Vol 5, No 1/2 (Winter/Spring 2019)
Effect of Nutrition Intervention on Indices of Growth in Day Care Centers of the City of Birjand, Iran
Background: Childhood malnutrition is the main risk factor for impaired mental and physical growth and several diseases and leads to premature death worldwide. Therefore, reducing childhood malnutrition is a top priority in most countries. In this regard, several studies have explored the effects of nutritional intervention on reducing childhood malnutrition, although mostly in controlled conditions and with small sample sizes. Data on community-based interventions are limited. In this study, we investigated the effects of providing hot meals at lunchtime on the growth of children in day care centers in rural areas of the city of Birjand, Iran.
Methods: This was a quasi-experimental study. Hot meals were offered for 6 months to all the children (n = 1809) in day care centers of rural Birjand. Height and weight of the children were measured before and after the intervention. Z-score indicators were calculated using WHO Anthro and Anthro plus software packages. SPSS was used for data analyses.
Results: Prevalence of wasting and stunting decreased after the intervention in both sexes. The decrease in stunting prevalence was significantly greater in boys than in girls. However, proportions of various categories of height-for-age Z-score (HAZ) did not change significantly in either sex. In both sexes, weight, height, body mass index, and weight-for-age improved significantly after the intervention. The prevalence of obesity and overweight did not change after the intervention.
Conclusion: Based on the findings, providing hot food at lunchtime in day care centers can reduce wasting and stunting in children in rural regions of Birjand, Iran.
Evaluation of Nutritional Assessment Quality and Rate of Referral to a Dietitian in Shariati Hospital, Tehran, Iran: A Clinical Audit
Background: Malnutrition is an acute or a chronic condition resulting from an imbalance in the intake, both in the form of undernutrition and over nutrition, leading to changes in the composition or reduced function of the body. Bio-social conditions and acute or chronic diseases are the most important factors affecting nutrition. It has been suggested that awareness of the prevalence and severity of malnutrition in hospitalized patients can be used by managers to understand the causes, health care system requirements, and health plans.
Methods: Medical records of 483 patients from 11 different wards of Shariati general hospital were assessed to evaluate the quality of nutritional assessment and the rate of referral to nutrition experts by physicians. This study consisted of two phases: evaluation of initial nutritional assessment and assessing the accuracy of malnutrition screening forms completion.
Results: Our study showed no initial nutritional assessment for 34% of the patients. Assessment of the accuracy of malnutrition screening showed that there was a considerable error in the reporting of BMI (66%), weight loss (51%), appetite loss (50%), and severity of the patient’s situation (39%). Also, the rate of referral to a nutritionist was 0% and 1% in the first and second phases of the study, respectively.
Conclusion: The present study showed that the quality of nutritional screening and subsequent referral to nutrition experts for professional nutritional assessment is negligible in Shariati hospital, Tehran, Iran.
Association of Cigarette Smoking and Serum Concentrations of Vitamins A and E in Men: A Case-Control Study
Background: Cigarette smoking is associated with changes in blood concentrations of some antioxidant vitamins. This study aimed to determine the association of cigarette smoking with serum concentrations of vitamins A and E in men.
Methods: This was a case-control study, in which the participants were 80 male smokers and 84 male nonsmokers (age range: 20-60 years). Data on dietary intake, health status, smoking habits, anthropometric characteristics, and vitamin levels were compared between cases and controls.
Results: Smokers had significantly lower concentrations of serum vitamin E (p = 0.001) and vitamin A (p = 0.013) compared with nonsmokers. However, serum vitamin E to cholesterol ratio was not significantly different between smokers and nonsmokers. Moreover, the highest circulating concentrations of vitamin E was observed in smokers who smoked ≤9 cigarettes per day (p < 0.03), while and the lowest vitamin E was seen in men smoking ≥20 cigarettes per day.
Conclusion: The results of this study identified that cigarette smoking is associated with lower levels of serum vitamin E and vitamin A, although it was not associated with vitamin E to cholesterol ratio.
Exploring the Underlying Factors for Fast Food Consumption Behavior among Adolescents: A Qualitative Study
Background: Overweight and obesity cause different disorders such as high blood pressure, inflammation, and cardiovascular diseases. So it becomes a major factor for enhancing different mortal diseases.
Due to the high tendency to consume fast food among adolescents, this study aims to identify the causes of adolescent’s desire for and fast food consumption.
Methods: An interview was carried out with some adolescents to explore the reasons and their consumption rate.
Results: The main factors promoting fast food consumption in students can be divided into 4 categories. Also, the students’ motivation in fast food ingestion can be explained in personal, social, and educational reasons.
Conclusion: Increasing number of fast food restaurants, peer pressure, parents’ role in choosing proper nutrition, and lack of knowledge about the risks of fast food are the main reasons for increased fast food consumption in adolescents.
Association of Food Insecurity with Nutrition Status, Food Diversity and Anthropometric Status in Iranian Elderlies: A Cross-Sectional Study
Background: Health and nutritional issues of the elderly are different from other age groups. The results of studies cannot be compared and concluded, because these studies have different operational definitions, such as considering food quality rather than the amount of food intake and also limiting some causes of food insecurity in the analysis and the presentation of results in others. Therefore, we investigated the effects of food insecurity on food diversity and the nutritional and anthropometric status of the elderly in Tehran.
Methods: This cross-sectional study was performed on 300 elderly residents in Tehran, with a mean age of 67.5 ± 5.74. Food insecurity was evaluated using the Household Food Insecurity Access Scale (HFIAS). The nutritional status and health of the elderlies were assessed using the Mini Nutritional Assessment (MNA). Waist circumference, weight, and height were measured and BMI was calculated. All statistical calculations were performed with the SPSS.
Results: The prevalence of malnourishment was significantly (p < 0.001) higher in the severely food-insecure group (62.5%). A significant inverse relationship was observed between the HFIAS scores and weight (β = -4.38, p < 0.001), body mass index (β = -1.46, p < 0.001), waist circumference (β = -3.37, p = 0.002), and dietary diversity score (DDS) (β = -0.738, p < 0.001). Moreover, we found a significant relationship between HFIAS and MNA scores (β = 0.486, p < 0.001). Participants in the food-insecure group had a greater risk of developing malnourishment (OR, 16.45; 95% CI, 8.55-31.66) and having poor dietary diversity (OR, 7.42; 95% CI, 2.87-19.16) compared with the food-secure group.
Conclusion: After adjusting for possible confounding factors, we found that food insecurity was associated with MNA score. We also found an inverse association between food insecurity and socioeconomic status, anthropometric measurements, and dietary diversity.
Effect of an Educational Intervention on Healthy Lifestyle in Iranian Children and Adolescents: The Iran-Ending Childhood Obesity (IRAN-ECHO) Program
Background: This study aimed at examining the effect of an educational program on children’s and adolescents’ knowledge of, attitude toward, and practice of healthy lifestyle habits.
Methods: This was a quasi-experimental nationwide intervention carried out as part of the Iran-Ending Childhood Obesity (IRAN-ECHO) program. Participants were selected from six cities of Iran. The sample size was calculated to be 1264 for each city. Knowledge of, attitude toward, and practice of healthy nutritional habits were measured at baseline and following the intervention. A physician and a dietitian provided recommendations on healthy diet, screen time, physical activity, and sleep time. Behavioral therapy was given when necessary.
Results: The prevalence of overweight or obesity was 7.6%. The frequency of students with desirable knowledge was significantly greater after the intervention compared with baseline (32.5% vs 24.8%, p = 0.02). The mean score for attitude toward obesity complications significantly increased from 73.09 to 74.78 (p = 0.03). There was also a significant increase in the mean score for the practice of low consumption of unhealthy snacks after the intervention (difference = 1.63, p = 0.03). The mean score for participation in mild physical activity increased from 50.67 to 65 after the intervention (p < 0.001). However, there were no significant changes in the number of students with desirable attitude and practice following the intervention (p> 0.05).
Conclusion: The study shows that an educational intervention based on WHO-ECHO recommendations can be useful for improving the knowledge of a healthy lifestyle in children and adolescents. Over time, it might lead to a positive attitude and behavior toward a healthier lifestyle. Continued professional education and implementation of guidelines for the prevention and management of early childhood overweight and obesity are suggested.
Adherence to a Mediterranean Dietary Pattern and Risk of Breast and Endometrial Cancers: A Systematic Review
Breast and endometrial cancers are the most prevalent cancers among women all over the world, with breast cancer being the first cause of cancer mortality in women. Major known risk factors for breast and endometrial cancers are obesity, low physical activity, and unhealthy and poor diet, contributing to about 30%-35% of cancer incidence. Recent evidence supports that adherence to a healthy dietary pattern such as the Mediterranean diet (MD) is associated with reduced risk of certain types of cancer, including breast and endometrial cancers. The data for the current review were identified through a systematic search on PubMed, Scopus, and Cochrane databases using the following search terms/keywords: “Mediterranean diet,” “Mediterranean dietary pattern,” “breast,” “mammary,” “endometrial,” “cancer,” “carcinoma,” and “neoplasm.” The reference lists of the included papers were also searched manually. Through the review process, eight case-control studies, four cohort studies, and one clinical trial were identified. The included studies were conducted among postmenopausal and premenopausal women in the United States and some European countries. The review suggests a protective role for the MD against breast cancer risk in both populations. According to the fact that there was insufficient research on the association of the MD pattern and endometrial cancer risk, its protective effect cannot be interpreted with certainty. Further studies in this area, especially interventional studies, are needed to determine causality.