The prevalence of gestational diabetes mellitus and its related risk factors in Gorgan, north of Iran. Selective or universal screening test is cost-effective?

Gestational diabetes mellitus (GDM) is the most prevalent metabolic disorder in pregnancy. GDM is defined in <1 % to 28 % of pregnancies, depending on the diagnostic criteria, the ethnic and racial characteristics. This study was performed to determine the prevalence of GDM and related risk factors among pregnant women in Gorgan, north of Iran. In a cross sectional study, 1276 pregnant women were recruited. All of women screened with glucose challenge test (GCT) in 24–28th wks of gestational age. Women with positive GCT underwent 100 g glucose tolerance test (OGTT). Diagnosis of GDM was according to Carpenter and Coustan’s criteria. GCT was positive in 200 women (15.8 % with CI: 13.8 %–17.8 %) and GDM was diagnosed in 62 case (4.9 % with CI:3.7 %–6.8 %). In a multiple logistic regression, risk factors such as age, BMI, history of macrosomia, familial history of diabetes and impaired fasting glucose (IFG) were identified as independent risk factors for GDM (p < 0.05). Among GDM cases, 3.2 %(2 women) had no risk factor. These results show moderate prevalence of GDM in north of Iran. It seems that a selective GDM screening method for women with some risk factors is more appropriate than general screening. © 2015, Research Society for Study of Diabetes in India

Impact of ethnicity upon body composition assessment in Iranian northern children

Objective: This study was designed to determine secular growth among rural children between two ethnic groups (Sisstanish and Non-Sisstanish ) in north of Iran. Methods: We chose 20 villages from 118 by cluster and simple sampling. All of 25-60 months old children in this area were considered in this study. Sample size was 1569 cases (632=Sisstanish and 937=Non- Sisstanish). Height, weight and personal identification were recorded by questioner. BMI percentile and under -1sd, -2sd and -3sd from NCHS were used for comparison. X2 test and T.test were used to analyze by software SPSS. Results: Sisstanish children were 900 g lighter and 4.39 cm taller than non-Sisstanish among all of age groups. T.test is significant between two groups based on weight and height (P<0.05). Stunting and underweight were observed in Sisstanish group 23% and 5.9% respectively more than in non-Sisstanish by -2sd criterion. There is a significant difference between two groups by stunting (P<0.05). Overweight (1.52%) and obesity (12.4%) were shown in Sisstanish group more than in non-Sisstanish group and Statistical differences is significant between them based on obesity (P<0.05). Conclusion: Secular growth in two groups is disproportionate and in Non-Sisstanish group is better than Sisstanish group. Sisstanish children suffer from severe height deficit and BMI high. Thereby, malnutrition is the most health problem in rural area in the north of Iran and nutritional intervention is necessary for solving these problems

Nutritional status of hemodialysis patients using subjective global assessment (SGA)

Background and Objective: Malnutrition is an important health problem in patients with end stage renal disease which increases morbidity and mortality. Early diagnosis of malnutrition can be important for nutritional supports in hemodialysis patients. This study was carried out to evaluate the nutritional status and its related risk factors in hemodialysis patients using subjective global assessment. Methods: This descriptive-analytic study was done on 117 hemodialysis patients in the 5th Azar hospital, in Gorgan, Iran during August to October 2013. The nutritional status was evaluated as normal, mild to moderate or severe malnutrition using subjective global assessment (SGA). The anthropometric and biochemical parameters of hemodialysis patients and its relation with nutritional status were determined. Results: Among 116 patients, 29.66%, 69.82% and 0.9% were well nourished, mild to moderate malnutrition and severe malnutrition, respectively. A significant negative correlation was seen between patient’s weight, BMI, mid-arm circumference and serum albumin with SGA score (P<0.05). Patient’s age and duration of hemodialysis positively correlated with malnutrition (P<0.05). No significant association was found between serum concentration of BUN, Cr and WBC count with nutritional status. Conclusion: This study has shown low prevalence of malnutrition in our population in comparison with other studies. However according to important of malnutrition in patients undergoing hemodialysis, the basic evaluation of nutritional status is needed for every patient

Effect of motivational interviewing on weight loss

Background and Objective: Obesity presented as the most pivotal public health problem. Motivational interviewing is a client-centered and direct technique to improve intrinsic motivation of people to change behavior using search and resolve ambivalence that its beneficial outcomes have widely been confirmed. This study was carried out to evaluate the effect of motivational interviewing on weight loss in women. Methods: In this randomized clinical trial study, 150 women with overweight and obesity were randomly divided into control, motivational interviewing and motivational interviewing and intention implementation groups. Data were collected through a researcher made questionnaire at baseline and 2 month follow up. Results: The score of protection motivation theory constructs including susceptibility, severity, rewards, self-efficacy, response efficacy and cost were significantly increased in the two intervention groups compared to the control group (P<0.05). Anthropometric characteristics were significantly reduced in the motivational interviewing and motivational interviewing with intention implementation group (P<0.05) in compare to the control group (P<0.05). Conclusion: Motivational interviewing integrated into intention implementation causes weight loss and increase the constructs score in women

Effect of camel milk in comparison with cow milk on blood glucose and lipid profile in patients with type 2 diabetes: A randomized clinical trial

Context: Type 2 diabetes mellitus (T2DM) is a common metabolic disorder. In traditional medicine, camel milk has been used in the treatment of some of diseases such as diabetes. The studies on effect of camel milk on glycemic control are limited and contradictory. Aims: The effect of camel milk on blood glucose and lipids in T2DM patients and compare it with the control group. Setting and Design: This case-controlled clinical trial study was performed in the endocrinology clinic in Iran. Materials and Methods: 50 patients with T2DM were allocated into two groups. 25 participants in the intervention group consumed 500 ml camel milk and 25 participants in the control group consumed 500 ml cow milk daily for 8 weeks. Weight, fasting blood sugar (FBS), total cholesterol (TC), and triglyceride (TG) were measured at the baseline and end of intervention. Statistical Analysis Used: Data were analyzed using SPSS v.16, independent t-test and analysis of covariance. Results: Mean of glycosylated hemoglobin (HbA1c) and TG concentration was significantly decreased in the camel milk group at the end of the study (P < 0.05). There was an increase in HbA1c in the cow's milk group, while the TG was not changed in this group. No significant differences were shown in weight, FBS, and TC at the end of the study in comparison with baseline values in any of the two groups. Conclusion: Camel milk can improve glycemic control according to HbA1c index. It might contribute to decreasing TG level in patients with T2DM. © 2021 Journal of Nursing and Midwifery Sciences

The effect of weight loss program on overweight and obese females based on protection motivation theory: A randomized control trial

Background: It is especially true that prevalence of overweight and obesity is increasing worldwide and it is probably because of changes in diet and physical behavior pattern. Objectives: The current study aimed to test the effect of weight loss program on overweight and obese females based on protection motivation theory. Methods: A randomized clinical trial (RCT) was implemented in the form of single blind. In total, 150 females with overweight and obesity were randomly divided into three groups including: 1, standard program group; 2, motivation interviewing (MI) group and; 3, motivation interviewing (MI) and intention intervention (II) condition (50 subjects in each group). They participated in a randomized clinical trial, also attended a private nutrition clinic in Gorgan city (Golestan province, North of Iran) for the first time. A researcher-made questionnaire and participant’s sheets (including three days food recall and anthropometric traits) were used to collect data. Data were analyzed using SPSS (ver.11) and statistical tests including Kruskal-Wallis, One-way ANOVA, Friedman test, Tukey test, Paired T-test and linear regression model were employed. Results: The mean age of females was 38.45 ± 9.49 years, most of them had academic degree 46.7 (n = 70), 78.7 (n = 118) were married and 60.7 (n = 91) were housewives. ANOVA repeated measure test showed that daily energy intake decreased two (P = 0.001) and six months (P = 0.001), weight (P = 0.007) and body mass index (BMI) (0.005) after intervention. Threat appraisal statistically differed six months after intervention (P = 0.001). Conclusions: Motivational interviewing resulted in decreased daily energy intake, anthropometric characteristics as well as augmented scores of coping and threat appraisal. © 2016, Iranian Red Crescent Medical Journal

The effects of modified alternate-day fasting diet on weight loss and CAD risk factors in overweight and obese women

<p>Abstract</p> <p>Background</p> <p>Obesity is a worldwide health problem with increasing prevalence. Decrease in energy intake has been shown to lower the risk of coronary artery disease in obese subjects. The common form of dietary restriction is daily calorie restriction (CR). Another form is alternate-day fasting (ADF). This study examined the ability of modified ADF to facilitate weight loss and lower cardiovascular risk factors in overweight and obese women.</p> <p>Methods</p> <p>15 adult subjects completed an 8 weeks trial (2 weeks observed and 6 weeks ADF). All women consumed very low calorie diet on the fast day and usually diet in every other day. Body weight (BW), fat mass and blood pressure (BP) were measured. Fasting blood samples were collected at the first and 57^th day of trial for biochemical analysis.</p> <p>Results</p> <p>During the course of the trial, BW of the subjects decreased (p < 0/0001) from 84/3 ± 11/44 kg to 78/3 ± 10/18 kg. Waist Circumference decreased from 87/87 ± 9/74 to 82/86 ± 9/68(p < 0/001). Reduction in systolic BP was seen from 114.8 ± 9.16 to 105.13 ± 10.19 mmHg (p < 0/001) and diastolic BP changed from 82.86 ± 10.6 to 74.5 ± 10.8 (P < 0.05). Total cholesterol decreased from 227/73 ± 49/96 to 214/67 ± 43/27, TG from 160/5 ± 46/18 to 143/9 ± 22/77, LDL from 149/46 ± 49/81 to 131/3 ± 50/97, and FBS from 102 ± 14/7 to 96 ± 11/79 mg/dl but were not significant. HDL increased from 42/32 ± 18/01 to 50/58 ± 19/46 and was not significant.</p> <p>Conclusion</p> <p>These finding suggest that short time ADF is a viable dietary option to help obese individuals lose weight and decrease some CAD risk factors. More and longer-term studies in human subjects are needed to support this important result.</p

Effects of weight loss via high fat vs. low fat alternate day fasting diets on free fatty acid profiles

Cardiovascular disease risk is associated with excess body weight and elevated plasma free fatty acid (FFA) concentrations. This study examines how an alternate-day fasting (ADF) diet high (HF) or low (LF) in fat affects plasma FFA profiles in the context of weight loss, and changes in body composition and lipid profiles. After a 2-week weight maintenance period, 29 women (BMI 30–39.9 kg/m2) 25–65 years old were randomized to an 8-week ADF-HF (45% fat) diet or an ADF-LF (25% fat) diet with 25% energy intake on fast days and ad libitum intake on feed days. Body weight, BMI and waist circumference were assessed weekly and body composition was measured using dual x-ray absorptiometry (DXA). Total and individual FFA and plasma lipid concentrations were measured before and after weight loss. Body weight, BMI, fat mass, total cholesterol, LDL-C and triglyceride concentrations decreased (P < 0.05) in both groups. Total FFA concentrations also decreased (P < 0.001). In the ADF-LF group, decreases were found in several more FFAs than in the ADF-HF group. In the ADF-HF group, FFA concentrations were positively correlated with waist circumference. Depending on the macronutrient composition of a diet, weight loss with an ADF diet decreases FFA concentrations through potentially different mechanisms