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Roustaee R, Eini-Zinab H, Ghodsi D, Mehrparvar Hosseini E, Omidvar N, Hosseini H, Hosseini Mousavi SO, Rafiee H. A 30-year trend of dairy consumption and its determinants among income groups in Iranian households. Front Public Health 2024; 12:1261293. [PMID: 38425466 PMCID: PMC10903262 DOI: 10.3389/fpubh.2024.1261293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
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.
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Affiliation(s)
- Roshanak Roustaee
- Department of Community Nutrition, Faulty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faulty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delaram Ghodsi
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Nasrin Omidvar
- Department of Community Nutrition, Faulty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedayat Hosseini
- Department of Food Science and Technology, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Omid Hosseini Mousavi
- Department of Community Nutrition, Faulty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Rafiee
- Department of Agricultural Economics, University of Tehran, Tehran, Iran
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Pourebrahim F, Omidvar N, Rezazadeh A, Eini-Zinab H, Shirani P, Ghodsi D. Food security and its association with socioeconomic status and dietary diversity in free living older people in Tehran, Iran. BMC Geriatr 2024; 24:128. [PMID: 38308219 PMCID: PMC10836019 DOI: 10.1186/s12877-024-04705-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 01/11/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Food security is a function of food access and dietary diversity. Older age is a period when adequate and diverse dietary intake is a challenge. This study aimed to investigate the association between food security on the one hand and dietary diversity and socioeconomic factors on the other hand among the free-living older people in the city of Tehran. METHODS In this cross-sectional study, 583 older people, aged 60-80 years living in Tehran city, were selected through the systematic cluster sampling method. Food security was determined by the United States Household Food Security Survey Module (US-HFSSM (.Socioeconomic status (SES) and two 24-h recalls were obtained. Dietary Diversity Score (DDS) was calculated using the FAO 2010 guideline. Multinomial logistic regression was applied. RESULTS The average age of participants was 67.87 ± 5.86 years. Based on US-HFSSM, 56.9% of older people were food secure; while 25.7%, 14.2% and 3.2% suffered from food insecurity (FI) without hunger, with moderate hunger, and with severe hunger, respectively. There was no association between FI and DDS, even after controlling for confounders. FI with mild hunger was associated with household income (OR = 2.744, 95% CI = 1.100-6.846), while FI with severe hunger was associated with Fars ethnicity (OR = 0.146, 95% CI = 0.051-0.424). CONCLUSIONS Overall, socio-economic status and demographic characteristics were the predictors of FI among older people. The findings can have implication in design and targeting of interventions directed at older people.
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Affiliation(s)
- Fatemeh Pourebrahim
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 46, Hafezi Street, Farahzadi Boulevard, Sharak Ghods, P.O. Box: 1981619573, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 46, Hafezi Street, Farahzadi Boulevard, Sharak Ghods, P.O. Box: 1981619573, Tehran, Iran.
| | - Arezoo Rezazadeh
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 46, Hafezi Street, Farahzadi Boulevard, Sharak Ghods, P.O. Box: 1981619573, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 46, Hafezi Street, Farahzadi Boulevard, Sharak Ghods, P.O. Box: 1981619573, Tehran, Iran
| | - Pedram Shirani
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 46, Hafezi Street, Farahzadi Boulevard, Sharak Ghods, P.O. Box: 1981619573, Tehran, Iran
| | - Delaram Ghodsi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sadat SAA, Pakravan-Charvadeh MR, Gholamrezai S, Rahimian M, Lane G, Béland D, Koc M, Clark N, Omidvar N, Sadeghi R, Vatanparast H. Factors associated with Afghan household food security pre- and post-Taliban regime. J Public Health Policy 2023; 44:551-565. [PMID: 37710011 DOI: 10.1057/s41271-023-00439-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/16/2023]
Abstract
To determine multifaceted determinants of household vulnerability to food insecurity in Afghanistan before and after the Taliban takeover, we randomly selected 555 households from 13 provinces, conducted in-person surveys, and applied the Household Food Insecurity Assess Scale (HFIAS) and Structural Equation Modeling (SEM). We collected data from January to April 2022. We observed an increase in both prevalence and severity of food insecurity among Afghan households after the Taliban takeover. Approximately, 98% and 70% of interviewed households were food insecure after and before the Taliban takeover, respectively. Similarly, households were more likely to be severely food insecure (81%) than before (40%). Our results showed that policy and political conditions contributed substantially to the food insecurity of Afghan households after the Taliban takeover. We recommend that the Taliban forces facilitate the presence of humanitarian organizations and NGOs to improve low-income households' food security, especially for women and children. We also recommend that international organizations enhance their attempts to negotiate with the Taliban to ensure freedom for women.
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Affiliation(s)
- Seyyed Amin Allah Sadat
- Department of Agricultural Economics and Rural Development, Lorestan University, Falakol' Aflak St, PO Box 465, Khorramabad, Lorestan, Iran
| | - Mohammad Reza Pakravan-Charvadeh
- Department of Agricultural Economics and Rural Development, Lorestan University, Falakol' Aflak St, PO Box 465, Khorramabad, Lorestan, Iran.
| | - Saeed Gholamrezai
- Department of Agricultural Economics and Rural Development, Lorestan University, Falakol' Aflak St, PO Box 465, Khorramabad, Lorestan, Iran
| | - Mehdi Rahimian
- Department of Agricultural Economics and Rural Development, Lorestan University, Falakol' Aflak St, PO Box 465, Khorramabad, Lorestan, Iran
| | - Ginny Lane
- College of Agricultural and Life Sciences, Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, USA
| | - Daniel Béland
- Department of Political Science, McGill University, Montreal, QC, Canada
| | - Mustafa Koc
- Department of Sociology, Centre for Studies in Food Security, Toronto Metropolitan University (Formerly Known As Ryerson University), Toronto, ON, Canada
| | - Nancy Clark
- Faculty of Human and Social Development, School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rasoul Sadeghi
- Faculty of Social Science, University of Tehran, Tehran, Iran
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK, S7N 5E5, Canada.
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Saif-Nijat J, Pakravan-Charvadeh MR, Gholamrezai S, Rahimian M, Lane G, Béland D, Koc M, Clark N, Omidvar N, Sadeghi R, Vatanparast H. The association of the quality of life with Afghan households' food insecurity before and after the recent political change in Afghanistan: a comparative analysis. BMC Public Health 2023; 23:2066. [PMID: 37872537 PMCID: PMC10591381 DOI: 10.1186/s12889-023-16967-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 10/11/2023] [Indexed: 10/25/2023] Open
Abstract
The overreaching objective of the current study is to investigate the association of quality of life with Afghan households' food insecurity. The data was collected immediately after the Taliban took control of a large part of Afghanistan. About a total of 555 households' heads participated in a face-to-face interview, using the HFIAS and WHOQOL-100 questionnaires along with some questions related to their socioeconomic characteristics at two different times, before and after the Taliban's takeover. The comparative analysis showed that 98% of Afghan households were food insecure after the Taliban takeover, while 70% of them faced food insecurity before the Taliban's takeover. The quality of life in the Taliban era is worse than before the Taliban. All dimensions of quality of life have decreased, and this decrease was more pronounced for the psychological, environmental, and physical domains. It is recommended that international organizations, NGOs, and local agents focus on these dimensions of the quality of life to improve food security.
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Affiliation(s)
- Jumakhan Saif-Nijat
- Department of Agricultural Economics and Rural Development, Lorestan University, Khorramabad, Lorestan, Iran
| | | | - Saeed Gholamrezai
- Department of Agricultural Economics and Rural Development, Lorestan University, Khorramabad, Lorestan, Iran
| | - Mehdi Rahimian
- Department of Agricultural Economics and Rural Development, Lorestan University, Khorramabad, Lorestan, Iran
| | - Ginny Lane
- College of Agricultural and Life Sciences, Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, USA
| | - Daniel Béland
- Department of Political Science, McGill University, Montreal, QC, Canada
| | - Mustafa Koc
- Department of Sociology, Centre for Studies in Food Security, Toronto Metropolitan University (formerly known as Ryerson University), Toronto, Canada
| | - Nancy Clark
- Faculty of Human and Social Development, School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tajrish, Velenjak, Iran
| | - Rasoul Sadeghi
- Faculty of Social Science, University of Tehran, Tehran, Iran
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
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Niknam M, Omidvar N, Eini-Zinab H, Kalantari N, Olazadeh K, Amiri P. Improving community readiness among Iranian local communities to prevent childhood obesity. BMC Public Health 2023; 23:344. [PMID: 36793004 PMCID: PMC9931445 DOI: 10.1186/s12889-023-15163-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Community Readiness Intervention for Tackling Childhood Obesity (CRITCO) is a theory-based intervention being developed to improve the readiness of an Iranian urban population to engage in childhood obesity prevention programs. This study aimed to explore changes in readiness of intervention and control local communities from diverse socio-economic areas of Tehran. METHODS This study was a seven-month quasi-experimental intervention implemented in four intervention communities and compared with four controls. Aligned strategies and action plans were developed around the six dimensions of community readiness. The Food and Nutrition Committee was established in each intervention community to make collaborative efforts among different sectors and assess the fidelity of the intervention. The pre-and post- readiness change was explored through interviews with 46 community key informants. RESULTS The total readiness of intervention sites increased by 0.48 units (p < 0.001) and shifted to the next higher level, from preplanning to the preparation stage. At the same time, the readiness of control communities decreased by 0.39 units (p < 0.001), although their readiness stage remained unchanged, reflecting the fourth stage. Also, a sex-dependent CR change was observed, such that the girls' schools showed a more remarkable improvement in interventions and less decline in controls. The readiness stages of interventions significantly improved for four dimensions related to community efforts, knowledge of the efforts, knowledge of childhood obesity issue, and leadership. Furthermore, the readiness of control communities significantly decreased on three of six dimensions related to community effort, knowledge of efforts, and resources. CONCLUSIONS The CRITCO successfully improved the readiness of intervention sites for addressing childhood obesity. It is hoped that the present study can be a spark for developing readiness-based childhood obesity prevention programs in Middle Eastern and other developing countries. TRIAL REGISTRATION The CRITCO intervention was registered at Iran Registry for Clinical Trials ( http://irct.ir ; IRCT20191006044997N1) on 11/11/2019.
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Affiliation(s)
- Mahdieh Niknam
- grid.411600.2Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran.
| | - Hassan Eini-Zinab
- grid.411600.2Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran
| | - Naser Kalantari
- grid.411600.2Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran
| | - Keyvan Olazadeh
- grid.411600.2Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran.
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Ahmadpour M, Omidvar N, Shakibazadeh E, Doustmohammadian A, Rahimiforoushani A. Development and evaluation of an intervention to improve food and nutrition literacy among Iranian Kurdish primary school children: An application of intervention mapping approach. Front Public Health 2023; 10:1059677. [PMID: 36684859 PMCID: PMC9845926 DOI: 10.3389/fpubh.2022.1059677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Background Food and nutrition literacy (FNLIT) is a relatively new term that is used to define the knowledge, skills, and behaviors necessary to achieve a healthy diet. Improving food and nutritional literacy in children is a necessary solution to eliminate nutritional disorders in this age group. The purpose of this study was to design, implement and evaluate an intervention to improve food and nutrition literacy in children aged 10-12 years old based on an intervention mapping (IM) approach. Methods This experimental study was performed in three phases. Through the first phase, an intervention was developed using the (IM) approach. In the second phase, the intervention was implemented for 6 months, and in the third phase, the intervention outcomes were evaluated and compared with the control group through a randomized controlled trial among 300 participants (each control and intervention group = 150). Results Before the intervention, there was no significant difference between the control and intervention groups in all subscales of FNLIT. After the intervention, there was a significant difference between the control and intervention groups in all subscales of FNLIT (P < 0/001). There were no differences between the two groups in terms of the FNLIT scores at baseline (P > 0.05). However, after 6 months of intervention, a significant difference was observed between the two groups (intra-group differences) (P < 0.001). Such a difference was not identified in the control group after 6 months also the results show the impact of socioeconomic factors and parental literacy on the average score of students' FNLIT and after the intervention, a significant difference was observed between the scores of control and intervention groups in all subscales of the FNLIT (P < 0.001). Conclusions The school-based intervention developed and evaluated in this study provides a basis for future programs targeting the improvement of FNLIT in children, especially in poor and deprived areas such as Kurdistan province. Clinical trial registration Iranian Clinical Trials Registry (IRCT) Code: 32094.
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Affiliation(s)
- Mohammad Ahmadpour
- Department of Health Education and Promotion, School of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimiforoushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Edalati S, Omidvar N, Takian A, Rasam F, Ghodsi D, Majdzadeh R. Participatory evaluation of municipal obesity prevention clubs in Tehran city: Strengths, challenges, and future direction. Front Public Health 2023; 11:1055210. [PMID: 36875369 PMCID: PMC9978347 DOI: 10.3389/fpubh.2023.1055210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/23/2023] [Indexed: 02/18/2023] Open
Abstract
Background and aim Community-based initiatives are important for obesity prevention. This study aimed to evaluate the activities of municipal obesity prevention clubs (OBCs) in Tehran, Iran, using a participatory approach. Methods The evaluation team was formed, and the members identified the OBC's strengths, and challenges and provided suggestions for change through a participatory workshop, observation, focus group discussions, reviewing relevant documents (n = 97), and 35 interviews with involved stakeholders. The MAXQDA software was used for data analysis. Results An empowerment training program for volunteers was identified as one of the strengths of OBCs. Despite the obesity prevention efforts of OBCs through public exercise sessions, healthy food festivals, and educational sessions, several challenges were identified that hinder participation in OBCs. These challenges included poor marketing strategies, poor training approaches in participatory planning, insufficient motivational support for volunteers, low perceived recognition of volunteers by the community, volunteers' low food and nutrition literacy, poor educational services in the communities, and limited funding for health promotion activities. Conclusion Weaknesses in all stages of community participation, including information, consultation, collaboration, and empowerment, in OBCs were detected. Facilitating a more enabling environment for informing and involving citizens, expanding neighborhood social capital, and involving health volunteers, academia, and all potential governmental sectors to collaborate for obesity prevention is recommended.
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Affiliation(s)
- Sareh Edalati
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhossein Takian
- Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Health Equity Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rasam
- Department of Social and Cultural Affairs of Tehran Municipality, Health Department, The Tehran Municipality's Organization, 15th District, Tehran, Iran
| | - Delaram Ghodsi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- Community-Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.,School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Niknam M, Omidvar N, Amiri P, Eini-Zinab H, kalantari N. Adapting the Community Readiness Model and Validating a Community Readiness Tool for Childhood Obesity Prevention Programs in Iran. J Prev Med Public Health 2023; 56:77-87. [PMID: 36746425 PMCID: PMC9925285 DOI: 10.3961/jpmph.22.409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES It is critical to assess community readiness (CR) when implementing childhood obesity prevention programs to ensure their eventual success and sustainability. Multiple tools have been developed based on various conceptions of readiness. One of the most widely used and flexible tools is based on the community readiness model (CRM). This study aimed to adapt the CRM and assess the validity of a community readiness tool (CRT) for childhood obesity prevention programs in Iran. METHODS A Delphi study that included 26 individuals with expertise in 8 different subject areas was conducted to adapt the CRM into a theoretical framework for developing a CRT. After linguistic validation was conducted for a 35-question CR interview guide, the modified interview guide was evaluated for its content and face validity. The quantitative and qualitative analyses were performed using Stata version 13 and MAXQDA 2010, respectively. RESULTS The Delphi panelists confirmed the necessity/appropriateness and adequacy of all 6 CRM dimensions. The Persian version of the interview guide was then modified based on the qualitative results of the Delphi study, and 2 more questions were added to the community climate dimension of the original CRT. All questions in the modified version had acceptable content and face validity. The final CR interview guide included 37 questions across 6 CRM dimensions. CONCLUSIONS By adapting the CRM and confirming linguistic, content, and face validity, the present study devised a CRT for childhood obesity prevention programs that can be used in relevant studies in Iran.
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Affiliation(s)
- Mahdieh Niknam
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding author: Nasrin Omidvar, Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan Street, Shahrak Qods, Tehran 1981629573, Iran E-mail:
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Co-corresponding author: Parisa Amiri, Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak Street, Shahid Chamran Highway, Tehran 1985717413, Iran E-mail:
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naser kalantari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ashoori M, Soltani S, T-Clark CC, Eini-Zinab H, Shakibazadeh E, Doustmohamadian A, Abdar-Esfahani B, Mazandaranian M, Omidvar N. Food and nutrition literacy: a predictor for diet quality and nutrient density among late adolescents. Turk J Pediatr 2023; 65:290-300. [PMID: 37114694 DOI: 10.24953/turkjped.2022.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Evidence regarding an individual`s food and nutrition literacy (FNL), and its impact on dietary behaviours, could guide the development of more effective interventions. This study sought to examine the association between FNL and its components with diet quality and nutrient density among Iranian senior highschool students. METHODS In this cross-sectional study, 755 senior high school students were recruited from high schools in Tehran, Iran. FNL was assessed using the Food and Nutrition Literacy Assessment Tool (FNLAT), a selfadministered questionnaire which has been locally designed and validated. Dietary assessment was performed by obtaining two 24-hour dietary recalls. Healthy Eating Index-2010 (HEI-2010) and nutrient-rich food index 9.3 (NRF9.3) were calculated to evaluate diet quality. Socioeconomic status, anthropometric measures, and the health status of participants were also assessed. RESULTS Higher FNL score was significantly correlated with higher HEI-2010 (β = 0.167, p < 0.001) and NRF9.3 (β = 0.145, p < 0.001) scores. Subgroup analysis indicated that these associations were significant only among males, but not females. Regarding components of FNL, skill dimension of FNL was a stronger predictor for HEI- 2010 (β = 0.174, p < 0.001) and NRF9.3 (β = 0.153, p < 0.001) than knowledge (β = 0.083, p = 0.054 for HEI-2010 and β = 0.107, p = 0.01 for NRF9.3). CONCLUSIONS FNL may be a significant predictor of diet quality and nutrient density among late adolescents. To improve the effectiveness of food and nutrition education, emphasis must be placed on skill development.
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Affiliation(s)
- Marziyeh Ashoori
- Student Research Committee, Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Cain C T-Clark
- Faculty Research Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohamadian
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behnaz Abdar-Esfahani
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Mazandaranian
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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10
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Sobhani SR, Edalati S, Eini-Zinab H, Kennedy G, Omidvar N. A comparative analysis of sustainability of the usual food intakes of the Iranian population, Iranian food-based dietary guidelines, and optimized dietary models. Front Sustain Food Syst 2022. [DOI: 10.3389/fsufs.2022.838741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Promoting sustainable diets might contribute toward achieving sustainable development goals. Considering the importance of national food-based dietary guidelines (FBDGs), this study aimed to assess and compare the sustainability dimensions of the usual Iranian dietary intakes with sustainable optimal diets based on Iranian (2006 and 2015 versions), Mediterranean, and vegetarian FBDGs. The usual dietary intakes of Iranian households were estimated using household expenditure survey data. Diet sustainability, including environmental (water, carbon, and land) footprints, cost, and nutrient-rich food (NRF) index, was calculated for the usual diet and compared with those of different FBDGs. Using linear and goal programming, optimal food models were calculated by minimizing environmental footprints and cost and maximizing NRF simultaneously for each FBDG, while maintaining nutritional considerations recommended by the FBDGs. Replacing the usual dietary intake of Iranians with the optimal diet based on the 2016 Iranian FBDG was associated with reductions equal to 20.9% for water footprint, 22.48% for carbon footprint, 20.39% for land footprint, 31.83% for cost, and 7.64% increase in NRF index. The optimal model based on the 2016 Iran FBDG was 10% more sustainable compared with the 2005 version. Changing the usual consumption of Iranians to the optimal model based on the Mediterranean pyramid was accompanied by the highest NRF index, lower environmental footprints, and cost compared to other models. The recent Iranian FBDG, compared with the older one, was more sustainable. Considering the dimensions of a sustainable diet for future FBDG revisions is recommended.
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11
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Omidvar N, Doustmohammadian A, Shakibazadeh E, Clark CCT, Kasaii MS, Hajigholam-Saryazdi M. Effects of school-based interventions on Food and Nutrition Literacy (FNLIT) in primary-school-age children: a systematic review. Br J Nutr 2022; 129:1-20. [PMID: 36177745 DOI: 10.1017/s0007114522002811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study systematically reviewed the evidence on interventions seeking to improve Food and Nutrition Literacy (FNLIT) functional, interactive and critical skills in primary school-aged children. Electronic databases, including PubMed/MEDLINE, SCOPUS, Web of Science, Cochrane, Pro-Quest and Google Scholar were systematically searched. Randomised and non-randomised controlled trials, pre-/post-test and case-control designs were included. The primary outcomes were three levels of FNLIT: functional, interactive and critical. All citations, full-text articles and abstract data were screened by two independent reviewers. Any conflicts were then resolved through discussion. The quality of the included studies was individually evaluated using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Two reviewers extracted data from the included studies, and a descriptive analysis was performed. The quality of all eligible studies (n 19) was rated as moderate/weak. A wide variety of skill-building activities were introduced by programmes, including recipe skills/food preparation, food label literacy, food tasting, gardening harvesting, and supporting cultural practices and ethnic foods. Only four studies measured food literacy (FL) (food label literacy) via a valid measure. Most interventions focused on the functional level of FL, except for two programmes (one scored weak and one scored moderate). In most of the studies, delivery of intervention content was facilitated by teachers (n 15). Promising interventions were tailored to the needs and interests of students, incorporated into the existing curriculum and facilitated by teachers. The successful intervention strategies led to improvements in functional, partly interactive and critical skills. Future interventions should focus, holistically, on all aspects of FNLIT, especially interactive and critical skills.
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Affiliation(s)
- Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, CoventryCV1 5FB, UK
| | - Maryam Sadat Kasaii
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Hajigholam-Saryazdi
- Library, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Chegini M, Shirani P, Omidvar N, Eini-Zinab H, Pour-Ebrahim F, Rezazadeh A. Relationship between diet quality and depression among Iranian older adults in Tehran. BMC Geriatr 2022; 22:708. [PMID: 36028815 PMCID: PMC9419352 DOI: 10.1186/s12877-022-03380-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background Depression is one of the prevalent mental disorders that is common in older ages. Evidence suggests that dietary intake status may potentially be associated with depression. However, this association has not been well studied in older adults, and the nature of the association remains unclear. This study aimed to investigate the association between diet quality and depression in free-living older adults living in Tehran city. Methods This cross-sectional study was conducted on 583 older adults (279 men and 304 women) aged 60 to 80 years living in Tehran city, selected by the systematic cluster sampling method. Individuals' dietary intake was determined by two non-consecutive 24-h dietary recalls, and diet quality was assessed calculating score of Healthy Eating Index-2015 (HEI-2015). The validated short form of the Geriatric Depression Scale (GDS-11) was used to assess depression status. A logistic regression model was used to assess the chance of depression across tertiles of HEI-2015 score. Results The point prevalence of depression was 22.5%, which was significantly higher in women (91 (69.5%) women vs. 40 (30.5%) men). A higher percentage of seniors at the higher tertile of HEI score were women, belonged to Fars ethnicity and had a higher score of activity of daily living (ADL). After adjustment for all potential confounders, the trend of depression chance was significantly decreased in those with higher HEI-2015 scores (p-for trend < 0.05). Conclusion Higher quality of diet was associated with a lower possibility of depression in the studied participants. Further studies are required to investigate the possible causal relationship. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03380-1.
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Affiliation(s)
- Maedeh Chegini
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pedram Shirani
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pour-Ebrahim
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezoo Rezazadeh
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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13
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Doustmohammadian A, Omidvar N, Keshavarz-Mohammadi N, Eini-Zinab H, Amini M, Abdollahi M. Development of a conceptual framework of food and nutrition literacy in children. BMC Nutr 2022; 8:91. [PMID: 36028904 PMCID: PMC9414122 DOI: 10.1186/s40795-022-00590-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 08/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to develop a conceptual framework to better understand food and nutrition literacy and its dimensions and components among Iranian children. METHODS The study included three sub-studies. First, two qualitative studies were conducted to explore experts' and students' perspectives and experiences regarding the topic. A comprehensive qualitative literature review was then conducted to identify food/nutrition literacy definitions and its components in the relevant literature. The data of the above three sub-studies were compiled as text data and were analyzed utilizing MAXQDA2010 software. RESULTS Two main domains, including cognitive and skill domains, emerged from the data analysis. The cognitive domain consisted of food- and nutrition-related knowledge included four subcategories "nutrition knowledge", "lifestyle knowledge", "food safety knowledge", and "knowledge of food and its preparation") as well as "food and nutrition understanding". The skill domain consisted of three dimensions: "functional", "interactive", and "critical" food and nutrition literacy. CONCLUSIONS The developed framework highlights the importance of integrated application of all dimensions of food and nutrition literacy among this population group. It can assist policymakers and curriculum developers in assessing education curricula and developing effective strategies for teaching and learning to increase students' food and nutrition literacy.
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Affiliation(s)
- Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, and National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Keshavarz-Mohammadi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, and Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, and National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Amini
- School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Abdollahi
- School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Babashahi M, Omidvar N, Joulaei H, Zargaraan A, Veisi E, Kelishadi R. Food Products with the Child-Targeted Packaging in Food Stores around Primary Schools in Tehran, Iran. J Prev (2022) 2022; 43:513-527. [PMID: 35476310 DOI: 10.1007/s10935-022-00679-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
The local retail food environment around schools can have an important role in encouraging children to low-quality food choices; and may act as a potential risk factor in their diet. Thus, evaluating the food environment is essential for adopting policies and programs that support healthy nutrition in children. This study aimed to investigate the frequency and nutritional characteristics of packaged processed/ultra-processed food and beverage products with child-oriented marketing attributes in food stores around primary schools in Tehran, Iran. This cross-sectional study was conducted on 239 food stores located within a 500-meter buffer around 64 primary schools in Tehran province. The presence of marketing strategies directed at children and nutrition information from traffic light labels of packaged foods available in these stores were extracted. Data were analyzed overall and separately for the subset of foods placed on front shelves at the entrance of stores. Among 445 discrete food products marketed to children via their packaging, 198 (44.49%) were placed on shelves in front of the stores entrance. Potato chips and bulky cereals group had the highest energy density (507.15 ± 44.05 Kcal/100gr). Due to the color code of traffic light labels, 100% of fruit juices had high levels of sugar. Of potato chips and bulky cereals, 89.38% were assigned a red color traffic light for total fat levels. Moreover, 62.50% of processed fruit and vegetables contained high levels of salt. The level of trans-fatty acids were not high in any of the food products. The high amount of sugar, salt, and fat in a remarkable proportion of food products marketed to children can be considered a risk factor for children's health. Initiation and implementation of appropriate policies to control the food environment around schools in Iran is recommended.
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Affiliation(s)
- Mina Babashahi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azizollaah Zargaraan
- Department of Food and Nutrition Policy and Planning Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elnaz Veisi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Mokari-Yamchi A, Omidvar N, Tahamipour Zarandi M, Eini-Zinab H. The Effects of Food Taxes and Subsidies on Promoting Healthier Diets in Iranian Households. Front Nutr 2022; 9:917932. [PMID: 35911111 PMCID: PMC9328754 DOI: 10.3389/fnut.2022.917932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Aim Price, as a key driver of food purchasing, has an important role in determining the consumer demand. This study is aimed to estimate the effect of food taxes and subsidies on purchasing patterns of Iranian households (HHs). Methods This study was performed in two phases. In phase one, a two-round Delphi study was conducted to determine and prioritize food-related fiscal policies; and in the second phase, using the Iranian Household Income and Expenditure Survey (HIES), we estimated an almost ideal demand system (AIDS) and simulated changes in purchases, nutrient intake, and consumer welfare under six different policy scenarios: (1) 20% subsidy on vegetables, (2) 20% subsidy on fruits, (3) 30% subsidy on legumes, (4) 25% tax on sugar and sweets, (5) 30% tax on sweetened beverages, and (6) 30% tax on hydrogenated oil and animal fats. Results The highest calorie reduction was detected in sugar and sweets tax, which has resulted in 949.67, 971.68, and 1,148.03 kilocalories decrease in energy intake per Adult Male Equivalent (AME) in all HHs, low-income HHs, and high-income HHs, respectively. In terms of welfare changes, high-income HHs will experience a lower change in welfare (−0.81 to 0.11%) relative to their income when compared with low-income HHs (−0.88 to 0.28%) due to fiscal policies. Conclusion Fiscal policies in Iran can be a potential way to improve dietary choices. The findings provide essential information for decision makers for the implementation of food-related fiscal policies.
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Affiliation(s)
- Amin Mokari-Yamchi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Tahamipour Zarandi
- Department of Economics, Faculty of Economics and Political Science, Shahid Beheshti University, Tehran, Iran
- *Correspondence: Morteza Tahamipour Zarandi,
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Hassan Eini-Zinab,
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16
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Doustmohammadian A, Omidvar N, Keshavarz-Mohammadi N, Eini-Zinab H, Amini M, Abdollahi M. The association and mediation role of Food and Nutrition Literacy (FNLIT) with eating behaviors, academic achievement and overweight in 10-12 years old students: a structural equation modeling. Nutr J 2022; 21:45. [PMID: 35778743 PMCID: PMC9248125 DOI: 10.1186/s12937-022-00796-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background Food and nutrition literacy is a key factor in shaping healthy dietary behaviors and may result in decreasing decrease the prevalence of overweight. Empirical research on food and nutrition literacy and its outcomes is limited, especially among children and adolescents. Thus, this study investigates the link between Food and Nutrition Literacy (FNLIT) with eating behaviors, academic performance, and overweight in 10–12 years old students in Tehran, Iran. Methods This study was performed through two phases: 1) Proposing a conceptual model of the relationship between FNLIT and its determinants and outcomes, based on the existing evidence and previous models, and 2) Testing the proposed FNLIT model through a cross-sectional study on 803 primary school students (419 boys and 384 girls, from 34 public and 10 private primary schools), aged 10–12 years using structural equation modeling. Demographic, socio-economic, and household food security characteristics were collected by interviewing the students and their mothers/caregivers using a questionnaire. FNLIT was measured by a self-administered, locally designed, and validated questionnaire. Results The fit indices suggested a reasonably adequate fit of the data to the hypothesized model (χ2/df = 2.03, p < 0.001, goodness of fit index (GFI) = 0.90, adjusted goodness of fit index (AGFI) = 0.88, comparative fit index (CFI) = 0.91, incremental fit index (IFI) = 0.91, root mean square error of approximation (RMSEA) = 0.04, standardized root mean residual (SRMR) = 0.06). SES was directly and positively related to FNLIT and its subscale in students. FNLIT score had a positive direct (non-mediated) relationship with healthy eating behavior and academic performance. This pattern was strongly reversed in unhealthy eating behavior. There was a full mediation relationship between FNLIT and overweight/obesity via healthy eating behaviors. SES predicted academic performance partially through the mediating effect of Food Label Literacy (FLL). The results indicated that despite the direct relationship between SES and academic performance, an indirect but negative relationship existed with food insecurity. The finding also revealed the fully mediating role of Food Choice Literacy (FCL) in the relationship between demographic factors and healthy eating behaviors. Our study also found that Interactive Food and Nutrition Literacy (IFNL) protected unhealthy eating behaviors, and FCL predicted healthy eating behaviors in children. Conclusion Our study draws attention to FNLIT, especially the skills domain, including IFNL, FCL, and FLL, as the most important determinant of healthy eating behavior, academic performance, and weight status in school-age children reduces social inequalities in children’s development. To ensure an adequate level of FNLIT, educators should assess and plan to enhance food literacy skills in children and adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-022-00796-8.
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Affiliation(s)
- Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, and National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, and National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Amini
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Abdollahi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sheikhi M, Omidvar N, Tabatabaei SM, Eini-Zinab H. Is nutritional functional diversity in the rural food and nutrition system associated with food security and nutrient adequacy? A case study of rural areas of Zahedan district, Iran. BMC Public Health 2022; 22:751. [PMID: 35421969 PMCID: PMC9008399 DOI: 10.1186/s12889-022-13134-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 03/31/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND An overlooked problem in food and nutrition system analysis is assuring adequate diversity for a healthy diet. Little is known about nutrient diversity in food and nutrition systems and how it transmits to dietary diversity. Nutritional functional diversity (NFD) is a metric that describes diversity in providing nutrients from farm to market and the consumption level. The objective of this study is to determine the NFD score at different stages of the rural food and nutrition system, including household's agricultural and home production, domestic food processing, purchased food, and diet. It also aims to explore the association between NFD and nutrient adequacy, food security, and anthropometric indicators. METHODS A cross-sectional study was conducted on 321 households in 6 villages of Zahedan district. The NFD score was measured at three subsystems (production, processing, and consumption) of the food and nutrition system. Household food security, mean adequacy ratio (MAR), and anthropometrics of the household's head were measured to assess the association between NFD and food and nutrition indicators. Linear and bivariate statistical techniques were applied to study the associations between variables. RESULTS In the rural food and nutrition system, the food purchased from the city plays the main role in the households NFD score. Their contribution to total NFD was twice that of the food items purchased from the village. The NFD score of homestead production and households food processing was found to be five times less than those of food purchased from cities. The food insecure households had significantly lower NFD scores for food purchased from the city and higher NFD scores for purchased food items from the rural market and native wild vegetable consumption. A strong and positive relationship was observed between NFD of food items purchased from the city and households'MAR. No significant association was found between the NFD score of homestead production, processing, and dependent variables, i.e. food insecurity, MAR, and household head anthropometrics. CONCLUSION NFD score, as a relatively new metric, could help in determining diversity from farm to diet and identifying the gaps to plan appropriate interventions for improving diversity in the local food system.
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Affiliation(s)
- Mahdieh Sheikhi
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, No. 7, Hafezi St., Farahzadi Blvd, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, No. 7, Hafezi St., Farahzadi Blvd, Tehran, Iran
| | | | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, No. 7, Hafezi St., Farahzadi Blvd, Tehran, Iran.
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18
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Sobhani SR, Omidvar N, Abdollahi Z, Al Jawaldeh A. Shifting to a Sustainable Dietary Pattern in Iranian Population: Current Evidence and Future Directions. Front Nutr 2022; 8:789692. [PMID: 35004817 PMCID: PMC8727882 DOI: 10.3389/fnut.2021.789692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/24/2021] [Indexed: 11/13/2022] Open
Abstract
The need for a shift in diet toward a more sustainable one has reached an urgency in certain regions, including Iran, due to more rapid climate change and a higher level of vulnerability. This study was undertaken to identify and summarize available data on changes required in the current Iranian diet to make it more sustainable and the extent to which current policies in the country have addressed such a shift. In this study, PubMed, Scopus, and Web of science, as well as Iranian scientific search engines, including Scientific Information Database and Magiran, were systematically searched from January 1990 to July 2021. A total of 11 studies and policy analyses were included in this study. Based on the findings, moving Iranian diet toward sustainability will require increase in consumption of dairy, fruits, vegetables, cereals, poultry, and legumes and decrease in consumption of bread, rice, pasta, red meat, eggs, fats, sugars, and sweets. There has been a great deal of effort and investment on policies and strategies to decrease the amount of sugar, salt, and fat (specifically trans-fatty acids) in the Iranian diet, which makes it more sustainable healthwise. Several policies and programs have been implemented to tackle non-communicable diseases (NCDs) by reducing access to unhealthy foods, which is in line with health dimension of a sustainable diet. However, there is almost no direct address to ecological aspect of sustainable diet in the food and nutrition policy documents in the ccountry. Development of an enabling environment to a sustainable diet will require policy and actions to improve public awareness, support study to provide evidence and identify possible alternatives, and plan and implement interventions/programs to promote and facilitate healthy and sustainable diets.
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Affiliation(s)
- Seyyed Reza Sobhani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Abdollahi
- Department of Nutrition, Ministry of Health and Medical Education, Tehran, Iran
| | - Ayoub Al Jawaldeh
- World Health Organization Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
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Niknam M, Omidvar N, Amiri P, Eini-Zinab H, Kalantari N. The Action Plan and Strategy Development for the Community Readiness Improvement for Tackling Childhood Obesity (CRITCO) Study. Int J Endocrinol Metab 2022; 20:e111371. [PMID: 35432551 PMCID: PMC8994822 DOI: 10.5812/ijem.111371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 07/09/2021] [Accepted: 08/15/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Community Readiness Improvement for Tackling Childhood Obesity (CRITCO) study has been developed based on the community readiness model (CRM) to improve the readiness of targeted local communities from two diverse socioeconomic districts of Tehran for tackling childhood obesity (CO) of late primary school children (10 - 12 years of age). OBJECTIVES This study aimed to describe the rationale and process of developing the fourth phase of CRITCO study by developing an intervention package. METHODS The readiness level data was used to analyze strengths, weaknesses, opportunities, and threats (SWOT) of four intervention sites to guide proper strategies in partnership with key community members. Then, the action plan was developed as a living document to guide a 6-month quasi-experimental community-based intervention around the six dimensions of CRM. Finally, the community engagement process, outcome, and evaluation process were explained. RESULTS The current report described the action plan and strategy development of the CRITCO study. Expectedly, this study can provide valuable information to guide the public health policymakers in planning and executing relevant interventions.
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Affiliation(s)
- Mahdieh Niknam
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naser Kalantari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Pourghaderi M, Omidvar N, Takian A, Ville AS, Kangarani HM, Eini-Zinab H. Who really counts in Iran’s National Food Assistance Program? Lessons from multi-stakeholder processes in the wicked policy area of food security. CAD SAUDE PUBLICA 2022; 38:e00341820. [DOI: 10.1590/0102-311x00341820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/21/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract: Multi-stakeholder processes - as a necessary part in the development of public policies - can provide diverse perspectives to inform and to improve food security policy-making. Iran’s National Food Assistance Program (NFAP) is one of the major welfare programs in Iran that reduces food insecutiry to low-income households. This study aimed to identify and to categorize actual and potential stakeholders in NFAP using the stakeholder salience model. According to Mitchell’s theory, stakeholders’ attributes (power, legitimacy, and urgency) were assessed based on the nature of their interactions, roles, and level of engagement. Results revealed a number of significant but marginalized stakeholders, including Iranian Ministry of Health (office of community nutrition improvement), academia, center for food and nutrition research, target group, charities, and international organizations, who have not received any targeted organizational attention and priority to their claims. The unbalanced attention provided to some stakeholder groups characterized as “definitive” and “dominant” and ignoring some important ones will jeopardize long-term viability and undermine support for the program with inevitable declines in legitimacy. Understanding the change in the stakeholders’ characteristics is the main variable to determine the allocation of organizational resources in response to different and rising stakeholders’ demands and possibly the projects outcomes. This will facilitate and enhance the possibility of knowledge exchange and learning, and greater trust among stakeholders during the food and nutrition policy-making process.
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Babashahi M, Omidvar N, Yazdizadeh B, Heidari-Beni M, Joulaei H, Narmcheshm S, Zargaraan A, Kelishadi R. Systematic review and meta-analysis of the most common processed foods consumed by Iranian children. East Mediterr Health J 2021; 27:918-930. [PMID: 34569048 DOI: 10.26719/emhj.21.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 03/01/2021] [Indexed: 11/09/2022]
Abstract
Background The trend of increasing overweight and obesity among children is a huge burden on health systems. In this regard, the growing availability of processed foods, often energy dense and nutrient poor, has become a major concern. Changing this trend will require evidence-based policies. Aims This systematic review aimed to identify the most common processed/ultraprocessed foods consumed by 4-12-year-old Iranian children. Methods We searched PubMed, Scopus and Web of science, as well as Persian scientific search engines, including Iran Research Information System, Scientific Information Database and Mag-Iran. We also assessed grey literature, that is, national studies and papers presented at relevant Iranian congresses. All data collected from studies were converted to daily servings (S/D). Mean and standard deviations of the included results were combined by performing meta-analysis with a random effects model. The I2 test was used to compute heterogeneity. Egger's test was used to assess publication bias. Results Ten studies with 67 093 children were included in this review. The meta-analysis demonstrated that the highest consumption of processed foods belonged to the sugars and sweets group with 8.01 S/D, followed by oils, and biscuits and cakes with 5.58 S/D and 3.33 S/D, respectively. Conclusion Given the high consumption of less healthy processed foods, robust policies to support healthy eating and help improve Iranian children's food environment are recommended.
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Affiliation(s)
- Mina Babashahi
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Bahareh Yazdizadeh
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Motahar Heidari-Beni
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Saba Narmcheshm
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Azizollaah Zargaraan
- Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
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22
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Niknam M, Omidvar N, Amiri P, Eini-Zinab H, Kalantari N. Community readiness for childhood obesity prevention programs: findings from an urban population in Iran. Health Promot Int 2021; 36:824-835. [PMID: 33111938 DOI: 10.1093/heapro/daaa101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to examine the Iranian local communities' readiness stage to engage with childhood obesity prevention programs for late primary school children in districts 2 and 16 of Tehran as the representatives of high and low socio-economic districts, respectively. First, a Delphi approach was conducted to assess the socio-cultural necessity/appropriateness and adequacy of the community readiness model and its dimensions as a planning basis for childhood obesity prevention program(s) in Iran. Then, the community readiness interview guide's translation, modification, content and face validity were performed. Finally, 66 interviews with key informants were conducted and scored to assess community readiness. The socio-cultural necessity/appropriateness and adequacy of community readiness model and its dimensions were confirmed by Delphi participants and two questions were added to the interview guide. Content and face validity of the interview guide were at acceptable levels. Assessment of the community readiness based on the key informants' perspective showed that the overall mean readiness score of targeted local communities was 4.61 ± 0.54 and 4.22 ± 0.26 in high and low socio-economic districts, respectively, corresponded to 'preplanning stage'. The highest score was 5.00 ± 0.48 correspond to the 'preparation stage', which belonged to girls' schools in district 2. Small differences were found in the readiness stage of local communities by sex and socio-economic status of schools. The results highlight the need to increase community awareness, gain their support to recognize childhood obesity as a priority, address cultural misconceptions and improve the obesity prevention programs to achieve a higher level of readiness.
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Affiliation(s)
- Mahdieh Niknam
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran 1985717413
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
| | - Naser Kalantari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
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Babashahi M, Omidvar N, Joulaei H, Zargaraan A, Zayeri F, Veisi E, Doustmohammadian A, Kelishadi R. Scrutinize of healthy school canteen policy in Iran's primary schools: a mixed method study. BMC Public Health 2021; 21:1566. [PMID: 34407797 PMCID: PMC8375065 DOI: 10.1186/s12889-021-11587-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 08/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schools provide an opportunity for developing strategies to create healthy food environments for children. The present study aimed to analyze the Healthy School Canteen (HSC) policy and identify challenges of its implementation to improve the school food environment in Iran. METHODS This mixed method study included two qualitative and quantitative phases. In the qualitative phase, triangulation approach was applied by using semi-structured interviews with key informants, documents review and direct observation. Data content analysis was conducted through policy analysis triangle framework. In the quantitative phase, food items available in 64 canteens of primary schools of Tehran province were gathered. The food's nutrient data were evaluated using their nutrition facts label. The number and proportion of foods that met the criteria based on Iran's HSC guideline and the World Health Organization nutrient profile model for the Eastern Mediterranean Region (WHO-EMR) were determined. RESULTS The main contextual factors that affected adoption of HSC policy included health (nutritional transition, high prevalence of non-communicable diseases and unhealthy food environment in and around the schools), political (upstream supportive policies and joint memorandums about health children between the Ministry of Health and Medical Education and Ministry of Education), structural (the lack of unified stewardship, inadequate human resource capacity, poor inter-sectional cooperation), economic (school financial problems, poor fiscal supportive of food policies), and socio-cultural (mothers working outside the home, the role of children's peer group, low nutrition knowledge of school principals) factors. Assessment of the school canteens showed that a large proportion of available foods did not comply with the national guidelines (54.7 ± 2.54%) and WHO-EMR model (85.6 ± 2.34%). The main reasons identified for incomplete implementation of the policy were inadequate physical and economic infrastructure to set up standard school canteens, lack of scientific criteria for food categorization, poor monitoring, high price of healthy foods, and conflict of interest among the actors. CONCLUSION The majority of foods and beverages available in the school canteens did not comply with national and regional standards. Iran HSC policy needs to be improved by using an evidence-based approach and active interaction between all key actors.
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Affiliation(s)
- Mina Babashahi
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azizollaah Zargaraan
- Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Zayeri
- Proteomics Research Center and Department of Biostatistics, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elnaz Veisi
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Kennedy G, Kanter R, Chotiboriboon S, Covic N, Delormier T, Longvah T, Maundu P, Omidvar N, Vish P, Kuhnlein H. Traditional and Indigenous Fruits and Vegetables for Food System Transformation. Curr Dev Nutr 2021; 5:nzab092. [PMID: 34423230 PMCID: PMC8373596 DOI: 10.1093/cdn/nzab092] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 05/18/2021] [Accepted: 06/25/2021] [Indexed: 11/29/2022] Open
Abstract
Fruit and vegetable consumption is recommended in numerous food-based dietary guidelines and forms a key recommendation in many international statements related to healthy diets. There are thousands of fruit and vegetable species from which to choose, but despite this abundance from nature, populations in most countries neither produce nor consume the recommended daily amounts of fruits and vegetables. There is enormous potential to better incorporate the wealth of diverse fruit and vegetable species and varieties into food systems. Known and preserved by indigenous communities, these hidden food treasures can foster collaborative research and learning. This perspective from the Task Force on Traditional and Indigenous Food Systems and Nutrition of the International Union of Nutritional Sciences (IUNS) highlights 5 key actions that can be taken by individuals, communities, and nations to reshape dialogue about traditional and indigenous fruits and vegetables to benefit people and planetary ecosystems.
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Affiliation(s)
- Gina Kennedy
- Chair, International Union of Nutritional Sciences (IUNS) Task Force on Traditional and Indigenous Food Systems and Nutrition, Falls Church, VA, USA
| | - Rebecca Kanter
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Namukolo Covic
- International Food Policy Research Institute, Addis Ababa, Ethiopia
| | - Treena Delormier
- Centre for Indigenous Peoples' Nutrition and Environment and School of Human Nutrition, McGill University, Montreal, Canada
| | | | - Patrick Maundu
- Kenya Resource Centre for Indigenous Knowledge, National Museums of Kenya, Nairobi, Kenya
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Prakash Vish
- Ramaiah University of Applied Sciences, Bangalore, India
| | - Harriet Kuhnlein
- Centre for Indigenous Peoples' Nutrition and Environment and School of Human Nutrition, McGill University, Montreal, Canada
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Nejad MS, Keshavarz-Mohammad N, Ramezankhani A, Zayeri F, Omidvar N, Liguori J. The Complex Role of Cognitive and Behavioral Factors in Salt Intake Levels of Women. J Lifestyle Med 2021; 11:82-89. [PMID: 34549030 PMCID: PMC8430310 DOI: 10.15280/jlm.2021.11.2.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background High salt intake is responsible for some serious health consequences. This study aims to investigate the interrelationship between salt intake cognitive and behavioral factors and urinary sodium excretion levels in women. Methods A descriptive analytical cross-sectional study was conducted in two residential complexes in Ahvaz city, Iran. 260 female participants were selected using systematic random sampling. Data on salt-related cognitive factors, including knowledge, perceived susceptibility, perceived severity, attitude, intention, self-efficacy, and behavior, were collected using a validated questionnaire. To determine true salt intake, 24-hour urinary sodium excretion level was measured. Data was analyzed using Pearson correlation, one-way Anova, and linear regression tests. Results 81.2% of the participants’ salt intake was higher than the WHO recommended value (5 grams/day). A significant relationship between sodium excretion level and knowledge (r = –0.332, p < 0.001), attitude (r = –0.144, p = 0.02), behavior (r = –0.130, p = 0.036), and perceived severity (r = –0.135, p = 0.03) was found. An R2 of 0.134 demonstrates a 13.4% variation in urinary sodium excretion, associated with knowledge and perceived severity. Conclusion Future interventions should aim to improve all the salt-related cognitive factors with placing an emphasis on increasing salt-related knowledge and perceived severity.
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Affiliation(s)
| | | | - Ali Ramezankhani
- Department of Public Health, School of Public Health and Safety, Tehran, Iran
| | - Farid Zayeri
- Department of Biostatistics, School of Paramedical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Julia Liguori
- London School of Hygiene and Tropical Medicine, London, England
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Ashoori M, Omidvar N, Eini-Zinab H, Shakibazadeh E, Doustmohamadian A, Abdar-Esfahani B, Mazandaranian M. Food and nutrition literacy status and its correlates in Iranian senior high-school students. BMC Nutr 2021; 7:19. [PMID: 34082827 PMCID: PMC8176697 DOI: 10.1186/s40795-021-00426-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/30/2021] [Indexed: 12/01/2022] Open
Abstract
Background Planning interventions to promote food and nutrition literacy (FNL) require a better understanding of the FNL status of the target group and its correlates. Aims This study aimed to examine the FNL status and its determinants in Iranian senior high-school students. Methods In this cross-sectional study, FNL and its components (food and nutrition knowledge, functional skills, interactive skills, advocacy, critical analysis of information, and food label reading skill) were evaluated by a locally designed and validated, self-administered questionnaire. Besides, socioeconomic, demographic, anthropometric measures, as well as academic performance of 626 senior high-school students were assessed. Results The mean ± SD of the total FNL score (within potential range of 0 to 100) was 52.1 ± 10.96, which is below the minimum adequate level of 60. The probability of high FNL knowledge score was significantly higher among students who majored in Natural Sciences (OR = 1.73, CI = 1.09–2.75), had better school performance (OR = 1.13, CI = 1.06–1.20) and higher SES score (OR = 1.20, CI = 1.01–1.44). The score for food label reading was significantly lower in girls (OR = 0.45, CI = 0.31–0.67), while those who had a family member with the nutrition-related disease were more likely to have a higher score of food label reading skill (OR = 1.48, CI = 1.01–1.64). Conclusion The level of FNL in senior high-school students in Tehran was relatively low. These findings have key messages for the education system and curriculum designers to have more consideration for food and nutrition-related knowledge and skills in schools. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00426-2.
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Affiliation(s)
- Marziyeh Ashoori
- Student Research Committee, Department of Community Nutrition, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan St. Farahzadi Blvd., Sharake Qods, Tehran, Iran.
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan St. Farahzadi Blvd., Sharake Qods, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohamadian
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behnaz Abdar-Esfahani
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan St. Farahzadi Blvd., Sharake Qods, Tehran, Iran
| | - Mohammad Mazandaranian
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan St. Farahzadi Blvd., Sharake Qods, Tehran, Iran
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Al-Jawaldeh A, Taktouk M, Doggui R, Abdollahi Z, Achakzai B, Aguenaou H, Al-Halaika M, Almamary S, Barham R, Coulibaly-Zerbo F, Ammari LE, Elati J, Nishtar NA, Omidvar N, Shams MQ, Qureshi AB, Nasreddine L. Are Countries of the Eastern Mediterranean Region on Track towards Meeting the World Health Assembly Target for Anemia? A Review of Evidence. Int J Environ Res Public Health 2021; 18:ijerph18052449. [PMID: 33801513 PMCID: PMC7967583 DOI: 10.3390/ijerph18052449] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/19/2021] [Accepted: 02/21/2021] [Indexed: 11/16/2022]
Abstract
Anemia is a multifactorial condition, with a complex etiology that involves nutritional and non-nutritional factors. The misconception that iron deficiency is equivalent to anemia may mask the need to address other potential causative factors. This review paper aims to (1) assess the burden of anemia vs. iron deficiency anemia (IDA) amongst women of reproductive age (WRA), pregnant women (PW), and children under five years old (underfive children, U5C) in the Eastern Mediterranean region (EMR); (2) evaluate trends in anemia prevalence and whether countries are on track towards meeting the World Health Assembly (WHA) target for 2025; and (3) characterize anemia reduction efforts and provide a road map for future programs. A search of pertinent literature and databases was conducted. Anemia prevalence in the EMR ranged between 22.6% and 63% amongst PW, 27% and 69.6% amongst WRA, and 23.8% and 83.5% amongst U5C. Data showed that the EMR is not on course towards meeting the WHA target. The contribution of IDA to anemia was found to be less than half. Other potential contributors to anemia in the region were identified, including micronutrient deficiencies, parasitic infestations, and poor sanitation. A framework of action was proposed as a roadmap to meet the targets set by the WHA.
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Affiliation(s)
- Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo 7608, Egypt;
| | - Mandy Taktouk
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon;
| | - Radhouene Doggui
- Family Medicine Department, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
- Medical Research Department, Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB E1A 7R1, Canada
| | - Zahra Abdollahi
- General of Nutrition Department, Ministry of Health and Medical Education, Tehran 15655-415, Iran;
| | - Baseer Achakzai
- Nutrition/Regulations, Ministry of Health, Islamabad 56000, Pakistan;
| | - Hassan Aguenaou
- Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Ibn Tofaïl University-CNESTEN, Rabat-Kénitra, Rabat-Kénitra 242, Morocco;
| | | | | | - Rawhieh Barham
- Nutrition Department, Ministry of Health, Amman 11118, Jordan;
| | | | - Laila El Ammari
- Nutrition Department, Ministry of Health, Rabat 335, Morocco;
| | - Jalila Elati
- SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, INNTA (National Institute of Nutrition and Food Technology), Tunis 1007, Tunisia;
| | | | - Nasrin Omidvar
- Community Nutrition Department, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19395-4741, Iran;
| | - Mohammad Qasem Shams
- Nutrition Department, World Health Organization (WHO), Kabul, Jalalabad Road Pul-e-Charkhi Kabul, Afghanistan;
| | | | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon;
- Correspondence: ; Tel.: +961-1-350000 (ext. 4547)
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Amini M, Esmaillzadeh A, Omidvar N, Abtahi M, Dadkhah Piraghaj M, Nikooyeh B, Neyestani TR. Development of a dish-based food frequency questionnaire for Iranian population. Med J Islam Repub Iran 2021; 34:129. [PMID: 33437725 PMCID: PMC7787032 DOI: 10.34171/mjiri.34.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Indexed: 11/05/2022] Open
Abstract
Background: Food frequency questionnaires (FFQs) are widely used in large studies worldwide. They usually seek to rank people according to their usual food intake rather than a specific period of time. In the present study, we aimed to develop a dish-based, semi-quantitative FFQ to seek habitual diet of general population aged 9 to 65 years in Tehran. Methods: To develop the FFQ, four main steps were taken. At the beginning a list of commonly consumed Iranian foods and mixed dishes was prepared. To prevent excessive questionnaire length, some food items were grouped. Then, reference portion sizes were defined for each mixed dish in the list. The portion sizes were defined either based on the most common food portions reported in existing data or based on conventional portioning. In the third step the frequency response for consumption of food items and mixed dishes were determined. In the last step, recipes were developed for mixed dishes based on several data sources, including previous surveys. Finally, the content validity of the questionnaire was evaluated by the expert panel. Results: The final food list of the FFQ comprised 142 food items and mixed dishes in six major food groups, including dairy products, breads, mixed dishes, dried fruits, nuts and seeds, fruits and vegetables, and miscellaneous food items and beverages. Nine frequency response options for all food items varying from "never or less than once per month" to "more than 6 times a day" were considered. A portion size was included for each item, whether food items or mixed dishes. Conclusion: As Iranian food recipes are typically characterized by various ingredients it is very difficult for the respondent to recall the amount and type of the ingredients. Likewise, information about cooking methods beside ingredients of foods are important to estimate their nutritive values, which can be explored only through asking about consumption of mixed dishes. The current FFQ was developed to overcome the mentioned problems. It can be applied in nationwide studies in which foods and/or nutrients are predominant determinant of health and/or diseases.
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Affiliation(s)
- Maryam Amini
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Abtahi
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Monireh Dadkhah Piraghaj
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Nikooyeh
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tirang R Neyestani
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ashoori M, Omidvar N, Eini-Zinab H, Shakibazadeh E, Doustmohamadian A. Development and Validation of Food and Nutrition Literacy Assessment Tool for Iranian High-school Graduates and Youth. Int J Prev Med 2020; 11:185. [PMID: 33456741 PMCID: PMC7804877 DOI: 10.4103/ijpvm.ijpvm_466_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 05/18/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Food and nutrition literacy (FNL) is an emerging concept that emphasizes not only on personal knowledge, but food and nutrition skills about. This study aimed to develop and validate a food and nutrition literacy assessment tool (FNLAT) for youth and high-school graduates in Iran. Methods: The study protocol included the following steps: First, FNL components for Iranian high-school graduates and youth were identified through literature review and interviews with experts. Delphi method was used in order to achieve consensus about FNL components. Then, the questionnaire items were generated, and its content and face validity were assessed. Construct validity of the questionnaire was evaluated through applying principal component analysis (PCA) and confirmatory factor analyses (CFA) in the next step. Finally, reliability of the FNLAT was assessed by calculating Cronbach's Alpha and evaluating test-retest reliability. Results: A 104-item questionnaire was developed. S-CVI was ≥90 which confirmed content validity of the questionnaire. PCA suggested that it was constructed of 6 factors, one in knowledge domain (food and nutrition knowledge) and five in skill domain (functional skills, interactive skills, advocacy, critical analysis of information, and food label reading skills). On the basis of CFA, the fit indices of the model had acceptable fit and confirmed construct validity of the FNLAT (X2/df = 1.58, RMSEA = 0.041; P = 1.00, RMR = 0.034, GFI = 0.79). The values of Cronbach's Alpha and intraclass correlation coefficient (ICC) confirmed internal consistency and time stability of the FNLAT and its subscales. Conclusions: The developed FNLAT is a valid and reliable tool to assess FNL in Iranian late adolescents and youth.
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Affiliation(s)
- Marziyeh Ashoori
- Student Research Committee, Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Departmentof Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohamadian
- Department of Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
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Amini M, Esmaillzadeh A, Omidvar N, Abtahi M, Dadkhah-Piraghaj M, Nikooyeh B, R. Neyestani T. Development of a dish-based food frequency questionnaire for Iranian population. Med J Islam Repub Iran 2020. [DOI: 10.47176/mjiri.34.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Haghighian Roudsari A, Vedadhir A, Amiri P, Kalantari N, Omidvar N, Eini-Zinab H. Developing and Validating Food Choice Determinants Questionnaire: An Instrument for Exploring Food Choice Determinants in Iran. Int J Prev Med 2020; 11:141. [PMID: 33088469 PMCID: PMC7554605 DOI: 10.4103/ijpvm.ijpvm_250_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/14/2019] [Indexed: 11/24/2022] Open
Abstract
Background: This study was carried out to design and validate a questionnaire to measure the majority of factors influencing food choices among adults in Iran. Methods: A sequential exploratory mixed-method approach was applied to develop the initial item pool of the Food Choice Determinants Questionnaire (FCDQ) starting with a qualitative study to explore the food choice dimensions and its components. Designing the initial questionnaire using these dimensions and the 36-item Food Choice Questionnaire (FCQ) was then performed. The face, content, and construct validity were also assessed. The construct validity of the questionnaire was assessed using the exploratory factor analysis (EFA). Cronbach's alpha was applied for each main theme to examine the internal consistency. Results: After content and face validity process, a 60-item FCDQ was developed with total items' content validity index (CVI) of 0.69 indicating a reasonable level. The Cronbach's alpha coefficients for each of the six constructs in the scale have shown satisfactory internal consistency. Conclusions: This instrument is valid and reliable to measure food choice determinants in adults and could be applied to design interventions aiming to better food choice.
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Affiliation(s)
- Arezoo Haghighian Roudsari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - AbouAli Vedadhir
- Department of Anthropology, Faculty of Social Sciences, University of Tehran, Tehran, Iran.,Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute of Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naser Kalantari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Doustmohammadian A, Omidvar N, Keshavarz-Mohammadi N, Eini-Zinab H, Amini M, Abdollahi M, Amirhamidi Z, Haidari H. Low food and nutrition literacy (FNLIT): a barrier to dietary diversity and nutrient adequacy in school age children. BMC Res Notes 2020; 13:286. [PMID: 32532341 PMCID: PMC7291429 DOI: 10.1186/s13104-020-05123-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/04/2020] [Indexed: 02/08/2023] Open
Abstract
Objective This study aims to assess the relationship between Food and Nutrition Literacy (FNLIT) and dietary diversity score (DDS); FNLIT and nutrient adequacy (NAR%, MAR%) in school-age children in Iran. Results This cross-sectional study was undertaken on 803 primary school students in Tehran, Iran. Socio-economic, as well as three 24-h dietary recalls were collected through interviewing students and their mothers/caregivers. FNLIT was measured by a self-administered locally designed and validated questionnaire. Low level of FFNL was significantly associated with higher odds of low DDS (OR = 2.19, 95% CI 1.32–3.62), the first tertile of fruit diversity score (OR = 3.88, 95% CI 2.14–6.99), and the first tertile of dairy diversity score (OR = 9.60, 95% CI 2.07–44.58). Low level of IFNL was significantly associated with probability of lower meat diversity score (OR = 1.73, 95% CI 1.07–2.81). Low level of FLL was also significantly associated with probability of lower DDS (OR = 1.81, 95% CI 1.11–2.94), dairy diversity score (OR = 2.01, 95% CI 1.02–3.98), and meat diversity score (OR = 2.14, 95% CI 1.32–3.45).Low FNLIT and its subscales were associated with higher odds of low level of NAR of protein, calcium, vitamin B3, B6, B9, as well as the probability of lower level of MAR.
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Affiliation(s)
- Azam Doustmohammadian
- Department of Nutrition Research, Department of Community Nutrition, National Nutrition and Food Technology Research Institute (WHO Collaborating Center) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (WHO Collaborating Center) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (WHO Collaborating Center) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Amini
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute (WHO Collaborating Center) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Abdollahi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute (WHO Collaborating Center) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Amirhamidi
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (WHO Collaborating Center) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homa Haidari
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute (WHO Collaborating Center) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Doustmohammadian A, Amini M, Esmaillzadeh A, Omidvar N, Abtahi M, Dadkhah-Piraghaj M, Nikooyeh B, Neyestani TR. Correction to: Validity and reliability of a dish-based semi-quantitative food frequency questionnaire for assessment of energy and nutrient intake among Iranian adults. BMC Res Notes 2020; 13:243. [PMID: 32410649 PMCID: PMC7222457 DOI: 10.1186/s13104-020-05079-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Azam Doustmohammadian
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7, Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573, Iran
| | - Maryam Amini
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7, Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573, Iran.
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Abtahi
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7, Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573, Iran
| | - Monireh Dadkhah-Piraghaj
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7, Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573, Iran
| | - Bahareh Nikooyeh
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7, Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573, Iran
| | - Tirang R Neyestani
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7, Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573, Iran
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Doustmohammadian A, Omidvar N, Shakibazadeh E. School-based interventions for promoting food and nutrition literacy (FNLIT) in elementary school children: a systematic review protocol. Syst Rev 2020; 9:87. [PMID: 32321581 PMCID: PMC7178560 DOI: 10.1186/s13643-020-01339-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 03/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Food and nutrition literacy is a newly emerged concept to connect food-related knowledge and skills to healthy diets. Its promotion is important to protect children as they eat too many low-nutrient, high-energy foods. Food and nutrition literacy promotion needs multi-dimensional interventions. In the process of developing an intervention to promote food and nutrition literacy, the present review protocol aims to critically examine the evidence in the area of school-based interventions for promoting food and nutrition literacy (FNLIT) in elementary school children. METHODS We will search PubMed/MEDLINE, EMBASE, Web of Science, CENTRAL, and ProQuest (from inception onwards). Additional studies will be identified through manual searching of reference lists. Quantitative studies (e.g., randomized controlled trial, quasi-randomized trials, and cluster randomized trials) evaluating the effect of interventions to promote food and nutrition literacy in elementary school children (5-12 years old) will be included. Main outcomes will be food and nutrition literacy at functional, interactive, and critical levels. Secondary outcomes will be dietary intake indicators (e.g., healthy eating index, DDS) and health outcome measures (e.g., reduction in BMI and less weight gain). Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion. The study methodological quality (or bias) will be appraised using appropriate tools. If feasible, we will conduct random effects meta-analysis. The quality of the included studies will separately evaluate using the validated Quality Assessment Tool for Quantitative Studies, developed by the Effective Public Health Practice Project (EPHPP). Data will be extracted by two reviewers from the identified relevant literature. Standard data synthesis and analysis will be used for the review. DISCUSSION This systematic review will summarize the evidence regarding the components, implementation methods, and effectiveness of the interventions of food and nutrition literacy promotion in elementary school children. The results of this review will provide a useful reference for policymakers and curriculum developers to assess education curricula and develop practical learning and teaching strategies to improve students' food and nutrition literacy. SYSTEMATIC REVIEW REGISTRATION PROSPERO (CRD42019135118).
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Affiliation(s)
- Azam Doustmohammadian
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Tehran, Iran
- Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Ahmadpour M, Omidvar N, Doustmohammadian A, Rahimiforoushani A, Shakibazadeh E. Children Food and Nutrition Literacy - a New Challenge in Daily Health and Life, the New Solution: Using Intervention Mapping Model Through a Mixed Methods Protocol. J Med Life 2020; 13:175-182. [PMID: 32742510 PMCID: PMC7378349 DOI: 10.25122/jml-2019-0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022] Open
Abstract
Food and nutrition literacy is a fundamental and new idiom among health policymakers. Improving children's food and nutrition literacy is a fundamental task, and it requires detailed planning. The aim of this study is to design, implement, and evaluate a food and nutrition literacy promotion intervention in elementary school children based on the Intervention Mapping model. This is a sequential study to design, implement, and evaluate a food and nutrition literacy promotion intervention in elementary school children aged 10-12 years old in Baneh city (Kurdistan, Iran). The study has three sequential phases, six steps based on the Intervention Mapping model, and four sub-studies. The questionnaire was transformed and culturally adapted since it was previously built for the city of Tehran; the results of a population-based cross-sectional survey indicated that the score for understanding food and nutrition information of a sample of 390 students aged 10-12 was mostly moderate and low (90.3% of participants). Therefore, a qualitative study on how to fix existing barriers, and extract facilitators and the best methods of interventions for promoting food and nutrition literacy of participants was conducted. Finally, an interventional study within six months for two intervention and control groups of elementary children 10-12 years old was carried out. The findings of this research will be used to design interventions and strategies based on needs assessment for improving students' skills in food and nutrition literacy in all dimensions of food and nutrition literacy.
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Affiliation(s)
- Mohammad Ahmadpour
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aazam Doustmohammadian
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimiforoushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Doustmohammadian A, Amini M, Esmaillzadeh A, Omidvar N, Abtahi M, Dadkhah-Piraghaj M, Nikooyeh B, Neyestani TR. Validity and reliability of a dish-based semi-quantitative food frequency questionnaire for assessment of energy and nutrient intake among Iranian adults. BMC Res Notes 2020; 13:95. [PMID: 32093755 PMCID: PMC7038538 DOI: 10.1186/s13104-020-04944-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/11/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study aimed to assess the validity and reliability of a dish-based, semi-quantitative food frequency questionnaire (DFFQ) for epidemiological studies in Iran. The DFFQ included 142 items (84 foods and 58 mixed dishes) which was filled in by 230 adults (110 men). All participants completed two separate DFFQs with a 6 months interval as well as six 24-h recalls, each month. Dietary biomarkers and anthropometric measurements were made. The validity was evaluated by comparing the DFFQ against 24-h dietary recalls and dietary biomarkers, including serum retinol and beta-carotene. Reliability was evaluated using intra-class correlation coefficient (ICC) and validity was determined by unadjusted and energy adjusted correlation coefficients (CC), de-attenuated CC, and cross-classification analyses. RESULTS ICC for reliability ranged between 0.42 and 0.76. De-attenuated CC for the FFQ and the 24-h recalls ranged between 0.13 and 0.54 (Mean = 0.38). The de-attenuated CC between the DFFQ and plasma levels of retinol and beta-carotene were 0.58 (P = 0.0001) and 0.40 (P = 0.0001), respectively. Cross-classification analysis revealed that on average 73% were correctly classified into same or adjacent quartiles and 5% were classified in opposite quartiles.
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Affiliation(s)
- Azam Doustmohammadian
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
| | - Maryam Amini
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Abtahi
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
| | - Monireh Dadkhah-Piraghaj
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
| | - Bahareh Nikooyeh
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
| | - Tirang R. Neyestani
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
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Brewis A, Workman C, Wutich A, Jepson W, Young S, Ahmed JF, Alexander M, Balogun M, Boivin M, Carrillo G, Chapman K, Cole S, Collins S, Figueroa L, Freeman M, Gershim A, Ghattas H, Hagaman A, Jamaluddine Z, Jepson W, Tshala‐Katumbay D, Krishnakumar D, Maes K, Mathad J, Maupin J, Mbullo P, Miller J, Muslin IM, Niesluchowski M, Omidvar N, Pearson A, Melgar‐Quiñonez H, Sanchez‐Rodríguez C, Rosinger A, Santoso MV, Schuster R, Srivastava S, Staddon C, Stoler J, Sullivan A, Tesfaye Y, Triviño N, Trowell A, Tutu R, Escobar‐Vargar J, Zinab H. Household water insecurity is strongly associated with food insecurity: Evidence from 27 sites in low- and middle-income countries. Am J Hum Biol 2020; 32:e23309. [PMID: 31444940 PMCID: PMC9942689 DOI: 10.1002/ajhb.23309] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/18/2019] [Accepted: 08/03/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Food and water insecurity have both been demonstrated as acute and chronic stressors and undermine human health and development. A basic untested proposition is that they chronically coexist, and that household water insecurity is a fundamental driver of household food insecurity. METHODS We provide a preliminary assessment of their association using cross-sectional data from 27 sites with highly diverse forms of water insecurity in 21 low- and middle-income countries across Africa, Asia, the Middle East, and the Americas (N = 6691 households). Household food insecurity and its subdomains (food quantity, food quality, and anxiety around food) were estimated using the Household Food Insecurity Access Scale; water insecurity and subdomains (quantity, quality, and opportunity costs) were estimated based on similar self-reported data. RESULTS In multilevel generalized linear mixed-effect modeling (GLMM), composite water insecurity scores were associated with higher scores for all subdomains of food insecurity. Rural households were better buffered against water insecurity effects on food quantity and urban ones for food quality. Similarly, higher scores for all subdomains of water insecurity were associated with greater household food insecurity. CONCLUSIONS Considering the diversity of sites included in the modeling, the patterning supports a basic theory: household water insecurity chronically coexists with household food insecurity. Water insecurity is a more plausible driver of food insecurity than the converse. These findings directly challenge development practices in which household food security interventions are often enacted discretely from water security ones.
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Affiliation(s)
| | - Cassandra Workman
- University of North Carolina at Greensboro, Greensboro, North Carolina
| | | | | | - Sera Young
- Northwestern University, Evanston, Illinois
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Edalati S, Omidvar N, Haghighian Roudsari A, Ghodsi D, Zargaraan A. Development and implementation of nutrition labelling in Iran: A retrospective policy analysis. Int J Health Plann Manage 2019; 35:e28-e44. [PMID: 31709620 DOI: 10.1002/hpm.2924] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 09/23/2019] [Accepted: 10/05/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Nutrition labelling is a strategy to promote healthy eating and combat non-communicable diseases (NCDs). The present study aimed to provide an analysis of the nutrition labelling policy and its opportunities to improve in Iran. METHODS Data were collected by 1) reviewing relevant documents and 2) semi-structured interviews with stakeholders through purposive and snowball sampling, continued until data saturation was achieved. A deductive content analysis was used by applying the policy triangulation framework and the Kingdon multiple stream theory. MAXQDA software was used to manage data analysis. RESULTS Iran, is the first country in the Eastern Mediterranean region which has accomplished to implement nutrition traffic light labelling. The main contextual factors that affected nutrition labelling policy to become a national included health, political commitment, and international factors. Poor involvement of media for public awareness of nutrition traffic labeling, the inconsistency of nutrition traffic light color ranking using food standard guidelines, lack of consistency between nutrition traffic light colors and the healthy/unhealthy nature of some food products and the absence of a comprehensive evaluation plan were among the policy challenges identified. CONCLUSIONS Strengthening the governance for a healthy food environment is recommended to improve the program. Also, establishing national portion sizes for food labelling, initiating public awareness campaigns, evaluation of the policy effect and public perception of the labels and their application are recommended.
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Affiliation(s)
- Sareh Edalati
- Student Research Committee, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezoo Haghighian Roudsari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delaram Ghodsi
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azizollaah Zargaraan
- Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Doustmohammadian A, Keshavarz Mohammadi N, Omidvar N, Amini M, Abdollahi M, Eini-Zinab H, Amirhamidi Z, Esfandiari S, Nutbeam D. Food and nutrition literacy (FNLIT) and its predictors in primary schoolchildren in Iran. Health Promot Int 2019; 34:1002-1013. [PMID: 30101341 DOI: 10.1093/heapro/day050] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This study used a locally designed and validated questionnaire to describe the distribution of food and nutrition literacy (FNLIT) in a cross-sectional sample of 803 students aged 10-12 years from elementary schools in Tehran city, Iran. Logistic regression was used to assess the extent to which various independent covariates were associated with low FNLIT. The data were used to identify significant differences using a range of social and cultural variables relevant to the context of school students in Iran. The results of the study showed that although the total FNLIT level was good, this headline finding masked important differences in the sub-domains. More than half of the children (69%) had high levels of FNLIT in the cognitive domain, but in the skills domain, very few (3%) scored highly. The study also identified some associations between the total FNLIT and its subscales and sociodemographic variables including gender, parent's education and age, birth order. These results highlighted groups within the school population who were at higher risk of having lower FNLIT levels. They also indicate that girls feel more able to exert choice and control over food and nutrition decisions than boys are but may be less able to do so in practice. Overall, these results are a general reminder to schools of the different learning needs of children from different family backgrounds. The article highlights the need for continuous improvement in the health education curriculum of schools in Iran, particularly highlighting the importance of giving greater attention to the development of practical food and nutrition skills alongside more traditional food and nutrition knowledge. Additional studies (with long-term follow-up) are needed to more fully assess and understand the predictors of FNLIT.
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Affiliation(s)
- Aazam Doustmohammadian
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Amini
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Abdollahi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Amirhamidi
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Esfandiari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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40
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Sobhani SR, Rezazadeh A, Omidvar N, Eini-Zinab H. Healthy diet: a step toward a sustainable diet by reducing water footprint. J Sci Food Agric 2019; 99:3769-3775. [PMID: 30637755 DOI: 10.1002/jsfa.9591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 12/28/2018] [Accepted: 01/10/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND This paper aims to assess different scenarios that reduce water use by following healthy diet recommendations. In this study, a food frequency questionnaire was used to assess the usual food intake of a sample of 723 individuals, aged 20-64 years, from Urmia, Iran. In order to calculate water use for production of food items, the water footprint method was applied. A linear programming technique was used to find a healthy diet with low blue water footprint in three scenarios. RESULTS The biggest decline in water use compared with real intake (57%) was found in scenario 1, where the model-generated consider energy intake equal to usual energy intake. In scenario 2, in which the proportion of each food group was allowed to be in accordance with the Iranian food pyramid, the reduction in water use was less than for scenario 1 (47%). In scenario 3, where the Recommended Dietary Allowance values were also added to the set of model restrictions, the water usage was 51% of the real diet. CONCLUSION A healthy diet with greater proportion of energy from fruit and dairy instead of a diet with high proportion of energy from 'meat-fish-poultry-eggs' and 'bread-cereal-rice-pasta' can supply all Recommended Dietary Allowances while reducing water use. © 2019 Society of Chemical Industry.
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Affiliation(s)
- Seyyed Reza Sobhani
- Student Research Committee, Faculty of Nutrition Sciences & Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezoo Rezazadeh
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences & Food Technology, Shahid Beheshti University of Medical, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences & Food Technology, Shahid Beheshti University of Medical, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences & Food Technology, Shahid Beheshti University of Medical, Tehran, Iran
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41
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Yazdi-Feyzabadi V, Omidvar N, Keshavarz Mohammadi N, Nedjat S, Karimi-Shahanjarini A, Rashidian A. Is an Iranian Health Promoting School status associated with improving school food environment and snacking behaviors in adolescents? Health Promot Int 2019; 33:1010-1021. [PMID: 28973644 DOI: 10.1093/heapro/dax045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Iranian Health Promoting Schools (IHPS) program was first piloted and then formally established in Iran in 2011 as a framework to promote healthy environment and behaviors such as proper dietary practice among adolescents. This study examined the role of IHPS in improving the school food environment and snacking behaviors among adolescents. In this cross-sectional study, 1320 eighth grade students from 40 middle schools with IHPS and non-IHPS program were selected using a proportional stratified random sampling method. A modified 55-item qualitative Food Frequency Questionnaire was used to assess the frequency of consumption of healthy and unhealthy snacks in the studied adolescents. Mixed effect negative binomial regression models were used to analyze the data. The association was also adjusted for individual variables, including gender, socio-economic status, pocket money, family structure and nutritional knowledge level. No significant difference was observed between the average of healthy and unhealthy snack items in IHPS and non-IHPS schools (p > 0.05). On the basis of adjusted analysis, being from/in IHPS was not associated with weekly frequency consumption of unhealthy [prevalence rate ratio (PRR) = 0.99; 95% CI: 0.85-1.16] and healthy (PRR = 1.08; 95% CI: 0.96-1.2) snacks among the adolescents. There was no difference regarding school food environment and snacking behaviors in IHPS and non-IHPS schools. This might indicate that there has been a weakness in institutionalizing the comprehensive concepts of the HPS approach in the studied schools. Addressing the proper understanding of HPS approach and the need for development of HPS through matching and adaptability with health promotion actions to reach defined standards, is necessary.
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Affiliation(s)
- Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Saharnaz Nedjat
- Epidemiology and Biostatistics Department, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Karimi-Shahanjarini
- Department of Public Health and Social Determinants of Health Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Arash Rashidian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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42
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Mansoori P, Majdzadeh R, Abdi Z, Rudan I, Chan KY, Aarabi M, Ahmadnezhad E, Ahmadnia S, Akhondzadeh S, Azin A, Azizi F, Dehnavieh R, Eini-Zinab H, Farzadfar F, Farzaei MH, Ghanei M, Haghdoost A, Hantoushzadeh S, Heydari G, Joulaei H, Kalantari N, Kelishadi R, Khosravi A, Larijani B, Mahvi AH, Bavani ARM, Mesdaghinia A, Mokri A, Montazeri A, Mostafavi E, Motevalian SA, Naddafi K, Nikfar S, Nojoumi SA, Noroozian M, Olyaeemanesh A, Omidvar N, Ostadtaghizadeh A, Pourmalek F, Rahimi R, Rahimi-Movaghar A, Rashidian A, Razaghi E, Sadeghi-Bazargani H, Zalani GS, Soori H, Tabrizi JS, Vedadhir A, Yazdizadeh B, Yunesian M, Zare M. Setting research priorities to achieve long-term health targets in Iran. J Glob Health 2018; 8:020702. [PMID: 30356511 PMCID: PMC6188089 DOI: 10.7189/jogh.08.020702] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Background In 2015, it was estimated that the burden of disease in Iran comprised of 19 million disability-adjusted life years (DALYs), 74% of which were due to non-communicable diseases (NCDs). The observed leading causes of death were cardiovascular diseases (41.9%), neoplasms (14.9%), and road traffic injuries (7.4%). Even so, the health research investment in Iran continues to remain limited. This study aims to identify national health research priorities in Iran for the next five years to assist the efficient use of resources towards achieving the long-term health targets. Methods Adapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 48 prominent Iranian academic leaders in the areas related to Iran’s long-term health targets, a group of research funders and policy makers, and 68 stakeholders from the wider society. 128 proposed research questions were scored independently using a set of five criteria: feasibility, impact on health, impact on economy, capacity building, and equity. Findings The top-10 priorities were focused on the research questions relating to: health insurance system reforms to improve equity; integration of NCDs prevention strategy into primary health care; cost-effective population-level interventions for NCDs and road traffic injury prevention; tailoring medical qualifications; epidemiological assessment of NCDs by geographic areas; equality in the distribution of health resources and services; current and future common health problems in Iran’s elderly and strategies to reduce their economic burden; the status of antibiotic resistance in Iran and strategies to promote rational use of antibiotics; the health impacts of water crisis; and research to replace the physician-centered health system with a team-based one. Conclusions These findings highlight consensus amongst various prominent Iranian researchers and stakeholders over the research priorities that require investment to generate information and knowledge relevant to the national health targets and policies. The exercise should assist in addressing the knowledge gaps to support both the National General Health Policies by 2025 and the health targets of the United Nations’ Sustainable Development Goals by 2030.
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Affiliation(s)
- Parisa Mansoori
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Joint corresponding authors
| | - Reza Majdzadeh
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Community Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran.,School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Joint corresponding authors
| | - Zhaleh Abdi
- National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Kit Yee Chan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,Nossal Institute for Global Health, University of Melbourne, Australia.,Joint corresponding authors
| | | | - Mohsen Aarabi
- Department of Family Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Diabetic Research Center, Cancer Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elham Ahmadnezhad
- National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Azin
- Reproductive Biotechnology Research Center, Avicenna Research Institute (ACECR), Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Dehnavieh
- Health Services Management Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Ghanei
- Chemical Injuries Research Center, Systems Biology and Poisoning Institute, Tehran, Iran
| | - AliAkbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sedigheh Hantoushzadeh
- Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Gholamreza Heydari
- Tobacco Prevention & Control Research Center, National Research Institute of TB & Lung Diseases, Shahid Beheshti University of Medical Sciences Tehran, Iran
| | - Hassan Joulaei
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naser Kalantari
- National Institute and Faculty of Nutrition Sciences and Food Technology, Department of Community Nutrition, Shahid Beheshti University of Medical Sciences
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ardeshir Khosravi
- Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Mahvi
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Center for Solid Waste Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Massah Bavani
- Department of Irrigation and Drainage Engineering, Aburaihan Campus, University of Tehran, Pakdasht, Iran
| | - Alireza Mesdaghinia
- School of Public Health, Tehran University of Medical Sciences, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Azarakhsh Mokri
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Institute for Health Sciences Research, ACECR. Tehran, Iran
| | - Ehsan Mostafavi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Seyed Abbas Motevalian
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.,Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shekoufeh Nikfar
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy and Pharmaceutical Management and Economics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Nojoumi
- Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Maryam Noroozian
- Memory and Behavioral Neurology Division, Department of Psychiatry, Tehran University of Medical Sciences (TUMS), Iran
| | - Alireza Olyaeemanesh
- National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran.,Health Equity Research Centre, Tehran University of Medical Sciences, Tehran Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition, Tehran, Iran
| | - Abbas Ostadtaghizadeh
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical sciences, Tehran, Iran
| | - Farshad Pourmalek
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Roja Rahimi
- Department of Pharmacy in Persian Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Rashidian
- Director of Information, Evidence and Research, Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
| | - Emran Razaghi
- Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Hamid Soori
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences
| | - Jafar Sadegh Tabrizi
- Tabriz Health Services Management Research Center, Health, Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - AbouAli Vedadhir
- Department of Anthropology, Faculty of Social Sciences, University of Tehran, Tehran, Iran.,UCL Department of Science and Technology Studies, University College London, Gower Street, London, UK
| | - Bahareh Yazdizadeh
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Zare
- Engineering Seismology Department, International Institute of Earthquake Engineering and Seismology (IIEES), Tehran, Iran
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Ghodsi D, Omidvar N, Rashidian A, Eini-Zinab H, Raghfar H, Aghayan M. Effectiveness of the national food supplementary program on children growth and nutritional status in Iran. Matern Child Nutr 2018; 14:e12591. [PMID: 29573559 DOI: 10.1111/mcn.12591] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/19/2017] [Accepted: 01/04/2018] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate the effectiveness of the national food distribution program on the growth and nutritional status of malnourished or growth-retarded children in 2 provinces of Iran. A quasi-experimental design was used for the effectiveness evaluation. Qualitative data were gathered to explain the results. An intervention group consisted of 362 children aged 6-72 months who were under coverage of the program. These children received monthly food as foodstuff, food vouchers, or cash. A comparison group included 409 children aged 6-72 months who were selected from those covered by the Primary Health Care system. Children anthropometric indices were measured at the baseline and also 6 months later. Twelve focus group discussions were held with mothers who had at least 1 child under the coverage of the program. At the end of the study, the mean weight-for-age Z scores, height-for-age Z scores, and weight-for-height Z scores increased compared with the baselines in both groups (p < .001). The differences between 2 groups in weight-for-age Z scores, height-for-age Z scores, and weight-for-height Z scores were not significant at the end of the study (p = .62, p = .91, and p = .94, respectively). According to the mothers' reports, factors affected the program outcome, that is, children anthropometric indices were low income, intrahousehold food sharing, irregular distribution, quantity and quality of the distributed food, and insufficient training. Providing foods for the malnourished children living in low-income families helped to prevent a worsening of their nutritional status; however, it has not been effective in solving the problem, probably due to the weak implementation and lack of empowerment strategies.
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Affiliation(s)
- Delaram Ghodsi
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Rashidian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Maryam Aghayan
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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44
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Esfandiari S, Omidvar N, Eini-Zinab H, Doustmohammadian A, Amirhamidi Z. Associations Among Food Insecurity, Academic Performance, and Weight Status in Primary Schoolchildren in Tehran, Iran: A Cross-sectional Study. J Nutr Educ Behav 2018; 50:109-117.e1. [PMID: 28870608 DOI: 10.1016/j.jneb.2017.05.365] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 05/30/2017] [Accepted: 05/31/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To examine the associations among household food insecurity (FI), academic performance, and weight status in urban primary schoolchildren. DESIGN Cross-sectional study. SETTING Primary schools in Tehran, Iran. PARTICIPANTS A total of 803 students (419 boys and 384 girls), aged 10-12 years, were recruited from 43 primary schools. MAIN OUTCOME MEASURES Levels of FI were measured using a locally validated, 18-item household food security survey module. Academic performance was assessed by 152 teachers through a specifically designed, 20-scale questionnaire. Standard anthropometric measurements were also taken. ANALYSIS Linear and multinomial regressions were conducted. RESULTS At the household level, FI was associated with poorer grades in all subjects studied (except for social science in FI without hunger) (P < .05). At the child level, a significant association was observed between low food security and poorer grades in all subjects studied, whereas for very low food security, this relationship was significant only for mathematics, reading, and science (P < .05). Food insecurity without hunger (odds ratio = 2.56; 95% confidence interval, 1.05-6.23) and low food security (odds ratio = 4.41; 95% confidence interval, 1.58-12.23) were associated with overweight only in girls. CONCLUSIONS AND IMPLICATIONS The findings confirm the need for policies and programs to improve students' dietary quality and food security to improve their health as well as educational attainment. Future research is needed to explore further the association between food security and academic performance.
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Affiliation(s)
- Saeed Esfandiari
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aazam Doustmohammadian
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeynab Amirhamidi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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45
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Haghighian Roudsari A, Vedadhir A, Amiri P, Kalantari N, Omidvar N, Eini-Zinab H, Hani Sadati SM. Psycho-Socio-Cultural Determinants of Food Choice: A Qualitative Study on Adults in Social and Cultural Context of Iran. Iran J Psychiatry 2017; 12:241-250. [PMID: 29472950 PMCID: PMC5816913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 08/19/2017] [Accepted: 09/09/2017] [Indexed: 10/24/2022]
Abstract
Objective: Food choice is a process through which people think, feel, and eat food. It does not only influence individuals' health and well-being, families and communities, but also it has an effect on regional, national, and global levels. This qualitative study was conducted to explore perceptions and lived experiences of Tehran adult residents on psychological, social and cultural determinants of food choice. Method: In this qualitative design, we recruited 33 adults aged 30 to 64 years from various districts of Tehran, capital of Iran, and we explored how people make decisions about food choice in practice and shape their perception, attitude, and eating practices. An individual in-depth semi-structured interview guide included major questions with follow-up probes was used to explore participants' current and past eating habits from childhood to adulthood, dietary change at different life courses, and effective psychological state on food selection in different seasons. Results: This study revealed that food choice in the studied adults (30-64 years old) was widely influenced by psychological, social, and cultural determinants, which can be categorized into 5 main themes: cultural context and patterns; social Structure and norms; information resources and media; household and family structure; and nutrition transition. Conclusion: The findings clarified the importance of social and cultural contexts, which influence the food choice of adults in a metropolis like Tehran. Many of these concepts are contextualized from childhood. These findings could serve as guideline to design socio-culturally appropriate strategies and improve dietary behaviors of Iranians.
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Affiliation(s)
- Arezoo Haghighian Roudsari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abouali Vedadhir
- Department of Anthropology, Faculty of Social Sciences, Tehran University, Tehran, Iran
| | - Parisa Amiri
- Department of Social Determinants of Health, Research Institute of Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naser Kalantari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Hani Sadati
- Department of Integrated Studies in Education, Faculty of Education, McGill University, Montreal, CANADA
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46
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Yazdi Feyzabadi V, Keshavarz Mohammadi N, Omidvar N, Karimi-Shahanjarini A, Nedjat S, Rashidian A. Factors Associated With Unhealthy Snacks Consumption Among Adolescents in Iran's Schools. Int J Health Policy Manag 2017; 6:519-528. [PMID: 28949464 PMCID: PMC5582438 DOI: 10.15171/ijhpm.2017.09] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 01/18/2017] [Indexed: 12/03/2022] Open
Abstract
Background: Well-informed interventions are needed if school-based health promotion is to be effective. Among other aims, the Iranian Health Promoting School (IHPS) program that was launched in 2011, has an important aim
of promoting dietary behaviors of adolescents. The present study, therefore, aimed to investigate the factors affecting
unhealthy snacking of adolescents and provide evidence for a more effective IHPS program.
Methods: In a cross-sectional study design, 1320 students from 40 schools in Kerman city were selected using a
proportional stratified random sampling method. A modified qualitative Food Frequency Questionnaire (FFQ) was
used to gather data about unhealthy snacking behavior. Data about intrapersonal and environmental factors were
obtained using a validated and reliable questionnaire. A mixed-effects negative-binomial regression model was used
to analyze the data.
Results: Taste and sensory perception (prevalence rate ratio [PRR]=1.18; 95% CI: 1.09-1.27), being a male (PRR=1.20;
95% CI: 1.05-1.38) and lower nutritional knowledge (PRR=0.96; 95% CI: 0.91-0.99) were associated with higher weekly
unhealthy snaking. Perceived self-efficacy (PRR=0.95; 95% CI: 0.91-1.00) negatively influenced the frequency of
unhealthy snaking, with this approaching significance (P<.06). In case of environmental factors, high socio-economic
status (SES) level (PRR=1.45; 95% CI: 1.26-1.67), single-parent family (PRR=1.14; 95% CI: 1.01-1.30), more social
norms pressure (PRR=1.08; 95% CI: 1.01-1.17), pocket money allowance (PRR=1.21; 95% CI: 1.09-1.34), easy
accessibility (PRR=1.06; 95% CI:1.01-1.11), and less perceived parental control (PRR=0.96; 95% CI: 0.92-0.99) all had
a role in higher consumption of unhealthy snacks. Interestingly, larger school size was associated with less unhealthy
snacking (PRR=0.79; 95% CI: 0.68-0.92).
Conclusion: Unhealthy snacking behavior is influenced by individual, socio-cultural and physical-environmental
influences, namely by factors relating to poor parenting practices, high SES level, family characteristics, improper social
norms pressure, and less knowledge and self-efficacy of students. This evidence can be used to inform a more evidencebased
IHPS program through focusing on supportive strategies at the home, school, and local community levels.
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Affiliation(s)
- Vahid Yazdi Feyzabadi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akram Karimi-Shahanjarini
- Social Determinants of Health Research Center and Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saharnaz Nedjat
- Epidemiology and Biostatistics Department, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Rashidian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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47
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Doustmohammadian A, Omidvar N, Keshavarz-Mohammadi N, Abdollahi M, Amini M, Eini-Zinab H. Developing and validating a scale to measure Food and Nutrition Literacy (FNLIT) in elementary school children in Iran. PLoS One 2017; 12:e0179196. [PMID: 28654646 PMCID: PMC5487019 DOI: 10.1371/journal.pone.0179196] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 05/25/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Food and nutrition literacy is an emerging term which is increasingly used in policy and research. Though research in this area is growing, progression is limited by the lack of an accepted method to measure food and nutrition literacy. The aim of this study is to develop a valid and reliable questionnaire to assess food and nutrition literacy in elementary school children in the city of Tehran. METHODS The study was conducted in three phases. To develop Food and Nutrition Literacy (FNLIT) questionnaire, a comprehensive literature review and a qualitative study were initially performed to identify food and nutrition literacy dimensions and its components. Content and face validity of the questionnaire were evaluated by an expert panel as well as students. In the second phase, construct validity of the scale was evaluated using Explanatory Factor Analyses (EFA) and Confirmatory Factor Analyses (CFA). In the last phase (confirmatory phase), the final version of the questionnaire was evaluated on 400 students. RESULTS Findings show Content Validity Ratio (CVR) and Content Validity Index (CVI) of the 62-item questionnaire at acceptable levels of 0.87 and 0.92, respectively. EFA suggested a six-factor construct, namely, understanding food and nutrition information, knowledge, functional, interactive, food choice, and critical. The results of CFA indicated acceptable fit indices for the proposed models. All subscales demonstrated satisfactory internal consistency (Cronbach's alpha≥0.70), except for critical skill subscale (0.48). The intraclass correlation coefficient (ICC = 0.90, CI: 0.83-0.94) indicated that Food and Nutrition Literacy (FNLIT) scale had satisfactory stability. Each phase of development progressively improved the questionnaire, which resulted in a 46-item (42 likert-type items and 4 true-false items) Food and Nutrition Literacy (FNLIT) scale. The questionnaire measured two domains with 6 subscales, including: 1) cognitive domain: understanding and knowledge; 2) skill domain: functional, food choice, interactive, and critical skills. CONCLUSION The developed food and nutrition literacy scale is a valid and reliable instrument to measure food and nutrition literacy in children. This measure lays a solid empirical and theoretical foundation for future research and tailored interventions to promote food and nutrition literacy in this age group.
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Affiliation(s)
- Aazam Doustmohammadian
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Morteza Abdollahi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Amini
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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48
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Ghodsi D, Omidvar N, Rashidian A, Raghfar H, Eini-Zinab H, Ebrahimi M. Key Informants' Perceptions on the Implementation of a National Program for Improving Nutritional Status of Children in Iran. Food Nutr Bull 2016; 38:78-91. [PMID: 28006961 DOI: 10.1177/0379572116682870] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Childhood malnutrition is a major public health issue. Multidisciplinary approach for Improvement of Nutritional Status of Children in Iran was implemented in order to reduce malnutrition among children. OBJECTIVE This study aimed to evaluate the implementation aspect of the program and to explore key informants' perceptions and experience regarding the factors affected its implementation. METHODS Data were collected through the review of secondary data and semistructured interviews at national, province, and local levels. Four layers of key informants were selected purposefully for interviewing, including policymakers, senior nutrition officers, head of Hygiene, Remedy and Insurance Affairs in Imam Khomeini Relief Foundation, and community health workers. Qualitative content analysis was carried out based on Supporting the Use of Research Evidence framework and Tailored Implementation for Chronic Diseases' checklist to interpret the viewpoints of the study participants. RESULTS Results showed that the program had successes in improving mother's knowledge on health, nutrition, and child care through health system and increased families' access to food, but there were some aspects that affected program's implementation. Some of these factors are the lack of clarity in the program's protocol and indicators, human shortage and inadequate financial resources, poor facilities, inattention to staff motivation, insufficient commitment among different sections, poor communication and supervision among different executive sections, and program protocols designing regardless of practical condition. CONCLUSION Based on the results, top-down approach in policymaking and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.
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Affiliation(s)
- Delaram Ghodsi
- 1 Department of Community nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- 1 Department of Community nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Rashidian
- 2 School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hassan Eini-Zinab
- 1 Department of Community nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marziyeh Ebrahimi
- 4 Department of Social Pathology, Academic Center of Education and Culture and Research, Kharazmi University, Tehran, Iran
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49
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Sadegholvad S, Yeatman H, Omidvar N, Parrish AM, Worsley A. Best Strategies to Improve School-leavers' Knowledge of Nutrition and Food Systems: Views from Experts in Iran. Int J Prev Med 2016; 7:119. [PMID: 27857832 PMCID: PMC5093892 DOI: 10.4103/2008-7802.193094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 09/26/2016] [Indexed: 12/01/2022] Open
Abstract
Background: The research to date does not present an articulated approach to ensure nutrition and food systems education is systematically implemented within schools. This paper aimed to investigate food experts’ views of the best strategies to improve school-leavers’ knowledge of nutrition and food systems. Methods: In this qualitative study, 28 Iranian food and nutrition experts from four major provinces (Tehran, Fars, Isfahan, and Gilan) were selected and agreed to be interviewed. Required data were collected through in-depth, semi-structured, face-to-face, or telephone interviews and were analyzed thematically using NVivo. Results: The experts’ suggested strategies to improve Iranian school-leavers’ knowledge of nutrition and food systems fell into three key themes: Policy, education processes, and supportive environments. Together they formed an overarching theme of a multileveled system approach for transferring knowledge. Conclusions: Development of a scaffolded education program could assist curriculum developers and policy makers to assess and update current nutrition and food systems education programs in schools. Insights gained about education initiatives in one country such as Iran can provide an important impetus to support nutrition and food system education more widely.
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Affiliation(s)
- Sanaz Sadegholvad
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, NSW, Australia
| | - Heather Yeatman
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, NSW, Australia
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anne-Maree Parrish
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, NSW, Australia
| | - Anthony Worsley
- Centre for Physical Activity Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
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50
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Rezazadeh A, Omidvar N, Eini-Zinab H, Ghazi-Tabatabaie M, Majdzadeh R, Ghavamzadeh S, Nouri-Saeidlou S. General and Central Obesity in Two Iranian Ethnic Groups Living in Urmia, West Azerbaijan, Iran: Effect of the Neighborhood Environment. Iran Red Crescent Med J 2016; 18:e27591. [PMID: 27651949 PMCID: PMC5020783 DOI: 10.5812/ircmj.27591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 02/17/2015] [Accepted: 03/07/2015] [Indexed: 11/16/2022]
Abstract
Background Emerging evidence suggests that neighborhood characteristics can have direct and indirect effects on the weight status of the residents. Objectives To assess the relationship between general and central obesity and the neighborhood environment in two ethnic groups (Azeri Turks and Kurds) living in Urmia city, Northwestern Iran. Patients and Methods In this cross-sectional study, 723 participants (427 women and 296 men) aged 20 - 64 years from two ethnic groups (Azeri Turks, n = 445; Kurds, n = 278) were selected from 38 neighborhoods using a combination of cluster, random, and systematic sampling methods. Neighborhood characteristics were obtained by a validated 22-item neighborhood and a health observational checklist. General and central obesity were measured and evaluated using standard methods. Principal component analysis (PCA) was used to define the dominant neighborhood environment. The association of neighborhood characteristics with general and central obesity was analyzed by a logistic regression model. Results Three common neighborhood environments were identified: 1) modern-affluent, 2) central-high access and 3) marginal. These three factors explained 73.2% of the total variance. Overall, the participants living in a higher tertile of the central-high access neighborhoods had an increased chance of central obesity (OR = 1.63, 95% CI: 1.13 - 2.34). Azeri Turks living in the highest tertile of the modern-affluent neighborhoods had a significantly higher likelihood of having general obesity (OR = 2.49, 95% CI: 1.37 - 4.01). Adjustment for age, gender, marital status, socioeconomic status (SES), energy intake, and physical activity did not change the results. However, after adjustment for educational level, the association was not significant. Conclusions The findings point to a relationship between neighborhood characteristics and obesity only in the Azeri Turks. However, educational level was more important than neighborhood quality in predicting the risk of obesity
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Affiliation(s)
- Arezoo Rezazadeh
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Nasrin Omidvar, Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2122357484, E-mail:
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | | | - Reza Majdzadeh
- National Institute of Health Research, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Saeid Ghavamzadeh
- Nutrition Department, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, IR Iran
| | - Sakineh Nouri-Saeidlou
- Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, IR Iran
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