The effectiveness of medical nutrition therapy for the control of weight and fasting blood sugar in the type 2 diabetic patients

چکیده: زمینه و هدف: با وجودی که نقش تغذیه درمانی در اداره دیابت از ابتدا مورد توجه قرار گرفته ولی کارآیی آن در دراز مدت کمتر مورد مطالعه قرار گرفته است. بر همین اساس، این مطالعه به منظور تعیین کارآیی دراز مدت تغذیه درمانی در کنترل بیماران دیابتی نوع 2 صورت گرفته است. روش بررسی: در یک مطالعه مداخله ای قبل و بعد 163 بیمار دیابتی نوع 2 که تازه تشخیص داده شده بودند مورد بررسی قرار گرفتند. ابتدا بیماران توسط کارشناس تغذیه ویزیت و ضمن تنظیم یک رژیم غذایی مناسب، آموزش های لازم در زمینه کالری ترکیبات غذایی، مقدار غذا، میان وعده و زمان غذا خوردن بر پایه کیفیت و عادات زندگی، وضعیت زندگی و وزن بیمار به آنها ارائه گردید. پس از یک ماه بیماران مجدداً توسط کارشناس تغذیه ویزیت و چگونگی کنترل شاخص ها، رژیم غذایی و چگونگی رعایت آن مورد بررسی قرار گرفت. پی‌گیری شاخص‌ها (وزن، قندخون، هموگلوبین گلیکوزیله) در فواصل 3 ماهه، 6 ماهه و یکساله انجام شد و نتایج با استفاده از آزمون آماری آنالیز واریانس مشاهدات تکرار شونده (Repeated Measures, ANOVA) مورد تجزیه و تحلیل قرار گرفت. یافته ها: میانگین سن بیماران مراجعه ‌کننده 3/9±2/51 سال بود. بر اساس نتایج این مطالعه در ابتدای مطالعه و سه ماه بعد از آن به ترتیب میزان قند خون 5/52±1/144 و 2/43±119 میلی گرم بر دسی لیتر (001/0

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<0.01) and being single (b=-0.4, p<0.05) and full time work in comparison with part-time work (b=-0.5, p<0.01) was negatively correlated with healthy dietary pattern, whereas age (b=-0.3, p<0.05), dieting (b=-0.4, p<0.01)  and history of hyperlipidemia had negative correlation (b=-0.41, p<0.01) with unhealthy dietary pattern.Our findings show the association between socio-demographic, lifestyle factors and dietary patterns of the worker

Participatory evaluation of municipal obesity prevention clubs in Tehran city: Strengths, challenges, and future direction.

Background and aim Community-based initiatives are important for obesity prevention. This study aimed to evaluate the activities of municipal obesity prevention clubs (OBCs) in Tehran, Iran, using a participatory approach. Methods The evaluation team was formed, and the members identified the OBC's strengths, and challenges and provided suggestions for change through a participatory workshop, observation, focus group discussions, reviewing relevant documents (n = 97), and 35 interviews with involved stakeholders. The MAXQDA software was used for data analysis. Results An empowerment training program for volunteers was identified as one of the strengths of OBCs. Despite the obesity prevention efforts of OBCs through public exercise sessions, healthy food festivals, and educational sessions, several challenges were identified that hinder participation in OBCs. These challenges included poor marketing strategies, poor training approaches in participatory planning, insufficient motivational support for volunteers, low perceived recognition of volunteers by the community, volunteers' low food and nutrition literacy, poor educational services in the communities, and limited funding for health promotion activities. Conclusion Weaknesses in all stages of community participation, including information, consultation, collaboration, and empowerment, in OBCs were detected. Facilitating a more enabling environment for informing and involving citizens, expanding neighborhood social capital, and involving health volunteers, academia, and all potential governmental sectors to collaborate for obesity prevention is recommended

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

Violation of food advertising regulations in Iran: A systematic review

Background: The prevalence of non-communicable diseases (NCDs) and the status of nutritionally high-risk behaviors in the country are not promising. Because of undeniable impact of media advertising on food choices, to combat the problem some regulations on food advertisements are developed in the country. However, the high prevalence of NCDs warns of the possibility that either the laws are not given the necessary attention or they are not implemented properly. Therefore in the present review, all studies on how the country's visual and written mass media comply with regulations related to food product advertisement were systematically reviewed. Methods: We searched all studies, including Persian and English articles, dissertations, and research projects, published and unpublished reports in eight domestic and international databases and search engines during the years 1996 to December of 2020 (25 years). Then, the content of the eligible studies was extracted, evaluated, and reported. Results: A total of 18 eligible studies (articles and reports) were included in the review. The results indicated violations of rules and regulations including displaying food products of low nutritional value and obese people, misleading/exaggerating claims, award offers, induction of gluttony, consumerism, and inconsistency with scientific facts. Most of the studies (55%) had, implicitly or explicitly, targeted children and adolescents. Conclusions: The results of this study indicated a violation of the rules and regulations of health policies, mainly in the field of promoting foods of low nutritional value during the study period. Violations of the ban on advertising for children were also reported in more than half of the studies

Socio-economic Differences in Dietary Intakes: The Comprehensive Study on Household Food Consumption Patterns and Nutritional Status of I.R. Iran

Background and Objectives: An association between socioeconomic status (SES) and poor health has been recognized. Inequalities in nutrition have been associated with inequalities in health. This study aimed to identify the social variability in the food and nutrient intake of Iranian households. Materials and Methods: This study was conducted in the framework of the Comprehensive Study on Household Food Consumption Patterns and Nutritional Status of I.R. Iran during 2001-2003. Households were selected by cluster systematic sampling method in urban and rural areas. SES was assessed through in-depth interviews. Assessment of food and nutrient intake was done using three consecutive 24-hour diet recalls completed by trained nutritionists. Some of the socio-economic variables were extracted by factor analysis as indicators of SES. Results: Among the 7158 studied households, 2496 (34.9%) were rural and 4662 (65.1%) were urban dwellers. Consumption of the food groups, including bread and cereals, vegetables, fruits, meats, eggs, milk and dairy products, sugar and sweets, was significantly different by the level of education, occupation (P<0.001) and living conditions (P<0.05). These factors explained 70% of variance in SES. In higher quintile of SES, consumption of bread and cereals, as well as sugar and sweets significantly decreased and meats, vegetables and fruits was increased. Intake of protein, calcium, vitamin C, riboflavin and retinol was higher in the third quintile of SES as compared to the first quintile (P<0.05). Conclusions: Based on our findings, an unhealthier dietary intake may exist among the households belonging to lower socio-economic level in Iran. This calls for appropriate policy making and intervention(s). Keywords: Socio-economic status, Food and nutrient intakes, Factor analysis, Househol

The Need for Consumer-Focused Household Food Waste Reduction Policies Using Dietary Patterns and Socioeconomic Status as Predictors: A Study on Wheat Bread Waste in Shiraz, Iran

Current household food waste (HFW) reduction plans usually focus on raising consumer awareness, which is essential but insufficient because HFW is predominantly attributed to unconscious behavioral factors that vary across consumer groups. Therefore, identifying such factors is crucial for predicting HFW levels and establishing effective plans. This study explored the role of dietary patterns (DP) and socioeconomic status (SES) as predictors of HBW using linear and non-linear regression models. Questionnaire interviews were performed in 419 households in Shiraz during 2019. A multilayer sampling procedure including stratification, clustering, and systematic sampling was used. Three main DPs, i.e., unhealthy, Mediterranean, and traditional, were identified using a food frequency questionnaire. Results indicated that a one-unit rise in the household&rsquo;s unhealthy DP score was associated with an average increase in HBW of 0.40%. Similarly, a one-unit increase in the unhealthy DP score and the SES score increased the relative likelihood of bread waste occurrence by 25.6% and 14.5%, respectively. The comparison of findings revealed inconsistencies in HFW data, and therefore the necessity of studying HFW links to factors such as diet and SES. Further investigations that explore HFW associations with household characteristics and behavioral factors will help establish contextual and effective consumer-focused plans

Household Food Waste Quantification and Cross-Examining the Official Figures: A Study on Household Wheat Bread Waste in Shiraz, Iran

The global consumer food waste (FW) estimates are mainly based on modeling data obtained from governments. However, a major data gap exists in FW at the household level, especially in developing countries. Meanwhile, the reliability of the existing data is questionable. This study aimed to quantify wheat bread waste (HBW) in Shiraz, Iran, and cross-examine the governmental HBW data. Face-to-face waste recall questionnaire interviews were conducted in 419 households from December 2018 to August 2019. A multistage sampling strategy consisting of stratification, clustering, and systematic sampling was employed. Moreover, we carried out a comprehensive document review to extract and analyze the official HBW data. The results revealed that the HBW in Shiraz is 1.80%&mdash;the waste amounts for traditional bread and non-traditional bread were 1.70% and 2.50%, respectively. The survey results were compared with the previous official data, revealing a substantial contradiction with the 30% HBW reported between 1991 and 2015. Possible reasons for this disparity are explored in this paper. Although our results cannot be generalized to other food commodities and locations, our findings suggest that considering the substantial likelihood of bias in the official data, policymakers should conduct more FW measurements and re-evaluate the accuracy of the existing data

Do Iranian Female-headed Households Have Lower Socio-economic and Nutritional Status Compared to Male-headed ones?

Background and Objectives: Poverty and risk of nutritional vulnerability of female-headed households (FHHs) are usually higher than male-headed households (MHHs). This study aimed at comparing the socio-economic status, and food and nutrient intake of FHHs and MHHs based on the data from Comprehensive Study on Household Food Consumption Patterns and Nutritional Status of Iran (2001-2003). Materials and Methods: In this cross-sectional study, the samples were urban and rural households of the country, which were determined by the Statistics Center of Iran using systematic cluster method. The socio-economic and demographic characteristics of households were asked by interview and observational techniques, and recorded in data forms. The dietary data were collected using three consecutive 24-hour recalls completed by nutrition experts. For the purpose of this study, FHHs and MHHs were compared in terms of socio-economic characteristics, consumption pattern and nutritional status. Results: From 7158 households of the study, 5.5% were female-headed including 116 rural (1/6%) and 280 urban (3.9%) households. Educational and occupational status among FHHs were significantly lower than among MHHs (p<0.05); however, in terms of average total expenditure per capita, accommodation type, and lodging facilities such as electricity and water consumption, no significant differences were observed between FHHs and MHHs. In contrast, MHHs enjoyed more facilities. The significant difference in food consumption among the urban households was only found in fruits and sweets, and in the rural areas, in oils and fats group (p<0.05). In FHHs, calcium, Vitamin C and thiamin intake was lower than in male-headed group. In the rural areas, the retinol and energy intake posted a lower and higher level, respectively, over MHHs (p<0.05). Conclusions: In spite of lower socio-economic level among FHHs, the differences in food and nutrient intake were only seen in fruits, calcium, Vitamin C and retinol intake, especially in the rural areas. Therefore, in the diet of these households, energy dense foods should be partly replaced by foods providing nutrients such as Ca, Vitamin C and retinol. Keywords: Female-headed households, Food consumption patterns, Nutritional status, Family structure, Socio-economic statu