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author:("dorothy, A")
2.  Maternal Obesity and Energy Intake as Risk Factors of Pregnancy-induced Hypertension among Iranian Women 
ABSTRACT
Pregnancy-induced hypertension is causing striking maternal, foetal and neonatal mortality and morbidity in the world. A case-control study was conducted on 113 women with gestational hypertension and 150 healthy pregnant women at Shahid Akbarabadi Hospital of obstetrics and gynaecology in south of Tehran. Women who were obese (OR 4.44; 95% CI 1.84-10.72) before pregnancy were more likely to develop gestational hypertension. Proportion of having excessive gestational weight gain was positively and significantly associated with development of gestational hypertension (OR 2.70; 95% CI 1.19-6.13). Furthermore, findings revealed that women who were in the highest quartile of mid-arm-circumference had a 3-fold increased risk of gestational hypertension compared to women in the lowest quartile (OR 8.93; 95% CI 2.16-36.93). We found that having been in the highest quartile of energy intake positively correlated with increased risk of gestational hypertension (OR 9.66; 95% CI 3.30-28.21). The results suggest pre-pregnancy obesity, excessive gestational weight gain, and increased intake of energy as potential risk factors of developing gestational hypertension.
PMCID: PMC4221454  PMID: 25395911
Body mass index; Energy intake; Gestational hypertension; Gestational weight gain; Pregnancy; Pre-pregnancy; Iran
3.  The association of family food security and depression in mothers having primary school children in Ray-Iran 
Background
As a major public health problem, food insecurity has adverse social and psychological effects, in addition to the impact on public health. This study aimed to determine the association of household food security and depression in mothers with primary school children in Ray County.
Methods
This descriptive, analytical cross-sectional study was conducted on 430 mothers with primary school children in the spring 2010. During a two-stage cluster sampling, an 18-items food security questionnaire (USDA) and the Beck depression inventory were completed via interviewing mothers. Chi-squared test, one-way analysis of variance, simple regression and stepwise multiple regression were used to describe and analyze data, and to identify related factors using SPSS-16 software.
Results
The prevalence of food insecurity and depression in mothers were 50.2% and 51.4% respectively. Also 34.6% of mothers in the "food secure" group were depressed and 77.8% in "food insecure with hunger" group were depressed and this difference was statistically significant. Twelve out of the 20 examined variables (age, family size, number of children, economic status, home ownership, employment households, educational level of the mother and also the head of household, height, energy intake, and carbohydrate and protein intakes) were significantly associated with food security and depression. Food insecurity and depression in mothers with primary school children in Ray County showed a significant positive correlation (P < 0.001).
Conclusion
The prevalence of household food insecurity and depression in the studied population were high. Since there is a significant relationship between food insecurity and depression, more attention must be paid to this group.
doi:10.1186/2251-6581-13-65
PMCID: PMC4060763  PMID: 24940566
Food security; Depression; Mother
4.  Perception of Weight and Health Status among Women Working at Health Centres of Tehran 
Perception of body-weight status is an important determinant of weight-related behaviours and may affect the burden of weight disturbances as a public-health problem. No study has assessed self-perception of the weight status regarding body-fat distribution among health workers to date. The aim of this study was to evaluate the association of the perception of weight and health status among 542 women working at health centres of Tehran. We assessed their perceived body-weight and health status and measured waist- and hip-circumference, weight, and height to calculate waist-to-hip ratio (WHR) as a measure of fat distribution and body mass index (BMI, kg/m2). Women reported their sociodemographic information, and the perceived weight and health status were compared with their actual fatness status, defined based on WHR and BMI, to determine misperception of weight status. Multivariate logistic regression models were performed to assess the predictive effects of various sociodemographic factors and actual fatness on the perception of weight and health status. The results showed that more than 40% of women with normal BMI overestimated their body-weight status while only 15.8% of these women had central obesity. BMI was the most important variable associated with misperceived weight status as normal-weight women had significantly more misperception (OR 8.16, 95% CI 4.82-13.82) than overweight/obese women. WHR did not show any significant relationships with perceived weight status. In addition, perception of health status was not associated with actual fatness indices. It is concluded, BMI was the main predictor of the perception of weight status in female employees. The importance of using body-fat distribution in the perceptions of weight and health status should be emphasized.
PMCID: PMC4089073  PMID: 24847594
Body mass index; Health centres; Perception of health status; Perception of weight status; Waist-to-hip ratio; Iran
6.  Is Household Food Insecurity Associated with Overweight/Obesity in Women? 
Iranian Journal of Public Health  2013;42(4):380-390.
Background
Despite reports on association between overweight/obesity among women and household food insecurity (FI) in developed countries, such association is not evident in developing countries. This study aimed to assess the association between household FI and weight status in adult females in Tehran, Iran.
Methods:
In this cross-sectional study, 418 households were selected through systematic cluster sampling from 6 districts of Tehran. Height and weight were measured and body mass index (BMI) was calculated. Socio-economic status of the household was assessed by a questionnaire. Three consecutive 24-hour diet recalls were completed. FI was measured using adapted Household Food Insecurity Access Scale. Logistic regression was used to test the effects of SES and food security on weight status, simultaneously. Using Structural Equation Modeling (SEM) potential causal relationships between FI and weight status was explored.
Results:
Only 1.0% of women were underweight, while 40.3% were overweight and 33% were obese, respectively. Severe, moderate, and mild food insecurity was observed in 11.5, 14.7, and 17.8%, respectively. Among women in moderately food insecure households, the possibility of overweight was lower than those of food secure households (OR 0.41; CI95%:0.17–0.99), while in severely food insecure households, the risk of abdominal obesity for women was 2.82 times higher than food secures (CI95%:1.12–7.08) (P<0.05). SEM detected no causal relationship between FI and weight status.
Conclusion:
Association of severe food insecurity with abdominal obesity in adult females of households may indicate their vulnerability and the need for tailoring programs to prevent further health problems in this group.
PMCID: PMC3684724  PMID: 23785677
Overweight; Abdominal obesity; Women; Food security; Household; Iran
7.  The association between depression, socio-economic factors and dietary intake in mothers having primary school children living in Rey, South of Tehran, Iran 
Background
According to the WHO report released in 2000, about 121 million people worldwide suffer from depression. The present study aimed to explore factors influencing depression in mothers from Rey, South of Tehran, Iran; who had elementary school children.
Methods
The cross-sectional survey was conducted in spring 2010. Four hundred thirty mothers, who had elementary school children, were selected through a two stage cluster sampling. Beck Depression Inventory (BDI) was used to assess depression in the mothers and a 24-hour food recall was used to collect information regarding their dietary intake. General information regarding economic condition and socio-economic status were also gathered using a questionnaire. The data was analyzed using chi-square, one-way analysis of variance and simple regression tests.
Results
In our study, 51.4% of the mothers suffered from depression. There was an inverse correlation between the educational level of the mothers and the heads of household, their occupational status, their marital status, their socio-economic condition and depression. Conversely, any increase in the family size worsened the depression. The daily intake of different macronutrients, except for fat, was lower in individuals of depressed group.
Conclusion
The present study emphasized the fact that more attention should be paid to the educational level and economic condition of the family in order to reduce maternal depression. Family size also plays an important role in this regard.
doi:10.1186/2251-6581-11-29
PMCID: PMC3598215  PMID: 23497656
Depression; Diet; Mothers; Socio-economic factors
8.  The association between depression, socio-economic factors and dietary intake in mothers having primary school children living in Rey, south of Tehran, Iran 
Background
According to the WHO report released in 2000, about 121 million people worldwide suffer from depression. The present study aimed to explore factors influencing depression in mothers from Rey, South of Tehran, Iran; who had elementary school children.
Methods
The cross-sectional survey was conducted in spring 2010. Four hundred thirty mothers who had elementary school children, were selected through a two stage cluster sampling. Beck Depression Inventory (BDI) was used to assess depression in the mothers and a 24-hour food recall was used to collect information regarding their dietary intake. General information regarding economic condition and socio-economic status were also gathered using a questionnaire. The data was analyzed using chi-square, one-way analysis of variance and simple regression tests.
Results
In our study, 51.4% of the mothers suffered from depression. There was an inverse correlation between the educational level of the mothers and the heads of household, their occupational status, their marital status, their socio-economic condition and depression. Conversely, any increase in the family size worsened the depression. The daily intake of different macronutrients, except for fat, was lower in individuals of depressed group.
Conclusion
The present study emphasized the fact that more attention should be paid to the educational level and economic condition of the family in order to reduce maternal depression. Family size also plays an important role in this regard.
doi:10.1186/2251-6581-11-26
PMCID: PMC3598164  PMID: 23497609
Depression; Diet; Mothers; Socio-economic factors
9.  Sarcopenia and its determinants among Iranian elderly (SARIR): study protocol 
Background
The elderly populations increase in world because of improved health status in communities, so health and independency of seniors has become and will be one of the main priorities of public health systems.
Ageing have been associated with changes in body composition, including loss of muscle mass, loss of bone mass and increase fat mass. Involuntary age related loss of muscle mass, sarcopenia,has been linked to functional impairment and physical disability. Several definitions for sarcopenia have been presented based on the method of measuring body composition, but an internationally accepted definition doesn’t presently exist yet.
In 2010, the European working group on sarcopenia developed a new definition for sarcopenia according to measure muscle mass and muscle function. Several studies have been done about sarcopenia in world, but to our knowledge this study is the first in Iran which is one of the largest countries of the Middle East that faces a fast growing elderly population. The aim of this study is to evaluate sarcopenia and related risk factors in Iran according new definition of sarcopenia.
Methods
This study will be conducted in two phase among elderly men and women over 55 years in the 6th district of TehranThe first phase will be a population-based cross-sectional study to determine the frequency of sarcopenia in the study population, and to conduct case finding for the second phase. The second phase will be a case–control study to comparison the metabolic and inflammatory factors in sarcopenic and non sarcopenic groups.
The association between sarcopenia and major dietary pattern will be evaluated using factor analysis.
Conclusion
This study is the first study that evaluates sarcopenia and its risk factor in Iranian elderlies.
We discuss details of how we collect the data and appropriate instruments to measure muscle mass, muscle power and muscle strength, and suitable cut- off to define sarcopenia in Iranian elderlies. We believe the result of our study can be useful to health policy makers prepare the necessary infrastructure for elderly health improvements and increase the quality of life in geriatric.
doi:10.1186/2251-6581-11-23
PMCID: PMC3598166  PMID: 23497567
Sarcopenia; Dietary pattern; Metabolic syndrome; Inflammatory marker
10.  Effects of EPA and Vitamin E on Serum Enzymatic Antioxidants and Peroxidation Indices in Patients with Type II Diabetes Mellitus 
Background:
Diabetes mellitus is associated with chronic changes in peripheral arteries because of oxidative stress and insufficient antioxidative defense mechanism. Omega-3 fatty acid supplementation could be effective in some diabetes complications; however, polyunsaturated fatty acids may increase lipid peroxidation. This study aimed to determine whether eicosapentaenoic acid alone or in conjunction with vitamin E had differential effects on serum antioxidants and peroxidation indices.
Methods:
This double-blind, placebo-controlled trial was carried out on 136 patients with type II diabetic mellitus (age 48.8±4.4 yr, BMI 27.8±1.7 kg/m2). The four groups of the study either received two grams of omega-3 fatty acids, 400 IU of vitamin E, a combination of the two or placebo for three months. Their serum total antioxidant capacity, enzymatic antioxidants and peroxidation indices were assessed.
Result:
Fasting serum TAC increased in EPA+E (10.7%, P< 0.001) and E groups (7.5%, P< 0.05). SOD, G-PX and G-RD increased in EPA group (7.3%, 5.1%, and 8.4%, P< 0.05, respectively). MDA and protein carbonyl decreased in EPA and E groups (respectively, 12.5%, 7.6% P< 0.05, P< 0.05; 13%, 15.3% P< 0.001, P< 0.05). After adjustment for baseline values, age, sex, BMI and duration of diagnosed diabetes, protein carbonyl decreased in EPA+E and E group (30.7%, 15.3%; P< 0.05 respectively) relative to the placebo group.
Conclusion:
EPA, by itself has a statistically significant effect on serum total antioxidant capacity, enzymatic antioxidants and peroxidation indices in diabetic patients compared to EPA+E or E alone.
Trial registration: ClinicalTrials.gov NCT00817622
PMCID: PMC3481622  PMID: 23113026
Diabetes mellitus; Eicosapentaenoic acid; EPA; Total antioxidant capacity; Vitamin E
11.  Coexistence of social inequalities in undernutrition and obesity in preschool children: population based cross sectional study 
Archives of Disease in Childhood  2003;88(8):671-675.
Aims: To test for the coexistence of social inequalities in undernutrition and obesity in preschool children.
Methods: Retrospective, cross sectional, study of routinely collected data from 74 500 children aged 39–42 months in 1998/99. Main outcome measures were weight, height, sex, and age routinely recorded by health visitors. Body mass index (BMI) standardised for age and sex, relative to UK 1990 reference data, was used to define undernutrition (BMI <2nd centile) and obesity (BMI >95th centile; BMI >98th centile). Social deprivation was assessed as Carstairs deprivation category (1 = most affluent to 7 = most deprived).
Results: Both undernutrition (3.3%) and obesity (8.5% above 95th centile; 4.3% above 98th centile) significantly exceeded expected frequencies from UK 1990 reference data. Undernutrition and obesity were significantly more common in the more deprived families. Odds ratios in deprivation category 7 relative to category 1 were 1.51 (95% CI 1.22 to 1.87) for undernutrition (BMI <2nd centile) and 1.30 (95% CI 1.05 to 1.60) for obesity (BMI >98th centile). The cumulative prevalence of under and overnutrition (malnutrition) in the most deprived group was 9.5% compared to 6.9% in the least deprived group.
Conclusions: Undernutrition and obesity are significantly more common than expected in young children and strongly associated with social deprivation. Both undernutrition and obesity have adverse short and long term health effects. Public health strategies need to tackle malnutrition (both undernutrition and obesity) in children and take into consideration the association with social deprivation.
doi:10.1136/adc.88.8.671
PMCID: PMC1719615  PMID: 12876159
12.  Obesity in Iranian children 
Archives of Disease in Childhood  2002;87(5):388-391.
doi:10.1136/adc.87.5.388
PMCID: PMC1763078  PMID: 12390907
13.  Early life risk factors for obesity in childhood: cohort study 
BMJ : British Medical Journal  2005;330(7504):1357.
Objective To identify risk factors in early life (up to 3 years of age) for obesity in children in the United Kingdom.
Design Prospective cohort study.
Setting Avon longitudinal study of parents and children, United Kingdom.
Participants 8234 children in cohort aged 7 years and a subsample of 909 children (children in focus) with data on additional early growth related risk factors for obesity.
Main outcome measures Obesity at age 7 years, defined as a body mass index 3 95th centile relative to reference data for the UK population in 1990.
Results Eight of 25 putative risk factors were associated with a risk of obesity in the final models: parental obesity (both parents: adjusted odds ratio, 10.44, 95% confidence interval 5.11 to 21.32), very early (by 43 months) body mass index or adiposity rebound (15.00, 5.32 to 42.30), more than eight hours spent watching television per week at age 3 years (1.55, 1.13 to 2.12), catch-up growth (2.60, 1.09 to 6.16), standard deviation score for weight at age 8 months (3.13, 1.43 to 6.85) and 18 months (2.65, 1.25 to 5.59); weight gain in first year (1.06, 1.02 to 1.10 per 100 g increase); birth weight, per 100 g (1.05, 1.03 to 1.07); and short (< 10.5 hours) sleep duration at age 3 years (1.45, 1.10 to 1.89).
Conclusion Eight factors in early life are associated with an increased risk of obesity in childhood.
doi:10.1136/bmj.38470.670903.E0
PMCID: PMC558282  PMID: 15908441

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