Major Dietary Patterns in Relation to Stunting among Children in Tehran, Iran

To the best of our knowledge, no information is available to link major dietary patterns to stunting during childhood, although dietary patterns are associated with chronic diseases. This study was conducted to determine the relationship between major dietary patterns and stunting in the first grade pupils of Tehran in 2009. In this case-control study, 86 stunted children (defined as height-for-age of less than the 5th percentile of CDC2000 cutoff points) were enrolled from among 3,147 first grade pupils of Tehran, selected using a multistage cluster random-sampling method. Participants for the control group (n=308) were selected randomly from non-stunted children (height-for-age more than the 5th percentile of CDC2000 cutoff points), after matching for age, sex, and area of residence. Dietary data were collected using two 24- hour dietary recalls through face-to-face interview with mothers. Factor analysis was used for identifying major dietary patterns. Mean consumption of dairy products (308\ub1167 vs 382\ub1232 g/day, p<0.05), dried fruits and nuts (2.58\ub19 vs 7.15\ub126 g/day, p<0.05) were significantly lower among stunted children than those in the control group. Three major dietary patterns were identified: \u2018traditional dietary pattern\u2019 that was dominated by bread, potato, fats, eggs, flavours, vegetables other than leafy ones, sugar, drinks, and fast food; \u2018mixed dietary pattern\u2019 that was dominated by leafy vegetables, fast foods, nuts, fats, cereals other than bread, fruits, legumes, visceral meats, sugars, eggs, and vegetables other than leafy vegetables; and \u2018carbohydrate-protein pattern\u2019 that was dominated by sweets and desserts, poultry, dairy, fruits, legumes, and visceral meats. No significant relationships were found between traditional and mixed dietary patterns and stunting. Individuals in the third quartile of carbohydrate-protein dietary pattern were less likely to be stunted compared to those in the bottom quartile (OR: 0.31, 95% CI 0.13-0.78, p<0.05). Adherence to dietary patterns high in protein (e.g. dairy, legumes, and meat products) and carbohydrates (e.g. fruits, sweets, and desserts) might be associated with reduced odds of being stunted among children

A qualitative study on physical health threatening factors of Iranian seafarers working on ocean going tankers

Background: Seafaring is a highly physically demanding profession in a risky environment due to exposure to unique job health related risk factors. The purpose of the study is to describe physical health threatening factors of Iranian seafarers working on tankers. Materials and methods: A qualitative content analysis with inductive approach was performed on 17 Iranian male seafarers in 2016. Subjects were selected by purposive sampling, which continued until data saturation. Data were gathered using semi-structural questionnaire via in-depth-interviews. All interviews were transformed into computer files. Analysis was done based on conventional content analysis approach. Results: Mean job history and age of the participants was 11.9 ± 7.2 and 35.8 ± 9.3 years, respectively. Two main themes emerged during analysis of data and categories were created. The themes are (1) physical health threatening factors at the ship; (2) high risk ranks at the ship. Conclusions: The need for addressing nutrition at sea was acknowledged by seafarers. Also, it seems that revision of some regulations regarding seafarers’ medical examination, oral health and heart diseases is necessary

Effectiveness of iron supplementation (6- and 12- weeks) on hematological parameters among non-anemic iron deficient female students

Background and aim: According to the current protocols made by international organizations, the duration of iron supplementation depends on the severity of iron deficiency, ranging from 3 to 6 months in individuals with iron depletion and iron deficiency anemia, respectively. This study was performed to compare 6 and 12 weeks iron supplementations on iron status among a group of non-anemic iron deficient female students. Methods: In this quasi-experimental study 53 female students were selected. Students were divided into two groups. Control group were consisted of 30 students who had Hemoglobin level more than 12 ml/dl and serum ferritin level more than 23 ng/dl. Experimental group were 23 non-anemic iron deficient female students with ferritin level less than 23 ng/dl. Experimental group were orally given ferrous fumarate (containing 50 mg iron elemental) daily for three months. Blood samples were collected from experimental group in the beginning, 6 and 12 weeks after the study and for the case group samples were collected in the beginning and at the end of the study and the number of blood cells (CBC), ferritin level and total iron binding capacity (TIBC) were measured. Data were analyzed using Analysis of Covariance and Paired-t tests. Results: Blood hemoglobin and serum ferritin concentrations increased after 6 weeks of supplementation among supplemented group, and were remained almost constant until the 12th week (P>0.001). Changes in serum iron concentrations at the end of study were not statistically different between two groups. Similar trend was observed for TIBC. Conclusion: This study showed that 3-month iron supplementation among iron deficient subjects, as advised by WHO, did not further improve iron status in non anemic iron deficient females compared to 6-weeks daily supplementation of 50 mg elemental Iron. It is obvious that these results cannot be considered to anemic subject

Households' food expenditures in urban areas of Iran: An application of small area estimation

Background: A fundamental factor for human development is food, and inequalities in nutrition have been related to inequalities in health .The purpose of this study was to estimate Household Food Expenditure (HFE) in urban areas of Iran at district-level using small area estimation (SAE) methods.   Design and Methods: We used the Fay-Herriot model, the well-known area-level model of SAE. The main data was urban data of HFE collected by Statistical Centre of Iran at 2013. The environment of our study was urban area of Iran and study unit was household. Results: Findings showed that average number of room at each household, migration rate, proportion of male headed households(PMH) and Proportion of the active population`s employed at district level had a significant effect on HFE. Comparison between aggregated province estimates and estimates reported by SCI was not significant (P=0.609). The lowest and the highest HFE belong respectively to Pishva district with 27,067 thousand rials(TRs) and to Boyer-Ahmad district  with 85,175 TRs. Conclusions: Small-area estimation is advantageous for surveillance of HFE at the district level. This method allows documentation of geographic disparities and improves our understanding of the spatial distribution of HFE in urban areas of Iran

Why has the taxing policy on sugar sweetened beverages not reduced their purchase in Iranian households?

ObjectiveThis study aimed at analyzing the effectiveness of the policy of taxing Sugar-Sweetened Beverages (SSBs) on their purchases during the last decade in Iranian households.MethodsThe present mixed method study was done in 2017 in four phases: (1) A meta-review of the fiscal policies during the last decade, (2) Collecting existing data on soft drinks’ production, price, and household expenditure during the last decade, (3) Conducting 19 semi-structured interviews with key informants, and (4) Facilitating a national meeting to achieve a consensus on the recommendations and future implications.ResultsDocument reviews showed that based on the Permanent Provisions of National Development Plans of Iran, the Ministry of Health and Medical Education (MOHME) should announce the list of health threatening products to increase taxation for them. The government is allowed to impose taxes on domestically produced and imported SSBs. The average household expenditure on SSBs increased in the rural and urban households of Iran during 2006–2016 in spite of taxation. In the different key informants’ opinion, only value-added tax (VAT) was implemented among different fiscal policies, and the other parts, including tax and tolls were debated.ConclusionThe present research findings further proposed some suggestions for increasing the effectiveness of financial policies in reducing the prevalence of NCDs in Iran

Factors affecting health-promoting lifestyle profile in Iranian male seafarers working on tankers

Background: Seafaring is a risky occupation that is associated with a high incidence of lifestyle-related diseases. The present study was carried out to examine health promotion behaviour and its associated factors in seafarers of the National Iranian Tanker Company. Materials and methods: A cross-sectional study was performed on 200 Iranian male seafarers in 2015. A self-administered socio-demographic and Health Promotion Lifestyle Profile II (HPLP-II) questionnaire was completed. One-way analysis of variance was used to identify significant differences among the various departments. The t-test was utilised to compare the HPLP-II scores according to the demographic variables. Multiple linear regression analysis was performed to assess the association between demographic variables and the overall HPLP-II score, in addition to the six health-promoting lifestyle subscale scores. Results: The mean age of the participants was 35.93 ± 9.51 years. Most of the seafarers were categorised as having a moderate (32%) or good lifestyle (61.5%). The mean lifestyle score was 136.14 ± 19.90, with the subscale spiritual growth showing the highest score (26.16 ± 5.03) and the subscale exercise behaviour showing the lowest score (19.95 ± 4.23). The lowest score for nutrition was found among the seafarers working in the engine department (engine: 20.41 ± 4.50, deck: 23.52 ± 4.97, and galley: 24.83 ± 4.64) (p < 0.05). Working in the engine department was found to have a significant negative effect on the nutrition score (B = –3.57, p < 0.05). Moreover, educational level was found to have a significant positive effect on spiritual growth (B = 2.97, p < 0.05). Conclusions: The findings suggest that health-related issues in this occupation, especially workers in the engine room, are a matter of concern

Seafarers’ mental health status and life satisfaction: Structural equation model

Background: A variety of factors influence seafarers' health. Such factors might affect their satisfaction with life. Aims: To examine the relationships between seafarers' mental health status and satisfaction with life by using a structural equation method. Methods: In this survey, 470 seafarers were selected via convenience sampling method from two shipping companies. Validated questionnaires including Satisfaction with Life Scale (SWLS), generalized anxiety disorder-7 (GAD-7), Post-traumatic Stress Disorder-8 (PTSD-8), Patient Health Questionnaire-9 (PHQ-9), General Health Questionnaire-12 (GHQ-12), Perceived Health status and Depression-Anxiety-Stress scale-21 (DASS-21) were used to assess different aspects of well-being and life satisfaction. The stratified path analysis method was applied to analyze the data. Results: 439 seafarers (200 officers and 237 non-officers) with a mean age of 34.5 (SD: 8.05) participated in the current study. The GHQ score directly affected satisfaction with life in both officers (β = 0.35) and non-officers (β = 0.40). Also, perceived health status directly and indirectly affected satisfaction with life among officers (β = 0.19) and non-officers (β = 0.06). While officers working days per month indirectly impacted satisfaction with life through the general anxiety disorder, perceived health status, depression, anxiety, stress and current mental health. In non-officers, generalized anxiety disorder had the most potent indirect effects on satisfaction with life through perceived health status and current mental health. Conclusion: Perceived health status, directly and indirectly, affected seafarers' satisfaction with life. Measures should be taken in order to improve seafarers' perceived health status and its effects on satisfaction with life

Economic Inequality in Healthy and Junk Foods Consumption and its determinants in Children and Adolescents: the CASPIAN- IV Study

Background: Nutritional habits and its determinants, especially in children and adolescents have recently turned into the one of the major concerns of health researches. We examine the diet contribution inequality in according to socio-demographic factors, age, gender, physical activity and body image to alleviate this gap in Iranian children and adolescents. Materials and Methods: Study sample was comprised of 14,880 students aged 6-18 years who selected from urban and rural districts of 30 provinces of Iran via stratified multi-stage sampling method. A short food frequency questionnaire was used for estimating the food group consumption. The Blinder-Oaxaca method was applied to investigate the inequality in the prevalence of healthy and junk foods consumption between the first and fifth socio-economic status (SES) quintiles. Results: The frequency of healthy and junk foods consumption showed considerable differences between the SES quintiles. The highest differences were found in the frequency of fresh fruit (25.38%), vegetable (12.92%), and milk (10.74%) consumption, respectively. The daily consumption of vegetables, and fresh and dried fruits increased linearly by increasing the SES quintiles. The highest absolute difference was seen in the frequency of fresh fruit consumption between the bottom and top of the socioeconomic groups (SII value=-32%).  The estimated SII was statistically significant for the consumption of all healthy and junk foods except for fast foods and milk consumption. The estimated C index for consumption of healthy and junk foods was positive and negative, respectively. Conclusion: This study provides the considerable information on the consumption of healthy and junk foods and its determinants among Iranian children and adolescents for better programming, developing health policies, and future complementary analyses

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio