The Association of General and Central Obesity with Major Dietary Patterns in Adult Women Living in Tehran, Iran

<p class="abstract"><strong>BACKGROUND:</strong> Using dietary pattern analysis method could provide more information about nutritional etiology of chronic disease such as obesity. The aim of this study is to determine the association between major dietary patterns and general and central obesity among adult women living in Tehran.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>A cross-sectional study was conducted in Tehran, Iran, with 460 women aged 20-50 years. Dietary intake in last year was collected by a semi-quantitative food frequency questionnaire. Weight, height and waist circumstance (WC) were measured with standard methods and body mass index (BMI) was calculated. General obesity was defined as BMI &ge; 30 kg/m² and central obesity as WC &ge; 88 cm. Factor analysis was used for identifying major dietary patterns. The association between major dietary patterns and general and central obesity were assessed by logistic regression analysis.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> Two major dietary patterns were extracted: "Healthy" and "Unhealthy" dietary pattern. After adjusting for confounders, individuals in the highest quartile of the unhealthy dietary pattern score were more likely to be generally (OR = 7.33, 95% CI: 2.39-22.51) and centrally obese (OR = 4.99, 95% CI: 2.08-11.94); whereas, those in the upper quartile of healthy dietary pattern were less likely to be generally (OR = 0.38, 95% CI: 0.15-0.98) and centrally obese (OR = 0.33, 95% CI: 0.16-0.71).<strong>&nbsp;</strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> Major dietary patterns of Tehrani women had a significant association with general and central obesity. Further prospective researches are required to confirm such associations.</p> <p class="abstract">&nbsp;</p><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td width="35" height="12"><br /></td></tr> <tr><td><br /></td> <td>&nbsp;</td></tr></tbody></table><p class="abstract">&nbsp;</p> <strong>Keywords:</strong> Dietary patterns, Factor analysis, Obesity, Women, Ira

Dietary Patterns and Risk of Gallbladder Disease: A Hospital-based Case-Control Study in Adult Women

Gallbladder disease is one of the most prevalent gastrointestinal disorders that may result from a complex interaction of genetic and environmental factors. This study examined the association of dietary patterns with gallstone disease among Iranian women. This case-control study was conducted in general teaching hospitals in Tehran, Iran. Participants were 101 female cases and 204 female controls aged 40-65 years who were admitted for problems other than GBD. Dietary patterns were identified using principal components analysis based on food frequency questionnaire. Compared to the control group, cases were less educated, less physically active, and consumed more total energy (p&lt;0.02). Having 653 livebirths increased the risk of gallstone by more than 5 times, followed by having rapid weight loss, being single, having familial history of gallstone, and consuming high total energy. Two distinct dietary patterns were identified in women (healthy and unhealthy). After adjustment for several confounding variables, healthy dietary pattern was associated with a decreased risk of gallstone disease (OR=0.14, 95% CI 0.048-0.4) while unhealthy dietary pattern was associated with an increased risk (OR=3.77, 95% CI 1.52-9.36). These findings confirm that dietary pattern approach provides potentially useful and relevant information on the relationship between diet and disease. Identifying risk factors will provide an opportunity for prevention of gallbladder disease in developing countries facing an increased risk of obesity

Validity of Energy Intake Reports in Relation to Dietary Patterns

The role of under- and overreporting of energy intake in determining the dietary patterns is yet unclear, especially in the Middle Eastern countries. This study identifies the prevalence of misreporting among Tehranian women aged 18-45 years and to compare the dietary intake patterns of plausible and all energy reporters. Dietary intakes and anthropometric data were collected. FitMate\u2122 metabolic analyzer and Goldberg equation were used in determining the under/overreporting of energy intake. Underreporters were more likely to be overweight and older compared to plausible reporters. Three dietary patterns emerged for all reporters, and two were identified for plausible reporters. Using only plausible reporters to determine dietary patterns was not similar to using all reporters. The proportion of underreporters was 59.3% in the mixture cluster, 30.4% in the unhealthy cluster, and 35.3% in the healthy cluster (p&lt;0.05). Underreporting of energy intake is not uniformly distributed among dietary pattern clusters and tends to be less severe among subjects in the unhealthy cluster. Our data suggested that misreporting of energy intake might affect the dietary pattern analysis

The effect of food service system modifications on staff body mass index in an industrial organization

Due to the adverse effects of obesity and overweight on health status of people, organizations that provide daily food aim for a healthy Body Mass Index among their staff. The purpose of this applied randomized controlled trial (RCT) was to study the effect of modifications in the food service section and nutritional intervention on the BMI of staff in an industrial center. In this applied randomized controlled trial which lasted for 40 days, 116 overweight people (BMI ≥ 26) were randomly selected and divided into control and test groups. Individual daily food plan was prepared by a dietitian and nutritional education sessions were held for test group. At the management level, food menu was modified reduce the calorie intake by at least 1000 Kcal per day for the test group and also cost less for the center. The kitchen staffs were trained to promote healthy cooking and improving the food taste. The satisfaction level of food service was also evaluated before and after the intervention, using a questionnaire. To analyze the findings, SPSS 16 software, independent t-test and paired t-test, and Macnemar test were used. The results showed that BMI in test group decreased from 27.5 ± 2.36 to 26.8 ± 2.15 (p&lt;0.05), while in control group increased by 0.5 Kg/m2. Similar result was observed in weight change. The level of satisfaction of food service following changes in the menu increased significantly in both groups. Also, cost of food and use of fat were reduced by 15% and 8%, respectively.  Dietary interventions and improving the nutritional knowledge along with modification in food service system could result in better weight management in organization staff using canteen food.  

Major Dietary patterns and related factors among workers of Oil Terminal Company in Kharg Island, Iran

This study was conducted to identify the dietary patterns among workers of Oil Terminals Company and to assess their association with socio-demographic and lifestyle factors.The sample size (392) was estimated by considering minimum correlation (r=0.2) between variables. This cross-sectional study was conducted in a representative sample of workers selected by a stratified random-sampling method (alloffices of the company). The head of company provided a list of workers, and the proportionof each center was specified via ni=ki/N × n [ni=number of participants from each center, ki=number of each center workers, N=number company workers, n= sample size (392)].Dietary pattern was identified by valid food frequency questionnaire containing 168 food items with specific serving size consumed by Iranians. Major dietary patterns analyzed by factor analysis. General characteristics across tertiles were compared by ANOVA and chi-square tests were used where appropriate. In addition, we used multivariate logestic regression tests to assess the relationship between demographic, socioeconomic and lifestyle variables and the adherence to the dietary patterns. Two major dietary patternswere extracted: "Healthy pattern" characterized by high consumption of fruits, fish, yellow vegetables, potato, garlic, whole cereals, yogurt drink, and salt. The second one named "unhealthy pattern" characterized by high consumption of soft drinks, sugar, mayonnaise, sweets, eggs, butter, and processed meat, high- fat dairy products, organ meat, French fries, refined cereals, snacks and artificial juice. Work hours were positively correlated (b=0.14; p&lt;0.01) and being single (b=-0.4, p&lt;0.05) and full time work in comparison with part-time work (b=-0.5, p&lt;0.01) was negatively correlated with healthy dietary pattern, whereas age (b=-0.3, p&lt;0.05), dieting (b=-0.4, p&lt;0.01)  and history of hyperlipidemia had negative correlation (b=-0.41, p&lt;0.01) with unhealthy dietary pattern.Our findings show the association between socio-demographic, lifestyle factors and dietary patterns of the worker

Dietary Inflammatory Index and Odds of Colorectal Cancer and Colorectal Adenomatous Polyps in a Case-Control Study from Iran

Background: Chronic inflammation is implicated in the development of colorectal cancer (CRC) and its precursor; colorectal adenomatous polyps (CAP). Some dietary factors are important triggers for systemic inflammation. Therefore, the present study aimed to investigate the association between the dietary inflammatory index (DII®) and the risk of CRC and CAP in an Iranian case-control study. Methods: 134 newly diagnosed CRC patients, 130 newly diagnosed CAP patients, and 240 hospitalized controls were recruited using convenience sampling. Energy-adjusted DII (E-DII) scores were computed based on dietary intake assessed using a reproducible and valid 148-item food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI) after adjusting for confounders. Results: The E-DII score ranged between −4.23 (the most anti-inflammatory score) to +3.89 (the most pro-inflammatory score). The multivariable-adjusted ORs for participants in the 3rd tertile compared to the 1st tertile was 5.08 (95%CI: 2.70–9.56; P-trend \u3c 0.0001) for CRC and 2.33 (95% CI: 1.30–4.02; P-trend = 0.005) for CAP. Conclusions: Our findings suggest that more pro-inflammatory diets, indicated by higher E-DII scores, might increase the risk of both CRC and CAP. Future steps should include testing these associations in a prospective setting in Iran

Diet and renal cell carcinoma

Renal cell carcinoma (RCC) represents 80-85% of all tumors of the kidney and is responsible for about 2% of all cancer deaths in developed countries. Its incidence varies among countries, among migrants, and by socioeconomic status suggesting that environmental factors play a major etiological role. There are many biologically plausible hypotheses that could explain why consumption of plant foods or alcohol might prevent or slow the development of this cancer. However findings from epidemiologic studies, mainly case-control studies, are not consistent. In a population-based prospective cohort of over 60, 000 women, included in the Swedish Mammography Cohort (SMC), we investigated the association between fruit, vegetable and alcohol consumption as well as the major dietary patterns, assessed by self-administered food frequency questionnaire (FFQ), and risk of RCC. We identified 122 incident cases of RCC (ICD-9 diagnosis code 189.0) diagnosed between the return of the questionnaire at baseline (1987-1990) and June 30, 2003, by linkage to the Regional Cancer Registry (paper I). In analyses of alcohol (paper II) and dietary patterns (paper IV) the follow-up was through June 30, 2004. Validity of the FFQbased. dietary patterns identified by factor analysis was estimated by comparing to the patterns based on4x7-day dietary records in 129 women from the SMC cohort; reproducibility was estimated in 212 women by comparing patterns from two FFQs filled in 1 year apart (paper III). In analyses of the association between dietary factors and RCC, we used Cox proportional hazards to estimate the risk as rate ratios (RR) with 95% confidence interval. We observed a non-significant inverse association between combined consumption of fruits and vegetables and RCC risk (multivariate RR = 0.55 (95% Cl, 0.25-1.21 for > 5 servings/day compared to <5-6/week); bananas and root vegetables were significantly inversely associated with RCC risk. Women who drank > 1 servings of alcoholic beverages/week had lower RCC risk than did women who drank <1servings/week (RR = 0.62, 95% Cl, 0.41-0.94); the corresponding estimate for women > 55 years of age was RR = 0.44, 95% Cl 0.22-0.88. We identified three major dietary patterns that we named "Healthy", "Western" and "Drinker". The validity of the three patterns was r(Spearman) =0.59, 0.50 and 0.85 and reproducibility 0.63, 0.68 and 0.73, respectively. Higher Healthy pattern scores were only non-significantly associated with decreased risk of RCC (the highest vs. the lowest tertile was RR=0.81; 95% Cl 0.45-1.48 and among women :S 65 years corresponding estimate RR-0.54; 95% Cl 0.27-1.10). There was a suggestion of an inverse association between the Drinker pattern and RCC risk (RR comparing the second and third with the first tertile, 0.56; 95% Cl, 0.34-0.95; and 0.72; 95% Cl, 0.42-1.22 respectively, (p=0.08 by Wald test); the association was more clear among women< 65 years (p=0.02 by Wald test). In conclusion, our findings from this large population-based prospective cohort study, suggested that high consumption of fruits and vegetables might be associated with reduced risk of RCC. Moderate alcohol consumption may be associated with decreased risk of RCC. We identified three major dietary patterns, and showed that identification of dietary patterns using the FFQ and factor analysis is a reproducible and valid method that can be used in nutritional epidemiology as an alternative approach to dietary assessment. Our data do not provide evidence for a significant inverse association between higher Healthy pattern scores and risk of RCC, but suggest an inverse association with higher Drinker pattern scores

Association between dietary patterns and depressive symptoms in adult women living in Tehran (2013)

Background: Depression is one of the most common mental illnesses. Few studies have investigated the association between dietary patterns and depression in developing countries. Objective: The aim of this study was to determine the association between dietary patterns and depressive symptoms in adult women living in Tehran in 2013. Methods: This cross-sectional study was carried on 217 women aged 20-45 years attending health centers in the north and west of Tehran in 2013. The subjects were selected by systematic cluster sampling method. Data were collected through demographic, food frequency, and physical activity questionnaires and the beck depression inventory. Major dietary patterns were identified by factor analysis and their association with depressive symptoms was assessed by logistic regression analysis. Findings: The prevalence of depressive symptoms was 63.2% in the studied women. Two major dietary patterns were identified (healthy and unhealthy). After adjusting for confounders, subjects with higher scores in the unhealthy dietary pattern had higher odds (OR=2.21, P=0.01) of depressive symptoms; but the healthy dietary pattern was not associated with depressive symptoms. Conclusion: With regards to the results, it seems that the unhealthy dietary pattern is associated with the risk of depression in women. Keywords: Depression, Diet, Statistical Factor Analysi