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Mehrabani S, Shoaei N, Shateri Z, Askarpour M, Nouri M, Keshani P, Honarvar B, Homayounfar R. Consumption of ultra-processed foods could influence the metabolic syndrome odds: A cross-sectional study. Food Sci Nutr 2024; 12:2567-2577. [PMID: 38628179 PMCID: PMC11016394 DOI: 10.1002/fsn3.3938] [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: 08/28/2023] [Revised: 12/13/2023] [Accepted: 12/20/2023] [Indexed: 04/19/2024] Open
Abstract
Metabolic syndrome (MetS) prevalence has augmented globally during recent decades. Over the past years, the consumption of ultra-processed foods (UPFs) has grown significantly worldwide. So, the present research investigated the association between UPFs and MetS in an Iranian sample. This cross-sectional research was conducted on people (n = 8841) in the Fasa cohort study, Fars province, Iran. The participants' dietary consumption over a year, UPF consumption, and MetS diagnosis were evaluated through a 125-item modified food frequency questionnaire, the NOVA food group classification, and the Adult Treatment Panel III of the National Cholesterol Education Program, respectively. The association between the quartiles (Q) of UPF intake and the odds of MetS was estimated using the backward LR method of multivariate analysis. In the multivariate model, after adjusting potential confounders, the association between UPF intake and the odds of MetS was significant (Q4: odds ratio (OR = 3.27; 95% confidence interval (CI): 2.76-3.89). Also, the odds of increasing triglycerides (TG), blood pressure, and fasting blood sugar (FBS) and decreasing high-density lipoprotein cholesterol (HDL-C) were significantly higher in the last quartile compared to the first quartile of UPFs (TG: OR = 1.71; 95% CI: 1.49-1.97, blood pressure: OR = 1.53; 95% CI: 1.30-1.79, FBS: OR = 1.30; 95% CI: 1.10-1.54, and HDL-C: OR = 1.22; 95% CI: 1.08-1.39). The current research found a relationship between UPF intake and MetS and its components, indicating a diet-containing UPFs can be related to the occurrence of noncommunicable diseases.
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Affiliation(s)
- Sanaz Mehrabani
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
- Department of Clinical Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
| | - Niloofar Shoaei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Zainab Shateri
- Department of Nutrition and Biochemistry, Faculty of MedicineIlam University of Medical SciencesIlamIran
| | - Moein Askarpour
- Department of Clinical Nutrition, School of Nutritional Sciences and DieteticsShiraz University of Medical SciencesShirazIran
- Students' Research Committee, School of Nutrition and Food ScienceShiraz University of Medical SciencesShirazIran
| | - Mehran Nouri
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
- Students' Research Committee, School of Nutrition and Food ScienceShiraz University of Medical SciencesShirazIran
- Department of Community Nutrition, School of Nutrition and Food SciencesShiraz University of Medical SciencesShirazIran
| | - Parisa Keshani
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Behnam Honarvar
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Reza Homayounfar
- National Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical SciencesTehranIran
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Joulaei H, Keshani P, Kashfinejad SM, Foroozanfar Z, Mohsenpour MA, Fararouei M. To assess the contributing factors of nutritional and health status amongst elderlies residing in the nursing homes of fars province, Iran: A cross sectional study. Health Sci Rep 2024; 7:e1940. [PMID: 38455646 PMCID: PMC10918975 DOI: 10.1002/hsr2.1940] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/17/2023] [Accepted: 02/17/2024] [Indexed: 03/09/2024] Open
Abstract
Background and Aims In line with the global trend, the number of elderly is rising in Iran. It should be noted that the nutritional and health needs of these people, especially those living in nursing houses, are extremely significant. The present study aimed to identify the nutritional and health status and uncover their relationship with received care services by elderlies residing in nursing homes. Methods All 373 elderlies living in the nursing homes in Shiraz entered the study, and the requisite data were collected by references to elderlies' files, respective nurses, and elderlies themselves. Results The majority of the elderlies were at risk of malnutrition (62.5% of the total population, 55.4% of females, and approximately 44.6% of males). Elderlies with no insurance coverage mainly fell into the at-risk and malnutrition categories. There was a significant relationship between the needs assessment scores, reflecting the need for physical and psychological actions, and elderlies' malnutrition (odds ratio = 1.87, 95% confidence interval: 1.79-1.95). For each unit increase in the Physical and psychological need score, the odds of exposure to malnutrition (vs. nonmalnourished and at risk of malnutrition) was 1.87 times after adjustment for confounders. Conclusion The results of our study revealed that most of the elderlies living in the nursing homes of Shiraz had some levels of malnutrition such as at-risk for malnutrition (62.5%) and malnourished (18.9%). Based on these results, it is suggested that health policy-makers take practical steps toward promoting the nutritional care of old people and direct extra supervision to nursing homes and all healthcare provisions.
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Affiliation(s)
- Hassan Joulaei
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Parisa Keshani
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | | | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | | | - Mohammad Fararouei
- Department of EpidemiologyShiraz University of Medical SciencesShirazIran
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Nouri M, Shateri Z, Rezaei M, Zangene A, Homayounfar R, Keshani P. Healthy beverage index could decrease odds of metabolic syndrome: A cross-sectional study. Food Sci Nutr 2023; 11:4562-4571. [PMID: 37576062 PMCID: PMC10420765 DOI: 10.1002/fsn3.3415] [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: 11/27/2022] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 08/15/2023] Open
Abstract
Some studies indicated that sugar-sweetened beverages (SSBs) were related to MetS risk, and others found no relationship between MetS and SSBs. Therefore, the present study aimed to investigate the relationship between healthy beverage index (HBI) and MetS in Iranian adults. This cross-sectional study was performed on baseline data FASA cohort. Out of 10,127 participants in the FASA cohort study, 8838 participants were included in this study. The National Cholesterol Education Program's Adult Treatment Panel (ATP) III was used for MetS definition. The HBI was calculated by a 125-item food frequency questionnaire with standard criteria. The association between HBI and MetS and its components was evaluated by univariate regression. Multivariate regression with the backward method was used for adjusting confounders. p < .05 was considered as statistically significant. Compared to the first quartile, it was observed that HBI in the last quartile was significantly related to lower odds of MetS in the multivariate analysis (odds ratio [OR] = 0.72; 95% confidence interval [CI]: 0.60-0.87, p < .001). Also, we observed a significant association between the last quartile of HBI with lower odds of high waist circumference (WC) (OR = 0.55; 95% CI: 0.45-0.67, p < .002). Our findings showed that the higher HBI score reduced MetS odds and WC. Therefore, to reduce the odds of MetS, a healthy pattern of beverage consumption, including drinking water, low-fat milk, unsweetened tea, and coffee, and reducing the consumption of SSB are recommended. More studies are needed to confirm the findings.
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Affiliation(s)
- Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food SciencesShiraz University of Medical SciencesShirazIran
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Zainab Shateri
- Student Research CommitteeAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Mahshid Rezaei
- Science and Research BranchIslamic Azad University of TehranTehranIran
| | - Ali Zangene
- Department of Community Nutrition, School of Nutrition and Food SciencesIsfahan University of Medical SciencesIsfahanIran
| | - Reza Homayounfar
- Non‐Communicable Diseases Research CenterFasa University of Medical SciencesFasaIran
| | - Parisa Keshani
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
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Omidifar N, Bagheri Lankarani K, Aghazadeh Ghadim MB, Khoshdel N, Joulaei H, Keshani P, Saghi SA, Nikmanesh Y. The Seroprevalence of Hepatitis A in Patients with Positive Human Immunodeficiency Virus. Middle East J Dig Dis 2023; 15:196-202. [PMID: 38023458 PMCID: PMC10660319 DOI: 10.34172/mejdd.2023.344] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background: Hepatitis A virus (HAV) can have severe manifestations in adult patients with other liver diseases, particularly in those infected with human immunodeficiency virus (HIV). This study aimed to measure immunity against HAV in HIV-positive individuals to determine the necessity of vaccination against HAV in this population. Methods: This cross-sectional study investigated 171 HIV-positive patients aged 18 years or older who were tested for serum IgG anti-viral hepatitis A antibody. The prevalence and its determinants were analyzed based on patient data. Results: The average age of the patients was 44.2 years old. The prevalence of HAV antibody positivity was 97.7%. The prevalence was higher in patients older than 30 years. There was a close association between hepatitis C virus (HCV) infection (P=0.002). There were no significant correlations between antibody levels and sex, marital status, employment status, education level, economic status, smoking status, drug use status, and physical activity level. The mean and median CD4+ counts in patients with positive (reactive) antibody (Ab) levels were 458 and 404±294, respectively, while the mean and median CD4+ counts in patients with non-reactive antibody levels were 806 and 737±137, respectively, in those who tested negative for anti-HAV Ab (P=0.05). Conclusion: The prevalence of anti-hepatitis A IgG antibodies in people with HIV was very high in Shiraz. There is an increasing trend in the number of older patients and those with HCV infections. The negative association with CD4 was borderline in this study, which needs to be confirmed in larger groups.
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Affiliation(s)
- Navid Omidifar
- Biotechnology Research Center and Department of Pathology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Department of Internal Medicine, School of Medicine, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mir Behrad Aghazadeh Ghadim
- Department of Clinical Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nika Khoshdel
- Department of Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Joulaei
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyyed Amirreza Saghi
- Cellular and Molecular Biology Research Center, Larestan University of Medical Sciences, Larestan, Iran
- Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran
| | - Yousef Nikmanesh
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Keshani P, Sarihi S, Parsaie N, Joulaei H. Dietary pattern association with CD4 cells count in patients living with human immunodeficiency virus: A cross-sectional study. J Public Health Res 2023; 12:22799036231181200. [PMID: 37434871 PMCID: PMC10331780 DOI: 10.1177/22799036231181200] [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: 07/07/2022] [Accepted: 04/28/2023] [Indexed: 07/13/2023] Open
Abstract
Background Considering contradictory reports about the impact of dietary pattern on CD4 cell count in previous studies and the potential importance of diet on the immune system, this study aimed to assess the association between dietary patterns and CD4 count among HIV-infected patients. Methods This cross-sectional study was conducted among HIV-infected patients aged 18-60 who registered in the referral Voluntary Counseling and Testing Center of Shiraz, Iran. The principal component analysis identified nutritional patterns and factors. The association between the score of the dietary patterns and CD4 count was considered in two categories of CD4 more/less than 500 and using backward logistic regression after adjusting for confounders. Results A total of 226 participants were included in the analysis. CD4 was significantly lower in males (p < 0.001). Participants with illegal drug use (p < 0.001), HCV (p = 0.001), and HBV (p < 0.001) had lower serum CD4. Four extracted dietary patterns were a Plant-rich diet, Healthy animal-based proteins, a Western diet, and Affordable calorie and protein patterns. There was an association between CD4 and Western diet patterns in the best model in which age, gender, weight, and HBV were included. Each unit increase in Western diet score increased the odds of CD4 less than 500 by 57% (OR = 1.57; CI 95% 1.06-2.34, p = 0.02). Conclusion Among the four dietary patterns, the Western diet comprising a high intake of refined sugar and grain, saturated and trans fats, and animal protein sources, especially high-fat red meat, had a statistically significant relationship with a decrease in CD4 cell count.
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Affiliation(s)
- Parisa Keshani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sorour Sarihi
- Department of Human Nutrition and Hospitality Management, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL, USA
- Alabama Research Institute on Aging(ARIA), The University of Alabama, Tuscaloosa, AL, USA
| | - Narges Parsaie
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Joulaei
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Joulaei H, Keshani P, Foroozanfar Z, Afrashteh S, Hosseinkhani Z, Mohsenpour MA, Moghimi G, Homayouni Meymandi A. Food insecurity status and its contributing factors in slums' dwellers of southwest Iran, 2021: a cross-sectional study. Arch Public Health 2023; 81:38. [PMID: 36899422 PMCID: PMC9999310 DOI: 10.1186/s13690-023-01049-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 02/24/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND One major factor causing food insecurity is believed to be poverty. Approximately 20 million Iranians live in slums with a vulnerable socioeconomic context. The outbreak of COVID-19, on top of the economic sanctions against Iran, has increased this vulnerability and made its inhabitants prone to food insecurity. The current study investigates food insecurity and its associated socioeconomic factors among slum residents of Shiraz, southwest Iran. METHODS Random cluster sampling was used to select the participants in this cross-sectional study. The heads of the households completed the validated Household Food Insecurity Access Scale questionnaire to assess food insecurity. Univariate analysis was utilized to calculate the unadjusted associations between the study variables. Moreover, a multiple logistic regression model was employed to determine the adjusted association of each independent variable with the food insecurity risk. RESULTS Among the 1227 households, the prevalence of food insecurity was 87.20%, with 53.87% experiencing moderate and 33.33% experiencing severe food insecurity. A significant relationship was observed between socioeconomic status and food insecurity, indicating that people with low socioeconomic status are more prone to food insecurity (P < 0.001). CONCLUSIONS The current study revealed that food insecurity is highly prevalent in slum areas of southwest Iran. The socioeconomic status of households was the most important determinant of food insecurity among them. Noticeably, the coincidence of the COVID-19 pandemic with the economic crisis in Iran has amplified the poverty and food insecurity cycle. Hence, the government should consider equity-based interventions to reduce poverty and its related outcomes on food security. Furthermore, NGOs, charities, and governmental organizations should focus on local community-oriented programs to make basic food baskets available for the most vulnerable households.
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Affiliation(s)
- Hassan Joulaei
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sima Afrashteh
- Department of Public Health, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Zahra Hosseinkhani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Ali Mohsenpour
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ghasem Moghimi
- Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Homayouni Meymandi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Ghasabi F, Hashempour A, Khodadad N, Bemani S, Keshani P, Shekiba MJ, Hasanshahi Z. First report of computational protein-ligand docking to evaluate susceptibility to HIV integrase inhibitors in HIV-infected Iranian patients. Biochem Biophys Rep 2022; 30:101254. [PMID: 35368742 PMCID: PMC8968007 DOI: 10.1016/j.bbrep.2022.101254] [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: 01/15/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/04/2022] Open
Abstract
Background Iran has recently included integrase (INT) inhibitors (INTIs) in the first-line treatment regimen in human immunodeficiency virus (HIV)-infected patients. However, there is no bioinformatics data to elaborate the impact of resistance-associated mutations (RAMs) and naturally occurring polymorphisms (NOPs) on INTIs treatment outcome in Iranian patients. Method In this cross-sectional survey, 850 HIV-1-infected patients enrolled; of them, 78 samples had successful sequencing results for INT gene. Several analyses were performed including docking screening, genotypic resistance, secondary/tertiary structures, post-translational modification (PTM), immune epitopes, etc. Result The average docking energy (E value) of different samples with elvitegravir (EVG) and raltegravir (RAL) was more than other INTIs. Phylogenetic tree analysis and Stanford HIV Subtyping program revealed HIV-1 CRF35-AD was the predominant subtype (94.9%) in our cases; in any event, online subtyping tools confirmed A1 as the most frequent subtype. For the first time, CRF-01B and BF were identified as new subtypes in Iran. Decreased CD4 count was associated with several factors: poor or unstable adherence, naïve treatment, and drug user status. Conclusion As the first bioinformatic report on HIV-integrase from Iran, this study indicates that EVG and RAL are the optimal INTIs in first-line antiretroviral therapy (ART) in Iranian patients. Some conserved motifs and specific amino acids in INT-protein binding sites have characterized that mutation(s) in them may disrupt INT-drugs interaction and cause a significant loss in susceptibility to INTIs. Good adherence, treatment of naïve patients, and monitoring injection drug users are fundamental factors to control HIV infection in Iran effectively.
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Key Words
- Antiretroviral therapy, ART
- Behavioral Diseases Consultation Center, BDCC
- Bictegravir, BIC
- C-terminal domain, CTD
- CRF35-AD
- Cabotegravir, CBT
- Catalytic core domain, CCD
- Dolutegravir, DTG
- Drug resistance
- Elvitegravir, EVG
- Grand average hydropathy, GRAVY
- HIV
- Human immunodeficiency virus, HIV
- INT, Integrase
- INTIs, Integrase inhibitors (INTIs)
- Injecting drug users, IDUs
- Integrase
- Integrase inhibitors
- Molecular docking
- N-terminal domain, NTD
- Naturally occurring polymorphisms, NOPs
- Post-translational modification, PTM
- Raltegravir, RAL
- Resistance-associated mutations, RAMs
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Affiliation(s)
- Farzane Ghasabi
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ava Hashempour
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nastaran Khodadad
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soudabeh Bemani
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamad Javad Shekiba
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Hasanshahi
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Keshani P, Shahraki HR. Modeling trend changes in percent of under five-year-old children with malnutrition amongst 39 Asian countries from 1987 to 2016 via growth mixture model. BMC Nutr 2022; 8:38. [PMID: 35484594 PMCID: PMC9052463 DOI: 10.1186/s40795-022-00530-x] [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: 08/04/2021] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
Purpose Malnutrition is an important public health issue and the main cause of child morbidity and mortality, especially in developing countries. The present study aimed to model trend changes in percentage of the malnourished children under 5 among 39 Asian countries during 1987 to 2016. Methods Information about percentage of the malnourished under 5 years children based on under-weight (weight for age) malnutrition for 39 Asian countries were extracted from Gapminder web site during 1987 to 2016. To cluster Asian countries based on trend changes, Growth Mixture Model (GMM) was implemented. All the statistical analyses were performed in Mplus 7.4 software and P < 0.10 in likelihood ratio test (LRT) was considered as statistically significant. Results Based on P-value of LRT, the model with 3 clusters was selected. Although, cluster 3 with 9 countries had higher intercept in 1987 and the worst situation in malnutrition, they gained a sharp decrease (− 0.93) in percentage of malnourished children under five annually. The slope of − 0.64 for cluster 1 countries indicate a moderate decrease annually in percent of children with malnutrition. The other 20 countries with slope of − 0.29 in their linear trend belonged to cluster 2 which shows slow decrease in the percentage of children with malnutrition. Conclusion The investments in public health and education programs, as well as political commitment and government proper response in line with needs and demands are crucial to promote food security, nourishing diets and improving child nutrition. Certainly, most of them are still a long way from eradicating malnutrition.
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Affiliation(s)
- Parisa Keshani
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Rahmatieh Educational Complex, Shahrekord, Iran.
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Joulaei H, Keshani P, Foroozanfar Z, Zamanian D, Hassani A, Parvizi F, Khadem Y, Omidifar N, Davarpanah MA. Serum zinc associated with immunity and inflammatory markers in Covid-19. Open Med (Wars) 2022; 17:702-711. [PMID: 35480398 PMCID: PMC8990765 DOI: 10.1515/med-2022-0469] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 01/01/2022] [Accepted: 03/09/2022] [Indexed: 01/08/2023] Open
Abstract
This study aimed to assess the association between serum zinc level with some inflammatory and immunity factors and the duration of hospitalization and mortality rate in patients diagnosed with Covid-19. In this cross-sectional study, blood samples were taken from polymerase chain reaction (PCR) positive patients. New patients diagnosed with Covid-19, admitted to different public hospital wards, were considered eligible for entering the study. The study was done on 179 hospitalized patients diagnosed with Covid-19. Fourteen patients died during the hospitalization and the in-hospital mortality rate was 7.8%, with 9.1% (13 patients) of patients with serum zinc level less than 70 mcg/dL and 3.4% (1 patient) of patients with zinc levels more than 70 mcg/dL. Higher levels of zinc were significantly associated with a higher and lower level of interferon-gamma (IFN-γ) (p-value = 0.035) and interleukin (IL)-6 (p-value = 0.004), respectively. The level of serum zinc did not have a significant association with mortality even after adjusting for confounding factors. The relationship between zinc level and the duration of hospitalization was also not significant. In conclusion, serum zinc level had an association with IL-6 and IFN-γ level, but it did not have any significant association with hospital duration or mortality.
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Affiliation(s)
- Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Parisa Keshani
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Daniel Zamanian
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences , Shiraz , Iran
| | | | - Fateme Parvizi
- School of Medicine, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Yasaman Khadem
- School of Medicine, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Navid Omidifar
- Clinical Education Research Center, and Department of Pathology, School of Medicine, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Mohammad Ali Davarpanah
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences , Shiraz , Iran
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Joulaei H, Keshani P, Ashourpour M, Bemani P, Amiri S, Rahimi J, Aliakbarpour M, Salehi-Abargouei A. The prevalence of stunting among children and adolescents living in the Middle East and North Africa region (MENA): A systematic review and meta-analysis. J Glob Health 2022; 11:04070. [PMID: 35003712 PMCID: PMC8711751 DOI: 10.7189/jogh.11.04070] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Given the strategic importance of the MENA, the state of war and inequity in the region and its effect on malnutrition which leads to mortality and reduced economic development in this region, the current study purposed to examine the prevalence of stunting as an indicator of chronic malnutrition in the MENA region, with consideration given HDI, rural/urban area, and war-involved countries. Methods The electronic databases of PubMed, SCOPUS, Web of science, and Embase were systematically searched, and English-language articles published between January 1, 2009 and December 31, 2019 were included in this study. The POLIS (population, outcome, location, indicator, study design) criteria were used to perform the systematic review, and studies involving children 2 to 18 years of age were selected. Results Fifty-eight (n = 2 202 869) were included based on the study's inclusion criteria. The prevalence of stunting in children in the total MENA region was 22.0% (95% confidence interval (CI) = 20.4-23.6; I2 = 99.92%, P < 0.0001). The studies included in the meta-analysis were analyzed by subgroups. The pooled prevalence of stunting in children aged 2-5 years old and children aged 6 and older was 25.7% and 16.5%, respectively. The pooled prevalence of stunting was 34.1% in rural and 12.4% in urban areas. The pooled prevalence of stunting according to HDI was 30.1%, 28.5%, 13.1%, in low, medium, and high HDI countries, respectively. Furthermore, the pooled prevalence of stunting according to war status was 28.5% in war-involved countries vs 20.6% in others. Conclusions High prevalence of malnutrition was seen based on stunting indicator in the meta-analysis study in the MENA region, and this issue became more pronounced when the data was divided into subgroups based on age, residential area, and HDI. Inequality regarding social, economic, and political factors leads to significant malnutrition in the mentioned region.
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Affiliation(s)
- Hassan Joulaei
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahkameh Ashourpour
- Department of Nutrition Sciences, School of Health, Larestan University of Medical Sciences, Larestan, Iran.Emam Reza Teaching Hospital, Larestan University of Medical Sciences, Larestan, Iran
| | - Peyman Bemani
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sanaz Amiri
- Department of Epidemiology, Health School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamileh Rahimi
- Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mohsen Aliakbarpour
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Department of nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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11
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Yosaee S, Clark CCT, Keshtkaran Z, Ashourpour M, Keshani P, Soltani S. Zinc in depression: From development to treatment: A comparative/ dose response meta-analysis of observational studies and randomized controlled trials. Gen Hosp Psychiatry 2022; 74:110-117. [PMID: 32829928 DOI: 10.1016/j.genhosppsych.2020.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 08/01/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND A previous meta-analysis suggested that zinc status may be linked to depression status. However, it remains unclear whether zinc status can predict the risk of depression development, or whether the monotherapy of zinc is superior to the combination of zinc supplementation and antidepressant medications in the treatment of depression. Therefore, this meta-analysis aimed to clarify the impact of zinc status and supplementation on depression development and status across all available evidence. METHODS PubMed, EMBASE, Scopus, and ISI web of science were searched, up to 14 May 2020, for relevant publications. Pooled relative risks (RRs) with 95% confidence intervals (CI) in observational studies, and mean and standard deviation (SD) for the change in depression score in RCTs were calculated using a random-effects model. RESULTS The meta-analysis of RCTs indicated that zinc supplementation significantly lowered depressive symptom scores of depressed patients [weighted mean difference (WMD = -4.15 point; 95% CI: -6.56, -1.75 point; P < 0.01)], and the improvement in depression status occurred only when zinc supplementation was prescribed as a monotherapy. The cohort studies showed that the highest level of zinc intake was associated with a 28% reduced risk of depression (RR: 0.66; 95% CI: 0.50, 0.82; I2 = 13.90). Dose-response analyses revealed a significant non-linear effect of baseline mood status on depression score. CONCLUSION Current evidence from observational studies and RCT's supports the potential benefits zinc to reduce the risk of, and alleviate, depression. However, further trials are needed to confirm the beneficial effect of zinc as a monotherapy versus adjunctive therapies.
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Affiliation(s)
- Somaye Yosaee
- Department of Nutrition Sciences, School of Health, Larestan University of Medical Sciences, Larestan, Iran; Emam Reza Teaching Hospital, Larestan University of Medical Sciences, Larestan, Iran
| | - Cain C T Clark
- Faculty Research Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Zahra Keshtkaran
- Nursing Department, Community based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahkameh Ashourpour
- Department of Nutrition Sciences, School of Health, Larestan University of Medical Sciences, Larestan, Iran; Emam Reza Teaching Hospital, Larestan University of Medical Sciences, Larestan, Iran
| | - Parisa Keshani
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sepideh Soltani
- Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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12
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Sharifi MH, Keshani P, Salehi A, Jaladat AM, Mirzaei Z, Nikseresht A. Association between multiple sclerosis and dietary patterns based on the traditional concept of food nature: a case-control study in Iran. BMC Neurol 2021; 21:453. [PMID: 34794406 PMCID: PMC8600729 DOI: 10.1186/s12883-021-02483-3] [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: 09/05/2021] [Accepted: 11/08/2021] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION It remains a matter of debate whether traditional concepts regarding the nature of food affect the development and progression of multiple sclerosis (MS).To date, there are limited studies that have investigated the association between MS and dietary patterns based on the categories of food nature (hot, cold, or balanced) defined in traditional medicine. METHOD This case-control study was conducted from October 2019 to February 2020. In total, 60 patients diagnosed with MS within the preceding 6 months and referred to our neurology outpatient clinic were included in our case group. The control group included 180 patients who were referred to the same center for general or orthopedic surgery. Dietary intake was assessed in both groups through a reliable and valid semi-quantitative food frequency questionnaire. Data were assessed using principal component analysis. RESULTS The mean age of the participants was 44.9 ± 17.33 years. The analysis showed that four food patterns were distinguished (eigenvalue > 1), namely "additives and cold-natured foods", "hot and balanced foods and nuts", "dairy and legumes", and "hot and balanced starches". These food patterns explained 57.8% of the total variance. After adjusting all confounding factors, individuals in the highest quartile and medium quartile of "additives and cold-natured foods" had an elevated MS risk compared with the lowest quartile (OR = 7.21, 95%CI = 2.01-12.38 and OR = 3.37, 95%CI = 1.02-11.35, respectively). Furthermore, individuals in the highest quartile of the "hot and balanced foods and nuts" group were protected against MS compared with its lowest quartile (OR = 0.28, 95%CI = 0.08-0.90). Moreover, a protective effect against MS was seen in the highest quartile of the "hot and balanced starches" group relative to its lowest quartile (OR = 0.34, 95%CI = 0.12-0.98). No significant association was found between "dairy and legumes" and the risk of MS. CONCLUSION This study revealed that dietary patterns based on the traditional concept of food nature might be associated with the risk of developing MS. This represents the first work in this area, so further research is recommended.
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Affiliation(s)
- Mohammad Hossein Sharifi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Salehi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zahra Mirzaei
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Alireza Nikseresht
- Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
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13
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Tabrizi R, Borhani-Haghighi A, Lankarani KB, Keshani P, Heydari ST, Keshavarz P, Azarpazhooh MR. Reliability and Validity of Simple Stroke Food Frequency Questionnaire (SS-FFQ) for Nutrition Monitoring in Patients with Acute Ischemic Stroke. J Neurosci Rural Pract 2021; 12:51-59. [PMID: 33531760 PMCID: PMC7846314 DOI: 10.1055/s-0040-1718843] [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] [Indexed: 02/08/2023] Open
Abstract
Objectives
Standard dietary questionnaires may have some limitations in cases with stroke, particularly in those suffering from language and communication difficulties. The present study aimed to develop a dietary questionnaire appropriate for patients with acute ischemic stroke (AIS).
Materials and Methods
Major food groups (
n
= 19) were first identified using the dietary questionnaire of the INTERHEART study. Using the Food Frequency Questionnaire (FFQ), an expert dietitian and a vascular neurologist then selected a total number of 68 corresponding food items from 168 available FFQ items. In the next phase, a panel of expert dietitians (
n
= 10) assessed the face validity and the content validity of these 68 items and approved a total number of 62 items for the final questionnaire, namely, the Simple Stroke FFQ (SS-FFQ). Employing test-retest method, the intraclass correlation (ICC) of the SS-FFQ was subsequently calculated in 30 randomly selected cases affected with AIS. Ultimately, principal component analysis (PCA) was utilized for 153 cases with AIS to assess the construct validity of the questionnaire concerned. The SPSS Statistics software (version 18: SPSS Inc., Chicago, Illinois, United States) as well as descriptive tests including mean and percentage were additionally used to account for the baseline characteristics of the study participants.
Results
The results revealed that the reliability of the newly developed form of the SS-FFQ was perfect (ICC = 0.86). Dietary conditions were further assessed administering the SS-FFQ on 153 cases of AIS with the mean age of 63.76 ± 15.93 years. The PCA results also showed that 15 extracted items of the given questionnaire could explain 73.10% of total item variance.
Conclusions
It was concluded that the SS-FFQ was a valid and reliable questionnaire to assess nutrient intakes among patients with AIS.
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Affiliation(s)
- Reza Tabrizi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Kamran B Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- Department of Community Nutrition, School of Nutrition and food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pedram Keshavarz
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Reza Azarpazhooh
- Department of Neurology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Clinical Neurological Sciences & Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
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14
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Bakhshayeshkaram M, Heydari ST, Honarvar B, Keshani P, Roozbeh J, Dabbaghmanesh MH, Lankarani KB. Incidence of metabolic syndrome and determinants of its progression in Southern Iran: A 5-year longitudinal follow-up study. J Res Med Sci 2020; 25:103. [PMID: 33824668 PMCID: PMC8019129 DOI: 10.4103/jrms.jrms_884_19] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 04/18/2020] [Accepted: 07/09/2020] [Indexed: 02/05/2023]
Abstract
Background Metabolic syndrome (MetS) is a cluster of conditions increasing the risk of serious diseases. This study aimed to define the predictors of MetS incident in a community-based cohort in Southern Iran, during a mean follow-up period of 5.1 years. Materials and Methods During the mean follow-up period of 5.1 years, a cohort study was conducted on 819 Iranian adults aged ≥18 years at baseline and followed to determine the incidence and predictors of MetS progression in Shiraz, a main urban region in the southern part of Iran. The International Diabetes Federation Guideline was used to detect the MetS. Multiple Cox's proportional hazards models were also used to estimate the predictors of new-onset MetS. Results The prevalence of MetS was 25.9% at baseline, and the overall incidence of subsequent MetS was 5.45% (95% confidence interval [CI]: 4.47-6.59). The incidence of MetS was significantly higher in women (7.12% [95% CI: 5.52-9.05]) than in men (3.92% [95% CI: 2.80-5.34]). Moreover, it increased by 5.02 (95% CI, 3.75-6.58) among individuals who had one metabolic component and by 12.65 (95% CI, 9.72-16.18) for those who had three or more components (P < 0001). The incidence of MetS was also analyzed using the multiple Cox's proportional hazards model for potential risk factors, and it was revealed that female gender (hazard ratio [HR] 2.45; 95% CI: 1.33, 4.50; P = 0.004), higher body mass index (HR 3.13; 95% CI: 1.43.6.84; P = 0.012), increased abdominal obesity (HR 1.45; 95% CI 0.85, 2.46; P = 0.045), smoking (HR 4.79; 95% CI 2.09, 10.97; P < 0.001), and lower high-density lipoprotein (HR 0.53; 95% CI: 0.29, 1.00; P = 0.044) significantly predicted the onset of MetS at baseline; however, age, systolic and diastolic blood pressure, serum uric acid, fasting blood glucose, cholesterol, triglyceride and creatinine, estimated glomerular filtration rate, marital status, level of education, and level of physical activity did not independently predict the onset of MetS when other covariates were considered. Conclusion This study showed the high-incidence rates of MetS in males and females residing in Southern Iran. Therefore, the prevention through community-based lifestyle modification should be implemented to reduce the burden of MetS and its complications.
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Affiliation(s)
- Marzieh Bakhshayeshkaram
- Shiraz Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sayed Taghi Heydari
- Department of Biostatistics, Shiraz Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behnam Honarvar
- Department of Public and Community Medicine, Shiraz Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- Department of Nutrition, Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamshid Roozbeh
- Department of Internal Medicine, Nephrologist, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Dabbaghmanesh
- Department of Internal Medicine, Endocrinologist, Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Department of Internal Medicine, Gastroenterologist, Shiraz Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Lankarani KB, Honarvar B, Keshani P, Raeisi Shahraki H. Determinant components of newly onset versus improved metabolic syndrome in a population of Iran. Sci Rep 2020; 10:19563. [PMID: 33177586 PMCID: PMC7659336 DOI: 10.1038/s41598-020-76531-2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 10/29/2020] [Indexed: 02/08/2023] Open
Abstract
This study aimed to determine the risk factors related to regression and progression of metabolic syndrome, in a 4-year cohort study. A total of 540 individuals (≥ 18 years old) participated in both phase of the study. Participants were categorized into 3 categories of regressed, progressed and unchanged metabolic syndrome (MetS). Demographic, anthropometric and biochemical parameters were assessed for each individual in both phase. Variables differences (delta: Δ) between the two phase of study were calculated. Unchanged group was considered as baseline category. Based on IDF, MetS had been regressed and progressed in 42 participants (7.7%) and 112 (20.7%) participants respectively, in the second phase. More than 47% of people, whose MetS regressed, experienced also NAFLD regression. Results of multiple variable analysis revealed that increased age, positive Δ-TG, and Δ-FBS, significantly increased the odds of MetS progression based on IDF and ATP III definitions, while negative Δ-HDL and Δ-neutrophil to lymph ration increased the odds of progression. On the other hand, negative Δ-TG and positive Δ-HDL significantly increased the odds of Mets regression based of both IDF and ATP III. Management of hypertriglyceridemia, hyperglycemia, and HDL is a critical, non-invasive and accessible approach to change the trend of MetS.
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Affiliation(s)
- Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behnam Honarvar
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Parisa Keshani
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Raeisi Shahraki
- Department of Biostatistics and Epidemiology, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
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16
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Keshani P, Hossein Kaveh M, Faghih S, Salehi M. Improving diet quality among adolescents, using health belief model in a collaborative learning context: a randomized field trial study. Health Educ Res 2019; 34:279-288. [PMID: 30915431 DOI: 10.1093/her/cyz009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
This study aimed to assess the impact of educational intervention, based on health belief model (HBM) and collaborative learning techniques on diet quality in adolescents. In this field trial study, 311 students aged 13-15 years old were included, of which 163 and 148 allocated in the experimental and comparison groups, respectively. They were selected through a stratified random sampling from 16 urban, secondary schools in 4 educational districts of Shiraz, the largest city in southern Iran. The revised children diet quality index was used to assess their diet quality. Using HBM as a framework for targeting determinants of dietary behavior, the intervention was performed in a collaborative learning context during the educational year (2015-16). Constructs of HBM and diet quality were measured before and after the intervention. All HBM's constructs and knowledge had significantly improved in the experimental group and mean differences were increased after the intervention. Diet quality improved in the experimental group (P < 0.001), which was significantly different from the comparison group (P = 0.001). The findings support the integration of appropriate models/theories into the context of collaborative learning methods to target large number of behavioral determinants, and ultimately increase the effectiveness of the educational interventions amongst adolescents.
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Affiliation(s)
- Parisa Keshani
- School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Kaveh
- Research Center for Health Sciences. Institute of Health. Shiraz University of Medical Sciences. Shiraz, Iran
| | - Shiva Faghih
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Moosa Salehi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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17
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Keshani P, Mousavi SM, Mirzaei Z, Hematdar Z, Maayeshi N, Mirshekari M, Ranjbaran H, Faghih S. Effect of a School-based Nutrition Education Program on the Nutritional Status of Primary School Children. Nutr Food Sci Res 2016. [DOI: 10.18869/acadpub.nfsr.3.1.27] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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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18
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Faghih S, Keshani P, Salar A, Rajaei SH, Mirzaei Z, Moosavi SM, Hematdar Z. Assessment of Obesity, Unhealthy Food Habits, and Nutritional Knowledge of Primary School Children. Int J School Health 2015. [DOI: 10.17795/intjsh-25186] [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: 11/25/2022] Open
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