Fluids Intake and Beverage Consumption Pattern among University Students

Background: Insufficient and inappropriate daily fluid intake in a long period may have adverseeffect on human's health. Therefore, the present study evaluated the amounts and sources of fluidsconsumed by university students to determine whether these amounts and sources of fluid wereenough and appropriate.Methods: In this descriptive study, 245 (142 females and 103 males) volunteer students of TabrizUniversity of Medical Sciences in 2009 were recruited. Food and fluid intake of subjects were assessedby 24-hour recall method of 3 days (two week days and one week- end included). Dietaryintake of subjects was analyzed by Nutritionist III software program. The mean total fluid intake(drinking fluid values merged with data on the water content of foods) and the rate of metabolicwater were figured out. Comparisons of the results with recommended dietary values were madeusing student's t-test.. Data of dietary intakes for two under-reporter female subjects were notincluded in the statistical analysis.Results: Daily total mean of fluid intake for girls (1598±40ml) and boys (1861±59ml) reflect thesum of beverages (Girls, 818±29ml; boys, 1147±57ml) and food water (Girls, 780±47ml; boys,714±86m). The most consumed beverage for girls and boys were water (40%) and tea (49%)respectively. Daily mean intake of milk for girls and boys were 106.31±10ml (13%) and57.30±11ml (5%), respectively.Conclusion: The mean daily fluid intake of subjects, specially water, and milk was lower than recommendedvalues. Therefore, there is an urgent need for tailored nutrition intervention targetingthe young adults to improve their beverage choices

Prevalence of smoking, alcohol consumption, and drug abuse in Iranian adults: Results of Azar Cohort Study

Background: Substance abuse has significant health impacts on families and society as a whole. We aimed to provide detailed prevalence estimates of substance abuse among the Azar Cohort Study respondents in Tabriz, Iran. Methods: Data on 15006 participants of Azar Cohort Study were analyzed. The variables included tobacco smoking, alcohol use, drug abuse, and socio-demographic characteristics. The prevalence of substance abuse (with a 95% confidence interval) was calculated using the direct standardization method. Results: Overall, 9.3% and 6.2% of the participants were regular and heavy cigarette smokers, respectively. Also, 1.9% and 2.1% of participants reported a history of using illicit drugs and alcohol, respectively. Substance abuse was more prevalent among males than females. Substance abuse varied significantly with age and socioeconomic variables. Conclusion: We identified specific demographic and socioeconomic groups with a higher prevalence of all studied behaviors. Such high-risk groups should be targeted when designing substance abuse prevention programs

Does long sleep duration increase risk of metabolic syndrome in Azar cohort study population?

Background: We decided to assess the correlation between metabolic syndrome (MetS) risks,sleep and napping duration in Azar cohort population according to the increasing incidence of MetS in the world and inconsistence results about sleep duration and MetS. Methods: In this cross-sectional study, MetS and sleep habits of 14916 subjects (35-70 years old) who inhabited in Shabestar city were determined by ATPIII and Pittsburg questionnaire respectively. Inclusion criteria were subjects with 35-70 years old and living in Shabestar for at least 9 months of the year.Results: According to the results, age, living place, body mass index, hypnotic drug use, sleep and napping duration and TV time were the risk factors of MetS. In this regard, long sleep duration (>9 h/24 h), napping (0.25-2 h/day), hypnotic drug use and watching TV (2 h/day)increased the risk of MetS by 1.18 (1.05-1.33), 1.16(1.07-1.26), 1.35(1.13-1.60), and 1.13(1.04-1.23) respectively.Conclusion: According to these results, it appears that proper education for improvement of sleep habit is necessary to reduce incidence of MetS and its consequences. However, there is need for more longitudinal researches and using objective method of sleep habits evaluation for more precise results

Prealbumin/CRP Based Prognostic Score, a New Tool for Predicting Metastasis in Patients with Inoperable Gastric Cancer

Background. There is a considerable dissimilarity in the survival duration of the patients with gastric cancer. We aimed to assess the systemic inflammatory response (SIR) and nutritional status of these patients before the commencement of chemotherapy to find the appropriate prognostic factors and define a new score for predicting metastasis. Methods. SIR was assessed using Glasgow Prognostic Score (GPS). Then a score was defined as prealbumin/CRP based prognostic score (PCPS) to be compared with GPS for predicting metastasis and nutritional status. Results. 71 patients with gastric cancer were recruited in the study. 87% of patients had malnutrition. There was a statistical difference between those with metastatic (n=43) and those with nonmetastatic (n=28) gastric cancer according to levels of prealbumin and CRP; however they were not different regarding patient generated subjective global assessment (PG-SGA) and GPS. The best cut-off value for prealbumin was determined at 0.20 mg/dL and PCPS could predict metastasis with 76.5% sensitivity, 63.6% specificity, and 71.4% accuracy. Metastatic and nonmetastatic gastric cancer patients were different in terms of PCPS (P=0.005). Conclusion. PCPS has been suggested for predicting metastasis in patients with gastric cancer. Future studies with larger sample size have been warranted

Lipid Profile as a Predictive Marker for Organ Dysfunction after Thoracoabdominal Surgery: A Cross-sectional Study

Background: Plasma total cholesterol is considered a negative acute phase reactant. In various pathological conditions, such as trauma, sepsis, burns, and liver dysfunction, as well as post-surgery, serum cholesterol level decreases. This study aimed to investigate the role of lipid profiles in determining the probability of organ dysfunction after surgery.Methods: This cross-sectional study included patients who underwent thoracoabdominal surgery and were admitted to the intensive care unit of Imam Reza Hospital in Tabriz, Iran, between October 2016 and September 2018. During the first two days of admission, blood samples were taken, and serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), Low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and albumin were measured. The relation between the changes in these laboratory markers and six organ functions including cardiovascular, respiratory, renal, central nervous system, hepatic, and hematologic, length of stay in the hospital and intensive care unit, mechanical ventilation duration, and vasopressor use were investigated. The independent t test was used to compare continuous variables. The association between different variables and organ dysfunction and mortality was evaluated by using logistic regression.Results: The serum TC increased the risk of mortality (OR=1.09, 95%CI=1.06-1.11, P<0.001), renal dysfunction (OR=1.09, 95%CI=1.06-1.12; P<0.001), liver dysfunction (OR=1.07, 95%CI=1.03-1.10; P<0.001), respiratory dysfunction (OR=1.08, 95%CI=1.05-1.13; P<0.001). Moreover, LDL, HDL, and TG were found to be inversely related to mortality, organ dysfunction, length of stay in the hospital and intensive care unit, mechanical ventilation duration, and vasopressor use. Conclusion: TC could be considered a risk factor for mortality, organ dysfunction, and clinical outcomes. On the other hand, LDL, HDL, and TG played a protective role in the patients’ mortality, organ dysfunction, and clinical outcomes

Validity and reproducibility of a food frequency questionnaire assessing food group intake in the PERSIAN Cohort Study

PurposeA semi-quantitative food frequency questionnaire (FFQ) was developed for use in the Prospective Epidemiological Research Studies in IrAN (PERSIAN Cohort), investigating non-communicable disease risk factors. This study aimed to assess the validity and reproducibility of this FFQ, through food group intake.MethodsParticipants, recruited from seven PERSIAN cohort centers, completed the FFQ at the beginning of the study (FFQ1) and at the end (FFQ2), with a 12-month interval in between, during which two 24-h dietary recalls (24 h) were completed each month. Correlation coefficients of the median intake of food groups recorded by the FFQs were compared to those of the 24 h to assess validity, and the two FFQs were compared to assess reproducibility of findings.ResultsOverall, data from 978 participants were included in this validation analysis. Of the 26 food groups assessed, Tea, Sugars, Whole/Refined Grains, and Solid Fats/Oils, had the strongest correlations (0.6–0.79), while Red Meat, Chicken and Eggs showed moderate correlations (0.42–0.59). The weakest correlations observed belonged to Fresh fruit Juice and Other Meats (0.23–0.32). Reproducibility was assessed among those who completed both FFQ1 and FFQ2 (n = 848), revealing moderate to strong correlations in all food groups, ranging from 0.42 in Legumes to 0.72 in both Sugar and Sweetened Drinks.ConclusionThe PERSIAN Cohort FFQ is appropriate to rank individuals based on food group intake

Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study

Introduction Over the past decades prevalence of diabetes has increased in Iran and other countries. This study aimed to update the prevalence of diabetes and prediabetes in Iran and to determine associated sociodemographic risk factors, as well as diabetes awareness and control. Methods This is a nationally representative cross-sectional survey that included 163,770 Iranian adults aged 35-70 years, from different ethnic backgrounds, between 2014 and 2020. Diabetes was diagnosed at fasting blood sugar of >= 6.99 mmol/L (126 mg/dL), or receiving blood glucose-lowering treatment. Multivariable logistic regression was applied to detect determinants associated with prevalence of diabetes and prediabetes, as well as predictors of diabetes awareness and glycemic control. Results Sex- and age-standardized prevalence of diabetes and prediabetes was 15.0% (95% CI 12.6-17.3) and 25.4% (18.6-32.1), respectively. Among patients with diabetes, 79.6% (76.2-82.9) were aware of their diabetes. Glycemic control was achieved in 41.2% (37.5-44.8) of patients who received treatment. Older age, obesity, high waist to hip ratio (WHR), and specific ethnic background were associated with a significant risk of diabetes and prediabetes. Higher awareness of diabetes was observed in older patients, married individuals, those with high WHR, and individuals with high wealth score. Moreover, glycemic control was significantly better in women, obese individuals, those with high physical activity, educational attainment, and specific ethnic background. Conclusions The prevalence of diabetes and prediabetes is increasing at an alarming rate in Iranian adults. High proportion of uncontrolled patients require particular initiatives to be integrated in the health care system

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe