فهرست مطالب پروین میرمیران

Prediabetes (Pre-DM), an intermediate dysglycemia characterized by isolated impaired fasting glycemia (i-IFG), isolated impaired glucose tolerance (i-IGT), or combined IFG-IGT, affects about 30% of middle-aged adults. Pre-DM increases the risk of developing type 2 diabetes (T2D), cardiovascular diseases, and death. Little is known about the possible factors affecting the likelihood of Pre-DM regression/progression. This study aimed to review the current evidence obtained from observational studies and clinical trials investigating the association of dietary factors with either the progression of Pre-DM to T2D or its regression to normoglycemia. Observational studies’ findings imply the protective effects of dairy products, fruits, and vegetables and adherence to healthy dietary patterns like the Mediterranean diet and those with a low-glycemic index (GI) against Pre-DM progression, favoring its regression to normoglycemia. The findings of clinical trials indicate that compared to common therapeutic approaches, lifestyle interventions, including dietary modifications and adherence to healthy dietary patterns, have similar/superior significant and sustained effectiveness in delaying or preventing Pre-DM progression. Dietary modifications focusing on restricted energy intake aiming to favor at least a 5% body weight (BW) loss or maintain the ideal BW, diets with higher protein and fiber content, and adherence to low-GI and Mediterranean diets may increase the chance of Pre-DM regression and returning to normoglycemia.

Development of artificial intelligence has provided novel opportunities for research in the field of nutrition sciences. This study was carried out with the aim of reviewing and comprehensively assessing studies linked to the field of diet and food patterns, using artificial intelligence and machine learning algorithms.

All studies published until June 2023 were searched using PubMed Cochrane, EMBASE and SCOPUS databases with associated keywords. No time and language restrictions were used.

After a complete review of the articles, 31 relevant articles were selected that were consistent with the purpose of the present study. Various machine-learning methods have various accuracy in predicting food patterns. For example, intelligent neural network is further accurate in predicting healthy food index quintiles, while it is further accurate in decision tree meals. Another use of machine learning includes extracting food patterns and investigating their relationships with various diseases such as obesity, heart diseases, stroke, risks of death from cardiovascular diseases and cancers. Machine learning methods such as decision trees are able to provide models for predicting adherence to various diets such as the Mediterranean diet.

Various artificial intelligence methods can help better understand food patterns linked to chronic diseases. The most important algorithms in the study of food patterns are decision tree, random forest, K-means, K-nearest neighbor, regression methods, support vector machine and intelligent neural network. These methods can help better understand dietary patterns associated with chronic diseases by categorizing and finding hidden associations between the groups and foods. Further studies are needed to better understand these connections.

This study aimed to determine the association between the quality and quantity of dietary carbohydrate (CHO) with the risk of pre-diabetes (pre-DM) progression to type 2 diabetes (T2D) and the chance of returning to normal glycemia.

 Dietary CHO quantity (total CHO and dietary fiber) and quality (glycemic index, glycemic load, insulin index, and insulin load) were assessed using a 168-item, semi-quantitative, valid, and reliable food frequency questionnaire in 334 men and women with pre-DM at baseline. The participants were followed for a median of 9 years. Fasting and 2-hours (after oral loading of 75 g glucose) plasma glucose concentrations were measured at baseline and subsequent examinations.

 During the study follow-up, 39.8% of the pre-DM subjects progressed to T2D, and 39.8% returned to normal glycemia. Dietary total CHO, glycemic index, glycemic load, insulin index, and insulin load were not significantly associated with pre-DM regression and progression during the study follow-up. A 25% reduced risk of developing T2D was observed per 5 g/1000 kcal per day by the increased dietary intake of fiber (odds ratio: 0.75, 95% CI: 0.58-0.98; P=0.038).

Total CHO intake and its quality were not associated with the change of glycemic status in pre-DM subjects, while higher intakes of dietary fiber decreased the risk of pre-DM progression to T2D.

There is still debate regarding the association between dietary saturated fatty acids (SFA) and the risk of type 2 diabetes mellitus (T2DM). The objective of this study was to investigate the association of dietary SFAs, their food sources, and substitution with other macronutrients, with the risk of T2DM.

The current study was conducted on 2295 adults out of the participants of the Tehran Lipid and Glucose Study (TLGS) based on the inclusion criteria. The baseline intake of SFAs was estimated using a validated 168-item food frequency questionnaire. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of T2DM in tertile categories of SFAs and their different food sources. The risk of T2DM was estimated with multivariable Cox regression for the substitution of SFAs with other macro-nutrients.

Over a median of 8.5 years of follow-up, 10.6% of participants were identified as T2DM patients. The study found no significant associations between the baseline dietary intake of total SFA, lauric acid (LA), myristic acid (MA), palmitic acid (PA), or stearic acid (SA) and the risk of T2DM. However, a higher intake of liquid oils was related to a higher risk of T2DM (HR=1.07, 95% CI=1.00-1.15). Moreover, the substitution of MA for SA was related to an increased risk of T2DM (HR=1.56, 95% CI=1.03-1.93).

There was no significant association between dietary SFAs and the risk of T2DM in the present study. Further prospective studies are needed to clarify the association between dietary fats and T2DM risk.

Various types of fatty acids are simultaneously present in the diet. Therefore, it is important to investigate their combined effects on the occurrence of metabolic diseases. This study aimed to determine the dietary fat quality indices and investigate the relationship between these indices and the risk of metabolic syndrome in an Iranian adult population.

A total of 1713 adults participating in the third phase of the Tehran Lipid and Glucose Study (TLGS), who were free of metabolic syndrome, were selected and followed up to the sixth phase. Dietary intakes were evaluated using a validated food frequency questionnaire. The risk of metabolic syndrome in the sixth phase of TLGS, adjusted for potential confounders, was estimated across the tertiles of all dietary fat quality indices, including atherogenic index, thrombogenic index, health-promoting index, ratio of polyunsaturated fatty acids to saturated fatty acids (PUFA/SFA), ratio of hypo- to hypercholesterolemia, total omega-3 fatty acids, and ratio of linoleic acid to α-linolenic acid (LA/ALA), using Cox proportional hazard regression models.

Over a median of 7.6 years of follow-up (2006-2008 to 2014-2017), 596 cases of metabolic syndrome were identified. After adjustment for confounding variables, there was no significant association between dietary fat quality indices and risk of metabolic syndrome. However, each 1-unit increment in the LA/ALA was associated with a 3% higher risk of metabolic syndrome [hazard ratio (95% confidence interval): 1.03 (1.00-1.01)].

Further prospective studies are needed to clarify the association between dietary fat quality indices and the risk of metabolic syndrome. In the present study, there was no significant association between dietary fat quality indices and metabolic syndrome incidence.

A diabetic wound is a long-term diabetes complication increasing the risk of mortality and amputation-related disability and decreasing the quality of life. Due to incorrect and incomplete use of standard therapies, complementary therapeutic strategies, including elevation of wound nitric oxide (NO) level by using NO donors, precursors, and inducers, have received attention in in vitro studies, animal experiments, and clinical trials. Here, we aimed to review the potential clinical applications of NO in accelerating wound healing in diabetes. Exogenous NO in the gaseous form or as acidified nitrite-containing ointments, NO-containing sprays, and NO-containing hydrogels has been applied in wound healing. Although limited clinical trials have been conducted to assess the efficiency of NO in accelerating diabetic wound healing, 56-100% effectiveness was reported for NO-based treatments compared to standard care. The known physiological functions of NO in wound healing include increasing the local blood flow, inducing angiogenesis, collagen synthesis, re-epithelization, wound closure, and anti-inflammatory effects via enforcing immune responses, and promoting potent broad-spectrum antibacterial effects. Considering the limited existing evidence, clinical trials with predefined effect sizes, i.e., wound area reduction, wound healing rate, and length of hospital stay, are required to confirm the efficiency of NO-based therapies compared to standard treatment.

This study aimed to investigate the relationship between the consumption of refined and whole grains and the risk of the metabolic syndrome in adults.

In this prospective study, the consumption of whole and refined grains was assessed in 1452 subjects who participated in the Tehran Lipid and Glucose Study using a valid and reliable food frequency questionnaire. Metabolic syndrome components were defined based on the Adult Treatment Panel criteria. The Cox regression model was used to investigate the relationship between the consumption of various types of cereals and the components of the metabolic syndrome.

The median of whole grains consumption was 121.7 g per day, and the average consumption of refined grains was 202.2 g per day. Refined grains have a significant and positive association with increased serum triglycerides (risk ratio [RR], 1.03; CI, 1.31-2.18), and abdominal obesity (RR, 1.33; CI, 1.02-1.75) blood pressure (RR, 1.33; CI, 1.01-1.75), and reduction of high-density lipoprotein (HDL; RR, 1.52; CI, 1.25-1.84) after adjustment for confounders. The consumption of whole grains had no relationship with the components of the metabolic syndrome.

Reducing the consumption of refined grains can prevent the occurrence of metabolic syndrome components.

Dietary intakes are one of the factors influencing the incidence of chronic kidney disease. The present study was performed to investigate the possible long-term effects of caffeine, tea and coffee consumption on the incidence of chronic kidney disease.

1780 adults participating in the third phase of the Tehran Lipid and Glucose Study (TLGS) (2006-2008) were selected for inclusion criteria. Dietary intakes were assessed using a food frequency questionnaire (FFQ). Demographic variables, anthropometrics, and biochemical data were measured at baseline and after six years of follow-up. To estimate the risk of chronic kidney disease, logistic regression analysis, adjusted for possible confounding variables, was used.

Participants’ mean (±SD) age at baseline was 33.96±15.40 years. During six years of follow-up, the incidence of chronic kidney disease (CKD) in the population studied was 17.9%. After adjusting confounding variables, the incidence of CKD did not show any significant relationship with tea, coffee, or caffeine intakes (adjusted odds ratio and confidence intervals for CKD in the third tertile of tea and caffeine intake compared to the first tertile and in coffee drinkers compared to non-drinkers were 0.92 (0.68-1.25), 0.87 (0.63-1.21) and 1.17 (0.90-1.51), respectively).

Inverse and non-significant relationship between tea and caffeine consumption with the incidence of CKD and a direct and non-significant relationship between coffee consumption and the incidence of CKD were observed in this study, necessitating further prospective studies to investigate the effects of dietary intakes on CKD.

Spexin, a novel neuropeptide with diverse physiological functions, can be a cardiovascular disease risk assessment biomarker. This study investigated the association between serum spexin concentration and cardiovascular risk factors in children and adolescents.

A search was conducted to collect studies between January 2007 and March 2021 in the PubMed, Embase, and Scopus databases. The keywords "neuropeptide Q" and "spexin," along with keywords related to diabetes, inflammation, metabolic syndrome, and cardiovascular disease, were used for the search.

A total of 11 full-text articles were included in the study. In six of the studies, the spexin level was lower in obese children and adolescents than in normal-weight individuals, and the difference was significant in four of them (p <0.05). An inverse relationship was observed between spexin and insulin resistance in six of the studies; however, no correlation was found between spexin and glucose in the studies. The results were contradictory regarding inflammation, but the positive correlation of spexin with anti-inflammatory agents showed the anti-inflammatory effects of this neuropeptide. Five of the studies investigated the relationship between spexin and cardiovascular diseases such as hypertension, and three of them showed a positive role for spexin in cardiovascular health. Also, one of the studies examined the effect of spexin on metabolic syndrome and confirmed the protective role of spexin.

It seems that this neuropeptide positively affects metabolic status, especially weight control and insulin resistance, in children and adolescents.

This study aimed to identify a specific dietary pattern related to insulin resistance and hyperinsulinemia in Tehranian adults.

This cross-sectional study was performed on 1063 men and women ≥25 years of age participating in the third phase of the Tehran Lipid and Glucose Study. The dietary pattern was derived by reduced ranking regression (RRR), using 34 food items as predictors and serum insulin concentration and homeostatic model assessment for insulin resistance (HOMA-IR) as response variables. The relationship between a dietary pattern and odds of hyperinsulinemia and insulin resistance (IR) was investigated, and the odds ratio (OR) and 95% confidence interval (CI) were reported.

The mean, standard deviation of age, and BMI of the participants was 43.0±12.2 years and 27.4±4.8 kg/m2. The derived patterns included higher consumption of processed meat, fish, drinkable yogurt, lemon juice, pickles, leafy vegetables, and lower consumption of starchy vegetables, garlic and onions, dried fruits, nuts, red meat, high-fat dairy, and coffee. After adjustment for potential confounding variables, a higher adherence to this pattern was associated with increased odds of hyperinsulinemia (OR=1.69, 95%CI=1.17-1.23, Ptrend=0.005) and IR (OR=2.97, 95%CI=1.66-5.32, Ptrend <0.001).

In this study, an RRR-derived dietary pattern related to serum insulin and HOMA-IR was associated with a higher odds of hyperinsulinemia and IR.

The research results have shown that a healthy lifestyle can prevent the development of metabolic syndrome. This study aimed to investigate the association of nuts, as one of the components of a healthy diet, with components of metabolic syndrome (MetS) and assess the modifying effect of physical activity (PA) on this association.

In this prospective study, the consumption of nuts by 1452 individuals participating in the Tehran Lipid and Glucose Study (TLGS) was examined using a validated food frequency questionnaire. The Cox regression model was used to determine the association between nuts and the risk of components of MetS. Also, the modifying effect of PA was assessed on this association using Cox regression.

Mean (SE) age and BMI at baseline were 36.5±13.3 and 25.6±4.5, respectively. The median intake of nuts was 18.8 g/per week. After adjustments for confounders, a significant inverse association was found between nuts and the risk of hyperglycemia, hypertension, hyperglycemia, and abdominal obesity. Among participants with moderate and high PA levels, nuts (higher or lower than the median) reduced the risk of component of MetS. This association was not observed in participants with low PA levels.

PA modifies the relationship between nuts intake and the risk of some components of MetS. However, no association was found between nuts intake and incidence of components of MetS at low PA levels.

 studies show that antioxidants prevent conversion of NO3/NO2 to nitrosamines compounds. tha aim of this study was to determine the potential effect of interaction between dietary intakes of vitamin C and NO3/NO2 on urinary and serum levels of NO3/NO2.

This cross-sectional study included 251 adults aged >19 years was performed in the phase 6 of  the Tehran Lipid and Glucose Study in 2015. Food intake was assessed using a semi-quantitative food frequency questionnaire. The average daily intake of nitrate and nitrite and vitamin C was estimated. Serum and urine levels of nitrate and nitrite were measured using  the Grease method. In order to determine the effect of vitamin C on the interaction of nitrate and nitrite in urine and serum, linear regression test was used to modify the effects of confounders.

There was a significant correlation between intake of nitrate and its urine level, above the median level of vitamin C intake (B = 0/004, P-value = 0/004). Also, this correlation remained significant after adjusting for age, sex, body mass index, calorie intake (B = 0.03, P-value = 0/001). The effect of vitamin C interactions on nitrate intake and urine level in the adjusted model for nitrate and nitrite was also found to be significant (B = 0/003 P-value = 0/001).

Increased intake of vitamin C significantly increases urinary excretion of nitrate and it is effective in  the interaction between dietary intakes and urinary excretion of nitrate.

This study aimed to investigate the Qur’an’s points of view in the field of human nutrition. All Qur’an verses related to human nutrition were extracted. To better understand the meanings of the verses, the books Tafsir Nemooneh and Al-Mizan were also used. All nutrition-related verses were categorized in thirteen sections. The main topics were discussed, including setting halal and haram standards, principles of healthy eating, and the food pattern considered by the Quran. The Quran has a plan for human nutrition and the main priorities of food supply sources, health standards, nutrition principles and food pattern considered by the Quran as well as food security are included in this plan.

Microalbuminuria is an independent risk factor for cardiovascular disease and is associated with all-cause mortality. The present study aimed to investigate the possible association between different types and amounts of dietary protein and microalbuminuria among Iranian adults participating in the Tehran Lipid and Glucose Study (TLGS).

Adults (1192 men and women; aged 19-86 years) participating in the sixth phase of TLGS (2014-2017), who had complete nutritional data with known urinary microalbumin levels, were included in the present study, according to the inclusion criteria. The dietary intake was assessed using a validated Feed Frequency Questionnaire (FFQ). Demographic variables, anthropometric indices, blood pressure, and biochemical data were also measured. To estimate the odds ratio (OR) of microalbuminuria (urinary microalbumin level: 20-200 mg/L), a logistic regression analysis adjusted for the confounding variables was performed.

The mean (±SD) of the participants’ age and body mass index at baseline were 44.96±14.00 years and 27.81±4.97 kg/m2, respectively. The prevalence of microalbuminuria in the study population was 14.4%. After adjusting for the confounding variables, the OR of microalbuminuria did not show a significant relationship with the protein intake. The adjusted ORs and 95% confidence intervals for microalbuminuria in the third tertile of total protein intake, animal protein intake, and plant protein intake were 1.08 (0.57-2.05), 1.19 (0.67-2.09), and 1.02 (0.56-1.88), respectively.

In the present study, there was no significant association between the total protein and plant protein intake and microalbuminuria. The animal protein intake increased the risk of microalbuminuria, although this relationship was not statistically significant.

Dietary diversity score is a nutrient intake adequacy index associated with the child growth. As mothers make the most important decisions affecting dietary patterns for their families and children, this study investigated possible relationships between the dietary diversity scores of children and mothers and the anthropometric statuses of preschool children for the first time in Iran.

In total, 236 children and their mothers participated in this cross-sectional study. Data about mothers and children weight, height and dietary diversity scores were collected using food recall questionnaires and dietary diversity questionnaires, respectively. Then, mothers and children were categorized into good, medium and weak dietary diversity score groups based on the protocols by the United Nation Food and Agricultural Organization. Furthermore, households were categorized into three major groups (low, middle and high) based on their socioeconomic statuses.

This study showed that child weight-for-age (p = 0.013) and weight-for-height (p = 0.03) included significant relationships with the mothers dietary diversity scores.

The better the mothers dietary diversity scores were, the more likely they were to have children with normal weight for height, weight for age and height for age values, compared to mothers with low dietary diversity scores.

This study aimed to investigate the interactions of weight change and fruit and vegetable intake with the incidence of metabolic syndrome (MetS) among adults.

This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) among 1915 adults during 8.9 years of follow-up. Dietary data were assessed using the food frequency questionnaire. Anthropometric, biochemical, and body weight data were measured at baseline and during the follow-up. MetS was defined according to the adult treatment panel III. The association between fruit and vegetable intake and MetS by adjusting weight was assessed using Cox regression analysis.

The median intake of fruit, vegetables, and both fruit and vegetables was 3.5 (IQR: 2.0-5.5), 3.1 (IQR: 1.9-5.9), and 6.9 (IQR: 4.0-7.8) servings per day, respectively. The intake of both fruit and vegetables was significantly and inversely associated with the MetS incidence after controlling for the confounders (hazard ratio: 0.73; 95% CI: 0.66-0.87). No significant association was found between the intake of fruit and vegetables and the risk of MetS. Based on the results, in participants with weight change less than 7%, the intake of fruit and vegetables and the intake of both fruit and vegetables reduced the risk of MetS. However, no association was observed among participants with weight gain more than 7% during the follow-up.

Weight change modifies the association between fruit and vegetable intake and the risk of MetS.

Vaspin is an adipokine that reduces insulin resistance and obesity. There is little evidence suggesting an association between diet and plasma vaspin levels, and no studies have investigated the vaspin gene expression. The current study aimed to investigate the association of dietary fatty acid (FAs) intake with vaspin gene expression in visceral and subcutaneous adipose tissues (ATs) among obese and non-obese individuals.

Visceral and subcutaneous ATs were obtained from 50 obese and 47 non-obese individuals with a body mass index (BMI) ≥30 and BMI <30kg/m2, respectively, who underwent open abdominal surgery. The dietary intake was evaluated using a validated food frequency questionnaire, and the daily intake of FAs, including total dietary fat, saturated FAs, monounsaturated FAs, and polyunsaturated FAs, was calculated. The relative expression of vaspin gene in ATs was measured by real-time polymerase chain reaction (PCR) using SYBR® Green.

The mean±SD of BMI in obese and non-obese subjects was 41.4±5.87 and 24.8±2.86 kg/m2, respectively. Comparison of vaspin gene expression in visceral and subcutaneous ATs of obese and non-obese individuals. showed higher expression leveles in the subcutaneous AT of obese individuals (P<0.034). In obese subjects, the dietary intake of polyunsaturated FAs (r=0.28, P=0.05) had a marginally significant positive association with vaspin gene expression in the visceral AT.

The results of the present study showed that vaspin gene expression was only higher in the subcutaneous AT of obese individuals as compared to non-obese subjects. There was no significant association between dietary FAs and vaspin gene expression. Therefore, further extensive studies are necessary to determine the underlying mechanism of the effect of vaspin on insulin resistance and to illustrate the possible role of dietary FAs in this regard.

The effects of herbal medicine in management of chronic diseases such as diabetes are under investigation. One of the most recent herbal medicine to management of diabetes is nigella Sativa. The mechanism of the effect of nigella Sativa on diabetes is not clear. One of the mechanisms that improves insulin resistance among type 2 diabetes is an increase in adiponectin concentration and a decrease in serum leptin concentration, but few studies have examined the effect of nigella Sativa on leptin and adiponectin concentrations. The aim of this double-blind randomized controlled clinical trial was to investigate the effect of nigella Sativa oil extract on serum leptin and adiponectin concentrations in patients with type 2 diabetes mellitus.

Forty-three type 2 diabetic patients, aged 30-55 years (20 women, age: 53.7±6.3 years) were randomly assigned to groups designated to the intervention (n=23) and the control (n=20) groups. Intervention group consumed 2 capsules daily, (500 mg extract of black seed oil), while control group consumed 2 capsules (500 mg, placebo), both for 8 weeks. Leptin and adiponectin concentrations were measured at baseline and again after the 8-week intervention. To calculate changes in leptin and adiponectin, baseline and end-of-intervention values were used to compare baseline and end-of-intervention values in each group, using the paired t-test.

Extract of black seed oil significantly decreased leptin concentrations in the intervention group (baseline 7.3±0.6; after intervention 5.2 ± 0.3, p < 0.005) compared to the control group (baseline 7.6 ± 0.9, after intervention 7.8 ± 0.9, p=0.41). There was no significant change in adiponectin concentrations after both Nigella Sativa Oil Extract and placebo consumption.

It seems that Nigella Sativa Oil Extract reduces serum leptin concentrations in type 2 diabetic patients, however no significant effect on adiponectin concentrations was found. 

There is controversy over the association between habitual physical activity and incidence of chronic kidney disease (CKD). The aim of this research was to investigate the association between physical activity and incidence of CKD in a population-based cohort study.

In Tehran Lipid and Glucose Study (TLGS) a prospective investigation was performed in 4226 individuals (1872 males and 2354 females) with no known CKD who were followed-up for six years (from phase 3 (2005-2007) to phase 5 (2012-2015). Baseline physical activity was accessed, and the metabolic equivalent of task (MET) hours per week was calculated. Glomerular filtration estimation (eGFR) was done using Modification of Diet in Renal Disease (MDRD) and CKD was determined as eGFR <60 ml/min/1.73 m2. Logistic regression was used to evaluate the association between CKD and MET categories by reporting odds ratio (OR) and 95% confidence intervals (95%CI).

The average MET values in males and females were 913 and 638 min/week, respectively. The incidence of CKD was 10.7% in men and 15.4% in women. After adjusting for potential confounders, men with high physical activity had a 30% (95% CI: 0.51-0.95) lower risk of incident of CKD than those with light physical activity (P=0.012). There was no significant association between levels of physical activity and CKD in women (P=0.059).

In this study, higher physical activity levels were associated with lower risk of CKD among men.

This randomized controlled clinical trial aimed to investigate the effects of dairy product consumption on fasting blood glucose, insulin resistance, blood pressure, and lipid profile in patients with type 2 diabetes.

Ninety-one diabetic patients were randomly assigned to one of the following three groups: group A, <1 serving of dairy products per day; group B, 2-3 servings of dairy products per day; and group C, 4-5 servings of dairy products per day. The biomarkers of fasting blood glucose, insulin resistance, blood pressure, and lipid profile were measured at baseline and after eight weeks of intervention.

The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) score and systolic blood pressure decreased significantly in participants, who consumed 4-5 servings of dairy products per day, compared to the other groups. However, no significant difference was observed in the lipid profile, fasting blood glucose level, weight, waist circumference, or blood pressure between the study groups (P>0.05 for all).

The consumption of 4-5 units of high-fat dairy products per day, with a fat content of 2.5%, improved insulin resistance and decreased systolic blood pressure in patients with type 2 diabetes. However, further clinical trials over a longer period of time are needed (Clinical Trial Registry No.: IRCT201207261640N8).

Gestational diabetes is one of the most common complications of pregnancy, which increases the risk of complications, such as preterm birth and low glucose at birth. Several studies have reported that diet plays an important role in preventing and managing gestational diabetes. The present study aimed to investigate the relationship between pre-pregnancy vegetable consumption and gestational diabetes in women residing in Tehran, Iran.

This prospective study was performed on 1026 women. Glucose tolerance tests were performed at 24-28 weeks of gestation, and the diagnostic criteria by the American Diabetes Association were used to define gestational diabetes. The participants’ dietary intake was examined, using a reliable and valid food frequency questionnaire, and their consumption of vegetables (i.e., green leaves, allium vegetables, cabbage, stems, and roots) was determined. The association between vegetable consumption and gestational diabetes mellitus was examined by logistic regression analysis.

A total of 71 (6.9%) women were diagnosed with gestational diabetes. The mean pre-gestational age and body mass index of the participants were 26.7±4.3 years and 25.4±4.5 kg/m2, respectively. The mean vegetable consumption in pregnant women with and without gestational diabetes was 134.7±17.1 and 116.1±5.3 g/day, respectively. The intake of stem vegetables (P=0.05) and fruit vegetables (P=0.04) in women without gestational diabetes was significantly higher than that of women with gestational diabetes. Fruit vegetables reduced the risk of gestational diabetes. However, no significant association was found between the intake of other vegetables and the risk of gestational diabetes after adjusting for confounding variables.

Considering the low consumption of fruit vegetables in women with gestational diabetes and the direct association between their intake and the lower risk of gestational diabetes, it is recommended to increase the intake of these vegetables to prevent this disease.

Community-based research has a heavier ethical mission than other research because it has to figure out how to better address health issues in the population under study, while protecting the rights of the population under study. The purpose of this study is to examine the ethics of community-based research and its observance at different levels of society, staff and participants.

This article searched the databases of Web of science, PubMed, Scopus, google scholar, Magiran, SID with keywords in ethics, community based studies and population based studies.

Five ethical principles that must be considered in communitybased research include: 1. Protecting the health and well-being of populations; 2. Respecting populations and their right to decide on themselves; (3. Protecting The vulnerable population and the need for specific research inquiries; 4. The protection of confidential information, the integrity, and respect for populations; 5. The fair distribution of the benefits of research into populations and the importance of infrastructure creation. These ethical principles must be taken into account at three levels of larger communities in which research is conducted (host societies), field staff and participants in the research. Ethical Considerations: Honesty and trustworthiness were observed in reporting articles and the findings of these articles were stated without bias.

Research ethics, such as delivering results to the community, enable the community to actively participate in the development of community-based research.

Obesity is one of the major health problems that is highly prevalent in the world. There is controversial evidence about the association between dietary nitrate and nitrite and obesity. The aim of this study was to investigate the association between dietary nitrate and nitrite intake and incidence of obesity phenotypes.

A prospective approach was used in this research that was conducted in participants of the Tehran Lipid and Glucose Study. The study included 1756 males and females and their nutritional, anthropometry, and biochemical information were recorded every three years and followed for six years. Food Frequency Questionnaire (FFQ) was administered to collect the data. General obesity phenotype, abdominal obesity phenotype, Hypertriglyceridemic-Waist Phenotype (HTW), and body adiposity index phenotype were determined. Then, the incidence of obesity phenotypes across tertiles and intakes of nitrate/nitrite was assessed using regression logistic test.

The cumulative incidence of HTW phenotypes was 25% after 6 years. The risk of HTW in highest tertiles compared to the lowest tertiles of total nitrate intake and intake of nitrate and nitrite through fruits decreased insignificantly by 6% (OR = 0.94, 95% CI = 0.72 - 1.17), 5% (OR = 0.95, 95% CI = 0.73 - 1.24), and 10% (OR = 0.90, 95% CI = 0.69 - 1.17), respectively.

Dietary nitrate and nitrite had no effect on the occurrence of HTW, BMI, and general and abdominal obesity phenotypes.

Adipose tissue affects body hemostasis by secreting a variety of proteins named adipokines. Plasma levels of apelin decreases after exercise; however, the evidence on gene regulation in adipocytes is rare. The aim of this study was to investigate the association of daily physical activity and applein gene expression and its serum levels in visceral and subcutaneous adipose tissues in non-obese and morbid obese subjects.

In this cross-sectional study, samples of visceral and subcutaneous adipose tissues were collected from patients (64) undergoing abdominal surgery. Data on physical activity was gathered using a valid and reliable International Physical Activity Questionnaire (IPAQ) and the metabolic equivalent (MET) was calculated. Apelin expression in fats was evaluated using the qRT-Real Time PCR method.

Mean age for non-obese and morbid obese groups was 45.6 and 39.6 years, and total physical activity was 1093 and 894 (MET), respectively. The expression of apelin was significantly higher in subcutaneous fat in morbid obese subjects, compared to non-obese adults (P=0.038). After controling age, waist circumference and insulin levels, total MET was significantly associated with subcutaneous adipose tissue (β=0.519 and β=0.395) in both, the non-obese and obese groups. Among obese individuals, occupational-related activity was associated with apelin expression in subcutaneous adipose tissue (β=0.391).

The association of physical activity and adipose tissue gene expression in non-obese and obese individuals indicates the positive effects of active lifestyles on adipokines secreted from adipose tissues.

Snack consumption is associated with cardiovascular disease (CVD) risk factors in children and adolescents. The aim of this study is to investigate the association of snack consumption and carotid intima media thickness (CIMT) among overweight and obesity children and adolescents.

In this cross sectional study, a total of 339 participants, aged 6 to 13 years with the body mass index Z score ≥1 enrolled in this study. Data on anthropometric measurements, pubertal status, and CIMT were documented. Food intakes of participants were measured by a valid and reliable food frequency questionnaire (FFQ). Linear and logistic regression were estimated. 

Mean age of study participants was 9.3 years and with 68.4% of obesity. After controlling for confounders, including age, sex, energy intake, puberty status, physical activity, and body mass index, one SD increase in intake of nuts decreased the CIMT, by 0.126 mm (P value=0.019). Moreover, participants in the last tertile of nuts intake had 63% lower risk of high CIMT in comparison with those who consumed less than 1.74 serving/wk of nuts (P for trend=0.006). When nuts intake was replaced by the sweet unhealthy snacks the CIMT decreased by 0.15 mm.

Our findings emphasize the positive impact of nuts consumption as a healthy snack on subclinical stages atherosclerosis. Clinical trial studies could examine the effect of different kinds of nuts consumption on CIMT and complications of CVD risk factors.