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1.  Validity of Energy Intake Reports in Relation to Dietary Patterns 
The role of under- and overreporting of energy intake in determining the dietary patterns is yet unclear, especially in the Middle Eastern countries. This study identifies the prevalence of misreporting among Tehranian women aged 18-45 years and to compare the dietary intake patterns of plausible and all energy reporters. Dietary intakes and anthropometric data were collected. FitMate™ metabolic analyzer and Goldberg equation were used in determining the under/overreporting of energy intake. Underreporters were more likely to be overweight and older compared to plausible reporters. Three dietary patterns emerged for all reporters, and two were identified for plausible reporters. Using only plausible reporters to determine dietary patterns was not similar to using all reporters. The proportion of underreporters was 59.3% in the mixture cluster, 30.4% in the unhealthy cluster, and 35.3% in the healthy cluster (p<0.05). Underreporting of energy intake is not uniformly distributed among dietary pattern clusters and tends to be less severe among subjects in the unhealthy cluster. Our data suggested that misreporting of energy intake might affect the dietary pattern analysis.
PMCID: PMC4089070  PMID: 24847591
Dietary patterns; Energy underreporting; Validity; Women; Iran
2.  Relationship between dietary approaches to stop hypertension score and presence or absence of coronary heart diseases in patients referring to Imam Hossein Hospital, Tehran, Iran 
ARYA Atherosclerosis  2013;9(6):319-325.
BACKGROUND
The dietary approaches to stop hypertension (DASH) dietary pattern reduces blood pressure. However, there is little information about the relationship between DASH and coronary heart diseases. This study aimed to assess the relationship between a DASH-style diet adherence score and coronary heart diseases (CHD) in patients referring for coronary angiography.
METHODS
In this study, 201 adults (102 males, 99 females) within the age range of 40-80 years who referred for coronary angiography were selected. Diet was evaluated using a validated food frequency questionnaire. DASH score was calculated based on 8 food components (fruits, vegetables, whole grains, nuts and legumes, low fat dairy, red/processed meats, soft drinks/sweets, and sodium). The relationship between DASH score and CHD was assessed using logistic regression analysis.
RESULTS
Mean of DASH score was 23.99 ± 4.41. Individuals in the highest quartile of DASH score were less likely to have CHD [odds ratio (OR) = 0.38, 95% confidence interval (CI): 0.16-0.86]. However, after adjustment for gender or smoking, there was little evidence that coronary heart disease was associated with DASH diet score. There was a significant negative correlation between DASH score and diastolic blood pressure (P ≤ 0.05).
CONCLUSION
In conclusion, having a diet similar to DASH plan was not independently related to CHD in this study. This might indicate that having a healthy dietary pattern, such as DASH pattern, is highly related to gender (dietary pattern is healthier in women than men) or smoking habit (non-smokers have healthier dietary pattern compared to smokers).
PMCID: PMC3933053  PMID: 24575133
Coronary Heart Disease; Dietary Approach to Stop Hypertension; Blood Pressure
3.  Effects of Zinc Supplementation in Patients with Major Depression: A Randomized Clinical Trial 
Iranian Journal of Psychiatry  2013;8(2):73-79.
Objective
Major depression is a mood disorder that causes changes in physical activity, appetite, sleep and weight. Regarding the role of zinc in the pathology of depression, the present study was aimed to investigate the effects of zinc supplementation in the treatment of this disease.
Methods
This study was a double-blind randomized clinical trial. Forty four patients with major depression were randomly assigned to groups receiving zinc supplementation and placebo. Patients in Zinc group received daily supplementation with 25 mg zinc adjunct to antidepressant; Selective Serotonin Reuptake Inhibitors (SSRIs), while the patients in placebo group received placebo with antidepressants (SSRIs) for twelve weeks. Severity of depression was measured using the Beck Depression Inventory at baseline and was repeated at the sixth and twelfth weeks. ANOVA with repeated measure was used to compare and track the changes during the study.
Results
The mean score of Beck test decreased significantly in the zinc supplement group at the end of week 6 (P < 0.01) and 12 (P < 0.001) compared to the baseline. The mean score of Beck Depression Inventory reduced significantly compared to the placebo group at the end of 12th week (P < 0.05)
Conclusion
The results of the present study indicate that zinc supplementation together with SSRIs antidepressant drug improves major depressive disorders more effectively in patients with placebo plus antidepressants (SSRIs).
PMCID: PMC3796297  PMID: 24130605
Major depressive disorder; Zinc supplement; placebo and Selective Serotonin Reuptake Inhibitors (SSRIs)
4.  Dietary patterns and risk of colorectal cancer in Tehran Province: a case–control study 
BMC Public Health  2013;13:222.
Background
Colorectal cancer is the third and fourth leading cause of cancer incidence and mortality among men and women, respectively in Iran. However, the role of dietary factors that could contribute to this high cancer incidence remains unclear. The aim of this study was to determine major dietary patterns and its relationship with colorectal cancer.
Methods
This case–control study was conducted in four hospitals in Tehran city of Iran. A total of 71 patients (35 men and 36 women, aged 40–75 years) with incident clinically confirmed colorectal cancer (CRC) and 142 controls (70 men and 72 women, aged 40–75 years) admitted to hospital for acute, non-neoplastic diseases were recruited and interviewed. Dietary data were assessed by 125-item semi-quantitative food frequency questionnaire. Multivariate logistic regression was used to estimate the relationship between dietary patterns and risk of colorectal cancer.
Results
Two major dietary patterns (Healthy pattern and Western pattern) were derived using principal component analysis. Each dietary pattern explained 11.9% (Healthy pattern) and 10.3% (Western pattern) of the variation in food intake, respectively. After adjusting for confounding factors, the Healthy dietary pattern was significantly associated with a decreased risk of colorectal cancer (OR= 0.227; 95% CI=0.108–0.478) while an increased risk of colorectal cancer was observed with the Western dietary pattern (OR=2.616; 95% CI= 1.361-5.030).
Conclusion
Specific dietary patterns, which include healthy and western patterns, may be associated with the risk of colorectal cancer. This diet-disease relationship can be used for developing interventions that aim to promote healthy eating for the prevention of chronic disease, particularly colorectal cancer in the Iranian population.
doi:10.1186/1471-2458-13-222
PMCID: PMC3605096  PMID: 23497250
Western dietary pattern; Healthy dietary pattern; Colorectal cancer; Case–control study; Iranian adults
5.  The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial 
Background:
Nearly 50% of older adults have insomnia, with difficulty in getting to sleep, early awakening, or feeling unrefreshed on waking. With aging, several changes occur that can place one at risk for insomnia, including age-related changes in various circadian rhythms, environmental and lifestyle changes, and decreased nutrients intake, absorption, retention, and utilization. The natural N-methyl-D-aspartic acid (NMDA) antagonist and GABA agonist, Mg2+, seems to play a key role in the regulation of sleep. The objective of this study was to determine the efficacy of magnesium supplementation to improve insomnia in elderly.
Materials and Methods:
A double-blind randomized clinical trial was conducted in 46 elderly subjects, randomly allocated into the magnesium or the placebo group and received 500 mg magnesium or placebo daily for 8 weeks. Questionnaires of insomnia severity index (ISI), physical activity, and sleep log were completed at baseline and after the intervention period. Anthropometric confounding factors, daily intake of magnesium, calcium, potassium, caffeine, calories form carbohydrates, and total calorie intake, were obtained using 24-h recall for 3 days. Blood samples were taken at baseline and after the intervention period for analysis of serum magnesium, renin, melatonin, and cortisol. Statistical analyses were performed using SPSS19 and P values < 0.05 were considered as statistically significant.
Results:
No significant differences were observed in assessed variables between the two groups at the baseline. As compared to the placebo group, in the experimental group, dietary magnesium supplementation brought about statistically significant increases in sleep time (P = 0.002), sleep efficiency (P = 0.03), concentration of serum renin (P < 0.001), and melatonin (P = 0.007), and also resulted in significant decrease of ISI score (P = 0.006), sleep onset latency (P = 0.02) and serum cortisol concentration (P = 0.008). Supplementation also resulted in marginally between-group significant reduction in early morning awakening (P = 0.08) and serum magnesium concentration (P = 0.06). Although total sleep time (P = 0.37) did not show any significant between-group differences.
Conclusion:
Supplementation of magnesium appears to improve subjective measures of insomnia such as ISI score, sleep efficiency, sleep time and sleep onset latency, early morning awakening, and likewise, insomnia objective measures such as concentration of serum renin, melatonin, and serum cortisol, in elderly people.
PMCID: PMC3703169  PMID: 23853635
Dietary supplementation; elderly; insomnia; magnesium
6.  Macronutrients, vitamins and minerals intake and risk of esophageal squamous cell carcinoma: a case-control study in Iran 
Nutrition Journal  2011;10:137.
Background
Although Iran is a high-risk region for esophageal squamous cell carcinoma (ESCC), dietary factors that may contribute to this high incidence have not been thoroughly studied. The aim of this study was to evaluate the effect of macronutrients, vitamins and minerals on the risk of ESCC.
Methods
In this hospital-based case-control study, 47 cases with incident ESCC and 96 controls were interviewed and usual dietary intakes were collected using a validated food frequency questionnaire. Data were modeled through unconditional multiple logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), controlling for age, sex, gastrointestinal reflux, body mass index, smoking history (status, intensity and duration), physical activity, and education.
Results
ESCC cases consumed significantly more hot foods and beverages and fried and barbecued meals, compared to the controls (p < 0.05). After adjusting for potential confounders, the risk of ESCC increased significantly in the highest tertiles of saturated fat [OR:2.88,95%CI:1.15-3.08], cholesterol [OR:1.53, 95%CI: 1.41-4.13], discretionary calorie [OR:1.51, 95%CI: 1.06-3.84], sodium [OR:1.49,95%CI:1.12-2.89] and total fat intakes [OR:1.48, 95%CI:1.09-3.04]. In contrast, being in the highest tertile of carbohydrate, dietary fiber and (n-3) fatty acid intake reduced the ESCC risk by 78%, 71% and 68%, respectively. The most cancer-protective effect was observed for the combination of high folate and vitamin E intakes (OR: 0.02, 95%CI: 0.00-0.87; p < 0.001). Controls consumed 623.5 times higher selenium, 5.48 times as much β-carotene and 1.98 times as much α-tocopherol as the amount ESCC cases consumed.
Conclusion
This study suggests that high intake of nutrients primarily found in plant-based foods is associated with a reduced esophageal cancer risk. Some nutrients such as folate, vitamin E and selenium might play major roles in the etiology of ESCC and their status may eventually be used as an epidemiological marker for esophageal cancer in Iran, and perhaps other high-risk regions.
doi:10.1186/1475-2891-10-137
PMCID: PMC3260093  PMID: 22185224
Esophageal squamous cell carcinoma; macronutrients; vitamins; minerals; Iran
7.  The Association of General and Central Obesity with Major Dietary Patterns in Adult Women Living in Tehran, Iran 
ARYA Atherosclerosis  2010;6(1):23-30.
BACKGROUND
Using dietary pattern analysis method could provide more information about nutritional etiology of chronic disease such as obesity. The aim of this study is to determine the association between major dietary patterns and general and central obesity among adult women living in Tehran.
METHODS
A cross-sectional study was conducted in Tehran, Iran, with 460 women aged 20-50 years. Dietary intake in last year was collected by a semi-quantitative food frequency questionnaire. Weight, height and waist circumstance (WC) were measured with standard methods and body mass index (BMI) was calculated. General obesity was defined as BMI ≥ 30 kg/m2 and central obesity as WC ≥ 88 cm. Factor analysis was used for identifying major dietary patterns. The association between major dietary patterns and general and central obesity were assessed by logistic regression analysis.
RESULTS
Two major dietary patterns were extracted: "Healthy" and "Unhealthy" dietary pattern. After adjusting for confounders, individuals in the highest quartile of the unhealthy dietary pattern score were more likely to be generally (OR = 7.33, 95% CI: 2.39-22.51) and centrally obese (OR = 4.99, 95% CI: 2.08-11.94); whereas, those in the upper quartile of healthy dietary pattern were less likely to be generally (OR = 0.38, 95% CI: 0.15-0.98) and centrally obese (OR = 0.33, 95% CI: 0.16-0.71).
CONCLUSION
Major dietary patterns of Tehrani women had a significant association with general and central obesity. Further prospective researches are required to confirm such associations.
PMCID: PMC3347807  PMID: 22577409
Dietary patterns; Factor analysis; Obesity; Women; Iran

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