f azizi

Cardiovascular diseases are common health problems in women. Evidence shows that serum prolactin levels can be related to the development of cardiovascular diseases. This study aimed to determine the association between prolactin levels and cardiovascular diseases in women.

In this population-based study, eligible women were chosen from the participants of the Tehran Lipid and Glucose Study. Cox model was used to evaluate the relationship between prolactin levels and the risk of cardiovascular diseases.

A total of 1279 women participated in this study. There was no significant difference in the prolactin levels between the two groups with and without cardiovascular diseases (p=0.98). Age (affected group: 36.97±7.24 years Vs. non-affected group: 31.68±7.26 years; p<0.001) and body mass index (BMI) (affected group: 28.07±4.52 kg/m2 Vs. non-affected group: 26.01±4.46 kg/m2; p<0.001) was significantly higher in the affected group than the non-affected group. Prolactin was not associated with an increased risk of cardiovascular diseases in the whole population and in the menopausal and non-menopausal groups. There was no association in unadjusted model. However, in the adjusted model, the risk of cardiovascular diseases increased by 7% and 12% for each unit of increase in age and BMI, respectively. Moreover, in postmenopausal women, the risk increased by 10 and 11% for each unit of increase in age and BMI, respectively. Also, the number of births increased the risk of cardiovascular diseases by 25% in the whole population and by 79% in women of reproductive age.

The results of this study did not show a statistically significant association between the risk of cardiovascular diseases and the serum prolactin levels in women.

This study was carried out on camel milk consumption to improve risk factors of type 1 and 2 diabetes and metabolic syndrome. The purpose of this systematic review was to assess effects of camel milk on glycemic indices and blood lipid profiles in patients with metabolic syndrome and type-1 and type-2 diabetes.

To extract original English articles published until May 2023 without limiting the year of publication, Scopus and PubMed databases were searched using the following keywords of “metabolic syndrome” or “type 1 diabetes” or “type 2 diabetes” or “lipid profile” or “insulin” or “fasting blood glucose”  or “HbA1c” and “camel milk”.

From 73 studies, 11 studies were included in the present systematic review .Seven studies assessed fasting blood sugar levels and in three studies, fasting blood sugar levels decreased after consuming camel milk. Moreover, seven studies assessed levels of HbA1c and in four studies, levels of HbA1c decreased significantly. Six studies investigated doses of insulin. In five studies, levels of insulin dose in the camel milk consumption group significantly decreased, compared to the beginning of the study. Furthermore, eight studies assessed the blood levels and in most of these studies, blood profiles changed.

Results of the consumption of camel milk on glycemic indices and blood lipid profiles were contradictory. It is necessary to carry out clinical trial studies with longer times and larger sample sizes.

 To overcome the limitations of the definition of metabolic syndrome (MetS) in clinical use, a health index named quantitative Metabolic Syndrome Severity Score (cMetS-S), has been recently introduced and validated in the Tehran Lipid and Glucose Study. This study investigated the association between the severity of MetS based on age and gender (cMetS- score), and cardiovascular diseases (CVD) beyond the components of MetS.

 At the beginning of the study, participants aged 20-60 years were enrolled. Those with cardiovascular disease, cancer, use of corticosteroid, estimated glomerular filtration rate <30 ml/min/1.73m², or pregnancy were excluded. The association between cMetS-S and cardiovascular diseases was evaluated continuously for 18 years follow-up among 8,500 participants using Cox proportional hazards regression models and its performance in predicting cardiovascular disease events was compared with the MetS criteria.

 Participants with higher cMetS-S showed a significant increase in the risk of cardiovascular disease (CVD), coronary heart disease (CHD), and non-coronary heart disease (non-CHD). Independent of the confounding factors of metabolic syndrome components, each 1-SD unit increase in cMetS-S was associated with risk ratios of 1.67, 1.60 and 1.88 for cardiovascular diseases, coronary and non-coronary cardiac events, respectively. Model fit analysis showed better CVD prediction value for cMetS-S independent of (MetS) components, compared with metabolic syndrome (p<0.0001).

 The cMetS-S predicts cardiovascular diseases more accurately than the MetS and its components. The standardized cMetS-S, which considers the weighted contribution of MetS components and their variations by age and gender, may serve as a health metric for determining the severity of metabolic syndrome.

Diabetes mellitus (DM) and polycystic ovary syndrome (PCOS) are rising health issues. Evidence highlighted the potential for an increased risk of PCOS among females with DM across various locations and ethnicities. This study aimed to investigate the prevalence of PCOS among Iranian females with and without DM.

In this population-based cross-sectional study, eligible females were selected from participants of the Tehran Lipid and Glucose Study (TLGS). For this study, females with complete data were selected from Phase VI (2016–2018) of TLGS. The logistic regression model was used.

At first, 4435 women with definite information about PCOS status were included, women with unclear diagnoses of DM and PCOS were excluded, and finally, 2867 were included in the study. Then, they were divided into two categories, Under 40 years and over 40 years. Among females without DM aged <40 years, 28.3%, and among those with DM aged <40 years, 53.7% had PCOS. Among participants with DM, PCOS patients were younger and had better fasting blood glucose levels. Using logistic regression for PCOS risk from a logistic regression model in participants, it was found that among patients with and without DM, increasing age decreased the odds of PCOS by 85% and 42%, respectively. On the contrary, among participants without DM, a family history of DM increased the risk of PCOS (odds ratio [OR] = 1.22, 95% confidence interval [CI] = 1.006 to 1.49, p=0.04).

The prevalence of PCOS was not significantly different between subjects with and without DM in our population.

There is still debate regarding the association between dietary saturated fatty acids (SFA) and the risk of type 2 diabetes mellitus (T2DM). The objective of this study was to investigate the association of dietary SFAs, their food sources, and substitution with other macronutrients, with the risk of T2DM.

The current study was conducted on 2295 adults out of the participants of the Tehran Lipid and Glucose Study (TLGS) based on the inclusion criteria. The baseline intake of SFAs was estimated using a validated 168-item food frequency questionnaire. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of T2DM in tertile categories of SFAs and their different food sources. The risk of T2DM was estimated with multivariable Cox regression for the substitution of SFAs with other macro-nutrients.

Over a median of 8.5 years of follow-up, 10.6% of participants were identified as T2DM patients. The study found no significant associations between the baseline dietary intake of total SFA, lauric acid (LA), myristic acid (MA), palmitic acid (PA), or stearic acid (SA) and the risk of T2DM. However, a higher intake of liquid oils was related to a higher risk of T2DM (HR=1.07, 95% CI=1.00-1.15). Moreover, the substitution of MA for SA was related to an increased risk of T2DM (HR=1.56, 95% CI=1.03-1.93).

There was no significant association between dietary SFAs and the risk of T2DM in the present study. Further prospective studies are needed to clarify the association between dietary fats and T2DM risk.

Various types of fatty acids are simultaneously present in the diet. Therefore, it is important to investigate their combined effects on the occurrence of metabolic diseases. This study aimed to determine the dietary fat quality indices and investigate the relationship between these indices and the risk of metabolic syndrome in an Iranian adult population.

A total of 1713 adults participating in the third phase of the Tehran Lipid and Glucose Study (TLGS), who were free of metabolic syndrome, were selected and followed up to the sixth phase. Dietary intakes were evaluated using a validated food frequency questionnaire. The risk of metabolic syndrome in the sixth phase of TLGS, adjusted for potential confounders, was estimated across the tertiles of all dietary fat quality indices, including atherogenic index, thrombogenic index, health-promoting index, ratio of polyunsaturated fatty acids to saturated fatty acids (PUFA/SFA), ratio of hypo- to hypercholesterolemia, total omega-3 fatty acids, and ratio of linoleic acid to α-linolenic acid (LA/ALA), using Cox proportional hazard regression models.

Over a median of 7.6 years of follow-up (2006-2008 to 2014-2017), 596 cases of metabolic syndrome were identified. After adjustment for confounding variables, there was no significant association between dietary fat quality indices and risk of metabolic syndrome. However, each 1-unit increment in the LA/ALA was associated with a 3% higher risk of metabolic syndrome [hazard ratio (95% confidence interval): 1.03 (1.00-1.01)].

Further prospective studies are needed to clarify the association between dietary fat quality indices and the risk of metabolic syndrome. In the present study, there was no significant association between dietary fat quality indices and metabolic syndrome incidence.

This study aimed to determine the association between the quality and quantity of dietary carbohydrate (CHO) with the risk of pre-diabetes (pre-DM) progression to type 2 diabetes (T2D) and the chance of returning to normal glycemia.

 Dietary CHO quantity (total CHO and dietary fiber) and quality (glycemic index, glycemic load, insulin index, and insulin load) were assessed using a 168-item, semi-quantitative, valid, and reliable food frequency questionnaire in 334 men and women with pre-DM at baseline. The participants were followed for a median of 9 years. Fasting and 2-hours (after oral loading of 75 g glucose) plasma glucose concentrations were measured at baseline and subsequent examinations.

 During the study follow-up, 39.8% of the pre-DM subjects progressed to T2D, and 39.8% returned to normal glycemia. Dietary total CHO, glycemic index, glycemic load, insulin index, and insulin load were not significantly associated with pre-DM regression and progression during the study follow-up. A 25% reduced risk of developing T2D was observed per 5 g/1000 kcal per day by the increased dietary intake of fiber (odds ratio: 0.75, 95% CI: 0.58-0.98; P=0.038).

Total CHO intake and its quality were not associated with the change of glycemic status in pre-DM subjects, while higher intakes of dietary fiber decreased the risk of pre-DM progression to T2D.

There has been a remarkable rise in medical research in Iran during the last 40 years, improving the global ranking of the country in the production of research documents from 54th to 16th in 2022. The aim of this review was to summarize medical research activities in Iran during the last 40 years and present predictions on the outlook of this field in coming years.

Related articles were retrieved from the Iran Doc Engine, and selected sections of three editions of the book “Health in the Islamic Republic of Iran” were reviewed.

Between 1980 and 2000, there was a remarkable rise in the number of medical universities and related schools in Iran. The number of students, both undergraduate and postgraduate, as well as PhD courses and residency programs, considerably increased in the country, in parallel with the debut of numerous clinical subspecialty programs in various clinical fields. Research centers and institutes were developed in many universities. Between 2001 and 2020, there was an extraordinary increase in the number of annual publications in medical fields. Citations to Iranian research articles have also increased. For the next 20 years, innovations in research activities and productions are expected to resolve many problematic issues in Iran’s health sector. Activities such as nurturing young, talented, and distinguished researchers, supporting scholars, devising more appropriate tools for the evaluation of the output, impact, and effectiveness of scientific productions, increasing the share of research from Growth National Product (GNP), and enhancing targeted research programs will be needed to safeguard the emerging goals of research activities in the next two decades.

The Covid-19 and the imposed restrictions, along with difficulty in accessing medical services, can affect the level of anxiety, stress, and depression of patients with diabetes. This study was conducted to determine the effect of the Covid-19 pandemic on the emotional status of these patients. A total of 318 individuals with type 2 diabetes who participated in the Tehran Lipid and Glucose Study between 2018 and 2020 were included in the current study. The data on perceived social support (PSS) and emotional state (ES) were collected before and after the Covid-19 outbreak using the multidimensional scale of perceived social support (MSPSS) and Depression, Anxiety, and Stress Scale-21 Items (DASS-21) questionnaires, respectively. Data were analyzed using paired T-tests and repeated measures tests. Mean total scores of PSS did not have significant differences before and after the outbreak of Covid-19. Comparison of the subscale scores indicates a significant increase in PSS from family (p=0.013) and a significant decrease in PSS from friends (p=0.039) in women, and an increase in PSS from significant others in both groups of women (p=0.019) and men (p=0.045). Comparing the ES scores before and after the outbreak of Covid-19 indicated that the adjusted model, anxiety, and stress scores decreased significantly after the Covid-19 outbreak in females. There was no significant difference in anxiety and stress scores in males and depression scores in both sexes. After the outbreak of Covid-19, levels of anxiety and stress in women have decreased, which can be due to the improvement of PSS from the family and, consequently, the reduction of diabetes-related concerns.

Precision medicine is a modern approach to medicine that employs the most effective strategies for preventing and treating each disease while considering individuals' diverse needs. This approach involves examining a person's ethnic background, lifestyle, genetic makeup, and metabolic profile to determine an appropriate diagnosis and treatment plan tailored to their specific circumstances and requirements. The necessary infrastructure for implementing this approach includes advances in tools and methods that identify individual molecular characteristics and enable the integration of large amounts of data. In addition to these technological advancements, physicians must possess the knowledge and skills to use these resources effectively to enhance their clinical practice. Therefore, the foundation for precision medicine lies in transforming medical education, which must focus on using massive genomic, metabolomic, epidemiological, clinical, and paraclinical data, utilizing computer technologies and artificial intelligence. The achievement of these goals can enable the adoption of tailored preventive, diagnostic, and therapeutic strategies for each patient group. This review article provides an introduction to precision medicine and its advancements in the field of endocrinology, with a focus on diabetes as one of the most prevalent endocrine diseases in contemporary societies. Additionally, we introduce the Tehran Cardiometabolic Genetic Study, which was conducted within the Tehran Lipid and Glucose Study framework and is a suitable candidate for implementing precision medicine approaches, given its 25-year follow-up and collection of genetic and clinical information from a population of fifteen thousand individuals.

This study aimed to investigate the relationship between the consumption of refined and whole grains and the risk of the metabolic syndrome in adults.

In this prospective study, the consumption of whole and refined grains was assessed in 1452 subjects who participated in the Tehran Lipid and Glucose Study using a valid and reliable food frequency questionnaire. Metabolic syndrome components were defined based on the Adult Treatment Panel criteria. The Cox regression model was used to investigate the relationship between the consumption of various types of cereals and the components of the metabolic syndrome.

The median of whole grains consumption was 121.7 g per day, and the average consumption of refined grains was 202.2 g per day. Refined grains have a significant and positive association with increased serum triglycerides (risk ratio [RR], 1.03; CI, 1.31-2.18), and abdominal obesity (RR, 1.33; CI, 1.02-1.75) blood pressure (RR, 1.33; CI, 1.01-1.75), and reduction of high-density lipoprotein (HDL; RR, 1.52; CI, 1.25-1.84) after adjustment for confounders. The consumption of whole grains had no relationship with the components of the metabolic syndrome.

Reducing the consumption of refined grains can prevent the occurrence of metabolic syndrome components.

Adopting diabetes self-care behaviors to control blood glucose is essential, but adherence to them has been challenged due to restrictions related to Covid-19. These restrictions have negatively impacted the psychosocial condition of individuals with diabetes, which could lead to poor self-care. Accordingly, this study aimed to explore the experiences of individuals with type 2 diabetes regarding self-care behaviors and diabetes management during the COVID-19 pandemic.

This qualitative study was conducted using conventional content analysis, the data of which were collected through interviews with people over 18 years of age with type 2 diabetes who were selected from the Endocrinology Clinic of Erfan Hospital in Tehran. Using telephone and WhatsApp, semi-structured interviews were conducted with 20 participants (15 women). Content analysis was done using the constant comparative method, and the open and axial coding method was applied. The data were manually coded, and the main themes and categories emerged from data.

Two main themes emerged from the data: 1) challenges and limitations toward diabetes self-care and 2) facilitators of efficient self-care. Challenges and limitations included 4 sub-themes: Inevitable lifestyle changes, psychosocial problems, limited/lack of access to health care services and medication, and adverse physical effects. Facilitators had 2 sub-themes: improved individual capability and maintaining social interaction.

Our findings indicated that inevitable lifestyle changes, limited access to health care, and adverse psychosocial consequences were the most critical challenges for diabetes management during the COVID-19 pandemic. Improving stress management skills and effective coping strategies can facilitate the adoption of self-care behaviors.

The new maize hybrid,Paya,is the result of the cross K47/2-2-1-2-2-1-1-1×K18.The single cross hybrid Paya produced an average grain yield of 11.47t/ha in preliminary yield trial in four locations in 2013,10.58t/ha in semi-final grain yield trail in seven locations in 2014,10.96 t/ha in final grain yield trials in 13 locations during 2015 -2016,and 11.33t/ha in final yield trail in 10 locations during 2017-2018 which were superior compared toKSC704as check,with an average grain yield of 9.34,9.46,10.72 and 11.04t/ha (in preliminary yield trial in2013semi-final grain yield trail in2014,final grain yield trails during 2015-2016 and2017-2018,respectively).In on-farm experiments carried out in eight regions,the new hybrid with an average grain yield of9.98t/ha compared to the check cultivar KSC704 with an average grain yield of 8.50t/ha,both with 14% grain moisture,showed 17.46% higher grain yield.Based on the results of the final forage yield trials in five locations,the new maize hybrid with an average yield of80.1t/ha,compared to KSC704 with an average yield of 75.9t/ha,revealed 4.2t/ha yield increase during2017and2018 years.The relative forage value (RFV) in the new maize hybrid (250.7) was higher than the check hybrid KSC704 (179.5).Also,based on the results of on-farm experiments in three regions,the new hybrid with an average forage yield of 85.93 t/ha,showed a 13.26% increase in forage yield compared to the check cultivar KSC704 with a forage yield of 75.87 t/ha.Although the new maize hybrid was superior to the KSC704 in terms of yield,stability,and rate of grain moisture reduction after physiological maturity; its most important advantage was its relative resistance and less infection to common smut disease (with9.16%infection) compared to the susceptible hybrid KSC704(with22.30%infection)as one of the main problems of maize farms in the country.More ever,the response of the new maize hybrid and the check cultivar KSC704 to Fusarium ear rot disease is semi-resistant.In general,the new maize hybrid,Paya,is suitable for cultivation in Karaj,Shiraz,Mashhad,Kermanshah,Moghan,Miandoab,Dezful,Kerman and Jiroft.

In recent years, groundwater pollution has been raised as an important environmental issue in developed and developing countries due to changing land use patterns. Among the many groundwater pollutants, we can mention the leachate produced from waste or municipal waste landfill, which poses many environmental hazards due to its toxicity and high durability in the environment. Kermanshah is the ninth most populous city and one of the metropolises of Iran, the center of which is Kermanshah and according to the 2016 census has a population of 946,651 people. Due to high population growth and immigration, it has led to an unprecedented increase in population that is not within the capacity of the city's infrastructure. As a result, along with many environmental problems in this city, it faces serious problems in terms of waste collection and disposal because the amount of waste production per citizen of Kermanshah is on average 750 to 900 grams per day, which is twice the global average. This waste is accumulated in the southern part of Kermanshah city and at a distance of about 15 km from it on the northern slope of Kuh-e Sefid. In this study, according to the geomorphological features of the region, the pollution of groundwater resources in the downstream areas of the landfill in Sarabghanbar of Kermanshah (Kermanshah city) has been investigated in GMS software environment and MODFLOW analytical code. In this study, first the geomorphological map of Kermanshah city in order to identify groundwater, soil, and slope and land type has been drawn. This map shows that the uneven erosion plain of the southern half of the city, due to the landfill of Kermanshah, can provide a source of pollution for Sarabghanbar springs. The groundwater level map shows the direction of water flow in this area from south and southeast to the center of the plain and then north and northeast. Landfill construction site, and groundwater flow direction are the main factors in the spread of pollution. Studies show that during the study period, the groundwater level in drought periods is constantly declining and its rate of rise in wet periods is always less than its rate of decline in dry periods. The results of MT3DMS quality model showed that in order to solve the problem of infiltration of landfill pollution in the groundwater network, among the several solutions that can be offered to water resource executives, one is blocking the border power supply of the plain and the other is controlling and preventing excessive drop. Groundwater level.

Conducted as a phenomenological qualitative research, the present study aims to explore the lived experiences of university professors and students with online classes during the Covid-19 pandemic. The statistical population consists of all the professors and students of the University of Kurdistan who either had taught/taken online classes before the coronavirus outbreak or experienced them for the first time during the pandemic. The theoretical saturation was reached after interviewing 31 students and professors. The findings suggest that, as opposed to traditional education, online classes led to the decline and loss of various academic opportunities, functions, and roles. According to most of the students surveyed, in the absence of physical classes, interaction and dialog among and between both sides (student–student, student–professor, and professor–professor) diminished dramatically. And, they were rather replaced by a form of mechanical, one-dimensional transfer of knowledge from a “transmitter” to a “receiver,” negatively affecting the learning, creativity, productivity, and skills of students. According to the professors, the rise in online classes in Iran has changed their role from “keepers of information” to, at best, “protectors of knowledge.” Most of the professors also believed that another unwanted outcome of the spread of online education had been the loss of interaction and dialog among the university’s faculty members.

The main objective of the present study is to evaluate the mechanical properties, biocompatibility, and bioactivity behavior of scaffolds made of hydroxyapatite (HA)-modified by MnO2 and Palladium (Pd) for biomedical applications. Throughout the research, HA, MnO2, and Pd were developed using sol-gel and precipitation methods, respectively. The properties of the scaffolds were determined using Scanning Electron Microscopy (SEM), Energy Dispersive Spectroscopy (EDX), atomic absorption, and Brunauer−EmmeS−Teller (BET) method. To investigate the in vitro cell proliferation and alkaline phosphatase (ALP) assays, cell culture was done. Furthermore, the mechanical properties of the scaffolds were investigated before and after immersion in Simulated Body Fluid (SBF), and the interaction of Dental Pulp Stem Cells (DPSCs) with the nanocomposite scaffolds was assessed. The obtained results showed that the HA/MnO2/Pd scaffolds were characterized by higher compressive strength (35.72%), toughness (35.68%), microhardness (80%), and density (0.44%) than HA/MnO2/Pd filled by chitosan (CS) binder scaffolds. The biocompatibility properties indicated higher cell proliferation and ALP assay on the HA/MnO2/Pd filled by CS scaffolds than those of HA/MnO2/Pd scaffolds.

In this research, to evaluate the groundwater resource Hydro-geochemical Characteristics in Basht Plain aquifer, Analytical results of 10 groundwater samples in dry and wet periods are used. One of the main factors that deteriorate the quality of groundwater is local geology which comprises mostly sedimentary rocks and in particular evaporates. To estimate of water quality, Hydro-geochemical diagrams, Geological Investigations, Ionic exchange, and Saturation Index studied. The type and facies of water in study area is Ca2+–HCO3- and Ca2+ – SO42-. The results of calculated saturation index show that the saturation index for carbonate minerals is positive and for sulfate minerals is negative. Reverse and normal ion exchange is one of the chemical processes controlling the chemical composition of groundwater. Based on the results, the water quality is controlled by flow paths and reservoir lithology. The GWQI map of ground water in aquifer shows that 91.3 and 8.7 percentage of ground water resources in this area are in good and bad category.

Intercropping or mixed culture is known as one of the oldest models of sustainable systems in agriculture. This method of cultivation provides the opportunity for farmers to benefit from biodiversity, reduces the potential damages caused by pests and diseases and maximize the use of water and soil resources. Alfalfa mixed culture with grasses is more common than their pure cultivation in many countries. For example, the direct use of alfalfa in pasture causes bloating of livestock, while its mixture with grasses eliminates this risk and it provides a balanced and complete diet. Several species of forage grasses such as orchard grass, lolium, festuca, canary grass and smooth brome grass are commonly used in mixed crops, especially with alfalfa. The results of studies conducted in Iran have indicated that land equivalent ratio (LER) and forage yield, as well as, quality are increased in alfalfa-grass mix cultures. Among studied forage grasses, mixed culture of alfalfa with festuca and canary grass provides more suitable forage yield and quality than other grasses.

Clinical education is the foundation of medical science education and feedback in education is the main responsibility of clinical educators. Self-assessment is also an evolutionary skill and an important part of the evaluation process. The present study compares the effect of oral and written feedback in clinical education on the relationship between performance and selfassessment of students.

This quasi-experimental study was conducted on 120 undergraduate midwifery students in 120 women in the gynecologic clinic and in the control, oral and written feedback groups. Sampling method was available in a convenient way. At first, the control group was selected and trained in the usual way, then the rest of the students were divided into oral and written feedback groups in alphabetical order, respectively. The criteria for providing feedback with the general feedback model (Feedback Sandwich) were verbal in the oral feedback group and in written feedback group. On the last day of each internship, a valid and validated checklist was completed for each student, as well as a clinical checklist, by another trainer.

The results showed that all three groups were homogeneous in terms of demographic information. The result of Pearson correlation test between student self-assessment and student performance in women's clinic after intervention in each of the three control groups (P = 0.01), oral feedback (P <0.001) and written feedback (P <0.001), There was a significant relationship between the two groups. In both groups oral and written feedback was significantly higher than that of the control group.

Considering the positive impact of using feedback on the relationship between students 'self-assessment and teacher's assessment of students' performance, the use of different written or oral feedback approaches with self-assessment of students in clinical education planning should be formally included.

There is little known about the relation between metabolic syndrome and fiber intake are available in Iran. We evaluated the relation between total, and various types and sources of dietary fiber and the prevalence of the metabolic syndrome.

In this cross sectional study, 2457 adults, aged 19-84 years were studied. Total dietary fiber intake and its types and sources were assessed using a validated semi quantitative food-frequency questionnaire. Blood pressure, Anthropometric, and biochemical measurements were assessed. The metabolic syndrome was defined according to definition by Iranian National Committee of Obesity.

In the multivariate-adjusted odds ratio, intakes of total (OR: 0.53; 95% CI: 0.39-0.74), both soluble (OR: 0.60; 95% CI: 0.43-0.84) and insoluble dietary fiber (OR: 0.51; 95% CI: 0.35-0.72), fruit fiber (OR: 0.51; 95% CI: 0.37-0.72), legume fiber (OR: 0.73; 95% CI: 0.53-0.99) and cereal fiber (OR: 0.74; 95% CI: 0.57-0.97) were inversely associated with the metabolic syndrome. There was not significant association between using vegetable and nut fiber and prevalence of metabolic syndrome.

Total dietary fiber, both soluble and insoluble fibers, and especially fruit and legumes fibers, reduce the metabolic syndrome among adults in Tehran.

The historical intertwinement of the spirituality and health is observed in the works of many medical figures of Iran, particularly Muslim figures. The emphasis on that the biological aspect of man should not be merely noticed in the healthcare, but also the mental, social and spiritual aspects of his health should be also considered, has increased. The complete meaning of the spiritual health is not limited to the effect of the praying and mental states on the treatment of diseases and its replacement for common medical treatments and/or supplementary medicine. In the Iranian-Islamic culture and atmosphere, the most effective factor on the people's health is to attain the spiritual health the thought and literature of which has been shaped and compiled based on Quran by dozens of theosophists and penmen and is considered as a source for the description of the spiritual health and supply of ways to attain it. The presentation of a comprehensive definition of the spiritual health and its indices and explaining its relation with the bases, institutes and internal elements of the society based on the culture, beliefs and sovereign values over the Iranian- Islamic society face an essential issue that requires the performance of more research.

The metabolic syndrome includes risk factors for non-communicable diseases such as central obesity, hyperglycemia, dyslipidemia and hypertension accompanied by pro-inflammatory and hypercoagulability states. The aim of this study was to determine the effects of weight change on incident metabolic syndrome.

This was a prospective cohort study, the population of which included all participants of the TLGS, phases one and two, >20 yrs and above, free of metabolic syndrome, based on the Iranian waist circumference, and NHLBI. Iranian waist circumference was defined with different cutoff points, according to cross sectional and outcome-based studies. Data was obtained by interviews, questionnaires, observation, and physical and laboratory examinations.The incidence of metabolic syndrome after 3.1 years of follow up was determined. Percent of weight change (PWC) was divided in five quintiles. Using the logistic regression test, odds ratio and 95% confidence interval of incident metabolic syndrome and its components for these quintiles, after adjusting for confounders, were calculated.

Age adjusted incidences of metabolic syndrome after a 3.1 year follow up, according to Iranian WC outcome were 20.6% (males 26%, females 20.9%) and for Iranian WC cross sectional and NHLBI were 26.2% (males 34.4%, females 26.1%) and 23.7% (males 24.4%, females 29.4%) respectively. For both genders, based on Iranian W.C and NHLBI, a weight reduction of at least 1.3%, compared to baseline, in women had a protective effect against incident metabolic syndrome. In men a weight gain of at least 1.4% since baseline resulted in an increase in the odds ratio. In women, weight gain of at least 1.3% since baseline, based on the Iranian WC cross sectional, NHLBI and at least 4% based on Iranian W.C-outcome resulted in progressive incidence of metabolic syndrome. These reductions of at least 1.3% in males and 2.5% in females, decreased the relative risk of abdominal obesity, but had no effect on other components of metabolic syndrome, including: hypertriglyceridemia, low HDL, hyperglycemia, and hypertension. Although in both sexes, increase in weight resulted in abdominal obesity, the cut off points according to various definitions were different.

Considering the preventive effect of weight loss against incident metabolic syndrome and abdominal obesity, we recommend educational programs to enhance awareness regarding overweight and obesity and motivate individuals to lose weight.

This study aimed at investigating the association between obesity indices (Body Mass Index (BMI), Waist Circumference (WC), Waist to Hip Ratio (WHR)) and dietary patterns derived from Reduced Rank Regression (RRR) analysis among Tehranian adults in a cohort study.

Over a duration of 6 years, 141 adults were examined before and after 6 years for obesity indices. Dietary intakes were recorded at baseline by two 24 hour dietary recalls. RRR analysis derived five patterns with respect to total fat, polyunsaturated-to-saturated fat ratio, cholesterol, fiber and calcium intakes. The calculated factor scores were categorized in quintiles and changes in obesity indices were scrutinized within these quintiles.

The first pattern (traditional) showed high loadings on refined carbohydrates, whole grain, vegetables, red and processed meat, saturated and trans fat, egg, showing significant high positive correlation with fat, cholesterol and calcium intakes (r=0.478, 0.626, and 0.486, respectively p<0.001). All obesity indices had an increasing trend across quintiles of pattern score (p<0.05 for BMI and WHR, p<0.001 for WC). The fifth pattern (egg) had high loading for eggs, salty snacks, and fruits, and negative loadings for red and processed meat, saturated and trans fat, plant oil, and dairy products, indicating increasing trends for WC (p<0.001) and WHR (p<0.05) after adjustment for potential confounders. Other patterns showed non-significant trends for obesity indices.

RRR analyses were indicative of two dominant dietary patterns correlated with increase in obesity indices in Tehran.

The metabolic syndrome is a constellation of risk factors that increase the incidence of cardiovascular disease and type 2 diabetes mellitus. The prevalence of obesity and metabolic syndrome in adolescents is escalating worldwide. Understanding the rising prevalence of this syndrome could help decrease the occurrence of fatal cardiovascular and diabetic complications. The present study was carried out to determine the prevalence of metabolic syndrome in adolescents with varying degrees of obesity, in order to conduct and implement, timely screening and interventions.

In a cross-sectional study conducted within the framework of the Tehran Lipid and Glucose Study (TLGS), phase 3, 1523 adolescents, 708 boys and 815 girls 10-19 years of age, were investigated. The prevalence of metabolic syndrome, based on modified definitions for ATP III, AHA, NHASES III and IDF, was determined in varing degrees of body weight (normal, at risk of overweight, moderate and severe overweight) and compared in different sex, age groups, menarche status and familial history of diabetes mellitus. Data was analyzed using the and Mann-Whitney tests and multiple logistic regression.

Overall, 15 percent of adolescents were at risk of overweight, 4. 2 percent had moderate overweight and 4. 6 percent were severely overweight, with no significant difference between the two sex groups (P=0. 381). Overall, the prevalence of metabolic syndrome, based on definitions for ATP III, AHA, NHANES III and IDF, was 9. 5, 5. 1, 17. 8 and 5. 8 percent, respectively, which was significantly higher in boys than in girls. Based on the 4 defintions, the prevalence of metabolic syndrome in the normal weight group was 2. 2, 0. 9, 8. 6, 0. 8 percent respectively, in the at risk of overweight group it was 21. 5, 11, 36. 4 and 11 percent, in moderate overweight group it was 42. 2, 23. 4, 64. 1 and 32. 8 percent, and in the severe overweight group it was 62. 9, 38. 6, 67. 1 and 47. 1 percent, respectively (P<0. 001). The prevalence of each metabolic risk factor and the number of these factors was higher in overweight adolescents. Only by the IDF definition, the prevalence of metabolic syndrome was significantly higher after-menarche than before it (P=0. 04). All definitions showed the higher prevalence of metabolic syndrome in positive familial history of diabetes mellitus (P<0. 001).

This study showed a high prevalence of overweight, obesity and metabolic syndrome in Tehranian adolescents, with significantly higher prevalence of metabolic syndrome in more obese adolescents. Metabolic syndrome was more prevalent, in boys, thosepersons with positive familial history of diabetes mellitus and in after-menarche aged girls,which data can be put to use in lifestyle modification programs.

This study amis at determining which components of the metabolic syndrome are the best predictors of its development.

In this cohort study, from the participants of the cross sectional phase of the Tehran Lipid and Glucose Study(TLGS), 2279 subjects (aged 20-87) who did not have the metabolic syndrome, based on modified ATP III criteria, and 2310 subjects (aged 20-87) without the metabolic syndrome according to IDF criteria were followed.

After a mean interval of 6.5 years, 462 and 602 new cases of the metabolic syndrome were diagnosed on basis of the modified ATP III and IDF criteria, respectively. The adjusted odds ratio for development of the metabolic syndrome by ATP III criteria was highest for central obesity in men, 2.8 (2.2-3.7) and for triglycerides in women, 2.8 (2.0-4.1). The adjusted odds ratio for development of the metabolic syndrome by IDF criteria was highest for triglycerides in both men and women, OR being: 2.8 (2.2-3.7) and 2.9 (1.9-4.3) respectively. The area under the ROC curves for waist circumference, triglycerides and HDL were the highest. A model that included waist circumference and triglycerides or waist circumference and HDL predicted the metabolic syndrome as well as a model that included all five metabolic syndrome components.

High risk subjects should undergo periodic screening, including measurement of waist circumference, triglycerides and plasma HDL, for timely prediction of development of metabolic syndrome.