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.
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.
Background: Deficiencies of micronutrients increase the risk of various infections in HIV-infected patients. Zinc deficiency in HIV-infected patients may be associated with decreased CD4 cell counts. Objectives: In this regard, the present study investigated the association between serum zinc levels, macro/micronutrient intake, and CD4 counts in HIV patients. Methods: The research population of this study included 194 adult HIV patients aged 18 to 70 years referred to Shiraz Behavioral Diseases Center, Shiraz, Iran. The CD4 cell counts were extracted from patients’ records. Serum zinc level was measured using atomic absorption method. Univariate and multivariate comparison of macro/micronutrient and food items with CD4 cells was performed using linear regression and SPSS20, and P < 0.05 was considered statistically significant. Results: Fifty-seven percent were male, and the mean age and SD of total participants was 43.76 ± 9.06 years. The association between serum zinc levels and CD4 serum count is close to the significance level (P = 0.05), but the dietary zinc intake was not significantly correlated with serum CD4 counts (P = 0.26). Vegetable intake (P < 0.001) and fruits (P = 0.01) as well as absorption of vitamin A (P = 0.002), vitamin C (P < 0.001), beta-carotene (P = 0.002), folate (P = 0.05), and fiber (P = 0.01) from diet showed a direct and significant association with serum CD4 levels in HIV patients. Consumption of hydrogenated oils (P = 0.04) showed a significant inverse association with serum CD4 levels in these patients. Conclusions: Evaluation of serum micro/macronutrients can play an essential role in the development of appropriate dietary and supplement guidelines provided by the healthcare system for HIV-infected patients, and it can influence the decision- and policy-making regarding the control of non-pharmacological management of these patients.
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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