Knowledge, attitude and practice of urban and ruarl households towards principles of nutrition in Iran: results of NUTRIKAP Survey.

Background: The aim of this study was to assess knowledge, attitude and practice of urban and rural households toward principles of nutrition in Iran. Methods: The study population was Iranian households who live in rural and urban areas in all provinces of the country. The sampling method at households’ level in each province was single stage cluster sampling with equal size clusters. The incumbent data was collected by a structured questionnaire and through the interview with the eligible subject in each household. Results: A total of 14,136 Iranian households were selected as total sample size, 9,149 urban households, and 4,987 rural households. Around 57.2% of urban and 49.5% of rural households was aware of food groups. Respectively in urban and rural households, about 35.1% and 39.7% had correct knowledge toward roles of food groups. Approximately 41.5% and 39.9% of households had accurate knowledge about reason of food eating in urban and rural areas, respectively. The results showed that 79.6% of them had favorable attitudes. The most of the households consumed red meat and poultry weekly whereas fish was eaten rarely. Fruits, vegetables and dairy were consumed daily in the most of households. Sugar intake was daily in the most of households and cream and butter intake was weekly. Conclusion: The most of households had moderate knowledge and good attitudes. Practice of families about food consumption was good. The results of this study can be used for proper intervention for improving of health society

Nutritional knowledge, attitude and practice of Iranian households and primary health care staff: NUTRIKAP survey

The aim of this study is to determine knowledge, attitude and practice of Iranian households and health staff on nutrition at province level. The sampling method in NUTRIKAP survey for households in each province is singlestage cluster sampling and the size of clusters is equal. The sampling method for health staff in each province is stratified random sampling. Samples are selected from physicians, health experts, health technicians, nutritionists and health assistants (Behvarz). Overall, 14136 people in 57 clusters in each province and 480 health staff over the country participate in this survey. The necessary data will be gathered by the structured questionnaire and the interview with the eligible person in each household. Data gathering from health staff will be carried out by selfadministered questionnaire. The results of this study can help the bureau of community nutrition to provide the proper interventions to improve nutritional health of households

Relationship between thyroid stimulating hormone and metabolic syndrome in overweight/obese children

Background: Background: Obesity, especially central obesity is related to many endocrine abnormalities, such as thyroid dysfunctions. Elevated levels of thyroid stimulating hormone (TSH) is common in obese children, however, it is not clear if such condition is associated with increased cardiovascular risk factors. The study aimed to determine the association between levels of TSH in overweight and obese children with components of metabolic syndrome (Mets). Methods: The study sample included 197 overweight/obese 6-7 year old children in Tehran, Iran. Anthropometric (weight, waist circumference and height), metabolic (high-density lipoprotein cholesterol, triglycerides and fasting blood glucose) and hormonal (TSH) variables, as well as blood pressure were measured. Mets was defined according to Cook definition. Results: Totally, 20.3% and 79.7% of children were overweight and obese, respectively. Elevated levels of TSH were diagnosed in 10 subjects (5.1%), while Mets was seen in 35.4%. The most frequent component of Mets was abdominal obesity (72.5%). A weak positive correlation between BMI for age, Z scores and TSH level (r =0.11, P value= 0.123) was observed only in girls (r=0.2, P value= 0.034). TSH was not associated with components of Mets. Conclusion: Elevated TSH levels may be found in obese children; however, the association between TSH elevation and cardiovascular disease risk factors, including components of metabolic syndrome needs further investigation

The effect of progressive muscle relaxation on anxiety and stress in nursing students at the beginning of the internship program

Background and aims: Anxiety is a complicated process appearing from low to high which may reduce the learning ability. It is common among nurses as they struggle to cope with increasingly complicated stressors such as examinations, article preparation and practical experiences. The aim of this study was to evaluate the effect of muscle relaxation on reduction of anxiety in nursing students before starting the internship program. Methods: In this study, 40 nursing students who were going to start their internship program were randomly divided into two equal groups. Before starting the internship program, all students were asked to fill a questionnaire (Spielberger Test Anxiety) to measure their anxiety. In addition, physiological parameters (blood pressure, pulse, respiration, temperature) were collected before and after the study in both groups. During a 45-min session, muscle relaxation training was given to the test group. Muscle relaxation practice was continued three times per day for two weeks. Two weeks after starting the internship, Spiel Berger Test Anxiety and physiological parameters were collected again in both groups. Data were analyzed using Chi-square and t tests. Results: The average age of the students in both groups was 22.7±2 (range=21 to 25 years) and the majority of the students were female (75%). No significant difference was observed between two groups for willingness to the nursing profession, birth rank and the average scores of the students from the previous years. The average anxiety score in control group before and after the study was 27.5±10.2 and 28.3±8.8 respectively (P>0.05). Average anxiety score in test group before and after the study was 25.4±19.5 and 29.2±14.1 respectively (P<0.05). Conclusion: To alleviate stressors associated with practical practice and create a healthy work environment for practice, it is recommended that nursing students have some progressive muscle relaxation before entering practical environments

The association between household socioeconomic status, breastfeeding, and infants' anthropometric indices

Background: The growth, learning, and contribution to active life in the communities are better in well-nourished children, and various factors influence infants' feeding. In this study, we assessed whether household socioeconomic status (SES) affects infants' length-for-age, weight-for-age (indicators of health and nutritional status) and breastfeeding (BF) (a necessity for optimal growth and health) status. Methods: In this cross-sectional study, 150 households with infants of 1–1.5 years old were interviewed on these variables: family size, dwelling ownership, duration of BF, exclusive BF (EBF) for 6 months, parents' age, parents' ethnicity, birth order, delivery type, and parents' education. Weight and length at 4 and 12 months were obtained from centers' records. To determine SES, we assessed total years of parents' education and household asset ownership by an index of nine owned assets. Results: The average of 4-month length in the low SES group was significantly lower than the two others (P < 0.05). In middle socioeconomic group, duration of BF was significantly higher (19.5 ± 7.3 months vs. 18.0 ± 8.0 months in low and 17.5 ± 7.9 months in high SES groups) (P < 0.05). Comparing illiterate mothers, university degree holders and university students were 73% less likely to not having EBF. Moreover, those with middle SES showed to be about 40% less likely to not having EBF. Conclusions: Nutritional status, duration of BF, and EBF might be determined by household SES and maternal education. Therefore, these findings can be used to decide how to focus on appropriate target groups in family education planning to improve children's development to its most possible

The Effects of Vitamin D Supplementation on Lipid and Inflammatory Profile of Healthy Adolescent Boys: A Randomized Controlled Trial

Background: Deficiency of vitamin D, an anti-inflammatory micronutrient with some favorable effects on lipid profiles, has been found to be highly prevalent in adolescents. We aimed to investigate the effect of a school-based vitamin D supplementation regimen on the correction of vitamin D deficiency as well as lipid and inflammatory profiles of healthy adolescent boys. Methods: In this randomized single-blind placebo-controlled trial, seventy-one healthy adolescent boys (age 17 years old) were recruited from one high school in Tehran, Iran, and randomly assigned to two groups. The supplement group received vitamin D pearls at a dose of 50,000 IU monthly for 6 months, this dose is indeed defined by the Ministry of Health in Iran for a potential national school-based vitamin D supplementation program. The other group was given placebo pearls for the same duration. Before and after the treatment, the serum levels of 25-hydroxy vitamin D (25(OH) D), parathyroid hormone (PTH), retinol, lead (Pb), the lipid profile and the inflammatory biomarkers were measured and compared. Results: Between-groups statistical analysis showed that a dose (50,000 IU/month) vitamin D significantly increased the serum levels of 25-hydroxyvitamin D (25 (OH) D) (p &lt; 0.001) and decreased serum levels of PTH (p = 0.003). No significant change was observed in serum levels of retinol and Pb. Between-group analysis revealed that the serum levels of TG (P = 0.001) decreased while an increase in serum levels of HDL (p = 0.021) was observed (p&thinsp;&lt; 0.05). Both the within- and between-group analysis showed that serum tumor necrosis factor receptor 2 (TNFR2) concentration declined while serum interleukin-10 (IL-10) increased in response to vitamin D supplementation (p&thinsp;&lt; 0.05). Conclusion: A supplementation regimen of (50,000 IU/month) vitamin D in a context with high rates of vitamin deficiency has shown positive impacts on the serum vitamin D, lipid profile and inflammatory biomarkers in healthy adolescent boys

Community interventional trial (CITFOMIST) of vitamin D fortified versus non-fortified milk on serum levels of 25(OH) D in the students of Tehran

Background: As prevention of osteoporosis becomes more imperative with the global ageing of the population, establishing different measures to fight vitamin D deficiency will also become increasingly important. The aim of this study is to help assess the efficacy of vitamin D fortified Milk on circulating concentrations of 25(OH)D (as the primary outcome), a widely accepted indicator of vitamin D status, in Tehran students. Another objective of the protocol is to help assess the compliance with fortified dairy in students of different socioeconomic classes. Method: The cluster-randomized-trial (CITFOMIST) is conducted on 15- to19-year olds guidance and high school students of both genders from different districts of Tehran, in wintertime. The schools enrolled in this study are randomly assigned to receive one of the three groups of milk (whole milk, milk that contained 600 IU Vit D/1000 cc, or Milk that contained WOO IU Vit D /1000 cc) for a 30-day period. In order to study the effect of vitamin D fortified milk on the circulating concentrations of 25(OH) D, a serum vitamin D levels-are checked in a subgroup before and after the intervention. Conclusion: There are few data on the efficacy of incremental doses of vitamin D from fortified foods among adolescents. This is while developing an optimal model to fight vitamin D deficiency needs further research on bone health Outcomes and the safety of vitamin D-fortified products. The Modified version of this-protocol could be applied in different parts of the country to assess the efficacy of a vitamin-D product

Cooking Pattern and Eating Behaviors in Association with Socioeconomic Status among Iranian Households: The NUTRI-KAP Survey

Background: Disparities in health may relate to differences in nutrition. Among dietary determinants, Socioeconomic Status (SES) plays an important role. Therefore, this study was aimed to investigate the association between SES and cooking pattern and consumed food among rural and urban Iranian households.     Methods: Overall, 14,136 households were selected through single-stage cluster sampling methods from urban and rural regions of 31 provinces of Iran in 2011-2012. Demographic, SES, cooking pattern and consumed food data were obtained through valid structured questionnaires by interviewing between trained interviewers with qualified people in households. Data were analyzed using STATA software ver. 11.0 (STATA Corp, College Station, Tex.) Results: In households with weak SES background, 70.4% of households cooked separately for any meal. The healthy cooking method for red meat and chicken, fish, celery, vegetables stew, onion and green bean was significantly higher in good SES ( P<0.001). Households with good SES had higher intake low fat dairy, liquid oil and iodized salt (P<0.001) compared with families with weak SES. Most consumed bread in three groups was Lavash (Local name).  Conclusion: Pattern of cooking and the type of consumed foods among different SES group and their relationship with each other. So based on this information will be facilitated for interventions and training for better nutrition pattern in society.     Keywords: Socioeconomic Status, KAP, Cooking pattern, Consumed foo