حسین دلشاد

Intelligence is defined as the capacity for abstraction, logic, understanding, self-awareness, learning, emotional knowledge, reasoning, planning, creativity, critical thinking, and problem-solving. According to recent studies, the Intelligence Quotient (IQ) of 31 countries of the world, has increased during the 20th century. The aim of this study is evaluation of the IQ of Iranians and also a brief review of research conducted on IQ.

We searched all relevant articles published from 1950 to 2021 in databases.

According to a 2021 study at Ulster Institute, the highest average IQ scores in the world belong to the Japanese, with the citizens of Taiwan and Singapore close behind.  The average IQ of Iranian population is 84 and the ranking of Iran is 119 among 199 countries in the world. The ranking of Iran has been reported from 23 to 110 in various websites. A meta-analysis of 52 studies conducted in Iran in 2019, reported that the mean Iranian IQ is 97.12, being 97.73 in ages less than 20 years old, and 105.61 in the population older than 20 years old. The IQ of Iranian school children was 89 before iodine supplementation in 1989 which reached 97, ten years after iodine supplementation.

We need a national study with appropriate methodology to measure Iranian IQ, but with the average IQ of 97 in juvenile Iranians, the ranking of Iran is 31. However, with respect to an average IQ of 106 in the population older than 20 years, the ranking of Iran is 3 among 199 countries in the world.

Physiological changes during pregnancy affect thyroid function and also free thyroxine (FT4) assay methods. These impacts make immunoassays unreliable for detecting hypothyroxinemia during pregnancy. Due to pregnant women’s adequate consumption of iodine in Iran, reference ranges of FT4 needs to be obtained for this group.

A total of 1077 Iranian pregnant women were randomly selected from health clinics in 12 provinces of Iran during all trimesters. Five hundred eighty-seven individuals were included in the study after applying the exclusion criteria to establish the reference range. Then, TSH, FT4, and TPOAB levels were examined.

The mean age of the participants was 27.6 ± 5.7 years, and the median urine iodine level was 236 μg/L (188-321). The 5th and 95th percentiles obtained for FT4 were 0.93 and 1.35 in the first trimester, 0.78 and 1.15 in the second trimester, and 0.77 and 1.15 ng/dl in the third trimester, respectively.

Due to the downward trend of the normal range of FT4 from the first to the third trimester of pregnancy, it seems necessary to consider the trimester-specific normal range for diagnosis and management of thyroid disease in Iranian pregnant women.

Rock salt and sea salt have the same chemical formula as sodium chloride. Recently, there has been widespread publicity about the consumption of sea salt and rock salt. This document highlights the  disadvantages of unrefined sea salt and rock salt and increasing risk of iodine deficiency disorders.

This study was performed by using guidelines and results of national and international researches.

Hypertension: All types of salts, pink or white, and fine or coarse crystals; have equal sodium content and nutritional value of sea salt, which is considered natural salt, is the same as that of refined iodized salt.Sodium in salt is the main cause of hypertension. Therefore, the notion that natural salt or sea salt is useful for treating hypertension has no scientific basis.Carcinogenic effect: Heavy metals and industrial chemical substances which enter waters of the oceans and seas are mixed with sea salt and rock salt and can cause some cancers in the body.Three decades ago most of the provinces faced moderate to severe iodine deficiency. Studies by Iranian researchers have shown severe complications of iodine deficiency, including growth retardation, hearing impairment and decreased IQ in children living in mountains of the country. By producing iodized salt refined by salt factories and the public consumption of iodized salt, iodine deficiency disorders have been controlled in the country since the early 1970s.

It is suggested that all members of the community use purified iodized salt in recommended levels.

In the first part, general points were reviewed about fasting and diabetes. The effect of fasting is different in various patients and different fasting conditions. In this section, 3 special items have selected for in-depth and specific

Case 1: Fasting in a 45-year-old man with history of diabetes for 4 years  and control with 2 oral medications.
Case 2: Fasting in a 54-year-old man with a history of type 1 diabetes mellitus for 10 years, controlled with insulin. He does not have any chronic complication of diabetes and also no history of hypoglysemic attack during last three months.
Case 3: Fasting in a 37-year-old woman in the sixth month of pregnancy under treatment with insulin. Her blood glucose monitoring with a glucometer is in acceptable range for pregnancy and has not had hypoglycemic attacks during insulin therapy.
In this article, some of the most important aspects of fasting in patients with diabetes and similar patients are discussed.

This study is concluded from a meeting was held  in the Academy of Medical Sciences about fasting and diabetes, and was performed by the method of focus group discussion and review library national documents. The present study was perpared  from 3 real cases.

The first case is capable to perform fasting, and by taking medicine twice a day, can fast under observation of physician. The second case, suffering from type 1 diabetes and should be treated with insulin. He is considered in very high-risk group of patients and fasting is harmful for him.Third case, is not allowed for fasting like other pregnant women with diabetes.

Fasting is recommended in patients suffering from type 2 diabetes, which are controlled with oral medications and without recent history of hypoglycemia attack or significant complications of diabetes. Fasting is not allowed in insulin dependent type 1diabetic patients and pregnant diabetic women.

The body’s strategy for coping with pain and stress in the delivery process is the secretion of opioid peptides, including β-endorphins. The aim of this study was to investigate the factors related to the concentration of umbilical cord blood β -endorphins in newborns born of primiparous women. In this descriptive study, 80 umbilical cord blood samples from neonates of primipara pregnant women were collected in 2 groups of 40 eligible elective cesarean section and normal delivery with gestational age of 38 to 42 weeks, single and low risk, 1 to 2 minutes postpartum, and β-endorphin concentration. The enzyme-linked immunosorbent assay was measured using ELISA kit. Data was analyzed by T-test, Chi-square, Analysis of variance and regression using SPSS 18 software. The mean of cord blood β-endorphins in normal delivery and cesarean section was 38±27.47 and 11.11±19.59 ng/l, respectively. There was a significant difference between the results of the two groups (P=0.03). Exercise during pregnancy was related to β-endorphin secretion (P<0.05), while gestational age, pain reduction methods, duration of the first and second stages of labor, duration of the infusion, and weight of the newborn did not affect β endorphin secretion. Natural delivery can provide the normal function of the body for the mother, fetus and baby and on the other hand, control the risk factors of the mother and the baby and promote maternal and neonatal outcomes.

Childhood obesity is an important risk factor for adult obesity and its consequences, its prevention and control are hence vital; considering the limited health resources, the most appropriate policies should be implemented.
After reviewing literature, taking into account national health policies and priorities, of other countries, international organization and guidelines of authorized officials, eight priority criteria and twenty policies for prevention of childhood obesity were extracted and submitted to selected stakeholders as questionnaires to determine policy priorities using the Delphi technique.
The three highest score priority criteria were efficacy, feasibility and inequality, Five high priority policies were: 1- Improving public health education in particular for healthy foods; 2- Adding obesity prevention and healthy diet disciplines/lessons to school teaching curriculum for mothers and kindergarten training courses; 3-Improving community and school physical activities and sports by revising management strategies; 4-Controling media regarding food and drink advertising and 5- Encouraging participation in physical activities by implementing revised policies for public transportation.
The prioritised policis in addition to other stakeholder opinions can be used for selecting most appropriate strategies and action plans to combat childhood obesity.

Iodine fortification is widespread. Systematic monitoring of iodine fortification programs should be carried out to secure an optimal fortification level. This study aimed to investigate the effectiveness of iodine fortification program by evaluation of goiter prevalence, median urinary iodine excretion of School children in Iranat baseline until now according to national studies data. In this study, all scientific papers of IDD surveillance system, results of IDD-related surveys at national levels searched by Scopus, PubMed, Science Direct, ScienceDirect, SID and IranMedex in English and Persian with no time limitation. National studies data are summarized, interpreted, and then organized. According to national nutrition and food safety document criteria, Goiter prevalence, urinary iodine excretion in schoolchildren and iodine content of salt at household, factory and distribution sites were acceptable, however lack of adequate iodine nutrition (insufficient or above requirement median urinary iodine) in some provinces were detectable yet. It seems Iran has made strong progress in the development of universal salt iodization strategy and meets all criteria for sustainable elimination of iodine deficiency. However, lack of adequate iodine nutrition in some provinces necessitates special attention and proper. Also according to systematic monitoring of iodine fortification programs importance, fifth national monitoring seems necessary.

Undiagnosed thyroid dysfunction may impair metabolic control in patients with diabetes. Due to the lack of adequate studies on the incidence of thyroid dysfunction in patients with type 2 diabetes mellitus there is no consensus regarding optimal thyroid screening strategies in routine diabetes care. The aim of this study was to determine the incidence of thyroid dysfunction in patients with type 2 diabetes. In this study، patients aged≥30 years، participants of in the prospective Tehran Lipid and Glucose Study، who had complete thyroid assessments were divided into two groups of 428 diabetic and 2847 nondiabetic controls and followed for 12 years. The incidence of thyroid dysfunction in these two groups was compared and the relative risk of type 2 diabetes for thyroid dysfunction was calculated. Compared to those without diabetes the disorders patients with diabetes were less likely to develop thyroid dysfunction (incidence rate 12. 56 vs. 16. 50 cases per 1000 person-years، Relative risk 0. 74، 95% CI، 0. 534-1. 026، P=0. 071). The incidence of thyroid dysfunction in type 2 diabetic patients is not higher than in non-diabetic individuals، indicating that routine screening of thyroid dysfunctions is not recommended in type 2 diabetic subjects.

Oxidative stress plays a key role in the pathogenesis of late diabetic complications, the markers of which could be improved by the beneficial effects of legumes. In this randomized crossover trial, 24 overweight subjects, aged 50-80 years, with type 2 diabetes, were selected. We aimed to determine the effects of non-soybean legumes consumption on oxidative stress markers such as ox-LDL (oxidative LDL), MDA (Malonedialdehyde) and TAC (total antioxidant capacity) in type 2 diabetic patients. The subjects were randomly assigned into two groups, receiving two diets – the TLC (controls) or the TLC diet with legumes (receiving 2 servings of legumes instead of meat three days of the week in the TLC diet). Duration of each diet was 8 weeks with a 4 week wash-out period. At the beginning and end of each dietary period, fasting plasma glucose, ox-LDL, MDA, TAC and weight were measured. After the nutritional intervention, diabetic patients, those individuals who followed the legume-based TLC diet had significant reduction in ox- LDL (-3.1±0.5 vs. -0.7±0.4; P=0.003) and MDA (-1.1±0.2 vs. -0.3±0.1; P=0.006), but no change was observed in the TAC and BMI of the case and control groups. The legume-based TLC diet improves oxidative stress markers in diabetic patients, compared to the legume-free TLC diet.

Unhealthy snacks contain high amounts of calories, simple sugars, fat, cholesterol, salt, additives, and conservatives. Increased consumption of these unhealthy snacks is one of the underlying factors for the prevalence of overweight, obesity, and metabolic disorders. In this study, we investigated the effects of unhealthy snacks on diet and the risk of metabolic syndrome after 3-years of follow-up in Tehranian adults. This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study, between 2006-2008 and 2009-2011, on men and women in Tehran, Iran. Dietary intakes of participants were measured using a validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were assessed at baseline and 3 years later. Multiple logistic regression models with adjustment for confounding factors were used to estimate the occurrence of metabolic syndrome (MetS) in each quartile of unhealthy snacks. The mean age of participants was 37.8 ± 12.3 years, and the mean of body mass index was 26.0 ± 4.5 kg/m2. Moreover, 39% of the participants were male. Daily energy intake, dietary energy density, and total fat and sodium intake were higher in the fourth quartile of unhealthy snacks consumption. There was a significant decreasing trend in dietary intake of carbohydrate, calcium, zinc, selenium, and fiber parallel to increase in consumption of energy-dense snacks. Participants who were in the highest quartile of energy intake from unhealthy snacks consumed less whole grains, vegetables, and dairy products. After adjustment for potential confounders, the risk of metabolic syndrome had a significant positive association with salty snacks consumption, and a non-significant positive association with consumption of candies, chocolate, and soft drinks. Increased daily energy intake from unhealthy snacks could be a risk factor for the occurrence of metabolic syndrome.