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A B S T R A C T Background and Objectives:Regarding the high prevalence of unhealthy food habits among Iranian children, we aimed to assess the effect of a school-based nutrition education program on nutritional status of primary school students in Shiraz. Materials and Methods:This randomized educational controlled trial was carried out on 221 primary school age children selected by cluster sampling in the elementary schools of Shiraz-Iran. The intervention consisted of 6 nutrition education sessions carried out through one year for children, using active learning methods. Mothers' education was carried out in person in both lecture and question-answer sessions also via sending text messages and pamphlets. Weight, height and waist circumference (WC) of children were measured before and after the intervention. Also a 168-item food frequency questionnaire was completed. Two separate nutrition knowledge questionnaires were filled up by children and their mothers. Data were analyzed using SPSS version 16.Results: 171 children (83 in the case and 88 in the control group), aged 9.5-10.5 years, completed the study. Anthropometric and nutritional knowledge of the participants in both the intervention and control groups was significantly increased. Weight, height, WC and nutritional knowledge increased significantly more in the intervention group compared to the controls. Consumption of fruits and vegetables decreased in the intervention group while plain sugar and fast foods intake increased among the controls. There were no significant differences between the changes in the intake of any of the food groups in the two groups. Conclusions:In conclusion, the designed nutrition education program could increase students' nutritional knowledge, and lead to a non-significant change towards reducing the consumption of unhealthy foods such as fast foods, sweets and salty snacks.

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Background: Dietary components predisposing to non-alcoholic fatty liver disease (NAFLD) have been conflicting to date. This study aimed to compare macro and micronutrients and food intake among non-lean and lean patients with NAFLD. Methods: Adult people older than 18 years from seven postal districts of Shiraz, Iran, were selected using multistage cluster randomized sampling. Nutrition status was queried by a standard food frequency questionnaire and NAFLD was detected by sonography.

Background. The study aimed to determine the correlation between different diet quality indices and glycemic status and lipid profile in patients with diabetes. Methods. This study was carried out on 235 patients with type 2 diabetes referred to Martyr Motahari Diabetes Clinic of Shiraz city so as to investigate the relationship between glycemic status and lipid profile and the diet quality using Healthy Eating Index (HEI-2010), phytochemical index (PI), and Diet Quality Index-International (DQI_I). Results. A positive correlation was indicated between the serum levels of LDL-C and HEI-2010 scores p = 0.026 . Furthermore, there was a positive correlation between the patients’ age and scores of PI p = 0.006 and between PI and DQI_I p < 0.001 . There was no significant relationship between the scores for all three indicators and biochemical parameters. Conclusion. The results of this study indicated that there was a significant correlation between the serum LDL-C levels and the HEI-2010 scores. Moreover, the age of the patients had a direct correlation with the PI scores.

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.

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; I 2 = 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.

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.