Efficacy of flour fortification with folic acid in women of childbearing age in Iran

Background: Flour fortification with folic acid is one of the main strategies for improving folate status in women of childbearing age. No interventional trial on the efficacy of folic acid fortification has been conducted so far in Iran. Objectives: To study the effects of flour fortification with folic acid on any reduction in neural tube defects (NTDs) and folate status of women of childbearing age. Methods: In a longitudinal hospital-based study, 13,361 postpartum women were studied after admission for childbirth before and after fortification. In addition, two cross-sectional surveys were conducted before (2006) and after flour fortification (2008). The cluster sampling method was used and 580 women, 15-49 years old, were studied as a representative sample of Golestan province in the north of Iran. Fasting blood samples were collected to measure serum vitamin B 12, folate and plasma homocysteine. Sociodemographic data, health characteristics and dietary intake were determined. Results: The mean daily intakes of folate from natural food before and after flour fortification were 198.3 and 200.8 μg/day, respectively. The total folate intake increased significantly from 198.3 to 413.7 μg/day after fortification (p < 0.001). Folate intake increased by an average of 226 μg/day from fortified bread. The mean serum folate level increased from 13.6 to 18.1 nmol/l; folate deficiency decreased from 14.3 to 2.3% (p < 0.001). The incidence rate of NTDs declined by 31% (p < 0.01) in the post-fortification period (2.19 per 1,000 births; December 2007 to December 2008) compared to the pre-fortification period (3.16 per 1,000 births; September 2006 to July 2007). Conclusions: Implementation of mandatory flour fortification with folic acid can lead to a significant increase in serum folate and a significant decrease in NTDs. Copyright © 2011 S. Karger AG, Basel

Efficacy of vitamin D3-fortified-yogurt drink on anthropometric, metabolic, inflammatory and oxidative stress biomarkers according to vitamin D receptor gene polymorphisms in type 2 diabetic patients: a study protocol for a randomized controlled clinical trial

<p>Abstract</p> <p>Background</p> <p>Development of type 2 diabetes mellitus (T2DM) is determined by the interactions of genetic and environmental factors. This study was designed to evaluate the possible role of VDR single nucleotide polymorphisms (SNPs) on different aspects of diabetic host response (anthropometric, metabolic, oxidative stress and inflammatory) to daily intake of vitamin D through fortified yogurt drink for 12 weeks.</p> <p>Methods/Design</p> <p>This study comprises two parts: (i) a case-control study; and (ii) an intervention trial. In the first part, VDR polymorphisms <it>(Taq1</it>, <it>FokI</it>, <it>Apa1</it>, <it>Bsm1</it>, and <it>Cdx2) </it>are determined in 350 T2DM patients and 350 non-diabetic subjects. In the second part, the possible effects of daily intake of two servings of vitamin D3-fortified yogurt drink (FYD; 500 IU vitamin D/250 mL) on some selected metabolic (including insulin resistance), inflammatory and oxidative stress biomarkers in 135 T2DM patients are assessed. To relate the resulted changes in the biomarkers to vitamin D replenishment, another group of diabetic patients (n = 45) are also included in the study who receive 2 servings of plain yogurt drink (PYD) a day. The primary outcome is serum level of 25(OH) D, which it is expected to be elevated only in FYD group. Secondary outcomes include improvements in glycemic, metabolic, inflammatory and oxidative stress biomarkers in FYD group compared to PYD group. Three VDR <it>FokI </it>polymorphisms are determined only in FYD group followed by comparison of changes in the biomarkers among these genotypic variants.</p> <p>Discussion</p> <p>The present study, at least in part, elucidates the discrepancies in the results of different vitamin D-diabetes studies pertaining to the genetic variations of the population. If VDR polymorphisms are found to influence the response to our intervention, then knowing distribution of VDR polymorphisms in both diabetic and non-diabetic populations can give a picture of the proportion of the community in whom up to 1000 IU/d vitamin D may not be effective enough to improve insulin resistance and related morbidities. Therefore, they should ideally receive further nutritional support according to their genotype.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01236846">NCT01236846</a></p

Regular consumption of vitamin D-fortified yogurt drink (Doogh) improved endothelial biomarkers in subjects with type 2 diabetes: a randomized double-blind clinical trial

<p>Abstract</p> <p>Background</p> <p>Endothelial dysfunction has been proposed as the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease, the major cause of death in diabetes. We recently demonstrated the ameliorating effect of regular vitamin D intake on the glycemic status of patients with type 2 diabetes (T2D). In this study, the effects of improvement of vitamin D status on glycemic status, lipid profile and endothelial biomarkers in T2D subjects were investigated.</p> <p>Methods</p> <p>Subjects with T2D were randomly allocated to one of the two groups to receive either plain yogurt drink (PYD; containing 170 mg calcium and no vitamin D/250 mL, n₁= 50) or vitamin D3-fortified yogurt drink (FYD; containing 170 mg calcium and 500 IU/250 mL, n₂= 50) twice a day for 12 weeks. Anthropometric measures, glycemic status, lipid profile, body fat mass (FM) and endothelial biomarkers including serum endothelin-1, E-selectin and matrix metalloproteinase (MMP)-9 were evaluated at the beginning and after the 12-week intervention period.</p> <p>Results</p> <p>The intervention resulted in a significant improvement in fasting glucose, the Quantitative Insulin Check Index (QUICKI), glycated hemoglobin (HbA1c), triacylglycerols, high-density lipoprotein cholesterol (HDL-C), endothelin-1, E-selectin and MMP-9 in FYD compared to PYD (<it>P </it>< 0.05, for all). Interestingly, difference in changes of endothelin-1, E-selectin and MMP-9 concentrations in FYD compared to PYD (-0.35 ± 0.63 versus -0.03 ± 0.55, <it>P </it>= 0.028; -3.8 ± 7.3 versus 0.95 ± 8.3, <it>P </it>= 0.003 and -2.3 ± 3.7 versus 0.44 ± 7.1 ng/mL, respectively, <it>P </it>< 0.05 for all), even after controlling for changes of QUICKI, FM and waist circumference, remained significant for endothelin-1 and MMP-9 (<it>P </it>= 0.009 and <it>P </it>= 0.005, respectively) but disappeared for E-selectin (<it>P </it>= 0.092). On the contrary, after controlling for serum 25(OH)D, the differences disappeared for endothelin-1(<it>P </it>= 0.066) and MMP-9 (<it>P </it>= 0.277) but still remained significant for E-selectin (<it>P </it>= 0.011).</p> <p>Conclusions</p> <p>Ameliorated vitamin D status was accompanied by improved glycemic status, lipid profile and endothelial biomarkers in T2D subjects. Our findings suggest both direct and indirect ameliorating effects of vitamin D on the endothelial biomarkers.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01236846">NCT01236846</a></p

The survey of the nutritional status of 25-36 month old rural children and some factors affecting it in the rural areas of Kerman

A survey was carried out to assess the nutritional status of 2-3 year old rural children and some factors affecting it in the rural areas of Kerman. All of the 25-36 month old children (i.e. 1015 children) under coverage of primary health care center were included in the study. About one-third of the children’s mothers (334 mothers) were questioned. The data were collected using questionnaires and face-to-face interviews with the mothers. In addition, weight (Wt) and height (Ht) of the children were measured. The nutritional status was determined using various classifications based on weight for age (Wt/A), height for age (Ht/A), and weight for height (Wt/Ht) and the effects of various factors on nutritional status was assessed. Based on the Z-score, cut-off point under -2SD from median of the reference population (NCHS), 16.1% of the children were underweight (Wt/A), 15.6% stunted (Ht/A), and 7.2% wasted (Wt/Ht). According to percentile classification, 20% of the children were underweight (Wt/A), 19.2% stunted (Ht/A), and 8.8% wasted (Wt/Ht). A statistically significant relationship was found between Wt/A and birthweight of the child, health and maternal nutritional practices. A statistically significant relationship was also found between Ht/A and family size, birth weight child, food budget and maternal nutritional practices. Similarly, a statistically significant relationship was found between Wt/Ht and food budget. The results showed a correlation between Ht/A and family size, birth height of the child. A correlation was also found between Wt/A and number of rooms per person. Keywords: Nutritional status, 25-36 month old children, Rural areas, Kerma

Serum Level of Adiponectin and Its Association with Insulin Sensitivity in Overweight Diabetic and Non-Diabetic Iranian Men

Background: Adiponectin is a protein produced exclusively by adipose tissue; the reduced level of which has been shown to be involved in a variety of obesity-related disorders, such as insulin resistance and diabetes, in different ethnic groups. This cross-sectional study was conducted to determine adiponectin level and its association with insulin sensitivity in 20 adult overweight type-2 diabetic and 20 healthy over-weight non-diabetic Iranian men for the first time. Methods: Body fat mass (Bio-electric impedance), serum level of adiponectin (ELISA), fasting blood sugar and fasting insulin were measured. Insulin sensitivity was calculated using QUICKI. Results: As expected, the mean adiponectin concentration was lower in diabetics (7.7 &plusmn;3&micro;g/ml) than non-diabetics (8.1 &plusmn; 2&micro;g/ml); however, the difference did not achieve statistical significance (P= 0.5). Adiponectin negatively correlated with fat mass. This correlation was stronger in diabetics with a higher fat mass (r= -0.3 in diabetics vs. r= -0.01 in non-diabetics; p: N.S.). Adiponectin positively related with insulin sensitivity in both groups, although this relation was only statistically significant in non-diabetics (r= +0.5; P= 0.04). The relation between insulin sensitivity and mean of adiponectin level was marginally significant even after adjustment for group (diabetic and non-diabetic), age and fat mass. Conclusion: Our findings are consistent with the studies on different ethnic groups which have indicated lower adiponectin levels in diabetics. Also our results confirm the relationship between a low adiponectin level and insulin sensitivity reported in earlier studies

Vitamin-D-free regimen intensifies the spatial learning deficit in Alzheimer's disease

Evidences support a link between nutrition and risk of neurodegenerative Alzheimer's disease (AD). This work was designed to find out if food regimens lacking vitamin D or with a supplement of vitamin D could affect spatial performances in the Alzheimeric animals. The experiment was done on the control and Alzheimeric (ALZ) animals on a normal regimen of food, as well as the Alzheimeric rats fed with regimens lacking vitamin D (ALZ-D) or supplemented with 1,25(OH)2D3 (ALZD). For learning the spatial task the animals were trained to locate a hidden platform in the Morris water maze. We found that the ALZ rats had an obvious lower performance compared with the control ones. Generally, the ALZ-D rats displayed a poorer spatial learning compared with either the ALZ or the ALZD rats. Vitamin D supplement did not significantly influence the spatial performance. We conclude that although vitamin D deficiency strengthens the spatial learning deficit in AD, a supplement of 1,25(OH)2D3 does not effectively underlie the maze performance. It can be concluded that subjects with AD must be protected from vitamin D inadequacy