Consumption of milk and dairy products in Iranian population; barriers and facilitators

A qualitative study to explore and identify reasons for dairy consumption and non-consumption among young adults (18-30 years old) in the UK and France

The aim of this study was to explore and identify why young adults aged between 18 and 30 years in the UK and France do or do not consume dairy products. Several studies have associated dairy products with a healthy diet, and the production of soft dairy, i.e. milk, yoghurt, and soft cheese, as more environmentally friendly than some other animal-based products. Yet recent reports highlight that dairy intake is lower than recommended for health, especially among young adults. Using a qualitative methodology, forty-five participants aged 18-30 years (UK: n = 22; France: n = 23) were asked about their reasons for (non)consumption of a wide range of dairy products. Audio-recorded focus groups and individual interviews were conducted in English in the UK and in French in France, transcribed and coded. A thematic analysis found four themes and sixteen sub-themes (theme product-related: sub-themes sensory, non-sensory, composition; theme individual-related: sub-themes mode of consumption, preferences, personal reasons, knowledge, attitudes and concerns, needs or cravings; theme cultural aspects: sub-themes product categorization, social norms, use; theme market offering: sub-themes alternative, packaging, value for money, availability) to influence participants' dairy (non)consumption in both countries. A seventeenth sub-theme (theme cultural aspects: sub-theme structure of the meal) was found to influence dairy consumption only in France. Further studies are needed to investigate these themes within larger samples, but these findings contribute to understanding dairy (non)consumption in young adults in the UK and France and may aid the development of strategies to improve young adults' diets.

Dietary changes during the COVID-19 lockdown in Iranian households: are we witnessing a secular trend? A narrative review

Background

The COVID-19 pandemic, which emerged in late 2019, influenced nearly all aspects of human life, including food choices and dietary habits.

Methodology

A web-based search was conducted from March to April 2024 in MEDLINE/PubMed, CINAHL, Embase, and the Cochrane Library for published reports of large-scale surveys of dietary changes during or shortly after the coronavirus pandemic lockdown in Iran. The keywords used were coronavirus OR COVID-19, diet OR nutrition, household, and Iran. Studies that focused on specific areas, subgroups (such as students), or just one city or province were not included. To monitor dietary changes from the years before the lockdown, we used and plotted data from the Household Income and Expenditure Survey (HIES), as provided by the Statistical Center of Iran.

Results

The overall results of the nationwide studies conducted during the lockdown period in Iran revealed that a significant proportion of the households reduced their consumption of milk, yogurt, cheese, red meat, white meat, eggs, and rice/bread. In approximately 47% of the households where weekly consumption of animal protein sources decreased, the consumption of rice and bread increased. Accordingly, 35 and 44% of households reported a decrease in the consumption frequency of fruits and snacks, respectively. Additionally, 21% of those who reduced their fruit consumption completely removed fruits from their food basket. Meanwhile, the use of dietary supplements, especially vitamin D, vitamin C, zinc, and multivitamins, had increased in households, particularly among those with higher incomes. Decreased income was a common reason for all of these dietary changes, which can have major health consequences in the long term.

Conclusion

This review provides evidence that the observed changes had already begun years before the pandemic and presumably have not yet returned to the pre-pandemic situation. Finally, we suggest some strategies for policymakers to overcome the crisis and enhance community the nutrition and health of general population.

Burden of colorectal cancer and its risk factors in the North Africa and Middle East (NAME) region, 1990-2019: a systematic analysis of the global burden of disease study

OBJECTIVE

The geographical differences in incidence rates of colorectal cancer (CRC) and its burden due to modifiable risk factors warrant investigating the CRC burden and its risk factors in different regions. In the current study, we aimed to estimate the burden of CRC and the share of its risk factors in the North Africa and Middle East (NAME), from 1990 to 2019.

STUDY DESIGN

Systematic review.

METHODS

The rates of incidence, prevalence, death, years of life lost (YLL), years lived with disability (YLD), and disability adjusted life years (DALYs) of CRC were estimated through the framework of the Global Burden of Diseases (GBD), Injuries and Risk Factors Study 2019 by age, sex, between 1990 and 2019. The CRC-related DALYs attributable to each lifestyle and metabolic risk factor was also estimated through a comparative risk assessment approach.

RESULTS

In NAME region, the trends of incidence, prevalence, death, YLL, YLD, and DALYs of CRC were increasing, with higher rates in males than females over this period. High and high-middle socio-demographic index (SDI) countries had greater CRC DALYs rate compared with middle- and low-SDI countries in 2019, except for Palestine [434.66 (95% UI: 368.82, 503.88)]. In NAME region, like the global, dietary risk (33.18%), low whole grain intake (19.79%), and low intake of milk (15.77%) were the major contributing risk factors to DALYs due to CRC in 2019.

CONCLUSIONS

Due to increasing trend of CRC burden and the considerable role of lifestyle and metabolic factors in its burden in NAME region, implementing fundamental strategies to minimize CRC burden and its risk factors is imperative.

A 30-year trend of dairy consumption and its determinants among income groups in Iranian households

Introduction

Milk and dairy products provide essential nutrients and have the potential to prevent chronic diseases, thus reducing healthcare costs. However, there is a lack of consistent and updated data on dairy consumption trends in Iran. This study aims to analyze the trends in dairy consumption among Iranian households from 1991 to 2021, focusing on household-level determinants across different expense groups.

Methods

The study uses data from the Iranian Household Expenditure and Income Survey conducted annually from 1991 to 2021 to analyze households' dairy consumption. The data includes values and expenses of food and non-food items purchased in the previous month, as well as demographic characteristics of household members. The households were categorized into 10 deciles based on their gross expense. The econometric model used weighted mean per capita milk, yogurt, cheese, and total dairy consumption based on milk equivalent for each decile. The model takes into account changes in income, prices, household composition, education level, occupation, and residency area using panel data. Data preparation and model estimation were performed using RStudio and STATA17 software.

Results

Based on the findings, in 1991, per capita milk, yogurt, and cheese consumption were 26.77 kg, 16.63 kg, and 2.42 kg, respectively. By 2021, these figures changed to 22.68 kg, 11.06 kg, and 3.79 kg, reflecting a decrease in milk and yogurt consumption but an increase in cheese consumption. Family size was positively correlated with yogurt consumption and head of the household spouse's job score were positively correlated with milk, yogurt and cheese consumption. Also, the presence of under five-year-old children and older adults members (over the age of 60) in the household was inversely related with yogurt and cheese consumption. Female-headed households tended to purchase more cheese, while their milk purchase level was significantly lower. Residing in urban areas was negatively related to milk, while cheese and total dairy consumption was higher in urban areas.

Discussion

The findings highlight the importance of targeted dairy subsidy interventions and educational programs to improve dairy consumption in Iranian households, especially among vulnerable groups. This will require urging policymakers and food system stakeholders for effective strategies that address macro-level factors to promote dairy consumption.

Insulinaemic potential of diet and lifestyle and risk of type 2 diabetes in the Iranian adults: result from Yazd health study

BACKGROUND

Previous studies have shown that insulin directly affects the risk of type 2 diabetes mellitus (T2DM) but the relationship between insulinaemic potential of diet and lifestyle and the T2DM risk is still unknown. Accordingly, we aimed to investigate the relationship between the insulinaemic potential of diet and lifestyle based on indices including empirical dietary index for hyperinsulinaemia (EDIH), empirical lifestyle index for hyperinsulinaemia (ELIH), empirical dietary index for insulin resistance (EDIR) and empirical lifestyle index for insulin resistance (ELIR) and the T2DM risk in the Iranian adults.

METHODS

This study was performed on data of enrollment phase of the Yazd Health Study (YaHS) and TAghzieh Mardom-e-Yazd (Yazd Nutrition Study) (TaMYZ) on 5714 adults aged 20-70 years (mean: 36.29 years). A validated food frequency questionnaire and clinical tests were used to assess food intake and T2DM ascertainment, respectively. We used the Cox regression analysis for determining the relationship between the indices and T2DM risk.

RESULTS

After adjusting for confounding variables, our findings showed that diet with higher ELIH score is 2.28 times more likely for T2DM risk (RR 2.28 [95% CI 1.69-2.56]), but there was no significant relationship between the EDIH, ELIR and EDIR scores and T2DM risk in adults, in the entire study population.

CONCLUSIONS

Our findings suggest that diets with higher ELIH score increases the T2DM risk, but there was no significant relationship between the EDIH, ELIR and EDIR scores and T2DM risk. Further epidemiological studies are needed to confirm our findings.

Graduate Student Literature Review: A scoping review on the impact of consumption of dairy products on phosphatidylcholine and lysophosphatidylcholine in circulation and the liver in human studies and animal models

Dairy consumption is inversely related to the risk of developing type 2 diabetes in epidemiological research. One proposed hypothesis is that phospholipid (PL) species associated with dairy consumption mediate this relationship. This scoping review aimed to identify the existing literature in animal and human trials investigating the impact of dairy products, including milk, yogurt, and cheese as well as dairy-derived PL supplementation on PL and its species in the circulation, summarizing the characteristics of these studies and identifying research gaps. A systematic search was conducted across 3 databases (PubMed, Scopus, and Web of Science) in March 2021. Of 2,427 identified references, 15 studies (7 humans and 8 animal studies) met the eligibility criteria and were included in the final narrative synthesis. The evidence base was heterogeneous, involving a variety of clinical and preclinical studies, metabolically healthy or obese/diabetic participants or animal models, and displayed mixed findings. Circulating postprandial concentrations of total PL were elevated acutely but unchanged after longer intervention with dairy products. The PL concentration remained stable even after a high dosage of milk supplemented with dairy-derived PL, which may be related to increased fecal excretion; however, certain phosphatidylcholine (PC) or lysophosphatidylcholine species were increased in circulation by interventions. These include several PC species with 32 to 38 total carbons in addition to the dairy biomarkers C15:0 and C17:0. The results of this scoping review demonstrate a small body of literature indicating that dairy products can influence blood concentrations of PC and lysophosphatidylcholine species in both rodents and humans without alteration of total PL and PC. There is a lack of well-designed trials in humans and animals that explore the potential differences between individual dairy foods on PL species. In addition, trials to understand the bioactive properties of PC and lysophosphatidylcholine species on cardiometabolic risk are needed.

COVID-19 epidemic lockdown-induced remarkable decrease in dairy products consumption of Iran population: does it really matter? National Food and Nutrition Surveillance

Background

The pandemic of the newly emerged coronavirus infection and its related disease, Covid-19, has influenced various aspects of human life including dietary habits. This study aimed to examine changes in dairy products consumption during Covid-19 lockdown period in a huge sample of Iranian households.

Methods

A cross-sectional descriptive-analytical study using a web-based electronic self-administered questionnaire designed to detect any changes in the consumption frequency of dairy products in the Iranian households during Covid-19 lockdown.

Results

A total of 21,290 households were enrolled. During Covid-19 epidemic lockdown, about 29%, 26% and 7% of the households had decreased their consumption frequency of milk, yogurt and cheese, respectively. The female-headed households were 21% more likely to decrease their consumption of milk, compared with male-headed households (OR = 1.21, 95% CI: 1.05–1.4). The households residing in food insecure provinces were 29%, 20% and 45% more likely to decrease their consumption of milk, yogurt and cheese as compared with those living in the food secure provinces. About 37%, 25.3%, 19.4% of those households who reported a decrease in consumption of dairy products had fully omitted them.

Conclusion

We found considerable decrement of dairy products consumption, especially milk and yogurt, in a high proportion of the studied households. Inadequate intake and, in some households, omission of dairy products can potentially bring about serious health outcomes with heavier economic burden. Further studies to track these changes over time and to evaluate their health consequences are warranted.

Consumption of Yoghurt and Other Dairy Products and Risk of Colorectal Cancer in Iran: The IROPICAN Study

BACKGROUND

There is evidence of an inverse association between yoghurt intake and risk of colorectal cancer (CRC). We aimed at investigating the association between the intake of yoghurt and other dairy foods consumed in Iran and CRC risk.

METHODS

Our analysis included 4070 subjects within the IROPICAN (Iran Study of Opium and Cancer) study. Detailed information was collected by the use of validated questionnaires. We estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between the intake of total dairy products, and, separately, of yoghurt, milk, cheese, kashk, dough, cream, ice cream, and other milk products, and CRC using unconditional logistic regression analyses. The intake was categorized in tertiles.

RESULTS

Overall, we analyzed 865 cases and 3205 controls. Total dairy products intake was not associated with CRC. The OR for one tertile increase (OR_T) in yoghurt intake was 0.97 (95% CI 0.87-1.08) for CRC and 0.66 (95% CI 0.52-0.84) for proximal colon cancer. Cream intake was associated with CRC (OR_T3 = 1.33, 95% CI 1.08-1.64), colon (OR_T3 = 1.37, 95% CI 1.03-1.81), and proximal cancer (OR_T3 = 1.29, 95% CI 1.04-1.61). The OR of distal colon cancer for ice cream intake was 0.59 (95% CI 0.43-0.82). Other dairy products were not associated with CRC risk.

Evaluation of Virulence Factors, Antibiotic Resistance, and Biofilm Formation of Escherichia coli Isolated from Milk and Dairy Products in Isfahan, Iran

Diarrheagenic E. coli (DEC) strains are important causes of gastrointestinal diseases worldwide, especially in developing countries. This study aimed to investigate the presence, antibiotic resistance, and potential biofilm formation in dairy products in Isfahan, Iran. A total of 200 samples, including traditional and pasteurized dairy products, were analyzed. In 200 samples, 54 E. coli isolates, including (48/110) and (6/90) positive samples of traditional and pasteurized dairy products, were detected. Furthermore, pathogenic strains were isolated from 30% of traditional dairy products and 5.55% of pasteurized dairy products. Most isolates were classified as enteropathogenic E. coli (EPEC). Moreover, antibiotic resistance was evaluated using the disk diffusion method for pathogenic E. coli. Overall, 73.68% of contaminated samples by pathogenic strains were resistant to at least one antibiotic. The highest resistance was observed against streptomycin (57.9%), followed by tetracycline (50%). Additionally, all isolates were sensitive to amikacin. For evaluating biofilm formation, the violet crystal assay was applied on a polystyrene microplate well for pathogenic isolates. In total, 68.42% of isolates were able to form biofilms. The presence of E. coli in dairy products indicates potential health risks for Iranian consumers. Serious measures are needed to control and prevent the spread of this pathogen.