Body Mass Index, Waist-circumference and Cardiovascular Disease Risk Factors in Iranian Adults: Isfahan Healthy Heart Program

Considering the main effect of obesity on chronic non-communicable diseases, this study was performed to assess the association between body mass index (BMI), waist-circumference (WC), cardiometabolic risk factors and to corroborate whether either or both BMI and WC are independently associated with the risk factors in a sample of Iranian adults. This cross-sectional study was performed on data from baseline survey of Isfahan Healthy Heart Program (IHHP). The study was done on 12,514 randomly-selected adults in Isfahan, Najafabad and Arak counties in 2000-2001. Ages of the subjects were recorded. Fasting blood glucose (FBG), 2-hour post-load glucose (2hpp), serum lipids, systolic and diastolic blood pressure (SBP and DBP), BMI, WC, smoking status, and total daily physical activity were determined. Increase in BMI and WC had a significant positive relation with the mean of FBG, 2hpp, SBP, DBP, serum lipids, except for HDL-C (p<0.001 for all). After adjustment for age, smoking, physical activity, socioeconomic status (SES), and BMI, the highest odds ratio (OR) (95% CI) for diabetes mellitus (DM) according to WC was 3.13 (1.93-5.08) and 1.99 (1.15-3.44) in women and men respectively. Moreover, the highest ORs based on BMI with adjustment for age, smoking, physical activity, SES, and WC were for dyslipidaemia (DLP) [1.97 (1.58-2.45) in women and 2.96 (2.41-3.63) in men]. The use of BMI or WC alone in the models caused to enhance all ORs. When both BMI and WC were entered in the model, the ORs for all risk factors, in men, according to BMI, were more compared to WC. However, in women, ORs for DM and hypertension (HTN) in WC quartiles were more than in BMI quartiles. BMI is the better predictor of DM, HTN, and DLP in men compared to WC. Conversely, in women, WC is a superior predictor than BMI, particularly for DM and HTN. Furthermore, the measurement of both WC and BMI in Iranian adults may be a better predictor of traditional risk factors of CVDs compared to BMI or WC alone

The relationship between ultra processed food consumption and premature coronary artery disease: Iran premature coronary artery disease study (IPAD)

BackgroundUltra-processed foods (UPF) consumption may affect the risk of PCAD through affecting cardio metabolic risk factors. This study aimed to evaluate the association between UPFs consumption and premature coronary artery disease (PCAD).MethodsA case–control study was conducted on 2,354 Iranian adults (≥ 19 years). Dietary intake was assessed using a validated 110-item food frequency questionnaire (FFQ) and foods were classified based on the NOVA system, which groups all foods according to the nature, extent and purposes of the industrial processes they undergo. PCAD was defined as having an stenosis of at least single coronary artery equal and above 75% or left main coronary of equal or more than 50% in women less than 70 and men less than 60 years, determined by angiography. The odds of PCAD across the tertiles of UPFs consumption were assessed by binary logistic regression.ResultsAfter adjustment for potential confounders, participants in the top tertile of UPFs were twice as likely to have PCAD compared with those in the bottom tertile (OR: 2.52; 95% CI: 1.97–3.23). Moreover, those in the highest tertile of the UPFs consumption had more than two times higher risk for having severe PCAD than those in the first tertile (OR: 2.64; 95% CI: 2.16–3.22). In addition, there was a significant upward trend in PCAD risk and PCAD severity as tertiles increased (P-trend < 0.001 for all models).ConclusionHigher consumption of UPFs was related to increased risk of PCAD and higher chance of having severe PCAD in Iranian adults. Although, future cohort studies are needed to confirm the results of this study, these findings indicated the necessity of reducing UPFs intake

A STUDY OF THE PREVALENCE OF THE USE OF DIFFERENT TYPES OF OIL AND FAT IN URBAN AND RURAL IRANIAN COMMUNITIES ACCORDING TO EDUCATION

AbstractINTRODUCTION: The prevalence of cardiovascular risk factors is increasing inindustrialized communities. Dyslipidemia is a modifiable cardiovascular risk factor whichis related to diet, especially consumption of hard margarine and hydrogenated fat.The prevalence of cardiovascular diseases and their risk factors differs in communities.We studied the prevalence of consumption of different types of oil and fat in areas ofCentral Iran.METHODS: The subjects were selected using randomized cluster sampling and dividedinto rural and urban groups. A 48-item standard food frequency questionnaire was filledout for every subject by a trained interviewer, who also obtained demographic data. Datawere analyzed with SPSS. Different educational groups and the two sexes in urban andrural areas were compared using chi square test and paired t-test. P values below 0.05were considered as significant.RESULTS: This cross-sectional descriptive study was performed on 12600 adultsubjects aged above 19 years in the cities of Isfahan, Najafabad, and Arak. Consumptionof olive oil and other types of oil in the urban community of Isfahan was higher than inthe rural community. Consumption of animal oil and fat was higher in the ruralcommunity of Isfahan. In subjects with high school education and higher, consumptionof different types of oil was not found to be different between urban and ruralcommunities, or between men and women. In Arak, no difference was found betweenrural and urban subjects with high school education and higher, in respect ofconsumption of different types of oil. Among subjects with lower education, however,consumption of olive oil and other types of oil was higher in urban areas andconsumption of animal oil and fat was higher in rural men. In Najafabad, no differencewas found between different educational groups in respect of the different types of oilconsumed; only consumption of animal oil in rural subjects educated below high schooldiploma was higher than in cities.CONCLUSIONS: Among individuals with high school education and higher, nodifference was found between rural and urban populations in respect of the types of oilconsumed. However, among individuals with low education, consumption of animal oiland fat as well as hard margarine was higher in the rural population, while the urbanpopulation consumed higher amounts of oil and olive oil. The pattern of oil and fatconsumption in men and women was different in the cities of Najafabad and Arak, butalmost similar in Isfahan. Geographical location and education affect the pattern of oiland fat consumption. Unhealthy lifestyle habits are more prevalent in members of therural population with low education.Key Words: Fat, oil, urban population, rural population, education

Anticonvulsant effect of the ethanol extract of Caesalpiniapulcherrima (L.) Sw., Fabaceae, leaves

In this study, ethanol extract of Caesalpinia pulcherrima (L.) Sw., Fabaceae, leaves (CPEE) was investigated for anticonvulsant effect against maximal electroshock (MES) and pentylenetetrazole (PTZ) induced seizures in rats and mice at dose levels 200 and 400 mg/kg, i.p. respectively. Diazepam (3 mg/kg, i.p.) was used as a standard anticonvulsant drug for comparison. CPEE was found to be safe up to the dose of 4000 mg/kg in mice, when administered intraperitoneally. The extract at 400 mg/kg dose produced significant (p<0.01) anticonvulsant effect w.r.t. control against PTZ-induced clonic seizures. In MES-induced seizure model, there were no significant alterations in the onset as well as duration of hind limb extension seizures as compared to control at a dose of 200 mg/kg when administered intraperitoneally. However, the extract (CPEE, 400 mg/kg i.p.) significantly (p<0.01) delayed the onset as well as decreased the duration of hind limb extension seizures (HLES) as compared to control. However, the extract, CPEE, percentage protection of the animals was increased at higher dose (200 mg/kg) in both the models. The results of the study suggest that ethanol extract of Caesalpinia pulcherrima (L.) Sw. leaves possess anticonvulsant effect

Validation of a simplified food frequency questionnaire for the assessment of dietary habits in Iranian adults: Isfahan Healthy Heart Program, Iran

BACKGROUND: Dietary assessment is the first step of dietary modification in community-based interventional programs. This study was performed to validate a simple food frequency questionnaire (SFFQ) for assessment of selected food items in epidemiological studies with a large sample size as well as community trails. METHODS: This validation study was carried out on 264 healthy adults aged &ge; 41 years old living in 3 district central of Iran, including Isfahan, Najafabad, and Arak. Selected food intakes were assessed using a 48-item food frequency questionnaire (FFQ). The FFQ was interviewer-administered, which was completed twice; at the beginning of the study and 2 weeks thereafter. The validity of this SFFQ was examined compared to estimated amount by single 24 h dietary recall and 2 days dietary record. Validation of the FFQ was determined using Spearman correlation coefficients between daily frequency consumption of food groups as assessed by the FFQ and the qualitative amount of daily food groups intake accessed by dietary reference method was applied to evaluate validity. Intraclass correlation coefficients (ICC) were used to determine the reproducibility. RESULTS: Spearman correlation coefficient between the estimated amount of food groups intake by examined and reference methods ranged from 0.105 (P = 0.378) in pickles to 0.48 (P &lt; 0.001) in plant protein. ICC for reproducibility of FFQ were between 0.47-0.69 in different food groups (P &lt; 0.001). CONCLUSION: The designed SFFQ has a good relative validity and reproducibility for assessment of selected food groups intake. Thus, it can serve as a valid tool in epidemiological studies and clinical trial with large participants. &nbsp;&nbsp;</div

Body Mass Index, Waist-circumference and Cardiovascular Disease Risk Factors in Iranian Adults: Isfahan Healthy Heart Program

Considering the main effect of obesity on chronic non-communicable diseases, this study was performed to assess the association between body mass index (BMI), waist-circumference (WC), cardiometabolic risk factors and to corroborate whether either or both BMI and WC are independently associated with the risk factors in a sample of Iranian adults. This cross-sectional study was performed on data from baseline survey of Isfahan Healthy Heart Program (IHHP). The study was done on 12,514 randomly-selected adults in Isfahan, Najafabad and Arak counties in 2000-2001. Ages of the subjects were recorded. Fasting blood glucose (FBG), 2-hour post-load glucose (2hpp), serum lipids, systolic and diastolic blood pressure (SBP and DBP), BMI, WC, smoking status, and total daily physical activity were determined. Increase in BMI and WC had a significant positive relation with the mean of FBG, 2hpp, SBP, DBP, serum lipids, except for HDL-C (p<0.001 for all). After adjustment for age, smoking, physical activity, socioeconomic status (SES), and BMI, the highest odds ratio (OR) (95% CI) for diabetes mellitus (DM) according to WC was 3.13 (1.93-5.08) and 1.99 (1.15-3.44) in women and men respectively. Moreover, the highest ORs based on BMI with adjustment for age, smoking, physical activity, SES, and WC were for dyslipidaemia (DLP) [1.97 (1.58-2.45) in women and 2.96 (2.41-3.63) in men]. The use of BMI or WC alone in the models caused to enhance all ORs. When both BMI and WC were entered in the model, the ORs for all risk factors, in men, according to BMI, were more compared to WC. However, in women, ORs for DM and hypertension (HTN) in WC quartiles were more than in BMI quartiles. BMI is the better predictor of DM, HTN, and DLP in men compared to WC. Conversely, in women, WC is a superior predictor than BMI, particularly for DM and HTN. Furthermore, the measurement of both WC and BMI in Iranian adults may be a better predictor of traditional risk factors of CVDs compared to BMI or WC alone

Improvement of dietary oil consumption following a community trial in a developing country: The role of translational research in health promotion

BACKGROUND: This study aimed to determine the effects of the interventions of Isfahan Healthy Heart Program (IHHP) on the type of oil consumed at the population level. It also tried to assess how this strategy has been effective as a health policy. METHODS: The IHHP, a six-year community intervention program (2001-07), aimed at health promotion through the modification of cardiovascular disease risk factors. It was performed in Isfahan and Najafabad counties (intervention area) and Arak county (reference area), all in central Iran. This study targeted the whole population of over 2,000,000 in the intervention area. The findings of annual independent sample surveys were compared with the reference area. Dietary interventions were performed as educational, environmental, and/or legislative strategies. RESULTS: From 2001 to 2007, the mean of changes for hydrogenated oil consumption was -3.2 and -3.6, and for liquid oil it was 3.6 and 2.8 times per week in the intervention and reference areas, respectively (P &lt; 0.001). According to Commerce office record, the increase in liquid oil distribution during 2000-2007 was significantly higher in Isfahan than Arak (34% vs. 25%). CONCLUSION: The effects of the simple, comprehensive, and integrated action-oriented interventions of our program could influence policy making and its results at the community level. It can be adopted by other developing countries. &nbsp; Keywords: Oil Consumption, Hydrogenated Oil, Liquid Oil, Community Trial</div

Potato consumption and cardiovascular disease risk factors among Iranian population

Background: Previous studies investigated the effects of dietary glycaemic index and glycaemic load on cardiovascular risk factors. Little evidence is available regarding the association between potato intake and cardiovascular risk factors in Iran. Objective: This cross-sectional study was conducted in the first stage of Isfahan Healthy Heart Programme. Methods: A total of 4774 subjects were included in the present study. Dietary intake was assessed with a 49-item food frequency questionnaire. Biochemical assessments were done according to the standard protocol. Results: There were significant associations between potato consumption and diabetes mellitus (odds ratio (OR): 1.38; 95% CI: 1.14-1.67; p < 0.001), high fasting blood sugar level (OR: 1.40; 95% CI: 1.17-1.68; p < 0.001) and low serum high density lipoprotein level (OR: 1.10; 95% CI: 1.01-1.20; p = 0.02) remained after adjustments for possible confounding factors. Conclusion: We found a positive relation between potato consumption, high fasting blood glucose level and diabetes mellitus

The association between daytime sleep and general obesity risk differs by sleep duration in Iranian adults

Background Sleep duration and daytime napping and obesity are related to adiposity; however, it is not clear whether the association between daytime napping and adiposity measures can differ by sleep duration. Aim To clarify the association between daytime napping and general and abdominal obesity based on sleep duration of participants. Subjects and methods This cross-sectional study was conducted on 1,683 individuals (837 men and 846 women) aged ≥ 35 years. Height, weight and waist circumference (WC) were measured according to the standard protocols. Body mass index (BMI) was calculated. Self-reported sleep duration (in a 24-hour cycle) was recorded. The odds of general and abdominal obesity were compared between nappers and non-nappers, stratified by their sleep duration (≤ 6 h, 6–8 h, ≥ 8 h). Results The mean (SD) age of participants was 47.48 ± 9.35 years. Nappers with a short sleep duration (≤ 6 h) had greater BMI and higher risk for overweight/obesity compared with counterpart non-nappers after adjustment for potential confounders (OR = 1.61, 95% CI = 1.07–2.41). In subjects with moderate sleep duration (6–8 h), nappers had a tendency towards higher BMI in comparison with non-nappers (28.04 ± 0.25 vs. 26.93 ± 0.51 kg/m2; p = 0.05), however, no significant difference was observed for the risk of obesity. Daytime napping was not related to the risk of obesity in long sleepers. No significant association was observed for abdominal obesity measures. Conclusions Daytime napping is associated with increased risk of overweight/obesity in short sleepers. However, in subjects with longer sleep duration, it is not related to the risk of overweight/obesity

The relationship between weight and CVD risk factors in a sample population from central Iran (based on IHHP)

&nbsp;&nbsp; BACKGROUND: Atherosclerosis is one of the leading causes of mortality all around the world. Obesity is an independent risk factor for atherosclerosis and cardiovascular diseases (CVD). In this respect, we decided to examine the effect of the subgroups of weight on cardiovascular risk factors. &nbsp;&nbsp; METHODS: This cross-sectional study was done in 2006 using the data obtained by the Iranian Healthy Heart Program (IHHP) and based on classification of obesity by the World Health Organization (WHO). In this study, the samples were tested based on the Framingham risk score, Metabolic Measuring Score (MMS) and classification of obesity. Chi-square and ANOVA were used for statistical analysis. &nbsp;&nbsp; RESULTS: 12514 people with a mean age of 38 participated in this study. 6.8% of women and 14% of men had university degrees (higher than diploma). Obesity was seen in women more than men: 56.4% of women and 40% of men had a Body Mass Index of (BMI) &ge; 25 Kg/m2. 13% of the subjects had FBS &gt; 110 and13.9% of them were using hypertensive drugs. In this study, we found that all risk factors, except HDL cholesterol in men, increased with an increase in weight. This finding is also confirmed by the Framingham flowchart for men and women. &nbsp;&nbsp; CONCLUSION: One of every two Americans, of any age and sex, has a Body Mass Index of (BMI) &ge; 25 Kg/m2. Obesity associated CVD and other serious diseases. Many studies have been done in different countries to find the relationship between obesity and CVD risk factors. For example, in the U.S.A and Canada they found that emteropiotic parameters, blood presser and lipids increased by age(of both sexes). Moreover, another study done in China, which is a country in Asia like Iran, shows that BMI has an indirect effect on HDL cholesterol, LDL cholesterol and triglyceride. This data is consistent with the results of the current study. However, In China they found that this relationship in men is stronger than women, but our study reveals the opposite. &nbsp; Keywords: Body Mass Index (BMI), Overweight, Cardiovascular Risk Factors, Framingham Risk Score, Metabolic Syndrome.</p