Journal of Nutrition, Fasting and Health
Volume:11 Issue: 2, Spring 2023

"Health for All by 2000" was launched by WHO in 1978 and is based on primary healthcare availability worldwide. During the month of Safar, many people from neighboring cities and countries travel to Mashhad. Since the qualitative approach can lead to a better understanding of access to healthcare from the perception of consumers, this study aimed to assess the perception of Pilgrims and healthcare providers of healthcare services and gain more profound knowledge about healthcare consumers’ experiences.  This qualitative study was conducted in Mashhad during Safar based on conventional content analysis from September 20-27, 2022. This study used a semi-structured in-depth interview on 36 participants, including pilgrims (n=27) and healthcare providers (n=9) such as medical doctors, nurses, and health experts selected through purposeful sampling. The interviews were transcribed word for word. The MAXqda software and Graneheim and Lundman’s qualitative content analysis were used for data analysis.  Data analysis revealed three categories, including 1. Understanding the challenges of the treatment services in terms of three subcategories: A. Lack of medical doctors, drug shortages, and higher prices of medicines, B. Experiencing the diseases (skin, cardiovascular diseases, poisoning, and digestive problems, musculoskeletal pain and asthma), and C. Lack of an appropriate place for patient examination and serum injection. 2. Understanding the challenges of health services, including three subcategories: A. Time and place insufficiency of services, B. Lack of access to sanitary detergents, C. Improper cleaning of resting spaces and places, and finally, 3. Understanding the challenges of welfare services, including two subcategories: A. Inadequacy and lack of access to the appropriate rest place, and B. poor quality and sortage of food.  The results indicated that access to healthcare, treatment, and welfare is more than just these services. Health policymakers’ commitment to improving healthcare equity, hopefully, leads to positive changes in the healthcare system. Therefore, enhancing social participation in the healthcare system and providing comprehensive education on the optimal use of healthcare services is necessary to empower pilgrims to access better healthcare.

Cardiovascular diseases (CVD) have been recognized as the leading causes of death worldwide and in Iran. Deaths from CVD diseases accounted for approximately 39.42% of Razavi Khorasan Province (RKP). This study aimed to evaluate the risk factors associated with CVD mortality in the residents of RKP.   This retrospective cohort study was conducted based on recorded information from the Vic Chancellery of Health Questionnaires of KRP (2016–2019). This study was conducted on 2,304,156 participants. CVD deaths made up about 50% of total deaths. The opium use, history of heart attack, BMI ≥40kg/m2, homemade alcohol, FBS mg/dL >126, diabetes, BMI ≥30kg/m2, permanent use of salt, Systolic blood pressure, Framingham risk score, and age were CVD risk factors, respectively (OR 6.59, 4.91, 3.25, 2.64, 2.00, 1.99, 1.89, 1.80, 1.09, 1.04, and 1.03, P = 0.001). In addition, higher educational level, female gender, BMI 25-27kg/m, healthier eating habits (higher consumption of dairy, fruits, and vegetables), moderate exercise, and aspirin use were identified as protective factors.   This study identified the demographic, behavioral, anthropometric and biochemical risk factors and preventive factors of CVD in RKP. These findings might justify the high incidence of sudden death in some cities of RKP like Dargaz.

Hormonal changes during menopause may result in type 2 diabetes. Therefore, the prevention of diabetes and its complications is essential during menopause. The effects of barley (Hordeum vulgare L) in maintaining blood glucose and insulin have been previously reported. This study was designed to evaluate the impact of roasted barley flour consumption on the blood sugar level of prediabetic postmenopausal women.  This randomized controlled trial study will be conducted on 68 prediabetic postmenopausal women referring to community health centers in Gonabad, Iran. All participants will complete a demographic questionnaire, and their fasting and two-hour postprandial blood glucose levels, HbA1C, will be recorded. The intervention group will receive 60g of roasted barley flour daily (20g before each meal) for four weeks, while the control group will receive no intervention. Fasting and two-hour postprandial blood glucose will be checked by venous blood sampling at baseline, two and four weeks after intervention. All participants will complete three-day food intake record and Beck's physical activity questionnaire during the study. Data will be analyzed using the statistical package for social sciences (SPSS) software (version 16), and a p-value less than 0.05 will be considered significant.  This study may prove the effectiveness of roasted barley flour in reducing blood glucose. Daily consumption of this compound can be recommended for prediabetic menopausal women.

Ramadan is the ninth month of the lunar year, in which Muslims avoid eating and drinking from sunrise to sunset. Insulin-like growth factor 1 (IGF1) is a small peptide circulating in the blood. IGF1 is essential in regulating proliferation, differentiation, apoptosis, and transformation. Studies have shown that a slight increase in IGF1 levels increases the risk of prostate, breast, colon, and lung cancer. This study evaluated the effects of fasting with regular consumption patterns and food avoidance on serum IGF1 concentration in healthy subjects before and after fasting.  A total of 40 healthy adults aged 18-55 years who fasted for about 16 hours a day and at least 20-25 days in Ramadan were included. The first sample was collected one week before Ramadan, and the second was obtained at the end of Ramadan. After taking 2cc of whole venous blood, sera were isolated, and IGF1 concentration was calculated by quantitative ELISA method using a DiaMetra kit.  There were 40 participants in the study, 31 of whom were female, and nine were male. The mean IGF1 before and after fasting was 198.6 ± 77.9 and 146.3 ± 44.5 ng/ml, respectively, with a 52 ng/ml difference.  Based on the results, fasting reduces the level of IGF1, indicating the benefits of fasting because of limiting the harmful effects of a risk factor for some diseases.

Obesity and metabolic syndrome are associated with inflammation, vascular endothelial dysfunction and cardiovascular complications.In this study, the aim was to investigate the effect of aerobic training combined with Selen Plus supplementation on the serum levels of nitric oxide and myeloperoxidase in obese women with metabolic syndrome.  In this quasi-experimental study, 48 obese women (30 ≤ BMI ≤ 36) with metabolic syndrome aged 30-45 years were randomly divided into 4 groups: control (no intervention); Selen Plus (1000 grams/daily); aerobic training (every other day) and combined group (aerobic training + selen plus). Fasting levels of nitric oxide and myeloperoxidase and anthropometric indices were measured before and 48 hours after the final training session in each group. ANCOVA statistical test was used to compare the data and paired t-test was used to determine intra-group changes (p < 0.05).  Compared to the control group, serum nitric oxide significantly increased and myeloperoxidase significantly decreased in the aerobic, selen plus and combined groups (p=0.001).Nitric oxide in the combined group increased significantly compared to selen plus group (p=0.042).  Selen plus supplementation during aerobic training is associated with improvement of vascular endothelial function indices in women with metabolic syndrome compared to its use alone.

Nowadays, improving anxiety, depression, and stress is important in managing non-alcoholic fatty liver (NAFLD). Thus, this study aimed to evaluate eight weeks of pomegranate peel (PP) supplementation on depression, anxiety, and stress scale changes among NAFLD patients.  This randomized clinical trial was conducted on 76 NAFLD patients assigned to the PP (n=39) or placebo (n=37) groups. Participants received the pomegranate peel (1500 mg/day) or placebo for eight weeks. PP capsules were prepared fromdry extract of PP by soaking. A diet with reduced calorie intake and healthy recommendations was given to all participants. The status of NAFLD was checked with two-dimensional elastography. Mental health was evaluated using depression, anxiety, and stress scale, and dietary intake was assessed by 3-day recall before and after the intervention.  The average age of the participants was 43.1±8.6 years, of whom 51.3% were women. In the PP group, weight, liver stiffness, and hepatorenal sonography index changes significantly differed from the placebo group before and after adjusting potential covariates, including weight and physical activity (P< 0.001). Depression and stress scores changed significantly in the PP group during the study before and after adjusting potential covariates (P= 0.002, 0.05, respectively). Anxiety score changes were insignificant between the two groups (P= 0.1).  Based on the results, eight-week supplementation of pomegranate peel ameliorated depression and stress symptoms among NAFLD patients.

Athletes and non-athletes use nandrolone (Na) for different purposes as a derivative of testosterone, and various results have been reported regarding its use. This study aimed to evaluate the effect of a period of resistance training (RT) on SOD, MDA, CRP, and cTn-C in the cardiac tissue of Na- exposed rats.  In the present experimental research, 20 male Wistar rats aged 8-10 weeks were randomly divided into four groups of five animals: (1) control, (2) sham, (3) Na (10mg/kg), (4) Na+RT. The RT group performed 1m ladder climbing in three sessions weekly for eight weeks. One-way ANOVA and Tukey’s post hoc tests were implemented to analyze the data (P≤0.05).  Levels of SOD were significantly lower in the Na+RT group compared to the control group (P=0.006). However, no significant difference was observed in levels of SOD in the Na group compared to the Na+RT group (P=0.99). In addition, the levels of MDA and CRP in the Na+RT group were significantly lower than in the Na group (P≤0.05). Histological studies showed that Na intoxication, RT, and RT with Na use did not affect tissue changes in the study groups.  Based on the results, nandrolone with and without resistance training increases heart disease risk indicators. However, the risk of heart disease in training and abusing nandrolone is less than the normal condition of this steroid without training.

A proper diet and physical activity benefit Alzheimer’s disease (AD). Therefore, this study aimed to evaluate the impact of endurance training (ET) with saffron (Sa) consumption on cytochrome C and calmodulin kinase 2 in the heart tissue of AD rats.  In this experimental study, 40 rats (AD induced by intraperitoneal 8mg/kg trimethyl tin) were divided into five groups of eight animals comprising: (1) AD, (2) Endurance training (ET), (3) saffron (Sa), (4) ET+Sa, and (5) sham (Saffron solvent) groups. The ET and ET+Sa groups ran on a treadmill at 15 to 20m/min (three sessions a week for eight weeks), each lasting 15 to 30 minutes. In addition, the Sa and ET+Sa groups were given 25mg/kg saffron extract per day. The Shapiro-Wilk test, one-way ANOVA, and Tukey’s post hoc tests were used to analyze the data (P≥0.05).  ET, Sa, and ET+Sa significantly decreased cytochrome C and calmodulin kinase 2 (P≥0.05). In addition, ET+Sa significantly reduced calmodulin kinase two more than training (P=0.04).  Based on the results, Training and saffron consumption appear to have the same impacts on reducing cytochrome C and calmodulin kinase 2. However, simultaneous training and saffron consumption can improve the gene expression levels of calmodulin kinase 2.

Controlling nutrition and exercise can affect the density and metabolism of bone tissue. Therefore, the aim of the present study was to investigate the effect of eight weeks of moderate intensity continuous training (MICT) and high intensity interval training (HIIT) along with Citrus aurantium (CA) on bone metabolic markers of elderly female rats.  In this experimental study, 64 elderly female rats (14 ± 2 months old and weight of 290 ± 25 grams) were divided into 7 groups including 1) control, 2) MICT, 3) HIIT, 4) MICT+CA, 5) HIIT+CA, 6) CA and 7) sham (normal saline) groups. HIIT with an intensity of 85- 110% VO2max and MICT with an intensity of 65% VO2max were performed and CA was injected at the doses of 300 mg/kg/day intraperitoneally. The variables were measured using the ELISA method with the Pars Azmoun kit. The data of the present research were analyzed using one-way analysis of variance and Tukey post hoc test (P≤0.05).  In MICT group the PTH and Na levels were significantly lower and Ca levels were higher than the C group (P≤0.05). PTH and Na levels in the MICT group were lower than the HIIT group (P≤0.05). Ca levels in the CA group were higher than the C group (P≤0.05). In MICT+CA and HIIT+CA groups, PTH levels were lower and Ca levels were higher than the C group (P≤0.05). Also, PTH and Na levels in HIIT+CA group were lower than the MICT+CA group (P≤0.05).  it seems that MICT has a better effect on bone metabolic markers than HIIT; meanwhile, HIIT with an antioxidant such as CA has more favorable effect on bone metabolic markers.

Controlling nutrition and exercise can affect the density and metabolism of bone tissue. Therefore, the aim of the present study was to investigate the effect of eight weeks of moderate intensity continuous training (MICT) and high intensity interval training (HIIT) along with Citrus aurantium (CA) on bone metabolic markers of elderly female rats.  In this experimental study, 64 elderly female rats (14 ± 2 months old and weight of 290 ± 25 grams) were divided into 7 groups including 1) control, 2) MICT, 3) HIIT, 4) MICT+CA, 5) HIIT+CA, 6) CA and 7) sham (normal saline) groups. HIIT with an intensity of 85- 110% VO2max and MICT with an intensity of 65% VO2max were performed and CA was injected at the doses of 300 mg/kg/day intraperitoneally. The variables were measured using the ELISA method with the Pars Azmoun kit. The data of the present research were analyzed using one-way analysis of variance and Tukey post hoc test (P≤0.05).  In MICT group the PTH and Na levels were significantly lower and Ca levels were higher than the C group (P≤0.05). PTH and Na levels in the MICT group were lower than the HIIT group (P≤0.05). Ca levels in the CA group were higher than the C group (P≤0.05). In MICT+CA and HIIT+CA groups, PTH levels were lower and Ca levels were higher than the C group (P≤0.05). Also, PTH and Na levels in HIIT+CA group were lower than the MICT+CA group (P≤0.05).  it seems that MICT has a better effect on bone metabolic markers than HIIT; meanwhile, HIIT with an antioxidant such as CA has more favorable effect on bone metabolic markers.