ahmad esmaillzadeh

Limited data are available linking dietary intake of fruit and vegetables to breast cancer, in particular among the Middle Eastern population. The present study was done to investigate the association of fruit and vegetable consumption with the risk of breast cancer in Iranian adult women.

Dietary intake of fruit and vegetables was assessed using a validated 106‑item Willett‑format semi‑quantitative dish‑based food frequency questionnaire. Logistic regression was used to determine the association between fruit and vegetable consumption and breast cancer. Women aged >30 years, residing in Isfahan, Iran from July 2013 to July 2015. Breast cancer was diagnosed during the maximum of the last 6 months by physical examination and mammography findings.

Overall, data on 350 cases and 700 controls were analyzed. After controlling for potential confounders, participants with the highest dietary intake of fruits had higher odds of breast cancer than those with the lowest intake (odds ratio [OR]: 8.23; 95% confidence interval [CI]: 4.37‑15.50), while those who consumed highest amounts of vegetables were less likely to have breast cancer than their counterparts (OR: 0.12; 95% CI: 0.06‑0.24). Although no significant associations were found between dietary intakes of fruits and vegetables and risk of breast cancer in premenopausal women, significant positive association between fruit consumption and breast cancer (OR: 16.80; 95% CI: 7.80, 36.21; P < .001) was observed in postmenopausal women.

We found an inverse association between dietary intake of vegetables and breast cancer. Fruit consumption was significantly associated with greater odds of breast cancer in this study.

 The present study aimed to investigate the association between dietary linoleic acid (LA) intake and breast cancer in women.

 In this population-based case-control study, we enrolled 350 pathologically confirmed breast cancer cases and 700 controls which were matched with cases in terms of age and socioeconomic status. Dietary intakes were assessed using a 106-item Willett-format semi-quantitative dish-based food frequency questionnaire (DS-FFQ). Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were estimated.

 A significant inverse association was found between LA intake and odds of breast cancer (OR: 0.41, 95% CI: 0.30-0.56). After adjusting for potential confounders, women in the highest tertile of dietary LA intake were 48% less likely to have breast cancer compared with those in the lowest tertile (OR: 0.52, 95% CI: 0.28-0.95). Such a significant inverse association was also seen among normal-weight women (OR: 0.29, 95% CI: 0.14-0.63), and premenopausal women (OR: 0.15, 95% CI: 0.02-0.95).

 The findings of current study provide evidence for a protective role of LA against breast cancer particularly among normal-weight and premenopausal women. Prospective studies are needed to confirm this association.

The aim of the present study was to ascertain the correlation between the intake of whole and refined grains and the risk of stroke in the Iranian adult population. This hospital-based case-control study was conducted at Alzahra University Hospital, Isfahan, Iran, in 2008. The cases (n=195) were stroke patients admitted to the neurology ward, and the controls (n=195) were patients admitted to other wards in this center, with no prior history of cerebrovascular accident or any neurological disorders. The usual dietary intakes of the study participants during the previous year were assessed using a validated semi-quantitative food frequency questionnaire. Whole and refined grains were defined according to the definition of the American Association of Cereal Chemists International; foods that contained at least 8 g per 30 g of their weight were considered as whole grains. The mean age of the case and control groups was 68.0 (±13.5) and 61.5 (±10.5) years, respectively; 40% of the cases and 53.3% of the controls were female. The total intake of whole grains (27.8±4.3 vs. 29.4±3.6 g/d, P=0.77) and refined grains (264±11 vs. 296±13 g/d, P=0.07) was not significantly different between the cases and controls. After adjusting for potential confounders, individuals in the second tertile of refined grain intake had a two-fold higher odds of stroke (OR: 2.02; 95% CI: 1.08-3.71), compared to those in the first tertile. Furthermore, no significant relationships were observed between the consumption of whole grains and the risk of stroke, before or after adjustment for confounding variables. No significant trend was found between the tertiles of refined or whole grain intake and the risk of stroke. The authors did not find a statistically significant association between the intake of whole and refined grains and the risk of stroke. Further prospective studies on the relationship between both whole and refined grains and stroke are warranted.

 There is considerable information about the interrelation of functional gastrointestinal disorders (FGIDs) and psychological disorders, called gut-brain interaction. Physiological and psychological variables have been linked with the etiology and severity of IBS. The nocebo effect (the opposite of placebo) is defined as increase in pain or other symptoms after use of an inactive or inert treatment/agent purported to increase pain or unpleasant symptoms. Some psychological mechanisms of nocebo include expectancies, conditioning, learning, memory, motivation, somatic focus, reward, anxiety, and meaning. Moreover, neurobiological factors are associated with the etiology of this phenomenon. The aim of present study is a discussion of the definition, existence, prevalence, etiology, and characteristics of the nocebo effect in irritable bowel syndrome (IBS).

 This paper presents a scoping review of the existence, frequency, and importance of the nocebo effect in IBS patients. Data sources included PubMed, PsycINFO, Google Scholar, and Scopus which were searched from their inception dates to 2022.

 The review of the obtained articles showed that psychological factors such as depression, anxiety, psychological distress, and some personality traits such as neuroticism are related to the occurrence of nocebo responses in IBS patients.

 The psychological factors associated with nocebo responses include expectancies, conditioning, learning, memory, patient’s personality. Moreover, societal factors and the quality of the patient-physician interaction, and neurobiological factors influence the process of diagnosis, course, and treatment of IBS through nocebo responses. Compared to the extensive research data related to the placebo effect, there is little information and few articles on the role of nocebo, especially in FGIDs. This paper summarizes the scope and importance of the nocebo effect and IBS and its interrelations with psychological factors like personality, anxiety, depression, and psychological distress.
 

The relationship between meat consumption and mental disorders is less investigated. We examined the association of meat consumption with the odds of depression, anxiety, and psychological distress in Iranian adults.

This cross-sectional study was conducted on 3362 subjects with18-55 years. Usual dietary intakes were assessed through the use of a dish-based 106-item semi-quantitative food frequency questionnaire (FFQ). Hospital Anxiety and Depression Scale(HADS), and General Health Questionnaire(GHQ), all validated in the Iranian population, were applied to collect data on anxiety, depression, and psychological distress, respectively.

In the current study, 28.6, 13.6 and 22.6%, of participants suffered from depression, anxiety, and psychological distress, respectively. Individuals in the top quartile of red meat intake had a 43% increased risk of depression (OR=1.43; 95%CI:1.09-1.89), compared to those in the first quartile, after adjustment for potential confounders. The highest vs. lowest red meat intake was related to a 92% greater risk of depression (OR=1.92;95%CI:1.17-3.15) in males. In overweight or obese individuals, despite the lack of any association between red meat intake and mental disorders, high intake of white meat was associated with a lower odd of psychological distress (OR=0.64;95%CI:0.42-0.99) and depression (OR=0.68;95%CI:0.45-1.00). In normal-weight participants, the highest vs. lowest red meat intake was related to 66% greater odds for depression than those (OR=1.66; 95%CI:1.14-2.42).

Red meat consumption was associated with an increased risk of depression, especially in men and normal-weight participants. In overweight or obese subjects, white meat intake was inversely associated with psychological distress.

Context: The validity of self-reported anthropometric indices has been examined in previous studies in different populations.

The aim of our study was to evaluate the validity of selfreported height, weight, body mass index (BMI), and waist circumference (WC) for the first time in middle-age staffs of Isfahan University of Medical Sciences. Settings and Design: In this cross-sectional study, a total of 171 men and women were selected from staffs of Isfahan University of Medical Sciences, Isfahan, Iran. Methods and Materials: Technician- and self-reported measurements of height, weight, and WC were collected from all participants. BMI was calculated by dividing weight in kg by height in meters squared. Overweight and obesity were defined as BMI ≥25-<29.9 and ≥30 kg/m2 , respectively. Abdominal obesity was defined as WC ≥94 and ≥80 cm in men and women, respectively. Statistical Analysis: Independent t-test, chi-square, Pearson and intraclass correlation coefficients (ICCs), as well as Kappa measurements, were used.

Fifty and 19 percentages of the study population were overweight and obese, respectively. Self-reported height (r = 0.83, P < 0.001, ICC =0.89, 95% confidence interval (CI): 0.85–0.92), weight (r = 0.95, P < 0.001, ICC = 0.979, 95% CI: 0.971–0.98), BMI (r = 0.70, P < 0.001, ICC = 0.81, 95% CI: 0.74–0.86), and WC (r = 0.60, P < 0.001, ICC = 0.71, 95% CI: 0.51–0.81) were highly correlated with actually measured ones. Approximately 80% and 65% of individuals who were defined as overweight and obese, respectively, based on actually measured data were correctly diagnosed as overweight and obese, respectively, based on self-reported data. The Kappa coefficients for different categories of weight situation and abdominal obesity were 0.59 and 0.32, respectively. Fifty-seven percent of participants who were diagnosed with abdominal obesity based on actually measured data were correctly diagnosed with abdominal obesity based on self-reported data. Also, approximately 48% and 69% of men and women, respectively, who were diagnosed with abdominal obesity based on actually measured data were correctly diagnosed with abdominal obesity based on self-reported ones.

We found that self-reported data of anthropometric measures are reasonable in middle-age staff of Isfahan University of Medical Sciences. Nevertheless, self-reported data on WC should be cautiously relined on, in particular, among men.

Most information on the association of dietary fat intake and gastro‑esophageal reflux disorder (GERD) came from developed countries, where lifestyle and other dietary components might be different from those in developing countries. This cross‑sectional study was, therefore, conducted to investigate the association between dietary fat intake and odds of having GERD in a large group of Iranian population. Study Design: This cross‑sectional study was done among 3362 adult population in Isfahan, Iran. Dietary intakes were collected by the use of a validated semi‑quantitative food frequency questionnaire.

Assessment of GERD was done using a validated self‑administered questionnaire examining the frequency of heartburn in the last 3 months. Individuals with the presence of heartburn symptoms sometimes, often or always during the last 3 months were defined as having GERD.

Participants in the top category of dietary fat intake had higher daily intakes of energy, macronutrients and micronutrients. Dietary intakes of all food groups were also significantly higher among those in the top quintile as compared with those in the bottom category of dietary fat intake (P < 0.001 for all). There were no significant associations between dietary fat intake and incidence of GERD in general population. Crude and multivariable‑adjusted models revealed no significant associations between dietary fat intake and having GERD in either gender.

We found no significant association between dietary fat intake and odds of having GERD in this population. Further studies, in particular of prospective designs, are warranted to clarify this association.

Personalized nutrition is a new approach in medical sciences that is based on genetic profile, individual needs, and environmental conditions considering health status and chronic diseases of every person. Studies have shown that genetic differences cannot solely justify various responses to medications and diets, and other important factors including gut microbiota are also involved. Human body hosts an active and dynamic ecosystem composed of a large number of microorganisms consisting of genes about ten times more than the human genome. Gut microbiota interacts with the human body through releasing metabolites such as short-chain fatty acids and secondary bile acids and fermentation products such as kynurenine, indoles and indole derivatives, tryptophan, serotonin, histamine, and dopamine. Body weight, metabolic rate, and health and diseases are formed as a result of these interactions.

The present study was conducted to evaluate the pattern of food preference among a large sample of Iranian adults.

In a cross‑sectional study within the study on the epidemiology of psychological alimentary health and nutrition (SEPAHAN) projects, a total of 6239 of 8694 subjects completed a 106‑item food preference questionnaire. Subjects indicated whether they liked, disliked or had gastrointestinal symptoms for each food item separately. They also reported the frequency of consumption for each food item.

We observed that presence of some foods such as yogurt, fruits and vegetables in the list of the most preferred food items and presence of kalbas, sausages and chips in the list of the most disliked food items, were representative of healthy dietary pattern in this population. Results also revealed that women liked unhealthy foods more than men (P value <0.05 for all significant food items). Moreover, in most of the food items, men reported less gastrointestinal symptoms than women (P value <0.05 for all significant food items). Our findings revealed that smokers disliked most of the healthy food items. We also observed that pregnant women regardless of the trimesters, reported dislike for sweet‑tasting food items.

More researches are suggested in order to indicate the origins of preferences and recommend some practical alternatives to improve the dietary pattern in society.

Determining and evaluating risk factors for cancers is very important for controlling and preventing these diseases. It is known that the factors associated with human nutrition can play a major role in the risk of cancer.

In this hospital-based case-control study, 80 patients with colorectal cancer (CRC) were compared with 160 controls in terms of risk factors. To assess food intake and food insecurity, the Food Frequency Questionnaire (FFQ) and Radimer/Cornell questionnaire were used respectively, in addition, the anthropometric indicators including height and weight were measured.

The patients in the CRC group had a lower food safety compared to the control group, which had a significant difference. In addition, in the study of anthropometric indicators and body composition, the body fat percentage was higher in the CRC patients compared to the control group. After adjustment with other possible confounding variables, only calorie intake, cholesterol, and fat were associated with CRC. After adjusting for other confounding factors, individual insecurity remained significant in the regression model, and the odds ratio showed that individuals with a food insecurity had a greater chance to join the cancer group.

Food insecurity, as well as high fat and calorie intake, were associated with an increased chance of joining the cancer group. In the case of food insecurity, more studies are needed. People with CRC have higher levels of fat and energy.

From the academic perspective, the differences between the educational curriculum of Medical Doctor (MD) and Doctor of Philosophy (Ph.D.) are quite clear in basic medical sciences. Therefore, it is necessary to establish a more effective relationship between these two programs to provide better clinical services and conduct joint research projects. In this regard, the present study was conducted to review the evidences of the Ph.D. in medical sciences to MD course  in other countries and to make suggestions for set up this course in Iran.

This study was conducted by reviewing the English articles published from 1960 to 2019 in PubMed, Scopus, Google Scholar, and Web of Science databases using the keywords, such as "Ph.D." AND "MD" OR "Ph.D. to MD course" in combination with the "Curriculum" OR "Program" OR "Course".

The results of the present study showed that the plans of the Ministry of Health in encouraging MD graduates to enter the Ph.D. courses in medical sciences have been effective in promoting clinical services. Therefore, this experience can be used to set up the Ph.D. to the MD course. Moreover, given the existence of the Ph.D. to MD course at some prestigious universities worldwide and considering the medical education program in Iran, this course can be set up at some internally accredited universities.    

It seems that launching the Ph.D. to MD courses in Iran as a 4-year course can provide an effective link between basic and clinical sciences, improve the quality of medical research, and increase the motivation of Ph.D. students and graduates.

Food frequency questionnaires (FFQs) are widely used in large studies worldwide. They usually seek to rank people according to their usual food intake rather than a specific period of time. In the present study, we aimed to develop a dish-based, semi-quantitative FFQ to seek habitual diet of general population aged 9 to 65 years in Tehran.

To develop the FFQ, four main steps were taken. At the beginning a list of commonly consumed Iranian foods and mixed dishes was prepared. To prevent excessive questionnaire length, some food items were grouped. Then, reference portion sizes were defined for each mixed dish in the list. The portion sizes were defined either based on the most common food portions reported in existing data or based on conventional portioning. In the third step the frequency response for consumption of food items and mixed dishes were determined. In the last step, recipes were developed for mixed dishes based on several data sources, including previous surveys. Finally, the content validity of the questionnaire was evaluated by the expert panel.

The final food list of the FFQ comprised 142 food items and mixed dishes in six major food groups, including dairy products, breads, mixed dishes, dried fruits, nuts and seeds, fruits and vegetables, and miscellaneous food items and beverages. Nine frequency response options for all food items varying from “never or less than once per month” to “more than 6 times a day” were considered. A portion size was included for each item, whether food items or mixed dishes.

As Iranian food recipes are typically characterized by various ingredients it is very difficult for the respondent to recall the amount and type of the ingredients. Likewise, information about cooking methods beside ingredients of foods are important to estimate their nutritive values,  which can be explored only through asking about consumption of mixed dishes. The current FFQ was developed to overcome the mentioned problems. It can be applied in nationwide studies in which foods and/or nutrients are predominant determinant of health and/or diseases.

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.

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.

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.

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.

One of the important challenges at the Universities of Medical Sciences is the mentorship of postgraduate students’ academic theses. Since 2015, the Research Mentorship Program (RMP) has been implemented with the aim of improving research knowledge and skill, thesis quality, and quantity and quality of papers of emerging from postgraduate students’ theses.

This was a prospective cohort study with census sampling method (nonprobability sampling), completed between 2015 and 2018. Twenty‑eight postgraduate students participated in the program. Each trainee student is done during the research period through the supervisor and another student in a higher level of education as mentor. Questionnaire with open‑ended questions and checklist was used for data gathering. For statistical analysis, Chi‑square test was used.

100% of the mentors and 93% of the mentee participated at the Research Mentorship Program were satisfied. In addition, the duration of the research course for the master’s students participated in the RMP was reduced. Participants in this program had higher quantity and quality of papers resulting from postgraduate student’s academic theses. RMP can enhance the postgraduate students’ knowledge and skills in their research projects and research methods, develop personal and professional relationships, and promote interpersonal communication as a student or mentor.

This program and its similar programs can improve the quality of postgraduate students’ academic theses and reduce their research period.

To construct a dietary guideline for patients with irritable bowel syndrome (IBS), data about foods these people exclude from their diet to improve their symptoms are necessary. This study was designed to assess the prevalence of food exclusions as well as the reasons for such exclusions in a large group of IBS patients. In this cross-sectional study, data on 3846 Iranian adults, 828 of whom were patients with IBS, working in 50 different health centers were examined. A 106-item self-administered Dish-based Semi-quantitative Food Frequency Questionnaire (DSFFQ) which was designed and validated specifically for Iranian adults was used for assessing dietary intake. IBS was assessed using a modified Persian version of the Rome III questionnaire. The whole prevalence of IBS was 21.5% (n = 828) in the total population (23.9% in women and 18.6% in men). Mean age of patients with IBS was 36.26 ± 7.91 years and for subjects without IBS, it was 36.52 ± 8.12 years. IBS patients had a greater probability to avoid consumption of ketchup (90% vs 33%, P = 0.005), Dough (100% vs 1%, P = 0.003), Gaz (50% vs. 1%, P = 0.035), grapes (33% vs. 7%, P = 0.034), fresh berries (56% vs. 14%, P = 0.036) and butter (100% vs. 60%, P = 0.02) due to gastrointestinal (GI) symptoms compared with healthy individuals. Although, the exclusion of plum (1% vs. 26%, P = 0.006), pickles (39% vs. 67%, P = 0.004), lemon juice (21% vs 35%, P = 0.027), egg (5% vs. 25%, P = 0.011), fresh fig (19% vs. 44%, P = 0.038) and cake (25% vs. 100%, P = 0.028) due to GI symptoms in IBS patients were lower than non-IBS participants. The present study showed that IBS patients were more likely to avoid consumption of ketchup, Dough, Gaz, grapes, fresh berries and butter due to GI symptoms compared with healthy individuals. Further studies are required to confirm these findings.

Glioma is the most common primary brain tumor, which mostly occurs in adults and is associated with high mortality. The purpose of this study was to investigate the association of food quality indices and glioma in Iranian adults.
 
This case-control study was performed on 128 patients with glioma and 256 healthy individuals (matched for age and gender) in hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, between 2009 and 2011. Dietary assessment was performed using a validated block-format 123-item semi-quantitative food frequency questionnaire. Dietary Indices (DDS, AHEI-2010) were developed based on standard methods. Data were analyzed by independent t-test, Chi-Square and ANOVA.
 
In this study, after controlling for potential confounders, a significant inverse association was found between DDS and risk of glioma (OR: 0.39, 95% CI: 0.17-0.89). This finding was also seen when further adjustment was made for BMI; so that participants in the highest quartile of DDS, were 59% less likely to have glioma compared to those in the lowest quartile (OR: 0.41, 95% CI: 0.18 - 0.93). In addition, a significant inverse association was found between adherence to AHEI and glioma; such that in the fully adjusted model, the participants in the fourth quartile of AHEI had 62% lower risk of glioma compared to those in the the first quartile (OR: 0.38, 95% CI: 0.17-0.84).
 
The results of this study showed that following a high-diversity healthy diet is associated with reduction in the risk of glioma.

Irritable bowel syndrome (IBS) is a chronic intestinal disorder, which is characterized by irritating pain during defecation or alteration of the bowel habits. In the curent study, the association of dietary glycemic index (GI) and glycemic load (GL) with the risk of this syndrome, was investigated in a large population of Iranian adults. This cross-sectional study was performed on 3363 adults in Isfahan. To assess GI and GL, a diet was used. The presence of IBS was evaluated using a modified Persian version of the ROME III questionnaire. General characteristics and dietary intakes of the participants across quintiles of dietary GI and GL, were investigated using one-way ANOVA, Chi square, and logistic regression in different models. In total, 748 subjects (22.2%) had IBS. The participants with the highest dietary GI had higher risk for IBS compared to those in the lowest category (OR: 1.34; 95% CI: 1.03-1.75). However, this association was not significant after adjusting for potential confounders (OR: 1.14; 95% CI: 0.81-1.61). A positive significant relationship was found between dietary GI and odds of IBS-constipation predominant (IBS-C) (OR: 1.96; 95% CI: 1.09-3.52), but was not observed for IBS-diarrhea predominant (IBS-D) (OR: 0.78; 95% CI: 0.43-1.40). There was no significant association between dietary GL and risk of total IBS or its subtypes. No significant association was found between dietary GI and GL and severity of IBS. The results of this study showed a significant association between dietary GI and risk of IBS and IBS-D as well as severity of IBS. However, a significant positive association was found between dietary GI and IBS-C, and no significant association was found between dietary GL and risk of total IBS or its subtypes as well as IBS severity.

Some studies have examined the association between micronutrient deficiencies and overweight in children, but data in this regard are conflicting. This study was done to investigate the association between serum levels of vitamin D, A and zinc with overweight in a large sample of Iranian toddlers. A total of 4261 toddlers, aged 15-23 months, who had an Iranian birth certificate and attended primary health care, were included in the current cross-sectional study. Weight and height were measured by experts based on standard protocols and body mass index (BMI) was calculated. Based on WHO criteria, overweight was defined as BMI-z-score of ≥1SD. Serum levels of 25(OH)D3 , retinol and zinc were measured for each toddler. Binary logistic regression was applied to assess the association of 25(OH)D3 , retinol and zinc levels with overweight. Mean age of study participants was 19.2 ± 8.4 months. After controlling for potential confounders, children in the highest quartile of serum 25(OH)D3 levels had lower odds of overweight compared with those in the lowest quartile (OR: 0.79, 95% CI: 0.63–0.99). Furthermore, a marginally significant inverse association was found between serum levels of 25(OH)D3 and overweight among urban toddlers (OR: 0.75, 95%CI: 0.56–1.00). Such a relationship was not seen for rural children. No other significant association was seen between serum levels of retinol and zinc and overweight either before or after controlling for covariates. In conclusion, we found a significant inverse association between serum levels of vitamin D and overweight among toddlers. Further studies, particularly of prospective nature, are required to confirm our findings.

Few studies have been performed on the adherence to the Mediterranean diet in relation to psychological health, particularly in the Middle East region. In the present study, the association between adherence to Mediterranean dietary pattern and psychological disorders (including depression, anxiety, and psychological distress), was investigated among a large population of Iranian adults.   This cross-sectional study was performed on 3172 adults (aged 18-55 years). The Mediterranean regimen model, was derived from the Trichopoulou et al. method. To investigate the relationship between Mediterranean diet and mental disorders, logistic regression was used with three modified models. In addition to the Mediterranean diet, the same analysis was performed for that pattern of food associated with psychological disorders.   The participants with the highest adherence to the Mediterranean diet had lower risk for depression (OR: 0.60, 95% CI: 0.46-0.78), anxiety (OR: 0.61, 95% CI: 0.42-0.86), and psychological distress (OR: 0.60, 95% CI: 0.45-0.79) compared to those with the lowest adherence. high intake of fruits and vegetables was associated with a lower risk of depression (Fruits: OR: 0.41; 95% CI: 0.31-0.54 and vegetables: OR: 0.53; 95% CI: 0.40-0.70), anxiety (Fruits: OR: 0.56; 95% CI: 0.39-0.79; vegetables: OR: 0.57; 95% CI: 0.39-0.84), and psychological distress (Fruits: OR: 0.47; 95% CI: 0.36-0.63; vegetables: OR: 0.46; 95% CI: 0.34-0.62). In contrast, high intake of grains was positively associated with depression (OR: 1.59, 95% CI: 1.12-2.27), anxiety (OR: 1.77, 95% CI: 1.11-2.82) and psychological distress (OR: 1.69, 95% CI: 1.16-2.45).   The findings of this study indicated an inverse association between adherence to Mediterranean dietary pattern and risk of psychological disorders (such as depression, anxiety, and psychological distress).

Limited data are available on the relationship between dietary factors and risk of glioma. The current study was conducted to investigate the association between dietary acid load (DAL) and risk of glioma in Iranian adults.   This case-control study was carried out on 128 patients with glioma and 256 healthy subjects (Matched for age and sex) in Tehran, Iran. A validated detailed food frequency questionnaire (FFQ) was used to assess dietary intakes of the participants. DAL was estimated using the protein to potassium ratio (Pro/K) and Glioma was diagnosed based on pathological tests. A detailed questionnaire including several non-dietary confounders was also completed.   In this study, the participants in the highest tertile of DAL score had a non-significant higher risk of developing glioma as compared to those in the lowest tertile (OR: 1.50; 95% CI: 0.88-2.57). After adjusting the confounding factors, those in the highest tertile of DAL score, were significantly more likely to develop glioma than those in the lowest tertile (OR: 1.87; 95% CI: 1.02-3.45). No significant effect was observed after further adjustment for dietary intakes of meats and processed meats, grains and nuts, fruits, tea, and coffee (OR: 1.97; 95% CI: 1.06, 3.65; p=0.03) and body mass index (OR: 1.96; 95% CI: 1.06, 3.64; p=0.03).   The results of this study was indicative of a significant positive association between dietary acid load, as estimated by Pro / K ratio, and risk of developing glioma among adults. Further studies, especially prospective cohorts with long-term follow up, are required to confirm these findings.

Although several studies are available linking individual dietary antioxidants to the risk of psychological disorders, data about the association of dietary total antioxidant capacity (TAC) with depression and anxiety are scarce. This study was conducted to investigate the association between dietary TAC and odds of depression and anxiety among Iranian adults. Material & Methods: In this cross-sectional study, dietary intakes of 3297 apparently healthy adults in Isfahan province, Iran, were assessed using a validated detailed food frequency questionnaire. Dietary TAC was estimated using the ferric-reducing antioxidant power (FRAP) international databases. Depression and anxiety were assessed using a validated Persian translated version of Hospital Anxiety and Depression Scale (HADS) questionnaire. Having the scores 0-7 in either subscales was considered as “normal” and the scores of 8 or more as the presence of depression or anxiety. Overall, 28.6% (n= 943) of study participants were depressed or at the borderline level, and 13.6% (n= 448) had anxiety or were at the borderline level. After controlling for potential confounders, including dietary intakes of omega-3 fatty acids, we found that those in the top quintile of dietary TAC were 43% less likely to be depressed than those in the bottom category (OR: 0.57; 95% CI: 0.40-0.82, Ptrend= 0.001). Regarding anxiety, there was a significant inverse association between dietary TAC and anxiety comparing extreme quintiles (OR: 0.62; 95% CI: 0.39-0.99, Ptrend= 0.06). A significant inverse association between dietary TAC and odds of depression and anxiety was found among adults. Further prospective studies are required to confirm these findings.

Most pregnancy-related complications are associated with increased risks of adverse outcomes for mother and her infant. Although, relations between diet and pregnancy’s complications indicate that there may be some benefits of nutritional factors to prevent such disorders, there are rare studies regarding the associations of dietary patterns and mentioned complications. So, the aim of the present study was to determine the relationship between dietary patterns and risk of pregnancy-related complications.

The current prospective observational study was based on the data collected from 812 pregnant women. Dietary data was collected using a validated semi-quantitative food frequency questionnaire.

Three major dietary patterns identified according to the results from the factor loading matrix were: (i) ‘western dietary pattern’; (ii) ‘traditional dietary pattern’; (iii) ‘healthy dietary pattern’. Overall, this study demonstrated a marginal significant inverse association between high adherence to healthy dietary pattern and chance of having pre-eclampsia. Also, a high chance of pre-eclampsia was observed among women with the most adherence to western dietary pattern.

We found that dietary patterns might be associated with the risk of pregnancy-related complications. Further studies are required to confirm these findings

Limited information exists regarding the effects of high protein (HP) diets on cardiovascular disease (CVD) risk factors among overweight and obese children. Our aim was to determine the effects of an HP diet on anthropometric indexes and CVD risk factors among overweight and obese children.
In a parallel randomized controlled trial, we recruited 50 overweight and obese children, aged 6-11 years, for a 10 week HP or control diet (protein, carbohydrate, fat: 25%, 45%, 30% in the HP diet vs. 15%, 55%, 30% in the control diet, respectively). Fasting blood glucose (FBG) serum insulin levels, lipid profiles, systolic and diastolic blood pressure (SBP and DBP), and anthropometric measurements were assessed using standard guidelines.
86% of children completed the trial. Percent changes (PC) for anthropometric and biochemical variables were not significantly different between the two groups. The PC of serum triglyceride (TG) level was significantly decreased in the HP group compared to in the control group (PC: -10.16±4.30% vs.12.11±7.80%; P = 0.01) in the crude model, but not in the adjusted model. For other variables, we did not find any significant differences between the HP group and the controls.
In the present study, we did not find any significant effect of adherence to an HP diet in improving anthropometric measurements or other CVD risk factors among obese and overweight children.

Limited data are available linking dietary total antioxidant capacity (TAC) to the risk of stroke. This study was conducted to investigate the association between dietary TAC and odds of stroke among Iranian adults.
This case-control study was done on 195 hospitalized stroke cases and 195 hospital-based controls in Al-Zahra hospital, Isfahan, Iran. Dietary intake of participants was assessed using a validated detailed food frequency questionnaire. Dietary TAC was estimated using the ferric-reducing antioxidant power (FRAP) international databases. Stroke was confirmed by a trained neurologist using standard imaging methods. Demographic information were obtained by related questionnaire. Anthropometric data were measured by appropriate scale and meter. Physical activity was also assessed by specific questionnaire and reported as MET-min/day.
Mean dietary TAC was not significantly different comparing cases and controls (10.2±6.0 vs 10.4±4.8, P= 0.61). However, after adjustment for potential confounders including dietary intakes of fiber and omega-3 fatty acids, we found almost significant inverse association between dietary TAC and odds of stroke; such that each unit increase in dietary TAC was associated with 29% reduced odds of stroke (OR: 0.71; 95% CI: 0.50-1.01, P= 0.06). When we examined the association across tertiles of dietary TAC, we found that after controlling for potential confounders, those in the top tertile of dietary TAC were 51% less likely to have stroke than those in the bottom tertile (marginally significant) (OR=0.49; 0.49-1.00, p=0.12).
We found an almost significant inverse association between dietary TAC and odds of stroke. Further studies of prospective design are required to confirm these findings.

The association between the speed of eating and gastroesophageal reflux disease (GERD) is less studied in Middle-Eastern countries. We aimed to find the relationship between the speed of eating and gastroesophageal reflux disease symptoms in a large sample of Iranian adults.
In this cross-sectional study, 4669 individuals fulfilled a questionnaire about their eating habits. Regarding the speed of eating, participants were asked: ‘How thoroughly do you chew foods? (not very well, well, very well)’, ‘How long does it take you to eat lunch? How long does it take you to eat dinner? ( 20 minutes). Gastroesophageal reflux disease was defined as having heartburn sometimes or more during the last three months. The severity of disease was assessed with a four-item scale rating (mild, moderate, severe, and very severe).
Findings: The prevalence of gastroesophageal reflux disease in study population was 23.7%. After adjustment of potential confounders, the association remained the same. Individuals who had “not very well” and ”well” chewed their food, had an increased risk of 94% and 38% to have gastroesophageal reflux disease with great frequency. When the mutual effect of other potential confounders were taken into account, association remained meaningful, those who had “not very well” and “well” chewed their food had an increased risk of 91% and 35% to have gastroesophageal reflux disease with great frequency. On the other hand, individuals who ate their lunch during more than 10 minutes had a reduced risk of 30% and 25% to have gastroesophageal reflux disease with great frequency.
We found a significant association between the speed of eating and gastroesophageal reflux disease symptoms and heartburn.