مهندس اکبرفاضل تبار ملکشاه

Pancreatic cancer (PC) is classed as the 7th leading cause of cancer-related death in the world. Previous evidence indicates that hyperglycemia, insulin resistance, diabetes, and obesity are implicated in pancreatic carcinogenesis. Thus, evaluation of the dietary intakes in the etiology of PC can be useful to identify the risk factors of the disease.
Methods and Materials: We examined the association between total intake of fruits, vegetables, and dietary fiber and the risk of PC in 50,045 participants aged 40-75 years within the Golestan Cohort Study. Dietary data were collected using a validated semi-quantitative food-frequency questionnaire, which was administered at baseline. Cox proportional hazards models were used to estimate multivariate hazard ratio with 95% confidence interval.
During 383,630 person-years of follow-up and after excluding the participants with incomplete baseline information, a total of 48,676 adults were evaluated. Until October 30, 2014, 54 cases of PC were confirmed based on the exact cause of death using ICD10 criteria. After considering all potential confounding factors, there was only a statistically significant inverse association between the risk of PC for the highest tertile of daily fiber intake compared with the lowest tertile (HR=0.41; 95% CI= 0.15-1.05; P for trend= 0.05). However, the relationship between fruits and vegetables and PC risk was not statistically significant.
In summary, based on the findings of this study, increased dietary fiber may reduce the risk of PC. This result highlights the importance of a diet rich in fiber in order to prevent PC progression. Finally, given the limited number of studies in this field and inconclusive results, there is still a need for new prospective studies with long follow-up.

Pancreatic cancer (PC) is classified as one of the most deadly cancers. Since the role of diet in modifying the effects of known risk factors of PC has been well established¡ exploring the dietary intakes in relation to the etiology of PC can be useful for elucidating the mechanisms of the disease progression.
This study was conducted within the Golestan prospective cohort study. The estimated intake of total fat and various dietary fat sources was calculated using a validated semi-quantitative food frequency questionnaire. The relationship between these dietary intakes and risk of PC was examined using Cox Regression and hazard ratio (HR) with 95% confidence interval (CI 95%) was reported.
During 383¡630 person-years follow-up and after excluding subjects with incomplete baseline information¡ a total of 48¡676 adults were studied. Until October 30¡ 2014¡ 54 cases of PC were confirmed by medical professionals¡ based on the medical records and the exact cause of death using the criteria of the International Statistical Classification of Diseases and Related Health Problems 10 (ICD10). After adjusting for potential confounders we did not observe any statistically significant relationship between the intake of total fat and various dietary fat sources and risk of PC. There was only a significant positive association between the risk of PC and daily intake of butter¡ cream¡ and solid vegetable oil in the age-adjusted regression models (HR=2.10; 95% CI=1.04-4.21; P for trend=0.03). However¡ this relationship was not remained significant anymore in the fully adjusted models.
Based on the results of the current research¡ after taking into account all of the potential confounding factors¡ dietary intake of total fat as well as various dietary fat sources had no significant association with the risk of PC. However¡ it is likely that consuming substantially less saturated and trans fat sources such as dairy fats as well as solid vegetable oils may be beneficial to reduce the risk of this cancer.

BackgroundPancreatic cancer (PC) is ranked as the 7th Leading cause of cancer death in the world and is among one of the most deadly cancers. Several lines of evidence indicate that insulin resistance, diabetes, and obesity are implicated in its carcinogenesis process.
Methods and MethodsWe examined the association between consumption of carbohydrate foods and risk of PC in the 50,045 participants (21241 men and 28804 women aged 40 to 75 years) of the Golestan Cohort Study in northeastern Iran. Dietary data was collected using a validated semi-quantitative food-frequency questionnaire. Cox proportional hazards models were used to estimate multivariate hazard ratio with 95% confidence interval.
Results During 8.5 years (383,630 person-years) of follow-up and after excluding participants with incomplete data, a total of 48,676 adults (20,683 men and 27,993 women) were studied. Until October 30, 2014, 54 cases of pancreatic cancer were confirmed by a medical team, based the medical records and the exact cause of death based on ICD10 criteria. After adjusting for age, total energy intake, history of diabetes, smoking status, education, opium, body mass index, waist to hip ratio, ethnicity, gender, MET, residential area and socioeconomic status we did not observe any statistically significant relationship between consumption of total carbohydrate and carbohydrate foods including whole grains and refined grains, sugars and potatoes and risk of PC.
ConclusionBased on the results of the present study, dietary intake of total carbohydrate as well as various carbohydrate food sources had no significant association with the risk of PC. Finally, given the limited number of studies in this field and their inconclusive results, there is still a need for new prospective studies with long follow up.

Osteoporosis is a multi-factorial chronic disease which is considered as a major health problem, yet preventable one. So assessment of knowledge, attitude and practice of the female students was the aim of this research.
This study is a cross-sectional descriptive-analytical one at 2014, where the population was female students of Mazandaran University of Medical Science in six affiliated schools whom were selected with randomized sampling. The data gathering tool was researchers-made one with proven reliability of Cronbach's alpha significant level (0.73) and validated with health science specialists and dietitians. The data were analyzed using SPSS Statistics V.18 software, Pearson & simple linear regression tests.
300 students were examined, with the average age of 23.5. The mean score of knowledge was 78.5 ± 0.9, and the mean score of attitude was 70.6 ± 11. About the relationship between knowledge and attitude, Pearson Correlation Coefficient equal to 0.5 was significant (P value Female students had "high" level of knowledge yet "rather good" attitude about osteoporosis. Nevertheless, for the most vital dimension (( "practice"), improper food habits plus poor physical activities are of the most significant challenges which to be considered in the related policy-making, planning and actions.

Dietary factors such as intake of minerals may play a role in the etiology of esophageal cancer. Although it has been hypothesized that manganese can affect the risk of some types ofcancer, its role in esophageal cancer is unknown. The objective of this study was to investigate the association between intakes of manganese with esophageal cancer in Golestan Cohort Study.
Golestan Cohort Study was launched in Golestan province, northeast Iran, and 50000 participants were enrolled from January 2004 to June 2008. Intake of manganese was assessed with a validated food frequency questionnaire. A Cox proportional hazard model was used to estimate hazard risks and 95% confidence intervals.
During the follow-up period, we identified 201cases of esophageal cancer according to the reports of pathological evaluations. Manganese intake was not significantly associated with the risk of esophageal cancer (Hazard Ratio (HR) for the top versus bottom quartile = 1.49, 95% CI: 0.91–2.45, p for trend =0.09). HR for 1 mg increase in manganese intake was1.05, (95% CI: 0.98–1.11, p=0.15). Although the graphical Restricted cubic spline (RCS) plots showed that the associations between manganeseand risk of ESCC washyperbolic-shaped, P for non-linear association was not significant (p =0.08).
Manganese intake is not associated with the risk of esophageal cancer in linear pattern.

Diabetes is a major risk factor of chronic diseases such as cardiovascular disease with high mortality. Prevalence of diabetes type 2 is increasing in Middle Eastand Iran. In the current study, relationship between major food patterns and diabetes type 2 were assessed. In this case control study, 332 subjects (110 newly diagnosed cases and 222 controls); 43-77 years of age were selected with simple sampling method. A valid semi- quantitative food frequency questionnaire was used to collect dietary intakes of subjects. Anthropometric characteristics and blood pressure were measured with standard instructions and body mass index (BMI) and waist to hip ratio (W/H) were calculated. Blood sample was gathered in order to metabolic variables assessment. Factor analysis was used to identify major food patterns. Relationship between major food patterns and diabetes type 2 was assessed by logistic regression analysis. Three major food patterns were identified in our study subjects: the healthy food pattern (rich in vegetables, vegetable oils, fish, fruits and nuts), the mixed food pattern (high consumption of salt, organ meats, dried fruits, poultry, tea, low- fat dairy products and other vegetables) and the traditional food pattern (high consumption of garlic, dough, high- fat dairy products, dried fruits, red meats, grains and animal fat). After controlling for confounding variables, subjects in the highest quartile of mixed and traditional food patterns had 117% (odds ratio: 2.17 and 95% CI: 1.0-4.50) and 113% (odds ratio: 2.13 and 95% CI: 1.03-4.41) higher odds of diabetes type 2, respectively, compared to those in the lowest quartile. Even before and after controlling for confounders, no overall significant relationship was observed between healthy food pattern and diabetes type 2. this study suggests that mixed and traditional food patterns are associated with an increased odd for type 2 diabetes.

Food consumption pattern and lack of some nutrients is known as main environmental risk factor of esophageal cancer. We investigated nutritional risk factor and food consumption pattern of people who live in high risk area in Golestan province. We investigated food consumption pattern of more than 30 years old Gonbad and Kalale's people who recruited in Golestan cohort study. Assessment carried out with validated 117 items semi quantitative food frequency questionnaire. We also used Iranaian data bank for nutritional analysis. Multiple linear regressions used to compare between sex, Gender, place and ethnicity. From 30463 subjects, aged 52.2 women, Turkmen ethnicity and rural dweller was 57.7%, 75% and 73.6% respectively. Overweight and obesity were common among urban dweller women in compare to other groups. Energy induced from carbohydrate, fat and protein were 65%, 22% and 13% respectively. People in Golestan had lower intake of some nutrients such as Riboflavin, fiber and vitamin A than recommended dietary allowance by FAO/WHO. Govaresh/ Vol. 12, No. 4, Winter 2008; 239-243