Stroke is a leading cause of death in developed countries. However, current therapeutic strategies for stroke have been largely unsuccessful. Several studies have reported important benefits on reducing the risk of stroke and improving the post-stroke-associated functional declines in patients who ate foods rich in micronutrients, including B vitamins. Folic acid, vitamin B6, and vitamin B12 are all cofactors in homocysteine metabolism. Growing interest has been paid to hyperhomocyste inemia as a risk factor for stroke. Experimental studies suggest that oxidative stress plays an important role in the pathogenesis of ischemic cerebral injury, and higher intake of antioxidants has been associated with a lower risk of stroke in large population studies. The aim of this study was to examine whether the dietary intake of B vitamins and antioxidants in patients with stroke were comparatively worse than those in patients without stroke.
In this case control study, 69 stroke patients (46 male, age = 56 ± 18 years and 23 female, age = 52 ± 7 years) admitted to Azzahra hospital between April 2009 and May 2010 were matched for age and sex with 60 patients (30 male and 30 female) from the same hospital who were not affected with acute cerebrovascular diseases and did not have a history of stroke. Dietary intake was assessed with a validated self-administered food frequency questionnaire (FFQ). FFQ was collected conducting face-to-face interview with one of the patients’ close relatives. Food intakes, translated into nutrient data, were compared between the two groups and with the recommended values.
Intake of folic acid in men with stroke and vitamin B12 in women with stroke was significantly lower than that in the patients without stroke (P < 0.05), but there was no significant difference between the two groups in the level of antioxidant consumption in women and men (P > 0.05).
Our findings suggest that increased folic acid, vitamin B12, and vitamin E, C intake may be associated with decreased risk of stroke.
Dietary quality; folic acid; stroke; vitamin B6; vitamin B12
Stroke is a leading cause of preventable morbidity and mortality in the United States. Numerous studies have shown that dietary carbohydrates play an important role in stroke incident. Therefore, this study aimed to assess the association between dietary intake of carbohydrate and its types and stroke incidence among Iranian adults.
A case-control study was performed among 46 men (5618) and 23 women (527) admitted to the Al Zahra hospital with stroke and 60 healthy people were chosen in control group. Dietary intake was measured by food frequency questionnaire (FFQ) including 168 items. Food processor software (version 2) was used to analyze data.
Anthropometric indices of male and female patients were (BMI: 297.5), (Waist: 11215) and (BMI: 25.53.5), (Waist: 925) respectively. Energy intake and carbohydrate consumption of patients in both genders was higher than the healthy subjects which was statistically significant among men (P < 0.05). Across different carbohydrate sources, refined carbohydrates consumption was higher among patients in both gender rather than the healthy subjects While, the healthy people had a higher whole grain consumption.
High carbohydrate intake specially refined sources with high glycemic index (GI) and glycemic load (GL) is associated with increased risk of stroke. Hence, dietary intake requires improvement to provide protection from life threatening outcomes.
Carbohydrate; glycemic index; stroke
Stroke is one of the most common causes of life-threatening disabilities and death around the world. Mortality rate is going to be doubled by 2030 in the Middle East countries. Prevention is a cost-effective approach to decrease risk of stroke. The present study assessed the relationship between dairy intake and stroke risk.
This hospital-based case-control study was directed in a University hospital. The common food consumption of 129 men and women was assessed with food frequency questionnaire (FFQ). The relationship between fermented and non-fermented dairy intake and stroke were assessed between two patient groups.
Total of dairy intake were lower in patients with stroke than control group (13.36 vs 19.61% in men and 11.14 vs 15.02% in women). Similar relationships were observed betweenfermented and non-fermented dairy intake and stroke in both genders.
Lower dairyconsumption can increase stroke risk in men and women.
Dairy; milk; stroke
Stroke is a leading cause of death. Current therapeutic strategies have been unsuccessful. Several studies have reported benefits on reducing stroke risk and improving the poststroke associated functional declines in patients who ate foods rich in fruits and vegetables. Their potential protective effects may be due to their antioxidants, calcium, potassium, riboflavine, peridoxin, riboflavin contents. Folic acid, peridoxin, and riboflavin are all cofactors in hyperhomocysteinemia as a stroke risk factor.Studies suggest that oxidative stress plays important roles in pathogenesis of ischemic cerebral injury and higher intake of antioxidants has been associated with a lower stroke risk. The aim of this study was to examine if the dietary intake of vegetables and fruits in patients with stroke were comparatively worse than those in patients without stroke.
In this case control study, 93 stroke patients admitted to Alzahra hospital were matched for age and sex with 60 patients who were not affected with acute cerebrovascular diseases and did not have a history of stroke. Dietary intake was assessed with a validated food frequency questionnaire.Food intakes were compared between two groups and with recommended value.
Mean daily intake of vegetable and fruits was more in male with stroke than male without stroke as well as calorie intake from vegetables and fruit was higher in male with stroke.Mean daily intake of vegetable and fruits were lower in women with stroke than women without stroke as well as calorie intake from vegetables and fruit was lower in women with stroke
Our findings suggest that increased vegetable and fruits intake may be associated with decreased risk of stroke
Dietary quality; fruit; stroke; vegetable
Obesity is a common health problem around the world. Studies have shown inverse relationship between serum vitamin D levels with obesity among patients and healthy population. The aim of this present study is to examine the relationship between serum vitamin D levels with general and abdominal obesity among migraine patients.
The present study is a cross-sectional and 66 migraine patients aged 19-61 years were included for analysis. Partial correlation was performed to assess association between serum 25-OH-D with general and abdominal obesity. Adjustments were performed for age, sex, and education.
No relationship was found between serum levels of vitamin D with general and abdominal obesity. However, a significant association was shown between waist circumferences (WC) with body mass index (BMI).
Serum levels of 25-OH-D were not associated with WC and BMI. Furthermore, after adjustment for confounder variables, no association was observed.
Association; migraine; obesity; vitamin D
University entrance is accompanied by major changes in social relationship, rules, and expectations that lead to psychological disorders in susceptible students. The goal of this research is to study the anxiety rate in Iranian medical residents in 2010-2011.
This study is a cross-sectional, descriptive study. It contains 370 medical residents from the 1st year to the 4th year of medical universities in Isfahan, Gilan, Zahedan, Sanandaj, and Kashan. The stratified sampling method proportionate to volume of participants is used in this study. The information is collected based on researchers’ questioners and Zung self-rating anxiety scale and analyzed with the use of spss software version 16, addition to descriptive and analytic tests (Pearson, one-way analysis of variance, t-test). Meaningful level is regarded as P ≤ 0.05.
The study showed that more than 92% of residents participated in the study did not demonstrate anxiety. Among 370 subjects 5.5% presented with mild symptoms of anxiety and no one had symptom of severe anxiety. A meaningful statistical relationship was observed between anxiety and sex, major of study and the city of study (P < 0.05). The results showed a positive meaningful relationship between the number of visits and the score of anxiety. On average the number of night floats were two in 1 week and the number of patient visit was 19 in the past 24 h. A meaningful statistical relationship between anxiety score and number of patient visits was observed.
The anxiety rate in medical students in this study compared to the findings of previous studies reveled very low anxiety in medical residents. The low rate of anxiety could be attributed to the sense of job security and the hope for a better future among residents. The high percentage of anxiolytics abuse and absence of anxiety producing factors among residents in addition to inaccurate response to the questionnaire may all contribute to the low rate of anxiety in this study.
Anxiety; medical residents; depression
Quercetin is a health-enhancing antioxidant bioflavonoid (1-3). This flavonoid occurs in variety of natural fruits and vegetables such as apple, cranberry, onion, broccoli, and teas. Many studies have shown that quercetin has possible positive effects on exercise performance. The aim of this study is the evaluation of effects of quercetin supplementation on VO2max and exercise performance in female athletes.
This study was done on 26 young female swimmers. Participants were assigned in to groups and supplemented orally for 8 weeks with either Quercetin (Solaray®, USA, Inc) or placebo (dextrose). Before and after intervention, athletes performed a continuous graded exercise test (GXT) on an electronically braked cycle ergometer (Lode, The Netherlands) to determine VO2max and time to exhaustion (TTE).
Participants in the quercetin group consumed higher energy and protein and lower carbohydrates and fats. There was no significant differences in VO2max, TTE, lactate, and body fat between pre- and post-supplementation neither in the placebo group nor in the quercetin group.
It is concluded that quercetin supplementation (1000 g/day) for 8 weeks in female athletes didn't show any significant association with exercise performance.
Performance; quercetin; swimmers
Young athletes have more nutritional needs than other adolescents because of physical activity and physical development. Optimal athletic performance results from a combination of factors including training, body composition, and nutrition. Despite the increased interest in nutrition and use of dietary supplements to enhance performance, some athletes might be consuming diets that are less than optimal. In wrestling it is common practice to optimize one's body composition and body weight prior to a competition season. This often includes a change in dietary intake or habits.
Twenty-eight wrestlers, between the ages of 17 and 25 years, participated in this study. Dietary intakes of micro and macro nutrients were collected by face-to-face interview, structured food frequency questionnaire (FFQ). Dietary intake of energy, carbohydrates, fats and proteins and micronutrients was evaluated.
Mean intakes of energy, carbohydrates, proteins and fat were higher than recommended dietary allowances (RDA). The mean intakes of all vitamins and minerals were higher than the RDAs in these wrestlers, except for vitamin D, biotin, zinc, iodine, chrome and molybdenum.
On the basis of our results, nutritional education should be given to these subjects and their families for promoting healthy eating habits.
Athletes; dietary behavior; nutritional status; wrestlers
Quercetin, which is considered as a health-promoting antioxidant, belongs to the broad flavonoids group. Numerous experimental studies have proved that quercetin and vitamin C provide anti-inflammatory and antioxidant properties. The aim of this study is to assess the effects of both quercetin and vitamin C on lipid profile and muscle damage in human subjects.
A randomized, placebo-controlled, double-blind clinical trial was carried out on 60 males for eight weeks. The subjects were randomly assigned to one of the four groups: 1) quercetin + vitamin C (500 mg/day quercetin + 200 mg/day vitamin C) 2) quercetin (500 mg/day quercetin + 200 mg/day placebo) 3) vitamin C (500 mg/day vitamin C + 200 mg/day placebo) and 4) placebo (500 mg/day placebo + 200 mg/day placebo). Blood samples, body weight and percent of body fat were measured before and after intervention. In addition, dietary intake was estimated using 24-h recall.
No significant changes occurred in high-density lipoprotein levels between groups and in the four groups before and after supplementation. Low density lipoprotein values decreased significantly (P = 0.048) in the “Quercetin + Vit C” group but decrease was not considerable in other groups before and after intervention and among groups. Fat-soluble vitamins' intake was significantly high among 4 groups.
Quercetin and vitamin C supplementation may not be beneficial in lipid profile improvement, although it may reduce induce muscle damage and body fat percent.
Athletes; lipid profiles; quercetin
Stroke is one of the most common causes of disabilities and death all over the world. The mortality rate of stroke is predicted to be doubled by 2030 in the Middle East countries. Nutrition is an effective strategy in prevention and management of stroke. This study assessed the relationship between various protein types and stroke risk.
Materials and Methods:
This hospital-based case-control study was performed in a University hospital. The data regarding consumption of usual food intake of 69 cases (46 men and 23 women) and 60 controls (30 men and 30 women) was collected with a food frequency questionnaire (FFQ). The mean consumption of red and white meat and vegetable and processed proteins consumption were compared between two groups.
The percent of total of daily protein intake were lower in patients with stroke in both sexes (25.92% vs 30.55% in men and 30.7% vs 31.14% in women).
Lower protein consumption may be observed in patients with stroke patients in both sex.
Meat; protein; stroke; vegetable protein
Experimental studies provide evidence of a relationship between stroke and mineral intake but this information in human are still limited and inconsistent. The purpose of this study was to investigate sodium, calcium and iron intake and stroke in Iranian patient and control population.
Materials and Methods:
In a case-control study with 46 stroke men (aged 56 ± 18 years) and stroke women (aged 52 ± 7 years) and 60 healthy people, we investigated the sodium, calcium and iron intake inthe patients.
After adjustment for age, sex and cardiovascular disease we found that a high sodium intake was associated with a statistically significant higher risk of stroke (P < 0/05). We saw a significant association between iron intakes in men (P < 0/05). And calcium was not significant associated with risk of stroke (P for trend >0/05).
These findings in men and women suggest that a low sodium intake may play a role in primary prevention of stroke.
Calcium; diet; epidemiology; iron; minerals; sodium; stroke
Stroke happens when blood flow to parts of brain stops. Stroke is sometimes called “brain attack.” Risk factor is something that increases the chance of getting a disease. Some risk factors for stroke cannot be changed, but some can be altered. The chance of stroke is higher in people who live an unhealthy lifestyle by: Being overweight as a result of over-eating, eating too much fat, smoking, etc., Therefore, we compared the fat intake between patients with stroke and normal population.
Materials and Methods:
Sixty nine patients with stroke (46 men and 23 women) as cases and 60 subjects (30 men and 30 women) as controls during April 2009 and May 2010 from Alzzahra hospital, Isfahan, Iran were evaluated. Dietary intakes were collected using a food frequency questionnaire (FFQ) through their close relatives such as spouse, daughter or mother. Also, anthropometry measurements such as weight, height and waist extracted from their medical files, however, body mass index (BMI) and waist to hip ratio (WHR) were calculated.
The intake of saturated fatty acids (SFA) and monounsaturated fatty acids (MUFA) both in men and women with stroke were significantly higher than controls (P = 0.04 and P = 0.03 for men and P = 0.05 and P = 0.02 for women, respectively). Also, the mean intake of hydrogenated fats, butter, cream, mayonnaise sauce and nuts were higher in men with stroke with respect in control group; while, women with stroke consumed more hydrogenated fats, vegetable oils, cream and mayonnaise sauce than controls.
Increased fat intake was observed in patients with stroke compared with normal population.
Butter; cream; fat; polyunsaturated fatty acids; stroke; saturated fatty acids; monounsaturated fatty acids
Migraine is common worldwide. In recent years, vitamin D deficiency has been determined as a global health problem. A few studies have shown inverse relationship between serum vitamin D levels and headache. Thus, in this study, we assessed relationship between serum vitamin D levels with migraine.
Materials and Methods:
The present study was a cross-sectional. Seventy-six migraine patients aged 10-61 years were included. The multiple linear regression was used to show association between serum 25-0H-D3 and migraine. Adjustments were performed for age, sex, waist circumference, body mass index (BMI), number of chronic diseases, and education level.
The positive weak relationship was observed between serum vitamin D and headache diary result (P = 0.042, r = 0.19). But, no significant relationship was observed between serum vitamin D and migraine severity (P = 0.741).
High levels of serum 25-OH-D3 was related to higher headache diary result. After adjustment for confounding variables, this significant association remained. No significant relationship was shown between serum vitamin D and migraine severity.
Migraine; relationship; vitamin D
Some epidemiological and interventional studies have shown the role of vitamin D on insulin secretion and resistance. A previous study in our center showed that intramuscular vitamin D decreases insulin sensitivity in pre-diabetic patients. We investigated the role of oral vitamin D on the insulin sensitivity index and insulin resistance in pre-diabetic patients.
Materials and Methods:
In a randomized clinical trial, we divided 45 people with pre-diabetes aged 47.4 ± 6.6 (range 33-61) years into three groups: group A subjects treated with 50,000 IU oral vitamin D and 500 mg calcium carbonate (n = 21), group B subjects treated with a single 300,000 IU intramuscular vitamin D and 500 mg calcium carbonate (n = 9), and group C subjects treated with 500 mg calcium carbonate alone (n = 15). Serum 25-hydroxyvitamin D [25(OH) D] was measured at baseline. If it was less than 75 nmol/l, 50,000 IU vitamin D was given weekly, and if serum 25(OH) D was more than that, vitamin D was administered every 2 weeks. Before and after 12 weeks of treatment, a 75-g glucose tolerance test was performed. We used paired t-test and analysis of variance (ANOVA) to analyze the data. P values less than 0.05 were considered significant.
Mean (SD) of serum vitamin D increased from 77.5 ± 39.2 to 118.8 ± 56.3 nmol/l (P = 0.009) in group A and from 80 ± 36 to 102.8 ± 43.3 nmol/l (P = 0.053) in group B, and decreased from 44.8 ± 18.3 to 34.6 ± 13.9 nmol/l (P = 0.06) in group C. Insulin sensitivity index (Matsuda) decreased from 11.4 ± 3 to 9.9 ± 3.2 (P = 0.046) in group A, but in comparison with other groups, it was not significant.
Oral vitamin D had no effect on insulin sensitivity in pre-diabetes patients in 12 weeks treatment. A randomized double-blind study with a longer duration of treatment is suggested to investigate the effect of vitamin D on insulin resistance.
Glucose tolerance test; insulin resistance; pre-diabetes; vitamin D; vitamin D deficiency
Diabetic muscle infarction (DMI) is an unusual complication of diabetes mellitus. It is usually seen in long-standing diabetes mellitus. This article presents a case of DMI in the left forearm of a 58-year-old woman. She had a swollen forearm. The level of creatine kinase was 5930 U/L. Her condition was initially suspected for either cellulitis or venous thrombosis. A magnetic resonance imaging (MRI) study of the forearm showed diffuse edema and abnormal signals of the left forearm. The diagnosis of DMI was made. She was treated conservatively and her symptoms resolved within a short period of time. DMI should be considered as a differential diagnosis of any painful and swollen limb in diabetic patients.
Diabetes mellitus; infarction; muscle
We investigated the effect of acute hypothyroidism on lipid concentrations especially on high density lipoprotein (HDL-cholesterol) level in athyroatic patients.
Materials and Methods:
Thirty-one patients, with a history of differentiated thyroid carcinoma and total thyroidectomy, who were candidates of radioiodine therapy, enrolled in the study. Their lipid profiles and serum thyrotropin stimulating hormone (TSH) levels were measured before and two-to-six weeks after thyroid hormone withdrawal. The lipid concentrations were compared with the paired t test and serum TSH using the Wilcoxon singed rank test. P values < 0.05 were considered statistically significant.
The median of TSH concentration was 0.06 mU / liter on thyroid hormone suppressive therapy and 102 mU / liter at the thyroid hormone withdrawal phase (P < 0.0001). The serum concentrations of all lipids were significantly increased after withdrawal (P < 0.0001). The mean (SD) of the HDL-cholesterol concentration rose from 44 ± 9 mg / dL to 58 ± 17 mg / dL. The levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride increased by 58, 75, 30, and 59%, respectively, during acute hypothyroidism.
The present study showed that thyroid hormone withdrawal altered the lipid concentrations significantly, in a short period of time. The levels of both atherogenic (LDL-cholesterol) and cardioprotective (HDL-cholesterol) particles increased concurrently. Their clinical importance should be investigated in future.
Cholesterol-HDL; hypothyroidism; lipid metabolism; thyroid hormones; thyroid neoplasms
Systemic lupus involves different body organs including lungs. However, there is limited information on the systemic lupus without respiratory symptoms. The aim of this study was to investigate the diffusing capacity of the lung for carbon monoxide in women with disseminated lupus erythematosus and to compare it with a control group.
This prospective study was conducted during 2005 in the Rheumatology Clinic of Alzahra Hospital, Isfahan, Iran. The diffusing capacity of the lung for carbon monoxide and pulmonary parameters were measured using the unrelated samples in 76 female patients with systemic lupus.
Mean diffusing capacity of the lung for carbon monoxide in patients with lupus was lower than the control group (P ≤ 0.001). The amount of corrected volumetric capacity of carbon monoxide in lungs of patients was significantly different from the control group (P ≤ 0.001). Residual volume and total capacity of lungs in the female patients with lupus were higher than the control group (P ≤ 0.001).
Decreased diffusing capacity for carbon monoxide in lungs of females with systemic lupus without respiratory symptoms is prevalent. It indicates alveolar capillary membrane involvement in these patients. Increased residual volume and total capacity of lungs in these patients can be caused by bronchiolitis.
Lupus Erythematosus; Transfer Capacity; Carbon Monoxide in Lungs; Total Capacity of Lungs
This study aimed to compare different body mass index (BMI) categories in individuals with diabetes, prediabetes and normal glucose tolerance among the first degree relatives of type 2 diabetic patients.
Materials and Methods:
A cross-sectional study was conducted during 2005-2007 in Isfahan, Iran. It evaluated 3323 first-degree relatives of diabetic patients selected by consecutive convenient sampling method. Participants were classified as diabetic, prediabetic, and normal glucose tolerance test groups according to the results of 75 g oral glucose tolerance test (OGTT). The analysis of variance (ANOVA) was used for comparison of quantitative variables, and chi square test for comparison of categorical parameters.
The study population consisted of 3323 individuals including 306 diabetics (98 males and 208 females), 1309 prediabetics (337 males and 972 females), and 1708 normal subjects (430 males and 1278 females). Among diabetic patients, the prevalence of obesity was 48.5% in women and 27.6% in men. Among prediabetics, the corresponding figures were 45.6% and 27.3%, respectively.
Our findings suggest that men are diagnosed with T2DM at lower BMI than women. Moreover, the alarming high prevalence of overweight and obesity among females necessitates preventing and controlling this underlying problem among females.
Diabetes Mellitus; Family History; Glucose Tolerance Test; Obesity; Prevention
Determination of vitamin D status in different age-groups in a community and in different climates of a country is necessary and has important implications for general health. The study was conducted to determine the prevalence of vitamin D deficiency among the adult population of Isfahan, a centrally-located city in Iran. In this cross-sectional study, 1,111 healthy people—243 men and 868 women—aged 41.4 (mean 14 and range 20-80) years, who attended a single-consultation outpatient clinic, were selected. Serum 25-hydroxy vitamin D (25-OHD), parathyroid hormone (PTH), calcium and phosphorus concentrations were measured. Mild, moderate and severe vitamin D deficiencies were defined as 25-OHD values of 20-30 ng/mL, 10-20 ng/mL, and <10 ng/mL respectively. The median (range) concentrations of 25-OHD were 21 (4.0-105.0) ng/mL in males and 18 (1.5-117) ng/mL in females (p=0.05). The prevalence of mild, moderate and severe vitamin D deficiencies among the adult population was 19.6%, 23.9%, and 26.9% respectively. Vitamin D deficiency was more prevalent among women (p=0.001) and younger age-group (p=0.001). Medians of 25-OHD in spring-summer and autumn-winter were 21 ng/mL and 18 ng/mL respectively (p=0.005). The prevalence of severe vitamin D deficiency was higher in autumn-winter than in spring-summer (odds ratio=1.6, 95% confidence interval 1.2-2.2, p=0.001). The prevalence of vitamin D deficiency was high in a sunny city—Isfahan— especially among women and younger population. The high prevalence of vitamin D deficiency in this city emphasizes the necessity of vitamin D supplementation as more exposure to sun is limited due to the type of clothing required by current law.
Adult; Cross-sectional studies; Parathyroid hormone; Seasonal variation; Vitamin D deficiency; Iran
The aim of this study is to investigate the need for diabetes primary prevention program in isolated impaired fasting glucose (i-IFG) of the first degree relatives of type 2 diabetics.
In a cross sectional study, 793 individuals with prediabetes [543 with i-IFG and 250 with isolated impaired glucose tolerance (i-IGT)] who were the first degree relatives of type 2 diabetic patients, were enrolled. Isolated IFG was considered as fasting plasma glucose between 100-125 mg/dl and 2 hour plasma glucose < 140 mg/dl and isolated IGT as FPG < 100 mg/dl and 2 hour plasma glucose between 140-199 mg/dl during an overnight fasting 75 g oral glucose tolerance test. Mean of the age, weight, waist circumference, body mass index, systolic and diastolic blood pressure, plasma glucose, HbA1C, and lipid profile were compared between two groups (i-IFG and i-IGT). The prevalence of cardiometabolic risk factors (BMI ≥ 25 kg/m2, hypertension, cholesterol ≥ 200 mg/dl, LDL-C ≥ 100 mg/dl, HDL-C ≤ 40 mg/dl, and triglyceride ≥ 150 mg/dl) adjusted by age, sex and BMI were compared.
The prevalence of cardiometabolic risk factors is higher in i-IFG group than i-IGT. The mean level of LDL-C is significantly higher in i-IFG than i-IGT group.
First degree relatives of T2DM with isolated impaired fasting glucose should probably be included in the primary preventive program for diabetes. However, longitudinal cohort study is required to show high progression of i-IFG to T2DM.
Prediabetic States; Diabetes Mellitus; Type II; Oral Glucose Tolerance Test; Primary Prevention; Dyslipidemia; Risk Factor; Iran