risk of incident hypertension in the highest, compared with the lowest quartile of total and salty snacks, was 2.99 (95% CI: 1.00-8.93) and 3.35 (95% CI: 1.10-10.17), respectively. CONCLUSION Energy-dense nutrient-poor solid snacks, both salty and sweet, may have undesirable effects on the incidence of MetS, with salty snacks having the potential to increase risk of incident hypertension in children and adolescents as well.
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Ewald DR, Haldeman PhD LA. Risk Factors in Adolescent Hypertension. Glob Pediatr Health 2016; 3:2333794X15625159. [PMID: 27335997 PMCID: PMC4784559 DOI: 10.1177/2333794x15625159] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 11/27/2015] [Accepted: 11/30/2015] [Indexed: 12/12/2022] Open
Abstract
Hypertension is a complex and multifaceted disease, with many contributing factors. While diet and nutrition are important influences, the confounding effects of overweight and obesity, metabolic and genetic factors, racial and ethnic predispositions, socioeconomic status, cultural influences, growth rate, and pubertal stage have even more influence and make diagnosis quite challenging. The prevalence of hypertension in adolescents far exceeds the numbers who have been diagnosed; studies have found that 75% or more go undiagnosed. This literature review summarizes the challenges of blood pressure classification in adolescents, discusses the impact of these confounding influences, and identifies actions that will improve diagnosis and treatment outcomes.
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Affiliation(s)
- D Rose Ewald
- The University of North Carolina at Greensboro, NC, USA
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Asghari G, Yuzbashian E, Mirmiran P, Mahmoodi B, Azizi F. Fast Food Intake Increases the Incidence of Metabolic Syndrome in Children and Adolescents: Tehran Lipid and Glucose Study. PLoS One 2015; 10:e0139641. [PMID: 26447855 PMCID: PMC4598125 DOI: 10.1371/journal.pone.0139641] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 09/14/2015] [Indexed: 11/18/2022] Open
Abstract
The aim of the study was to evaluate the association between fast food consumption and incidence of metabolic syndrome (MetS) and its components among children and adolescents over a 3.6 year follow-up. Dietary data of 424 healthy subjects, aged 6–18 years, was collected using a valid and reliable food frequency questionnaire. Metabolic syndrome was defined according to the Cook et al criteria. Consumption of fast foods including hamburgers, sausages, bologna (beef), and fried potatoes was calculated and further categorized to quartiles. Multiple logistic regression models were used to estimate the incidence of MetS and its components in each quartile of fast food intake. The incidence of MetS was 11.3% after a 3.6 year follow up. In the fully adjusted model, compared to the lowest quartile of fast food intake, individuals in the highest had odds ratios of 2.96 (95% CI: 1.02–8.63; P for trend<0.001), 2.82 (95% CI: 1.01–7.87; P for trend = 0.037), and 2.58 (95% CI: 1.01–6.61; P for trend = 0.009) for incidence of MetS, hypertriglyceridemia, and abdominal obesity, respectively. No significant association was found between fast food intakes and other components of MetS. Fast food consumption is associated with the incidence of MetS, abdominal obesity, and hypertriglyceridemia in Tehranian children and adolescents.
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Affiliation(s)
- Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Emad Yuzbashian
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - Behnaz Mahmoodi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hosseinpanah F, Salehpour M, Asghari G, Barzin M, Mirmiran P, Hatami H, Azizi F. "Adolescent metabolic phenotypes and early adult metabolic syndrome: Tehran lipid and glucose study". Diabetes Res Clin Pract 2015; 109:287-92. [PMID: 26026779 DOI: 10.1016/j.diabres.2015.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 12/20/2014] [Accepted: 05/03/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the predictive role of adolescent metabolic phenotypes in development of early adult metabolic syndrome (MetS). STUDY DESIGN A group of 1446 adolescents (44.8% boys), participants of the Tehran Lipid and Glucose Study, with a mean (SD) of age 14.6 (2.2) years, followed for 10.4 years. Logistic regression models were developed to evaluate the predictive power of different metabolic phenotypes for adult MetS. Moreover, areas under the receiver operating characteristic (ROC) curve were estimated to compare the prediction power of metabolic phenotypes for adult MetS. RESULTS The prevalence of MetS was 14.6% (29.7% and 2.4% for adult males and females, respectively) at the end of follow up. The most frequent metabolic phenotype in adolescent was high TGs/low HDL-C (23.7%), while the prevalence of high TGs/high WC was 10.4% and the other phenotypes were less than 10%. After adjustment for baseline BMI Z-Score and BMI change, high TGs/low HDL-C (OR: 1.70, 95%CI: 1.23-2.37), high WC/high BP (OR: 1.75., 95%CI: 1.08-2.84), high BP/low HDL-C (OR:1.68, 95%CI: 1.05-2.60) and high WC/low HDL-C (OR: 2.41, 95% CI: 1.37-4.23) phenotypes were associated with adult MetS. However, their AUCs were significantly lower than overweight or obesity. CONCLUSION Some combinations of metabolic abnormalities in adolescence predict early adult MetS, independent of baseline BMI Z-Score and BMI change. However, the discriminative power of these phenotypes was weak, in comparison to adolescent overweight or obesity.
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Affiliation(s)
- Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
| | - Mostafa Salehpour
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Hatami
- Department of Public Health, Shahid Beheshti University of medical science, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mirmiran P, Yuzbashian E, Asghari G, Hosseinpour-Niazi S, Azizi F. Consumption of sugar sweetened beverage is associated with incidence of metabolic syndrome in Tehranian children and adolescents. Nutr Metab (Lond) 2015. [PMID: 26225136 PMCID: PMC4518610 DOI: 10.1186/s12986-015-0021-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Intakes of high sugar-sweetened beverages (SSBs) in adults can escalate risk of metabolic syndrome (MetS); however, data of longitudinal studies in children and adolescents are lacking. In this study we assessed consumption of SSBs in relation to incidence of MetS among children and adolescents during a 3.6 year follow-up. Methods This study was a population-based longitudinal study, in which 424 subjects, aged 6–18 years, from the Tehran Lipid and Glucose Study with complete data on dietary intake, blood pressure, anthropometry, and biochemical indices were followed for 3.6 years. Dietary intake was collected using a valid and reliable food frequency questionnaire. MetS was defined according to the Cook criteria. Sugar sweetened beverages included all kinds of sugar sweetened carbonated soft drinks (SSSDs) and fruit juice drinks. Results Average daily intakes of SSSD and fruit juice drinks were 38.5 ± 75.0 and 32.3 ± 60.1 g, respectively. After adjustment for confounders, compared to the first quartile, the odds ratio of incident MetS in the highest quartile of SSB and SSSD was 3.20 (95 % CI: 1.06–9.90) and 3.01 (95 % CI: 1.17–7.74), respectively. Regarding incidence of MetS components, compared with the lowest quartile, the highest quartile of SSSDs showed odds ratios of 2.49 (95 % CI: 1.00–6.53) for abdominal obesity and 2.79 (95 % CI: 1.02–7.64) for hypertension. No significant association was found between consumption of fruit juice drink and SSSD with other components of MetS. Conclusions Children and adolescents with high intakes of carbonated beverages could be at increased risk of MetS, abdominal obesity, and hypertension.
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Affiliation(s)
- Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Emad Yuzbashian
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Hosseinpour-Niazi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Amiri P, Ghofranipour F, Jalali-Farahani S, Ahmadi F, Hosseinpanah F, Hooman HA, Parvin P, Ghasemi M. Inventory of Determinants of Obesity-Related Behaviors in Adolescents: Development and Psychometric Characteristics. Int J Endocrinol Metab 2015; 13:e24618. [PMID: 26401142 PMCID: PMC4577734 DOI: 10.5812/ijem.24618v2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 04/08/2015] [Accepted: 05/13/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The rising prevalence of childhood obesity is a major health problem worldwide. Hence, there is a growing need for health professionals to become capable of assessing the factors that determine lifestyle in a culturally relevant manner. OBJECTIVES This study aimed to develop and assess a questionnaire for measuring determinants of obesity-related behaviors in Tehranian adolescents. PATIENTS AND METHODS Based on the results of a qualitative study and an extensive literature review, the 44-item "Inventory of determinants of obesity-related behaviors in adolescents (IDOBA)" with eight subscales was developed: 1) unhealthy nutrition and physical inactivity; 2) stress-related eating; 3) perceived inability; 4) perceived lack of threat; 5) perceived priority of educational achievement; 6) perceived acceptability; 7) motivation loss; and 8) lack of support. Validity of IDOBA was assessed, utilizing face, content, and construct validity methods. To confirm face validity, ten overweight/obese adolescents completed the questionnaire. To calculate content validity ratio (CVR) and content validity index (CVI), a different panel of ten experts commented independently on the necessity, relevance, clarity, and simplicity of each item. To assess construct validity using exploratory factor analysis (EFA), a total of 478 adolescents (57.7% male) aged 13 to 18 years, who were recruited from schools, participated in the study. Confirmatory factor analysis (CFA) was used to test whether the data fit the hypothesized measurement model that was derived from EFA. Test-retest and internal consistency methods were used to assess reliability of the IDOBA scale. RESULTS All items were perceived as relevant and comprehendible by adolescents. Content validity was confirmed by the panel of experts. The internal consistency, as measured by Cronbach's alpha coefficients, exceeded the minimum reliability standard of 0.60 for eight subscales. No ceiling effects were observed. Detected floor effects ranged from 0.2% for perceived acceptability subscale score to 18.8% for lack of threat subscale score. The EFA suggested an eight-factor construct and the results of the CFA indicated acceptable fit indices for the proposed model. All subscales demonstrated satisfactory test-retest reliability (intra-class correlation coefficient, 0.42 - 0.91) over one month. CONCLUSIONS Results provided initial evidence that the IDOBA is a valid and reliable instrument for measuring determinants of obesity-related behaviors in Iranian adolescents, indicating that the questionnaire can be used in future weight management programs for Tehranian adolescents.
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Affiliation(s)
- Parisa Amiri
- Research Center for Social Determinants of Endocrine Health, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Fazlollah Ghofranipour
- Department of Health Education, Tarbiat Modares University, Tehran, IR Iran
- Corresponding author: Fazlollah Ghofranipour, Department of Health Education, Tarbiat Modares University, P. O. Box: 14115-111, Tehran, IR Iran. Tel: +98-2182883869, E-mail:
| | - Sara Jalali-Farahani
- Research Center for Social Determinants of Endocrine Health, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Tarbiat Modares University, Tehran, IR Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Haidar Ali Hooman
- Department of Psychology, Shahid Beheshti University, Tehran, IR Iran
| | - Parnian Parvin
- Research Center for Social Determinants of Endocrine Health, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Students' Research Committee, Shahid Beheshti University of Medical Sciences, Tehran,IR Iran
| | - Mohammadreza Ghasemi
- Research Center for Social Determinants of Endocrine Health, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Students' Research Committee, Shahid Beheshti University of Medical Sciences, Tehran,IR Iran
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Ghotboddin Mohammadi S, Mirmiran P, Bahadoran Z, Mehrabi Y, Azizi F. The Association of Dairy Intake With Metabolic Syndrome and Its Components in Adolescents: Tehran Lipid and Glucose Study. Int J Endocrinol Metab 2015; 13:e25201. [PMID: 26425126 PMCID: PMC4584419 DOI: 10.5812/ijem.25201v2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 04/08/2015] [Accepted: 04/27/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Epidemiological studies have shown that consumption of dairy product plays an important role in prevention and treatment of Metabolic Syndrome (MetS). OBJECTIVES The objective of this study was to examine the association of dairy intake with MetS and its components in Tehranian adolescents. PATIENTS AND METHODS In this cross-sectional study, 785 adolescent aged 10 to 19 years, participated from the fourth phase of the Tehran Lipid and Glucose Study. Usual dietary intake was assessed using a valid semi quantitative food frequency questionnaire. Total dairy, low fat and high fat dairy, milk, yoghurt and cheese were evaluated. Assessment of anthropometric, biochemical and blood pressure was performed and MetS was defined according to the de Ferranti criteria. RESULTS The mean age of subjects was 14.8 ± 2.9 years. The prevalence of MetS was 22.2% (girls: 19.5% and boys: 25.2%). The most prevalent risk factor for MetS in boys was high waist circumference (53.4%) and among girls was low HDL-C (53.1%). Energy density and intake of protein, total fat, saturated fat, cholesterol, calcium and phosphor were higher in the highest quartile of dairy consumption than the lowest quartile. After adjustments for confounders, odds ratios with 95% confidence interval for MetS in the highest quartile of total dairy, low fat dairy, high fat dairy, milk, yoghurt and cheese compared with lowest quartile were respectively 0.97 (0.57 - 1.66), 1.44 (0.83 - 2.49), 0.97 (0.56 - 1.67), 0.70 (0.42 - 1.18), 1.62 (0.99 - 2.64) and 0.72 (0.44 - 1.18). CONCLUSIONS Results of this study did not support the hypothesis that dairy products consumption protects against MetS and its components.
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Affiliation(s)
- Shirin Ghotboddin Mohammadi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Tehran, IR Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Parvin Mirmiran, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Tehran, IR Iran. Tel: +98-2122357484, Fax: +98-2122416264; 22402463, E-mail:
| | - Zahra Bahadoran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Tehran, IR Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Alizadeh M, Didarloo A, Esmaillzadeh A. Dietary Patterns of Young Females and Their Association With Waist Circumference as a Health Index in Northwest of Iran, 2007. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e17594. [PMID: 26082846 PMCID: PMC4464382 DOI: 10.5812/ircmj.17(5)2015.17594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 08/13/2014] [Accepted: 11/24/2014] [Indexed: 12/26/2022]
Abstract
Background: Despite the higher prevalence of overweight and obesity among young people in western countries, the 50th and 95th percentile ranks for waist circumference in the Iranian young Females are higher than those of the western ones. Objectives: Identifying major dietary patterns in Iranian young females, which associate with central obesity, can probably explain the difference between Iranian young females’ pattern and those of their western peers regarding obesity. Patients and Methods: In the current cross-sectional study, a total of 257 young females aged 11 - 15 years old from Talaat Intelligent Guidance School, Tabriz, Iran (2007) were selected for the study using non-probability simple sampling method. Then, usual dietary intakes of all subjects were evaluated by a food frequency questionnaire and anthropometric measurements such as weight, height, waist circumference, and Body Mass Index (BMI) using the standard protocols. Data were analyzed by inferential statistics (One-way ANOVA, Tukey test for Post-Hoc Analysis, Chi-square test, age-adjusted means, analysis of covariance with Bonferroni correction, correlation and partial correlation) by SPSS software. Results: In the current study, six major dietary patterns were extracted using factor analysis method. Before and after controlling the age, subjects in the upper tertile of the Iranian Central Obesity Making Dietary Pattern (rich in cruciferous vegetables, green leafy vegetables, soft drinks, tomatoes, other vegetables and vegetable oils) had larger waist circumference in comparison with the ones in the lower tertile (before controlling for age: 64.2 ± 9 vs. 61.6 ± 7 P = 0.03; after: 64.5 ± 0.8 vs. 61.5 ± 0.8, P = 0.009). However in lacto vegetarian dietary pattern (rich in legumes, potato, other vegetables, dough, high-fat dairy products and margarine), individuals in the upper tertile had significantly lower weight, waist circumference and body mass index (BMI) in comparison with the ones in the lower tertile (weight: 44.9 ± 9.3 vs. 51.4 ± 10.6, P < 0.01; WC: 59.9 ± 8 vs. 64 ± 7.9, P < 0.01; BMI: 18.6 ± 3.1 vs. 20.6 ± 3.5, P < 0.01). Conclusions: The current study findings suggest that the Iranian Central Obesity Making Dietary Pattern is directly associated with waist circumference (marker of central obesity), while lacto vegetarian dietary pattern is reversely associated with weight, waist circumference and BMI. Special obesity pattern in Iranian young females can be justified by Iranian Central Obesity Making Dietary Pattern”.
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Affiliation(s)
- Mohammad Alizadeh
- Food and Beverages Safety Research Center, Department of Nutrition, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, IR Iran
| | - Alireza Didarloo
- Social Determinants of Health Research Center, Department of Health and Preventive Medicine, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, IR Iran
- Corresponding Author: Alireza Didarloo, Social Determinants of Health Research Center, Department of Health and Preventive Medicine, Faculty of Medicine, Urmia University of Medical Sciences, P. O. Box: 57561-15111, Urmia, IR Iran. Tel: +98-4412752372, Fax: +98-4412780800, E-mail:
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran
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Faghih S, Keshani P, Salar A, Rajaei SH, Mirzaei Z, Moosavi SM, Hematdar Z. Assessment of Obesity, Unhealthy Food Habits, and Nutritional Knowledge of Primary School Children. INTERNATIONAL JOURNAL OF SCHOOL HEALTH 2015. [DOI: 10.17795/intjsh-25186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ahadi Z, Shafiee G, Qorbani M, Sajedinejad S, Kelishadi R, Arzaghi SM, Larijani B, Heshmat R. An overview on the successes, challenges and future perspective of a national school-based surveillance program: the CASPIAN study. J Diabetes Metab Disord 2014; 13:120. [PMID: 25614853 PMCID: PMC4302132 DOI: 10.1186/s40200-014-0120-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 12/02/2014] [Indexed: 12/25/2022]
Abstract
The Childhood and Adolescence Surveillance and PreventIon of Adult Non-communicable disease (CASPIAN) study is implemented in the Islamic Republic of Iran from 2003. The aim of this national school- based surveillance program was to provide accurate data of regular surveys of this program to be reviewing methodology, protocols, data collection and questionnaires of these surveys. Information was obtained from articles and books were published from CASPIAN studies. The CASPIAN studies were repeated every two years, with blood sampling for biochemical factors every four years. Methods and questionnaires of all surveys were similar at their core level and some optional factors added in different surveys. The results of CASPIAN studies represent the public health of Iranian children and adolescents that are useful for policy makers and based on them, intervention programs can set in national and sub-national level.
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Affiliation(s)
- Zeinab Ahadi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Department of Public Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Sima Sajedinejad
- National Professional Officer, World Health Organization Office in Iran, Tehran, Iran
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center and Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Salehi-Abargouei A, Shiranian A, Ehsani S, Surkan PJ, Esmaillzadeh A. Caesarean delivery is associated with childhood general obesity but not abdominal obesity in Iranian elementary school children. Acta Paediatr 2014; 103:e383-7. [PMID: 24903542 DOI: 10.1111/apa.12711] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 03/03/2014] [Accepted: 06/02/2014] [Indexed: 11/29/2022]
Abstract
AIM This study examined the association between Caesarean delivery and general and abdominal obesity among children. METHODS In a cross-sectional study, 635 children aged from 6 to 12 years of age (476 girls and 159 boys) were randomly selected from Isfahan elementary schools. Weight, height and waist circumference were measured. General obesity and abdominal obesity were defined based on World Health Organization growth charts and Iranian national cut-off points, respectively. Parents were asked about delivery type and other factors potentially related to childhood obesity using a self-administered questionnaire. The association between delivery type and obesity was examined using univariate and multivariate logistic regression models. RESULTS The overall prevalence of general and central obesity was 17.6% and 17.1%, respectively, and Caesarean delivery was significantly associated with general obesity after controlling for potential confounders (OR: 2.46; 95% CI: 1.30-4.63, p = 0.005). We observed a significant association between Caesarean delivery and abdominal obesity in crude analyses (OR: 1.66; 1.02-2.69, p = 0.04), but this disappeared after adjusting for covariates (OR: 1.96; 0.82-4.69, p = 0.13). CONCLUSION Our results suggest that Caesarean delivery is adversely associated with general childhood obesity, but not abdominal obesity. This provides support for recommending vaginal births, unless contraindicated. Further research in large populations is required to confirm these findings.
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Affiliation(s)
- Amin Salehi-Abargouei
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
- Student Research Committee; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
| | - Afshin Shiranian
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
- Student Research Committee; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
| | - Simin Ehsani
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
- Student Research Committee; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
| | - Pamela J. Surkan
- Department of International Health; Johns Hopkins Bloomberg School of Public Health; Baltimore MD USA
| | - Ahmad Esmaillzadeh
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
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Rafraf M, Hasanabad SK, Jafarabadi MA. Vitamin D status and its relationship with metabolic syndrome risk factors among adolescent girls in Boukan, Iran. Public Health Nutr 2014; 17:803-9. [PMID: 24477119 PMCID: PMC10282248 DOI: 10.1017/s1368980013003340] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 10/15/2013] [Accepted: 10/17/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate vitamin D status and its association with components of the metabolic syndrome (MetS) in adolescent girls attending high school in Boukan, Iran during winter 2012. DESIGN A cross-sectional study. SETTING High schools of Boukan city, Iran. SUBJECTS A sample of 216 girls aged 14-17 years was selected by multistage random sampling from four districts of Boukan. Weight, height, waist circumference, blood pressure, daily energy intake, physical activity and serum 25-hydroxyvitamin D (25(OH)D), fasting blood glucose, TAG and HDL-cholesterol levels of all participants were evaluated. Serum 25(OH)D level <20 ng/ml was defined as vitamin D deficiency. RESULTS Mean serum 25(OH)D was 7.26 (sd 2.81) ng/ml and 96 % of the participants had vitamin D deficiency. According to age-modified definitions of the National Cholesterol Education Program Adult Treatment Panel III, MetS was diagnosed in 10.6% of the participants. In multivariable regression analysis after adjustment for BMI, energy intake and physical activity level, serum 25(OH)D was inversely associated with fasting blood glucose (β = -0.143, P = 0.04). No significant relationship was found between serum 25(OH)D and other components of MetS. CONCLUSIONS The high prevalence of vitamin D deficiency warrants national polices and interventions towards improving this major health problem among adolescent girls. Low 25(OH)D level was significantly associated with increased fasting blood glucose. Prospective studies are needed to determine the effects of vitamin D deficiency on the development of MetS and related metabolic diseases in adolescent girls.
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Affiliation(s)
- Maryam Rafraf
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Saadat Karimi Hasanabad
- Students' Research Committee, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Mohammad Asghari Jafarabadi
- Medical Education Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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Mohammadi F, Qorbani M, Kelishadi R, Baygi F, Ardalan G, Taslimi M, Mahmoudarabi M, Motlagh ME, Asayesh H, Larijani B, Heshmat R. Association of cardiometabolic risk factors and hepatic enzymes in a national sample of Iranian children and adolescents: the CASPIAN-III study. J Pediatr Gastroenterol Nutr 2014; 58:463-8. [PMID: 24253369 DOI: 10.1097/mpg.0000000000000246] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Elevated liver enzymes including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) may be associated with metabolic syndrome (MetS) and cardiovascular disease. We investigated the association of cardiometabolic risk factors and liver enzymes in a nationally representative sample of Iranian children and adolescents. METHODS The national study was conducted in the framework of the third survey of Childhood and Adolescence Surveillance and PreventIon of Adult Non-communicable Disease study. Subjects were 3948 students (1942 girls, 67.55% urban, mean age 14.7 ± 2.4 years) who were recruited by multistage random cluster sampling from 27 provincial counties in Iran. Physical examination and laboratory tests were conducted under standard protocols. RESULTS Participants with elevated serum ALT had higher levels of almost all cardiometabolic risk factors than other participants; this difference was not significant for fasting blood glucose, total cholesterol, and diastolic blood pressure in both sexes, as well as low-density lipoprotein cholesterol in girls. Participants with generalized and abdominal obesity, MetS, elevated blood pressure, triglycerides, and total cholesterol had increased risk for elevated ALT; this risk remained significant after adjusting for sex and age. Low high-density lipoprotein cholesterol was found as a predictor for both elevated ALT (odds ratio 2.182, 95% confidence interval 1.533-3.105) and AST (odds ratio 2.022, 95% confidence interval 1.438-2.844) even after adjusting for all potential confounders. General (B 0.158, SE 0.030) and abdominal obesity (B 0.058, SE 0.029), MetS (B 0.231, SE 0.048), and triglycerides (B 0.094, SE 0.030) were associated with ALT:AST ratio after adjusting for all potential confounders (P < 0.001). CONCLUSIONS We documented strong relations of elevated ALT, AST levels, and ALT:AST ratio with most cardiometabolic risk factors. This relation was independent of anthropometric indexes. Liver enzymes can be considered as a cardiometabolic risk factor from childhood, and as an additional component of the MetS.
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Affiliation(s)
- Fatemeh Mohammadi
- *Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran †Department of Public Health, Alborz University of Medical Sciences, Karaj ‡Pediatrics Department, Child Growth and Development Research Center, and Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan §Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran ¶Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz #Department of Medical Emergencies, Qom University of Medical Sciences, Qom **Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Kelishadi R, Poursafa P. A review on the genetic, environmental, and lifestyle aspects of the early-life origins of cardiovascular disease. Curr Probl Pediatr Adolesc Health Care 2014; 44:54-72. [PMID: 24607261 DOI: 10.1016/j.cppeds.2013.12.005] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 12/04/2013] [Indexed: 12/29/2022]
Abstract
This article is a comprehensive review on developmental origins of health and disease regarding various factors related to the origins of cardiovascular diseases from early life. It presents a summary of the impacts of various factors such as epigenetics; gene-environment interaction; ethnic predisposition to cardiovascular diseases and their underlying risk factors; prenatal factors; fetal programming; maternal weight status and weight gain during pregnancy; type of feeding during infancy; growth pattern during childhood; obesity; stunting; socioeconomic status; dietary and physical activity habits; active, secondhand, and thirdhand smoking, as well as environmental factors including air pollution and global climate change on the development and progress of cardiovascular diseases and their risk factors. The importance of early identification of predisposing factors for cardiovascular diseases for primordial and primary prevention of cardiovascular diseases from early life is highlighted.
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Affiliation(s)
- Roya Kelishadi
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parinaz Poursafa
- Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Rahmanian M, Kelishadi R, Qorbani M, Motlagh ME, Shafiee G, Aminaee T, Ardalan G, Taslimi M, Poursafa P, Asayesh H, Larijani B, Heshmat R. Dual burden of body weight among Iranian children and adolescents in 2003 and 2010: the CASPIAN-III study. Arch Med Sci 2014; 10:96-103. [PMID: 24701221 PMCID: PMC3953979 DOI: 10.5114/aoms.2014.40735] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 02/15/2013] [Accepted: 03/25/2013] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Our aim was to compare changes of body mass index (BMI) and waist circumference (WC) curves of Iranian children by comparing the results of two national surveys of a surveillance program, i.e. CASPIAN-I (2003-2004) and CASPIAN-III (2009-2010). The second objective was to evaluate the prevalence of obesity, overweight and underweight among 10-18-year-old Iranian children and adolescents. MATERIAL AND METHODS This study was performed among students who were selected by multistage random cluster sampling from urban and rural areas of 27 provinces of Iran, as part of a national survey of school student high risk behavior entitled CASPIAN-III, conducted in 2009-2010. RESULTS We evaluated 5088 school students (50.2% boys). In rural areas, underweight was more common in boys and overweight and obesity in girls. In urban areas underweight and obesity were more common in boys, whereas overweight was more common in girls. The highest prevalence of underweight (23.5%) was seen in students aged 13 years and the lowest (11.4%) in those aged 18 years. Underweight was significantly more common in rural than in urban areas (22.1% vs. 15.8%, respectively, p < 0.0001) and overweight/obesity was more common in urban than in rural areas. Compared with the findings in 2003-2004, the overall prevalence of elevated body mass index (16.6%) including obesity (9.1%) and overweight (7.5%) as well as underweight (17.5%) increased from 2003 to 2010. CONCLUSIONS In recent years, the double burden of nutritional disorders has increased among Iranian children and adolescents, especially in rural areas. This change may be related to epidemiologic transition, notably in terms of nutrition transition and rapid changes in lifestyle habits. This finding is an important issue for policy-makers for interventional preventive programs.
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Affiliation(s)
- Masoud Rahmanian
- Yazd Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Department of Public Health, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Esmaeil Motlagh
- Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center (CDRC), Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Aminaee
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Gelayol Ardalan
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mahnaz Taslimi
- Bureau of Health and Fitness, Ministry of Education and Training, Tehran, Iran
| | - Parinaz Poursafa
- Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Bagher Larijani
- Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center (CDRC), Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Amiri P, Jalali-Farahani S, Zarkesh M, Barzin M, Kaviani R, Ahmadizad S. Reliability and validity of the Iranian version of the QAPACE in adolescents. Qual Life Res 2014; 23:1797-802. [PMID: 24563109 DOI: 10.1007/s11136-014-0625-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to determine the reliability and validity of the Iranian version of the Quantification de l'Activite Physique en Altitude Chez les Enfants (QAPACE) in adolescents. METHODS After linguistic validation, the Iranian version of the QAPACE was completed by 359 (52.4 % girls) schoolchildren, aged 15-18 years. Test-retest reliability of the questionnaire was determined by intraclass correlation coefficients (ICCs). For validation purposes, two methods were used for (1) the correlation between VO2peak and the DEE and (2) known-group validity, which was examined by comparing the normal weight adolescents and those who were overweight/obese. RESULTS ICCs for test-retest ranged from 0.79 to 0.98. The mean scores in test-retest surveys for total score and all of the subscores were significant (p < 0.05). Sex-specific analysis showed a significant correlation between VO2peak and DEE over 12-month, school, and vacation periods in girls (p < 0.05). The mean values for all activities except for transportation, other activities in school, personal artistic activities, sport competition, and home activities were significantly lower in overweight/obese group than normal group. CONCLUSION Our results support the initial reliability and validity of the Iranian version of QAPACE as a daily physical activity measure in adolescents.
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Affiliation(s)
- Parisa Amiri
- Research Center for Social Determinants of Endocrine Health, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hosseinpanah F, Asghari G, Barzin M, Ghareh S, Azizi F. Adolescence metabolic syndrome or adiposity and early adult metabolic syndrome. J Pediatr 2013; 163:1663-1669.e1. [PMID: 24011762 DOI: 10.1016/j.jpeds.2013.07.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 06/20/2013] [Accepted: 07/19/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate the predictive role of adolescent metabolic syndrome (MetS) in development of early adult MetS, independent of adult body mass index (BMI). STUDY DESIGN 1424 adolescents (639 boys), participants of the Tehran Lipid and Glucose Study, followed for 10.4 years, were analyzed and logistic regression models were developed. Using the areas under the receiver operating characteristic curve, the discriminatory ability of adolescent MetS and overweight or obesity was evaluated. Net reclassification improvement was calculated to determine the accuracy of classification by adolescent MetS in place of overweight or obesity. RESULTS The mean ± SD of age and BMI were 14.6 ± 2.2 years and 20.3 ± 4.2 kg/m(2), respectively. The prevalence of MetS was 13.3% and 14.6% at baseline and after follow-up, respectively. The risk of developing early adult MetS among subjects who were overweight or obese in adolescence but nonobese as adults (OR: 1.65) was lower than the risk among subjects who were obese as adults but nonobese as adolescents (OR: 8.45). After adjustment for adult BMI, adolescent MetS and overweight or obesity did not show any association with the risk of adult MetS. Area under the receiver operating characteristic curve was higher for obesity (0.619) than MetS (0.589) and the net reclassification improvement value for MetS was 1.5% (P = .398). CONCLUSION Adolescent MetS or adiposity did not predict early adult MetS independent of adult BMI. The addition of adolescent MetS to obesity does not improve the predictive power for early adult MetS.
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Affiliation(s)
- Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Bamoshmoosh M, Massetti L, Aklan H, Al-Karewany M, Goshae HA, Modesti PA. Central obesity in Yemeni children: A population based cross-sectional study. World J Cardiol 2013; 5:295-304. [PMID: 24009819 PMCID: PMC3761183 DOI: 10.4330/wjc.v5.i8.295] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 06/20/2013] [Accepted: 07/25/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To establish percentile curves and to explore prevalence and correlates of central obesity among Yemeni children in a population based cross-sectional study.
METHODS: A representative sample of 3114 Yemeni children (1564 boys, 1550 girls) aged 6-19 years participating in the HYpertension and Diabetes in Yemen study was studied. Data collection was conducted at home by survey teams composed of two investigators of both genders. Study questionnaire included questions about demographics, lifestyle, and medical history. Anthropometric measurements included body weight, height, waist circumference (WC) and hip circumferences. Waist to hip ratio (WHR) and waist-to-height ratio (WHtR) were then calculated. Age and gender specific smoothed percentiles of WC, WHR, and WHtR were obtained using lambda-mu-sigma parameters (LMS method). The independent predictors of central obesity defined as (1) WC percentile ≥ 90th; (2) WHtR ≥ 0.5; or (3) WC percentile ≥ 90th and WHtR ≥ 0.5, were identified at multivariate logistic regression analysis adjusted for age, gender, urban/rural location, years of school education, sedentary/active life-style.
RESULTS: Percentile curves for WC, WHR and WHtR are presented. Average WC increased with age for both genders. Boys had a higher WC than girls until early adolescence and thereafter girls had higher values than boys. WHR decreased both in boys and girls until early adolescence. Thereafter while in boys it plateaued in girls it continued to decrease. Mean WHtR decreased until early adolescence with no gender related differences and thereafter increased more in girls than in boys towards adult age. Prevalence of central obesity largely varied according to the definition used which was 10.9% for WC ≥ 90th percentile, 18.3% for WHtR ≥ 0.5, and 8.6% when fulfilling both criteria. At adjusted logistic regression WC ≥ 90th percentiles and WHtR ≥ 0.5 were less prevalent in rural than in urban areas (OR = 0.52, 95%CI: 0.41-0.67 and 0.66, 0.54-0.79 respectively), being more prevalent in children with sedentary lifestyle rather than an active one (1.52, 95%CI: 1.17-1.98 and 1.42, 95%CI: 1.14-1.75, respectively).
CONCLUSION: Yemeni children central obesity indices percentile curves are presented. Central obesity prevalence varied according to the definition used and was more prevalent in urban sedentary subjects.
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Kuba VM, Leone C, Damiani D. Is waist-to-height ratio a useful indicator of cardio-metabolic risk in 6-10-year-old children? BMC Pediatr 2013; 13:91. [PMID: 23758779 PMCID: PMC3686671 DOI: 10.1186/1471-2431-13-91] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 05/15/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Childhood obesity is a public health problem worldwide. Visceral obesity, particularly associated with cardio-metabolic risk, has been assessed by body mass index (BMI) and waist circumference, but both methods use sex-and age-specific percentile tables and are influenced by sexual maturity. Waist-to-height ratio (WHtR) is easier to obtain, does not involve tables and can be used to diagnose visceral obesity, even in normal-weight individuals. This study aims to compare the WHtR to the 2007 World Health Organization (WHO) reference for BMI in screening for the presence of cardio-metabolic and inflammatory risk factors in 6-10-year-old children. METHODS A cross-sectional study was undertaken with 175 subjects selected from the Reference Center for the Treatment of Children and Adolescents in Campos, Rio de Janeiro, Brazil. The subjects were classified according to the 2007 WHO standard as normal-weight (BMI z score>-1 and<1) or overweight/obese (BMI z score≥1). Systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glycemia, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), Homeostatic Model Assessment--Insulin Resistance (HOMA-IR), leukocyte count and ultrasensitive C-reactive protein (CRP) were also analyzed. RESULTS There were significant correlations between WHtR and BMI z score (r=0.88, p<0.0001), SBP (r=0.51, p<0.0001), DBP (r=0.49, p<0.0001), LDL (r=0.25, p<0.0008, HDL (r=-0.28, p<0.0002), TG (r=0.26, p<0.0006), HOMA-IR (r=0.83, p<0.0001) and CRP (r=0.51, p<0.0001). WHtR and BMI areas under the curve were similar for all the cardio-metabolic parameters. A WHtR cut-off value of >0.47 was sensitive for screening insulin resistance and any one of the cardio-metabolic parameters. CONCLUSIONS The WHtR was as sensitive as the 2007 WHO BMI in screening for metabolic risk factors in 6-10-year-old children. The public health message "keep your waist to less than half your height" can be effective in reducing cardio-metabolic risk because most of these risk factors are already present at a cut point of WHtR≥0.5. However, as this is the first study to correlate the WHtR with inflammatory markers, we recommend further exploration of the use of WHtR in this age group and other population-based samples.
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Affiliation(s)
- Valesca Mansur Kuba
- Reference Center for the Treatment of Children and Adolescents, Campos, Rio de Janeiro, Brazil.
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