Iron, Iodine and Vitamin A in the Middle East; A Systematic Review of Deficiency and Food Fortification

Background: Micronutrient deficiency is one of the major public health problems in the Middle East affecting economic, political and social development of countries. The three commonest micronutrient deficiencies belong to iron, iodine and vitamin A. Methods: we conducted a systematic review of published English articles in the Middle East countries using databases from PubMed, World Health Organization and Food and Agriculture Organization from 1985 onward. A total of 6050 articles were identified and after evaluation based on eligibility criteria, 81 articles included in this systematic review.Results: Despite implementation of flour fortification other control strategies, the prevalence of iron deficiency is moderate to severe in the Middle Eastern countries, because of ineffective iron fortification program, food interaction and hemoglobin application as anemia indictors in these countries. Mild to severe iodine deficiency disorders exist in many countries of the Middle East, due to lack of effective iodine supplementation program. The prevalence of vitamin A deficiency is mild to severe and there is lack of vitamin A fortification program in many countries in this region.Conclusion: Despite unharmonized efforts to control malnutrition of micronutrients, iron, iodine and vitamin A deficiencies are still exist in some countries of the Middle East. Effective, well controlled and harmonized programs for elimination of micronutrient deficiencies need to be initiated for governments and supported by international organizations in this region

Association between some dietary factors and risk of hypertension: Tehran lipid and glucose study (2008-11)

Background and Objective: Hypertension in long time can cause cardiovascular disorders and increase chance of stroke. This study was done to determine the association between some dietary factors and risk of hypertension. Methods: This cross-sectional study was conducted on the fourth phase (2008-11) of Tehran lipid and glucose study (TLGS). In this study 6089 subjects (2807 males and 3282 females), aged 19-70 years, were participated and dietary, demographic, anthropometric and blood pressure of each subject were collected. Dietary intake was assessed using a validated and reliable food frequency questionnaire with 147-items. Odds ratio for hypertension according to quartiles of dietary factors was determined using logistic regression with adjustment for confounder variables. Results: The rate of hypertension was 29.8%. Mean of weight, body mass index, waist circumference, prevalence of abdominal obesity and alliteration in the hypertensive subjects were significantly higher than normotensive subjects (P<0.05). There was a non significant direct relationship between energy density, total fat and saturated fat. Higher consumption of fiber was associated with lower risk of hypertension (OR: 0.62, 95% CI: 0.37-0.97). The risk of hypertension increased in the highest quartiles of dietary protein (OR: 1.20, 95% CI: 1.02-1.43). Odds ratio for hypertension was higher among subjects whom consumed lower fruits and nuts than those subjects with higher fruits consumption (OR: 1.33, 95% CI: 1.15-1.85) and nuts (OR: 1.21, 95% CI: 1.02-1.42). Conclusion: High consumption of fiber could protect against hypertension while some dietary factors such as high consumption of protein could increase risk of hypertension