golnaz ranjbar

Sanctions against a country could be a shock to the country's economy for a specific period. Iran has been subject to various sanctions for the past 40 years, and these sanctions have intensified since 2011. Unprecedented sanctions were imposed on Iranians after the United States withdrew from the Joint Comprehensive Plan of Action (JCPOA) agreement, and a disastrous economic situation was the outcome of this international issue. The present study aims to evaluate the impact of this situation on weight gain of pregnant mothers and birth weight as well as food security of their families.

The data of pregnant women and newborns were extracted from Sina Electronic Health System (SinaEHR®) questionnaires. These questionnaires were completed by trained healthcare workers in comprehensive health service centers. The data of 266,182 pregnant women were collected through questionnaires from 19 comprehensive health centers related to Razavi Khorasan province and were prepared for statistical analysis. Then, data analysis was done using the statistical method of Generalized Estimating Equations (GEE) by SPSS software.

Examining the data of 266,182 pregnant mothers during the sanctions period of 2017 to 2020 in Iran shows that the weight gain of pregnant mothers (P<0.001) and the birth weight of the newborns (P<0.047) have decreased significantly.

According to the results, there has been a significant reduction in the two variables of weight gain in pregnant women and newborns’ birth weight, which confirms the debilitative effects of sanctions on these important outcomes.

Acute-phase inflammatory and oxidative response following major gastrointestinal surgeries may lead to critical conditions in pediatric patients. Selenium plays a key role in the antioxidant defense system and anti-inflammatory pathways, which are important in the clinical outcomes of patients admitted to the pediatric intensive care unit (PICU). The present study aimed to assess the possible correlations between serum selenium levels and clinical outcomes in PICU patients undergoing major gastrointestinal surgeries.

This cross-sectional study was conducted on 66 critically ill pediatric patients who were in the postoperative stage of major gastrointestinal surgeries. Serum selenium concentration was assessed using the atomic absorption method, and the clinical outcomes were collected prospectively.

Serum selenium concentration upon PICU admission was 38.9±9.8 ng/ml, and no significant correlation was observed between the serum selenium level and the nutritional status of the patients. Furthermore, no significant associations were denoted between the serum selenium concentration and some clinical outcomes, such as the duration of ventilator dependency, PICU length of stay, and PICU/28-day mortality. However, the statistical analysis of the obtained data showed negative, significant associations between the serum selenium concentration, infection rate, and length of hospital stay (P= 0.01 and P=0.04, respectively).

According to the results, serum selenium concentration decreased in the post-gastrointestinal-surgery patients admitted to the PICU upon PICU admission, and the reduction was associated with prolonged hospitalization and a higher infection rate.

Today, obesity is considered one of the most important and common problems in the field of world health, found to have a significant coexistence with many physical diseases and mental problems. The present study aimed to explain the model of bulimia nervosa based on the components of mindfulness and anxiety sensitivity with the mediating role of body image and psychosomatic symptoms in obese women.

The statistical population in this research included all patients diagnosed with obesity in the treatment centers of Tehran, Iran, in 2021. The research sample included 384 women diagnosed with obesity followed by removing the distorted questionnaires leading to 357 statistically analyzed samples. The questionnaires used in this research were the Five Facet Mindfulness Questionnaire (FFMQ), the psychosomatic disorders questionnaire, the self-body questionnaire, the Anxiety Sensitivity Index-Revised (ASI-R), and the Binge Eating Scale (BES), which were completed by the subjects following the principles of ethics in the research. The findings were statistically analyzed using path analysis and descriptive and inferential indicators. Data analysis was done using the SPSS software, AMOS software, and other appropriate tests.

The model had a favorable fit in terms of statistics, and it was also found that psychosomatic symptoms as a mediating variable could not have provided a significant explanation for the prediction paths of bulimia nervosa based on anxiety sensitivity and component mindfulness (P < 0.01).

In the treatment of obese people with bulimia nervosa, paying attention to psychological and emotional indicators can be of great importance.

Cinnamon is extracted from the inner bark of Cinnamomum trees. Recent studies have indicated that cinnamon is a safe and cost-effective treatment for improving body weight, lipid profiles, insulin resistance, and blood pressure. This systematic review aimed to summarize the effect of cinnamon supplementation on adipokines and appetite-regulating hormones.

This comprehensive literature search was conducted using databases such as PubMed, Scopus, ISI Web of Science, and Google Scholar up to March 2022 without any limitation. The quality of eligible studies was evaluated through the Cochrane Collaboration’s tool for assessing the risk of bias.

This systematic review included six clinical trial studies (363 participants), among which, only one study was performed on children, and two investigations were conducted on obese participants. A decreasing effect was found in the level of leptin and visfatin after cinnamon supplementation. Two out of three studies examined adiponectin levels and revealed non-significant effects of cinnamon consumption on this parameter. Two studies evaluated ghrelin levels and found an increase after cinnamon supplementation. The result of cinnamon supplementation on other biomarkers such as glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, and resistin was inconsistent.

The result of this systematic review indicated the increasing effect of cinnamon supplementation on ghrelin levels and decreasing effect on leptin and visfatin levels. However, more clinical data are required to clarify the beneficial effects of cinnamon on adipokines levels due to the controversial findings of the studies.

The relation between the anthropometric status of household members and food insecurity is complicated and not clearly defined. The current study aimed to examine the prevalence of food insecurity (FI) and its association with maternal and child anthropometric indices and dietary intake in a low-income district located in the northeast of Iran.  This cross-sectional survey was conducted on 400 representative households. The participants were mothers of children aged ≤6 years. Food security with 18-item USDA questionnaire, anthropometric status of mothers and children was measured by measuring weight and height dietary intake with food frequency questionnaire.  Fifty-eight percent of households were food insecure. No correlation was denoted between food insecurity and anthropometric indices, except for maternal height (P=0.02). After adjustment for the other variables, food insecurity was inversely correlated with maternal age (OR: 1.12; 95% CI: 1.06-1.19), maternal education level (OR: 8.41; 95% CI: 1.89-37.46), the employment status of the spouse (OR: 4.28; 95% CI: 2.02-9.05), socioeconomic status (OR: 12.86; 95% CI: 4.84-34.16), and the number of children aged ≤6 years (OR: 2.83; 95% CI: 1.16-6.80). The mean carbohydrate, fat, energy and folic acid consumption were observed to be lower in the food insecure mothers (P<0.05), while the mean intake of fruits was higher in the food-secure mothers (P<0.001).  Women in households with a low socioeconomic status were at an elevated risk of food insecurity and micronutrient deficiencies.

the present study aimed to translate the cystic fibrosis questionnaire for adolescents and adults (CFQ-R 14+) into Persian, and assess its validity and reliability.
In total, 35 patients with cystic fibrosis (CF) completed the Persian version of CFQ-R 14+, and Forced Expiratory Volume in one second (FEV1) and body mass index (BMI) were measured. In addition, the Pediatric Quality of Life inventory (PedsQL) was completed by the subjects. The validity of the CFQ-R 14+ was assessed using the face validity, Content Validity Ratio (CVR), and Content Validity Index (CVI), along with concurrent and know-group validities for checking its construct validity. The scale’s reliability was also estimated by test-retest and Cronbach's alpha coefficients.
After forward-backward translation, the values of the total CVR and CVI and their sub-items were higher than 0.8 and 0.49 respectively. Most of the scales had strong internal consistency (Cronbach's Alpha≥0.70), and the test-retest correlations were within the range of 0.72-0.95, considered significant for all the scales. Moreover, strong correlations were observed between the total CFQ-R and PedsQL 4.0 (r=0.9; P<0.001), as well as moderate-to-strong incomparable domains (r=0.4-0.8). A significant correlation was denoted between the total CFQ-R scale and FEV1 (r=0.42; P=0.01), while a reverse correlation was observed between the total CFQ-R scale and age group discrimination (r=-0.35; P=0.03).
According to the results, the Persian version of the CFQ-R 14+ is a reliable and valid instrument for measuring the health-related quality of life among Iranian adolescent and adult patients with CF.

The present study aimed to translate the cystic fibrosis questionnaire-revised (CFQ-R) for children with cystic fibrosis (CF) into Persian and evaluate the reliability and validity of the instrument.
About eighty individuals including children and their parents were enrolled in this cross-sectional study. Demographic characteristic and disease severity parameters of the subjects were recorded. After translation of the CFQ-R to Persian, the participants completed the parent or child translated version of the CFQ-R, as well as the PedsQL 4.0. Reliability and validity analyses were, then, carried out.
The forward-backward translation was employed in this study. The total content validity ratio (CVR) and content validity index (CVI) were above 0.8 and at least 0.49, respectively. The internal reliability of each domain was acceptable (Cronbach alpha coefficients 0.65-0.91). Appropriate domains of the CFQ-R and pediatric quality of life inventory (PedsQL 4.0) were correlated, indicating the acceptable concurrent validity (r=0.5-0.7). In addition, test-retest reliability was assessed using correlation-coefficients, which were considered significant for both the child version (r=0.88; P˂0.001) and parent version (r=0.78; P˂0.001). Moreover, the CFQ-R scales showed significant correlations with the clinical indices and the construct of disease severity in the child and parent version.
According to the results, the Persian version of the child and parent CFQ-R has acceptable reliability and validity indices; and may be suggested to be used in clinical trials for the clinical evaluations and follow-ups of Iranian children with CF.

Propolis is a sticky, resinous substance produced by honeybees from various plants. Various biological properties of propolis and its extracts have been recognized in previous studies including the antiseptic, anti-inflammatory, antioxidant, antiviral, hepatoprotective, antitumor, antibacterial and antimycotic properties. This study aimed to summarize the effect of propolis on metabolic parameters in human adults using systematic review and meta-analysis.

A comprehensive systematic search was performed in ISI Web of Science, PubMed, Scopus, and Google Scholar up to July 2020 for controlled clinical trials evaluating the impact of propolis on lipid profile and liver enzyme biomarkers. A random effects model was used to calculate the weighted mean difference (WMD) and 95% confidence interval (CI) as the difference between the mean for the intervention and control groups.

The present meta-analysis included six randomized controlled trials. There was significant reduction in Aspartate Aminotransferase (AST) in comparison to the control groups (WMD=-2.01; 95% CI: -3.93--0.10; p=0.039). However, a non-significant effect was observed in Triglycerides (TG), Total cholesterol (TC), low-density lipoprotein (LDL), High-density lipoprotein (HDL) (WMD=-0.05 mg/dl; 95% CI: -0.27-0.18; p=0.688; WMD=7.08 mg/dl; 95% CI: -37.31-51.46; p=0.755; WMD=-0.94 mg/dl; 95% CI: -6.64-4.77; p=0.747; WMD=3.14 mg/dl; 95% CI: -1.84-8.13; p=0.216, respectively).

Current meta-analysis revealed that propolis supplementation can reduce AST; nevertheless, there was no significant effect on lipid profile indices and ALT.

Enteral tube feeding intolerance (ETFI) is one of the most common complications of enteral nutrition (EN), which may lead to increased mortality and length of intensive care unit (ICU) stay. This study aimed to determine the prevalence of ETFI and effects on feeding intolerance on nutrition and clinical outcomes in Iran.

This cross‑sectional study was conducted in 2019 at the three general ICUs of Imam Reza Hospital in Mashhad, Iran, during 7 days on 245 patients. The collected data included demographic characteristics, primary diagnosis, the Acute Physiology and Chronic Health Evaluation II (APACHE ІІ) score, Sequential Organ Failure Assessment (SOFA) score, duration of mechanical ventilation, and length of ICU stay. Feeding intolerance was assessed using daily questionnaires for 7 days. ETFI was determined as the interruption of EN based on gastrointestinal causes, including large gastric residuals, abdominal distension, vomiting, diarrhea, and subjective discomfort.

Overall, 245 critically ill patients (122 males and 123 females) were included in this study, with a mean age of 58.43 ± 19.2 years in three general ICUs. The highest prevalence rate of ETFI was 91.8%, which occurred on the 2nd day although the rate decreased in the following days. The minimum ETFI was observed on the last day (38.8%). Feeding intolerance was associated with the increased APACHE II scores (P = 0.04), SOFA scores (P < 0.001), and duration of mechanical ventilation (P < 0.001) compared with the tolerant patients. The most common causes of ETFI in the patients admitted to the ICU were gastric residual volume (GRV), large GRV, vomiting, and distension.

ETFI was prevalent in almost two‑third (66%) of the critically ill patients receiving EN based on the GRV. ETFI was associated with deteriorated nutritional status and clinical outcomes.

Ramadan fasting (RF) is a model of calorie restriction similar to intermittent fasting, which is extensively practiced by a large population of Muslims. Limited and controversial studies have investigated the physiological changes induced by 30 days of RF. The present study aimed to evaluate the effects of Ramadan fasting on the resting metabolic rate and body composition of overweight and obese individuals.  This study was conducted on 21 men and women aged 18-40 years. The subjects avoided eating and drinking for one month during the holy month of Ramadan (at least 20 days) and received a routine diet without an intervention between Iftar and dawn (Sahur). Before and after the study, the energy of the basal metabolic rate was measured via indirect calorimetry, and body composition was measured by bioimpedance (InBody s10). In addition, the physical activity of each participant was evaluated using a pedometer during one week. During the study, each participant received a 24-hour recall once a week.  Compared to the pre-study period and after four weeks of RF, body weight (77.91±11.83 vs. 77.01 ±11.75 kg; P<0.05) decreased, while the body fat percentage (34.84±7.07 vs. 38.48±5.93%; P<0.001) increased. However, the resting metabolic rate had no significant changes (P=0.641), while the total fat-free mass and visceral fat mass significantly deceased after the study (P<0.001). The mean daily energy intake increased after the study compared to before RF (3,290±785.82 vs. 2,458±535.32 kcal; P<0.05). Moreover, the total carbohydrate and sugar intake increased significantly after RF (437.04±101.02 and 194.04±56.87 g per day vs. 310.09±87.12 and 60.42±31.57 g per day).  According to the results, RF may effectively improve metabolic parameters and prevent the decline of the basal metabolic rate if accompanied by nutritional support and healthy dietary recommendations.

Gastric bypass surgery is an intervention used to treat class III obesity and its complications. Evidence is scarce regarding its benefits among the Iranian population, especially its role in resolving obesity-related complaints and comorbidities. The present study aimed to investigate the impact of gastric bypass surgery on the improvement of obesity-related complaints and comorbidities in morbid obesity.

This study was conducted on 35 morbidly obese patients who volunteered to undergo gastric bypass surgery. Anthropometric data, comorbidity status, and dietary habits were collected at baseline and six months postoperatively. Data analysis was performed in SPSS version 16.0.

The majority of the patients were female (80%). A significant difference was observed in the frequency distribution of normal dietary habits (five regular meals per day) before and after surgery (P = 0.01). In comparison, the distribution was not significant for snacking and three large meals per day (P > 0.05). All complaints of eating disorders according to self-reports (e.g., overeating and night eating syndrome) significantly improved (P < 0.05 ). Moreover, the dose of the medications prescribed for the comorbidities associated with obesity reduced significantly (P = 0.001). The frequency of several obesity-related complaints (e.g., knee pain, hirsutism, acanthosis nigricans, and sleep apnea) also decreased significantly (P < 0.05). However, no significant improvement was observed in hair loss, brittle nails, and menstrual dysfunction (P > 0.05).

Accordingly, gastric bypass surgery could improve obesity-related complaints six months postoperatively. Also, according to the patients’ self -declaration, patients’ adherence to “normal eating habits” increased during this period, and their eating disorders like night eating syndrome (NES) and overeating behaviors decreased compared to before the surgery.

Indirect calorimetry (IC) is the optimal tool for the assessment of the resting energy expenditure, as well as the reference standard for energy expenditure measurement. During the outbreak of coronavirus, performing respiratory tests such as IC has become challenging. The current guidance was designed to prevent the virus spread at calorimetry centers.

This protocol was devised in accordance with the latest recommendations of the World Health Organization (WHO) and Centers for Disease Control (CDC), as well as the related articles.

Due to the specific features of COVID-19, unnecessary ICs should be avoided in the hotspots of the disease. If these tests must be performed, adherence to the validated infection control recommendations is critical.

Celiac disease (CD) is an immune-mediated enteropathy that occurs in genetically predisposed individuals associated with gluten intake. Currently, the only effective treatment for CD is life-lasting elimination of gluten from the diet, but adhering to it throughout life is burdensome. In addition, strict compliance with a gluten-free diet (GFD) does not lead to a complete restoration of intestinal microbiota. Although gluten is known to be a trigger in CD, various studies have demonstrated that the gut microbiota is involved in gluten metabolism, regulation of intestinal barrier permeability, and modulation of the immune response. Therefore, the gut microbiota has an important role in the pathogenesis, progression, and clinical manifestations of CD. This evidence supports the hypothesis that probiotics act as a strategy to modulate the intestinal microbiota into an anti-inflammatory state. Probiotics such as some bacterial species of the genera Bifidobacterium and Lactobacillus can protect the epithelial cells from gliadin-induced damage and improve symptoms and quality of life in GFD-treated patients, as an adjunctive treatment. This narrative review aims to discuss the recent scientific evidence of the relationship between the intestinal microbiota changes in CD and to understand the role of probiotics in CD treatment.

Breast milk composition is affected by several factors such as maternal diet and body mass index. Milk fats include a major calorie content of the milk, which changes dramatically throughout the lactation. The aim of the present study was to assess breast milk fatty acid profile in overweight and obese mothers and its correlations with maternal body mass index.

Milk samples were collected from 73 healthy lactating women referring to various health centers in Mashhad. Data were collected using food frequency questionnaire to assess the maternal dietary intakes. Breast milk fatty acid profile was assessed using gas chromatography.

Breast milk content of saturated fatty acids was higher in obese mothers than overweight mothers (p = 0.03) with positive correlations with maternal body mass index (r = 0.256; p = 0.037). Furthermore, breast milk monounsaturated fatty acids were negatively correlated with pre-pregnancy body mass index (r = -0.385; p = 0.003) and pre-pregnancy body weight (r = -0.276; p = 0.026). However, no significant correlations were observed between the maternal body fat mass and fat proportion with the breast milk fatty acids (p > 0.05). Moreover, no significant associations were seen between dietary saturated fatty acids, milk monounsaturated fatty acids, polyunsaturated fatty acids, n-3 polyunsaturated fatty acids and n-6 polyunsaturated fatty acids with the corresponding fatty acids in breast milk (p > 0.05).

Based on the results, breast milk of the obese mothers included higher proportion of saturated fatty acids, while no significant differences were observed in the contents of milk monounsaturated fatty acids and polyunsaturated fatty acids between the overweight and obese women. Furthermore, maternal pre-pregnancy body mass index was negatively correlated with the contents of milk monounsaturated fatty acids, while it was positively correlated with saturated fatty acids contents.

Household food insecurity is defined as the limited or uncertain access to adequate and safe food or limited ability to obtain food in a socially acceptable manner. Preeclampsia is a severe case of high-risk pregnancy, which endangers the health of women across the world, especially in developing countries. The current study aimed to use the nutritional deficiencies theory in pathogenesis of preeclampsia and determine the correlation between food insecurity and preeclampsia.

This case-control study was conducted on 100 women with preeclampsia and 200 normal pregnant women with the gestational age of 20 weeks. Participants were selected via purposive sampling according to the eligibility criteria. Data were collected using the USDA questionnaire for food insecurity, socioeconomic data, and demographic data through interviews.

The findings indicated that the frequency of food insecurity was significantly higher in the preeclampsia women than the healthy women (71% vs. 21%; P < 0.001). Logistic regression indicated that the risk of preeclampsia was six times higher among pregnant women in the unsafe food status group than those in safe food status group [odds = 6.4; 95%CI: 3.3-12.4; P < 0.001]. Among the studied variables, socioeconomic status, history of stillbirth, history of preterm delivery, and ethnicity were significantly associated with preeclampsia during pregnancy (P < 0.05). In addition, women with low socioeconomic status were twice at the higher risk of preeclampsia compared to those with favorable socioeconomic status [odds = 2.7; 95%CI: 1.1-6.2; P = 0.01].

The current study indicated that the prevalence of food insecurity was high in Iranian women with preeclampsia, especially those with a history of preterm labor, history of stillbirth, low socioeconomic status, or non-Persian

Acute inflammation in critically ill patients could affect the metabolism, including nutritional needs and nutrient uptake. Diet also affects the body through various mechanisms, such as the reduction of inflammatory processes, antioxidant capacity, and alteration of lipid profiles and the microbial balance of the intestine. The dietary inflammatory index is a predictive index of inflammatory dietary potential. The present study aimed to hypothesize whether designing a new low dietary inflammatory index formula with high antioxidants could reduce the inflammatory factors in critically ill patients. 

This single-center, prospective, randomized, single-blind, controlled study was conducted on patients with severe trauma, who were randomly assigned to the standard formula (n=10) and intervention formula (n=10) upon admission to the intensive care unit. 

The primary outcomes of the study were the clinical status, metabolic factors, and inflammatory biomarkers. 

Since no studies have been focused on the formulation of antioxidant micronutrients in terms of dietary inflammation indices, this research aimed to investigate the effects of this formulation with a low inflammatory profile on the metabolic and inflammatory markers of patients with multiple traumas.

Oxidative stress and inflammation could occur after major gastrointestinal surgeries. Selenium is a micronutrient with anti-inflammatory and antioxidant properties, which could improve the inflammatory markers in the children admitted to the intensive care unit (ICU) after gastrointestinal surgeries. Due to the lack of evidence on the potential effects of high-dose selenium on post-surgical critically ill children, the present study aimed to evaluate the effects of high-dose selenium supplementation on the levels of inflammatory markers and oxidative stress status in pediatric patients after gastrointestinal surgery. 

Methods and analysis:

 We will conduct a single-blinded, randomized, parallel group superiority trial at Akbar Pediatrics Hospital in Mashhad, Iran. The sample population will consist of 70 patients undergoing gastrointestinal surgery, who will admit to the ICU at the selected hospital. The control group will receive the recommended dietary allowance (RDA) doses of selenium, and the intervention group will receive 20 µg/kg/d of selenium. The primary outcomes, (the pro-oxidant-antioxidant balance (PAB) status, interleukin-1 beta (IL-1β), and high-sensitivity C-reactive protein (hs-CRP)) will be measured before surgery and upon discharge time. The secondary outcomes, (serum glutathione peroxidase (GPX) level and serum and urine selenium levels), will be measured before surgery, after surgery, and upon ICU discharge time. We will perform the intra-group and inter-group data analysis in SPSS software, and we will consider the intention-to-treat approach, statistical significance level of <0.05, and 95% confidence interval in all the statistical analyses.

 Pediatric observational studies have indicated that most critically ill children have low serum selenium level, which is associated with the increased incidence of multiple organ failure and deteriorated clinical outcomes. Selenium plays a key role in the endogenous antioxidant defense mechanism and inflammatory pathways.

 The present study aimed to assess the effects of high-dose selenium supplementation on the improvement of inflammatory and oxidative stress indices, as well as clinical outcomes, in pediatric patients with severe oxidative stress and inflammation following major gastrointestinal surgeries.

 This prospective, single-blind, randomized, parallel group superiority trial was conducted at the pediatric intensive care unit (PICU) of Akbar Pediatric Hospital in Mashhad, Iran in 2019. Patients were assigned to the supplementation (high-dose selenium: 20 µg/kg/d) and control groups (placebo with the recommended dietary allowance doses of selenium) using stratified blocks. Among 72 eligible critically ill children after gastrointestinal surgery, 66 patients completed the study. Inflammatory markers were measured and compared between the groups, including high-sensitivity C-reactive protein (hsCRP), interleukin 1 beta (IL-1β), prooxidant-antioxidant balance (PAB) assay, and clinical outcomes. Data analysis was performed in SPSS version 20 using the intention-to-treat approach.

 Only 14 patients had optimal serum selenium concentrations before the surgery and PICU admission. At the end of the study, 90.6% of the patients (n = 29) in the intervention group and 100% (n = 34) of those in the placebo group had suboptimal serum selenium levels (< 50 ng/mL). Although supplementation with high-dose selenium decreased the inflammatory markers in the post-surgical critically ill children (-18 mg/mL and -37.5 pg/mL for hsCRP and IL-1β, respectively), the administered dose could not improve the serum glutathione peroxidase (GPx) concentrations as the selenium functional marker, as well as the PAB assay as the single test to assess the balance/imbalance of the oxidants and antioxidants simultaneously. Additionally, clinical outcomes such as infections, length of ICU stay, and 28-day mortality did not improve after the intervention.

 According to the results, high-dose selenium supplementation (20 µg/kg/d) in the post-surgical critically ill children could improve the serum inflammatory markers. However, the changes were suboptimal with no significant effects of the serum GPx concentrations, antioxidant defense system, and clinical outcomes.

To compare thyroid volume , thyroid stimulating hormone (TSH) , Free T4  and  prevalence of thyroid nodules between obese and  non-obese subjects .Also,  association  between BMI  and insulin resistance status with various parameters of thyroid gland was evaluated.

Fifty –two patients with obesity and 38 normal body mass index (BMI ) volunteers, aged 20-50 years , were enrolled in this cross-sectional study. Patients with diabetes, history of thyroid disorders, and patients who were taking medications that influence their blood glucose or insulin levels or modified thyroid function tests, were excluded. TSH,free T4, insulin and glucose and thyroid sonography were carried out and results compared between two groups. P<0.05 was considered as significant.

Thyroid volume was higher (p<0.001) and free T4 was lower (p<0.001) in patients with obesity but there was no difference in TSH between groups. Prevalence of thyroid nodules was 15.7% and 10.8% in obese and non-obese groups, respectively (p=0.51). Frequency of nodules was significantly higher in insulin resistant than non- insulin resistant subjects (22% vs.2%, p=0.01). BMI was associated with    thyroid volume ( r =0.44 , p< 0.001) and  freeT4 ( r = - 0.35 , p=0.001)  . HOMA-IR(Homeostatic Model Assessment for Insulin Resistance ) had no correlation with thyroid volume (p= 0.38), but associated  with  FreeT4 (r= -0.25 , p=0.01).

Free T4 was lower and volume of thyroid was higher in obese subjects, but TSH  and frequency of thyroid nodules had no significant difference between obese and non-obese counterparts. Insulin resistant individuals had more nodules but  thyroid volume was mainly associated with BMI.

Oxidative stress after major surgeries is associated with the development of poor clinical outcomes including delayed wound healing and increase in Pediatric Intensive Care Unit (PICU) length of stay. Due to the growth and development phase in childhood, the change in the levels of oxidative stress and inflammation is of high importance in these patients. Notably, the acute metabolic stress which is in association with oxidative stress rate, is believed to increase after major surgeries in pediatric patients. It is suggested that the presence of selenium in different selenoenzymes and selenoproteins, may play a major role in anti-oxidative defense system in surgical inflammation through regulation of glycolysis, gluconeogenesis, insulin transport pathways and gene expression of inflammatory mediators and other functions of lymphocytes B and T, natural killer and lymphokine activated killer cells. Selenium requirement in acute metabolic stress following major surgeries is essential for pediatric cases, therefore selenium supplementation in such patients may be helpful and cost effective in long term. Further clinical studies are required to clarify the potential beneficial effects of selenium supplementation in addition to its dose safety and efficacy rate.

 Under difficult conditions, the military need high-energy macronutrients and micronutrients during intense physical activities in order to achieve optimal fitness levels.

 This randomized controlled trial aimed to assess the effects of a designed compact food bar (CFB) on the maximal oxygen uptake (VO2Max) and physical fitness in military athletes.

 This randomized controlled trial was conducted on 50 athletes aged 20 - 50 years, who were assigned into two experimental and control groups. The subjects in the compact food bar (CFB) received three packs of CFB (700 kcal each), containing functional compounds (e.g., caffeine and L-arginine), every day for 10 days. The control group consumed the regular food used in military training courses with the same daily calorie count for the same period. The exercise performance was assessed using sports tests, maximal oxygen uptake (VO2Max) as a measure of cardio-respiratory endurance in vitro, cardiopulmonary exercise tests, blood pressure, and anthropometric examinations based on the participants’ body composition and physical activity. The measurements were performed using a pedometer, and the data were recorded at baseline and after the intervention. The data was then analyzed in SPSS software version 16.

 VO2Max and some of the exercise tests, including push-up, sit-and-reach test, and jump pair length, revealed significant increases in CFB group, compared to the control group (P < 0.05). However, the concerned variable seemed to have no significant effects on the anthropometric indices (weight and body mass index) and body composition (lean body mass and body fat mass) in CFB group (P > 0.05).

 According to the findings, the consumption of the proposed CFB, in comparison to regular food, could effectively improve the exercise performance in military athletes.

Childhood obesity is a serious health problem worldwide and the number of critically ill obese children is rapidly increasing in Pediatric Intensive Care Units (PICUs). Given the importance of optimal energy and nutrient delivery that may lead to improved clinical outcomes in PICUs, we addressed the nutrition support aspects of managing critically ill obese children in PICUs.

This review was conducted on the National Library of Medicine’s PubMed, Scopus, Cochrane, and Embase databases using a combination of relevant MeSH terms and keywords to provide updates on the nutritional management of obese patients in PICUs. The MeSH terms included “Child”, “Pediatrics”, “Infants”, “Obesity”, “Morbid Obesity”, “Obesity Management”, “Complications”, “Nutrition Assessment”, “Diet Therapy”, and “Intensive Care Units”. The keywords were as followed: critical care, critical illness, intensive care enteral and parenteral nutrition, morbidity, and mortality. The reference lists of the relevant articles were also reviewed to ensure adequate study identification. Thereafter, 348 records were identified and screened for eligibility in the title and abstract and duplicate publications were removed. Finally, after assessment for eligibility, 42 relevant articles published in English from 1990 to 2018 were obtained and read thoroughly in the reviewing process.

Obese children are at a high risk of nutritional deprivation in PICUs. Obesity, metabolic stress, and inflammation can affect the metabolism of nutrients in critically ill obese children. Screening for potential micronutrient deficiencies, optimal isocaloric feeding with adequate macronutrients, and micronutrients should be considered in critically ill obese children.

This review provided recent evidence to help intensivists for initial nutrition assessment and realistic nutrition care planning for critically ill obese children.

Olivier salad is one of the most common cold fast foods in our country that is nutritious because of its various ingredients, so it is susceptible to bacterial contamination. This study aimed to evaluate the chemical and microbial quality of Olivier salads that were sold in Mashhad groceries.  In this study, 26 samples from two types of Olivier salad (Chicken (17 samples) and Meat (9 samples) were collected from the local markets. Samples were transferred to the laboratory in cold flasks and then microbial (coliform bacteria, Escherichia coli, Staphylococcus aureus, Salmonella spp, clostridium perfringens , mold, and yeast), and chemical quality (levels of potassium sorbate, potassium benzoate, and benzoate alone) were evaluated  based on the Iran national standard No. 17813 and. 17813-a-1, respectively.  Chemical tests in the samples showed no significant difference between the amounts of potassium sorbate, potassium benzoat, and benzoate alone (P>0.05) in different samples. Of the total samples, 7.7% (2/26) and 23.07% (6/26) of the Olivier salad samples were contaminated with Salmonella and Escherichia coli, respectively. Staphylococcus aureus was negative in all of the samples.  Salmonella and Staphylococcus aureus have particular importance in food contaminations. Lack of hygiene during production, contamination of raw materials, and elevation of storage temperature are  critical factors for the increased level of contamination. So control and monitoring of the food chain is necessary.