Background The Tehran Lipid and Glucose Study (TLGS) is a long term integrated community-based program for prevention of non-communicable disorders (NCD) by development of a healthy lifestyle and reduction of NCD risk factors. The study begun in 1999, is ongoing, to be continued for at least 20 years. A primary survey was done to collect baseline data in 15005 individuals, over 3 years of age, selected from cohorts of three medical heath centers. A questionnaire for past medical history and data was completed during interviews; blood pressure, pulse rate, and anthropometrical measurements and a limited physical examination were performed and lipid profiles, fasting blood sugar and 2-hours-postload-glucose challenge were measured. A DNA bank was also collected. For those subjects aged over 30 years, Rose questionnaire was completed and an electrocardiogram was taken. Data collected were directly stored in computers as database software- computer assisted system. The aim of this study is to evaluate the feasibility and effectiveness of lifestyle modification in preventing or postponing the development of NCD risk factors and outcomes in the TLGS population. Design and methods In phase II of the TLGS, lifestyle interventions were implemented in 5630 people and 9375 individuals served as controls. Primary, secondary and tertiary interventions were designed based on specific target groups including schoolchildren, housewives, and high-risk persons. Officials of various sectors such as health, education, municipality, police, media, traders and community leaders were actively engaged as decision makers and collaborators. Interventional strategies were based on lifestyle modifications in diet, smoking and physical activity through face-to-face education, leaflets & brochures, school program alterations, training volunteers as health team and treating patients with NCD risk factors. Collection of demographic, clinical and laboratory data will be repeated every 3 years to assess the effects of different interventions in the intervention group as compared to control group. Conclusion This controlled community intervention will test the possibility of preventing or delaying the onset of non-communicable risk factors and disorders in a population in nutrition transition. Trial registration ISRCTN52588395

Objective: To describe the relative validity and reliability of the FFQ used for assessing nutrient intakes of participants in the Tehran Lipid and Glucose Study (TLGS). Design: A total of 132 subjects (sixty-one males and seventy-one females) were included in the study. Dietary data were collected monthly by means of twelve 24 h dietary recalls (24hDR). Subjects completed two, 168-item semi-quantitative FFQ. Blood and urine samples were taken every season for measurement of plasma biomarkers and urinary N and K. Results: Mean age and BMI of the participants were 35?5 (SD 16?8) years and 25?5 (SD 5?2) kg/m 2 , respectively. The mean energy-adjusted and deattenuated correlation coefficients for overall nutrient intake between the 24hDR and FFQ2 were 0?44 and 0?37 in #35-year-olds and .35-year-olds, respectively, and for individual nutrients ranged from 0?24 to 0?71 in men (mean r 5 0?53) and from 0?11 to 0?60 in women (mean r 5 0?39). The mean energy-adjusted reliability coefficients varied from 0?48 in #35-year-olds to 0?65 in .35-year-olds, and ranged from 0?41 to 0?79 in men (mean r 5 0?59) and from 0?39 to 0?74 in women (mean r 5 0?60). The FFQ2 and 24hDR produced exact agreement rates ranging between 39?6 % and 68?3 % in men and between 39?6 % and 54?1 % in women. The ranges of questionnaire validity coefficients, with the sample correlation between the questionnaires and biochemical marker as the lower limit and the estimate obtained by the method of triads as the upper limit, were 0?21-0?56 (protein) and 0?37-0?61 (K). Conclusions: The FFQ developed for the TLGS has reasonable relative validity and reliability for nutrient intakes in Tehranian adults.

Background: Although individual foods and nutrients have been associated with the metabolic syndrome, whether dietary patterns identified by factor analysis are also associated with this syndrome is not known. Objective: We aimed to evaluate the association of major dietary patterns characterized by factor analysis with insulin resistance and the metabolic syndrome among women. Design: Usual dietary intakes were assessed in a cross-sectional study of 486 Tehrani female teachers aged 40 -60 y. Anthropometric and blood pressure measurements were performed, and fasting blood samples were taken for biomarker assessment. The metabolic syndrome was defined according to Adult Treatment Panel III guidelines, and insulin resistance was defined as the highest quartile of the homeostasis model assessment scores. Results: We identified 3 major dietary patterns by factor analysis: the healthy dietary pattern, the Western dietary pattern, and the traditional dietary pattern. After control for potential confounders, subjects in the highest quintile of healthy dietary pattern scores had a lower odds ratio for the metabolic syndrome (odds ratio: 0.61; 95% CI: 0.30, 0.79; P for trend 0.01) and insulin resistance (0.51; 0.24, 0.88; P for trend 0.01) than did those in the lowest quintile. Compared with those in the lowest quintile, women in the highest quintile of Western dietary pattern scores had greater odds for the metabolic syndrome (1.68; 1.10, 1.95; P for trend 0.01) and insulin resistance (1.26; 1.00, 1.78; P for trend 0.01). Higher consumption of traditional dietary pattern was significantly associated only with abnormal glucose homeostasis (1.19; 1.04, 1.59; P 0.05). Conclusion: Significant associations exist between dietary patterns identified by factor analysis, the metabolic syndrome, and insulin resistance.Am J Clin Nutr 2007;85:910 -8.