Background: Role of dietary modifications on the treatment and management of diabetes and complic... more Background: Role of dietary modifications on the treatment and management of diabetes and complications was shown by many researchers. This study was designed to examine the association of major dietary patterns with diabetes-related cardio-metabolic risk factors in Iranian diabetes. Methods: Totally, 525 type 2 diabetic subjects with mean age 55 ± 10 yr were included in this cross-sectional study in 2014 that followed for at least two years by the Diabetes and Metabolic disease Clinic of Tehran University of Medical Sciences, Tehran, Iran. Blood samples were collected after 12 h fasting for glycemic and lipid profiles. Information on the general characteristics, anthropometric, blood pressure measurements and physical activity level was collected. Dietary data were obtained by a validated food frequency questionnaire. Dietary patterns were obtained factor analysis (principal component analysis). Results: Three major dietary patterns retained through principal component analysis: We...
Background: Adiponectin and leptin are hormones which are related to body fat tissues and body we... more Background: Adiponectin and leptin are hormones which are related to body fat tissues and body weight. In pregnant women, conflicting associations have been reported between the role of serum concentrations of adiponectin and leptin with infant birth weight. The aim of this study was to determine the association between maternal and cord blood adiponectin and leptin concentrations with birth weight. Methods: As a cross-sectional study 86 pregnant women referred to university hospital clinics were recruited. Maternal and umbilical cord blood samples were obtained in delivery room just after birth. The maternal and umbilical cord serum samples were analyzed for adiponectin and leptin. Their birth weight and height were measured at labor. Results: The mean of maternal BMI, birth weight, and gestational age was 23.8±4.8 kg/m2, 3.13±0.14 kg, and 38.15±2.6 week, respectively. No correlation between adiponectin and birth weight were found. Birth weight positively correlates with leptin. C...
Journal of the American College of Nutrition, Mar 11, 2015
Zinc (Zn) and selenium (Se) are essential trace elements involved in thyroid hormone metabolism. ... more Zinc (Zn) and selenium (Se) are essential trace elements involved in thyroid hormone metabolism. This study was conducted to investigate the effects of Zn and Se supplementation on thyroid function of overweight or obese female hypothyroid patients in a double-blind, randomized controlled trial. Sixty-eight female hypothyroid patients were randomly allocated to one of the 4 supplementation groups receiving Zn + Se (ZS; 30 mg Zn as zinc-gluconate and 200 μg Se as high-selenium yeast), Zn + placebo (ZP), Se + placebo (SP), or placebo + placebo (PP) for 12 weeks. Serum Zn, Se, free and total triiodothyronine (FT3 and FT4), free and total thyroxine (FT4 and TT4), thyroid-stimulating hormone (TSH), and anthropometric parameters were measured. Dietary intake was recorded using 24-hour food recall. Physical activity questionnaire was completed. No significant alterations were found in serum Zn or Se concentrations. Mean serum FT3 increased significantly in the ZS and ZP groups (p < 0.05) but this effect was significant in the ZP group compared to those in SP or PP groups (p < 0.05). Mean serum FT4 increased and TSH decreased significantly (p < 0.05) in the ZS group. TT3 and TT4 decreased significantly in the SP group (p < 0.05). Mean FT3:FT4 ratio was augmented significantly in the ZP group (p < 0.05). No significant treatment effects were found for TT3, FT4, TT4, or TSH between groups. This study showed some evidence of an effect of Zn alone or in combination with Se on thyroid function of overweight or obese female hypothyroid patients.
Journal of the American College of Nutrition, 2015
Zinc (Zn) and selenium (Se) are essential trace elements involved in thyroid hormone metabolism. ... more Zinc (Zn) and selenium (Se) are essential trace elements involved in thyroid hormone metabolism. This study was conducted to investigate the effects of Zn and Se supplementation on thyroid function of overweight or obese female hypothyroid patients in a double-blind, randomized controlled trial. Sixty-eight female hypothyroid patients were randomly allocated to one of the 4 supplementation groups receiving Zn + Se (ZS; 30 mg Zn as zinc-gluconate and 200 μg Se as high-selenium yeast), Zn + placebo (ZP), Se + placebo (SP), or placebo + placebo (PP) for 12 weeks. Serum Zn, Se, free and total triiodothyronine (FT3 and FT4), free and total thyroxine (FT4 and TT4), thyroid-stimulating hormone (TSH), and anthropometric parameters were measured. Dietary intake was recorded using 24-hour food recall. Physical activity questionnaire was completed. No significant alterations were found in serum Zn or Se concentrations. Mean serum FT3 increased significantly in the ZS and ZP groups (p < 0.05) but this effect was significant in the ZP group compared to those in SP or PP groups (p < 0.05). Mean serum FT4 increased and TSH decreased significantly (p < 0.05) in the ZS group. TT3 and TT4 decreased significantly in the SP group (p < 0.05). Mean FT3:FT4 ratio was augmented significantly in the ZP group (p < 0.05). No significant treatment effects were found for TT3, FT4, TT4, or TSH between groups. This study showed some evidence of an effect of Zn alone or in combination with Se on thyroid function of overweight or obese female hypothyroid patients.
Since both dietary carbohydrate and fatty acids separately affect carbohydrate metabolism, how di... more Since both dietary carbohydrate and fatty acids separately affect carbohydrate metabolism, how dietary macronutrients distribution may have different effects on carbohydrate metabolism pathways and regulation of blood glucose especially in diabetic patients. In this cross-sectional study 750 type 2 diabetic patients (261 men and 489 women, aged 35-65 years),who at least two years were followed in Diabetes and Metabolic disease Clinic of Tehran University of Medical Sciences, were recruited according to inclusion and exclusion criteria by simple sampling. Dietary data were collected by a validated food frequency questionnaire. Other variables were anthropometric measurements, Stress, physical activity level, Biochemical analyses including fasting and postprandial plasma glucose, Glycated hemoglobin, total cholesterol, low and high density lipoproteins, triglycerides and 25-hydoxy D3. Linear regression models were used to assess the association of covariates with the mean concentrations of HbA1C in quintiles and multivariate linear regression model was used to distinguish the impacts of dietary macronutrient composition of the diet. Carbohydrate and dietary fiber intakes were inversely (P: < 0.0001 and 0.003 respectively) and dietary amount and proportion of saturated, mono-unsaturated and poly-unsaturated fatty were positively (P: < 0.0001, 0.03, 0.01 and 0.01 respectively) associated with HbA1C concentrations. Multivariate linear regression macronutrient density model that controlled for age, sex, diabetes duration and calorie intake showed that carbohydrate was inversely associated with HbA1C (P < 0.0001, R(2) = 15%). Results were also the same in the other three models adjusted for stress and exercise levels in model 2, waist circumference and sum of meals in model 3 and serum triglyceride and 25-hydroxy vitamin D in model 4(P < .0001, <.0001 and 0.0003 respectively). Calorie intake of 25 Kcal/body weight was identified as a cut of point of the negative effect of dietary carbohydrate and 30 for the positive effect of fat on HbA1c respectively (P = 0.04 and 0.03). Moreover, carbohydrate intake was positively (β = 0.08, P = 0.01) and protein (β = -0.04, P < 0.0001), SAFA (β = -0.04, P < 0.0001) and MUFA (β = -0.02, 0.07) proportion were negatively associated with increment in calorie intake. This study showed that the substitution of fat for carbohydrate is associated with low concentrations of HbA1c in high calorie consuming type 2 diabetic patients.
Journal of Pediatric Endocrinology and Metabolism, 2000
Recent studies have shown normal thyroid function in infants whose mothers receive methimazole (M... more Recent studies have shown normal thyroid function in infants whose mothers receive methimazole (MMI) during breast-feeding. This study evaluates the long-term effect of MMI on thyroid function and intellectual development of such children. Eighty-two children aged between 48 and 86 months were studied. Forty-two children had been breast-fed while their thyrotoxic lactating mothers received daily doses of MMI 20-30 mg in the first, 10 mg in the second and 5-10 mg for additional 10 months of therapy. Thyroid function of infants remained normal during the one year of MMI therapy of their mothers. Forty other infants served as controls. Serum T4, T3, and TSH concentrations, urinary iodine, thyroid antibodies, intelligence quotient (IQ), verbal and functional (performance) components (Wechsler and Goodenough tests) were measured in all children of the two groups. Height, weight, serum T4, T3, TSH and antithyroid antibody titers were not different between children in the two groups. The mean IQ was 107 +/- 17 vs 106 +/- 16 (Goodenough test) and 103 +/- 10 vs 103 +/- 16 (Wechsler test) for children of thyrotoxic mothers and control children, respectively. There was no difference in verbal and functional IQ and their components between children of thyrotoxic MMI treated mothers and control children. Thyroid function and physical and intellectual development of breast-fed infants whose thyrotoxic lactating mothers were treated with 20-30 mg doses of MMI daily are normal at age 48 to 86 months.
A B S T R A C T Background and Objectives: Studies have shown that many people with diabetes are ... more A B S T R A C T Background and Objectives: Studies have shown that many people with diabetes are fasting in the holy month of Ramadan. Ramadan fasting causes several changes in metabolism, habit and lifestyle that are associated with an increased risk of hypoglycemia and hyperglycemia in diabetic patients. An educational program based on behavioral science theory in the field of diet and medication changes, proper physical activity during Ramadan fasting, recognizing risks and symptoms of fasting complications and the management may improve the diabetic patients' ability in changing lifestyle, reduce the risk of fasting complications and weight and metabolic control during Ramadan. This study aimed to investigate the effect of nutritional education program based on health belief model (HBM), on the knowledge of type 2 diabetic patients who fast in Ramadan. Materials and Methods: This randomized clinical trial was conducted on 53 type 2 diabetic patients referring to the Diabetes Clinic of Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences and tending to fast during Ramadan, who were recruited based on the research inclusion criteria. The subjects were randomly assigned into two groups of intervention (n=28) and control (n=25). A week before Ramadan, the intervention group was educated based on HBM. In a week before and after Ramadan, the data on demography, HBM components and knowledge were collected through face-toface interview by trained nutritionists. Results: The research results revealed that the education program in the intervention group significantly increased the HBM components such as perceived severity, perceived benefits, perceived barriers, and self-efficacy comparing to the baseline and the control group (P<0.005). At the end of the study, there was a significant difference in the scores of knowledge about fasting conditions and medications, nutrition and physical activity between the two groups (P<0.001, P=0.049 and P=0.013, respectively). The educational intervention significantly increased the total knowledge score, as well as the fasting conditions and medications and blood glucose control scores compared to the baseline values; also in comparison with the control group, the scores of fasting conditions and medications, blood glucose control and total knowledge increased significantly in the intervention group. Conclusions: The findings showed an increase the knowledge level and improvement in the HBM components in the intervention group compared with the control group. It seems that focused Ramadan education could increase Ramadan knowledge of patients and empower them to proper management of diabetes during the holy Ramadan.
Background: Role of dietary modifications on the treatment and management of diabetes and complic... more Background: Role of dietary modifications on the treatment and management of diabetes and complications was shown by many researchers. This study was designed to examine the association of major dietary patterns with diabetes-related cardio-metabolic risk factors in Iranian diabetes. Methods: Totally, 525 type 2 diabetic subjects with mean age 55 ± 10 yr were included in this cross-sectional study in 2014 that followed for at least two years by the Diabetes and Metabolic disease Clinic of Tehran University of Medical Sciences, Tehran, Iran. Blood samples were collected after 12 h fasting for glycemic and lipid profiles. Information on the general characteristics, anthropometric, blood pressure measurements and physical activity level was collected. Dietary data were obtained by a validated food frequency questionnaire. Dietary patterns were obtained factor analysis (principal component analysis). Results: Three major dietary patterns retained through principal component analysis: We...
Background: Adiponectin and leptin are hormones which are related to body fat tissues and body we... more Background: Adiponectin and leptin are hormones which are related to body fat tissues and body weight. In pregnant women, conflicting associations have been reported between the role of serum concentrations of adiponectin and leptin with infant birth weight. The aim of this study was to determine the association between maternal and cord blood adiponectin and leptin concentrations with birth weight. Methods: As a cross-sectional study 86 pregnant women referred to university hospital clinics were recruited. Maternal and umbilical cord blood samples were obtained in delivery room just after birth. The maternal and umbilical cord serum samples were analyzed for adiponectin and leptin. Their birth weight and height were measured at labor. Results: The mean of maternal BMI, birth weight, and gestational age was 23.8±4.8 kg/m2, 3.13±0.14 kg, and 38.15±2.6 week, respectively. No correlation between adiponectin and birth weight were found. Birth weight positively correlates with leptin. C...
Journal of the American College of Nutrition, Mar 11, 2015
Zinc (Zn) and selenium (Se) are essential trace elements involved in thyroid hormone metabolism. ... more Zinc (Zn) and selenium (Se) are essential trace elements involved in thyroid hormone metabolism. This study was conducted to investigate the effects of Zn and Se supplementation on thyroid function of overweight or obese female hypothyroid patients in a double-blind, randomized controlled trial. Sixty-eight female hypothyroid patients were randomly allocated to one of the 4 supplementation groups receiving Zn + Se (ZS; 30 mg Zn as zinc-gluconate and 200 μg Se as high-selenium yeast), Zn + placebo (ZP), Se + placebo (SP), or placebo + placebo (PP) for 12 weeks. Serum Zn, Se, free and total triiodothyronine (FT3 and FT4), free and total thyroxine (FT4 and TT4), thyroid-stimulating hormone (TSH), and anthropometric parameters were measured. Dietary intake was recorded using 24-hour food recall. Physical activity questionnaire was completed. No significant alterations were found in serum Zn or Se concentrations. Mean serum FT3 increased significantly in the ZS and ZP groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) but this effect was significant in the ZP group compared to those in SP or PP groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Mean serum FT4 increased and TSH decreased significantly (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) in the ZS group. TT3 and TT4 decreased significantly in the SP group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Mean FT3:FT4 ratio was augmented significantly in the ZP group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). No significant treatment effects were found for TT3, FT4, TT4, or TSH between groups. This study showed some evidence of an effect of Zn alone or in combination with Se on thyroid function of overweight or obese female hypothyroid patients.
Journal of the American College of Nutrition, 2015
Zinc (Zn) and selenium (Se) are essential trace elements involved in thyroid hormone metabolism. ... more Zinc (Zn) and selenium (Se) are essential trace elements involved in thyroid hormone metabolism. This study was conducted to investigate the effects of Zn and Se supplementation on thyroid function of overweight or obese female hypothyroid patients in a double-blind, randomized controlled trial. Sixty-eight female hypothyroid patients were randomly allocated to one of the 4 supplementation groups receiving Zn + Se (ZS; 30 mg Zn as zinc-gluconate and 200 μg Se as high-selenium yeast), Zn + placebo (ZP), Se + placebo (SP), or placebo + placebo (PP) for 12 weeks. Serum Zn, Se, free and total triiodothyronine (FT3 and FT4), free and total thyroxine (FT4 and TT4), thyroid-stimulating hormone (TSH), and anthropometric parameters were measured. Dietary intake was recorded using 24-hour food recall. Physical activity questionnaire was completed. No significant alterations were found in serum Zn or Se concentrations. Mean serum FT3 increased significantly in the ZS and ZP groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) but this effect was significant in the ZP group compared to those in SP or PP groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Mean serum FT4 increased and TSH decreased significantly (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) in the ZS group. TT3 and TT4 decreased significantly in the SP group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Mean FT3:FT4 ratio was augmented significantly in the ZP group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). No significant treatment effects were found for TT3, FT4, TT4, or TSH between groups. This study showed some evidence of an effect of Zn alone or in combination with Se on thyroid function of overweight or obese female hypothyroid patients.
Since both dietary carbohydrate and fatty acids separately affect carbohydrate metabolism, how di... more Since both dietary carbohydrate and fatty acids separately affect carbohydrate metabolism, how dietary macronutrients distribution may have different effects on carbohydrate metabolism pathways and regulation of blood glucose especially in diabetic patients. In this cross-sectional study 750 type 2 diabetic patients (261 men and 489 women, aged 35-65 years),who at least two years were followed in Diabetes and Metabolic disease Clinic of Tehran University of Medical Sciences, were recruited according to inclusion and exclusion criteria by simple sampling. Dietary data were collected by a validated food frequency questionnaire. Other variables were anthropometric measurements, Stress, physical activity level, Biochemical analyses including fasting and postprandial plasma glucose, Glycated hemoglobin, total cholesterol, low and high density lipoproteins, triglycerides and 25-hydoxy D3. Linear regression models were used to assess the association of covariates with the mean concentrations of HbA1C in quintiles and multivariate linear regression model was used to distinguish the impacts of dietary macronutrient composition of the diet. Carbohydrate and dietary fiber intakes were inversely (P: &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001 and 0.003 respectively) and dietary amount and proportion of saturated, mono-unsaturated and poly-unsaturated fatty were positively (P: &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, 0.03, 0.01 and 0.01 respectively) associated with HbA1C concentrations. Multivariate linear regression macronutrient density model that controlled for age, sex, diabetes duration and calorie intake showed that carbohydrate was inversely associated with HbA1C (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, R(2) = 15%). Results were also the same in the other three models adjusted for stress and exercise levels in model 2, waist circumference and sum of meals in model 3 and serum triglyceride and 25-hydroxy vitamin D in model 4(P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.0001 and 0.0003 respectively). Calorie intake of 25 Kcal/body weight was identified as a cut of point of the negative effect of dietary carbohydrate and 30 for the positive effect of fat on HbA1c respectively (P = 0.04 and 0.03). Moreover, carbohydrate intake was positively (β = 0.08, P = 0.01) and protein (β = -0.04, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001), SAFA (β = -0.04, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and MUFA (β = -0.02, 0.07) proportion were negatively associated with increment in calorie intake. This study showed that the substitution of fat for carbohydrate is associated with low concentrations of HbA1c in high calorie consuming type 2 diabetic patients.
Journal of Pediatric Endocrinology and Metabolism, 2000
Recent studies have shown normal thyroid function in infants whose mothers receive methimazole (M... more Recent studies have shown normal thyroid function in infants whose mothers receive methimazole (MMI) during breast-feeding. This study evaluates the long-term effect of MMI on thyroid function and intellectual development of such children. Eighty-two children aged between 48 and 86 months were studied. Forty-two children had been breast-fed while their thyrotoxic lactating mothers received daily doses of MMI 20-30 mg in the first, 10 mg in the second and 5-10 mg for additional 10 months of therapy. Thyroid function of infants remained normal during the one year of MMI therapy of their mothers. Forty other infants served as controls. Serum T4, T3, and TSH concentrations, urinary iodine, thyroid antibodies, intelligence quotient (IQ), verbal and functional (performance) components (Wechsler and Goodenough tests) were measured in all children of the two groups. Height, weight, serum T4, T3, TSH and antithyroid antibody titers were not different between children in the two groups. The mean IQ was 107 +/- 17 vs 106 +/- 16 (Goodenough test) and 103 +/- 10 vs 103 +/- 16 (Wechsler test) for children of thyrotoxic mothers and control children, respectively. There was no difference in verbal and functional IQ and their components between children of thyrotoxic MMI treated mothers and control children. Thyroid function and physical and intellectual development of breast-fed infants whose thyrotoxic lactating mothers were treated with 20-30 mg doses of MMI daily are normal at age 48 to 86 months.
A B S T R A C T Background and Objectives: Studies have shown that many people with diabetes are ... more A B S T R A C T Background and Objectives: Studies have shown that many people with diabetes are fasting in the holy month of Ramadan. Ramadan fasting causes several changes in metabolism, habit and lifestyle that are associated with an increased risk of hypoglycemia and hyperglycemia in diabetic patients. An educational program based on behavioral science theory in the field of diet and medication changes, proper physical activity during Ramadan fasting, recognizing risks and symptoms of fasting complications and the management may improve the diabetic patients' ability in changing lifestyle, reduce the risk of fasting complications and weight and metabolic control during Ramadan. This study aimed to investigate the effect of nutritional education program based on health belief model (HBM), on the knowledge of type 2 diabetic patients who fast in Ramadan. Materials and Methods: This randomized clinical trial was conducted on 53 type 2 diabetic patients referring to the Diabetes Clinic of Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences and tending to fast during Ramadan, who were recruited based on the research inclusion criteria. The subjects were randomly assigned into two groups of intervention (n=28) and control (n=25). A week before Ramadan, the intervention group was educated based on HBM. In a week before and after Ramadan, the data on demography, HBM components and knowledge were collected through face-toface interview by trained nutritionists. Results: The research results revealed that the education program in the intervention group significantly increased the HBM components such as perceived severity, perceived benefits, perceived barriers, and self-efficacy comparing to the baseline and the control group (P<0.005). At the end of the study, there was a significant difference in the scores of knowledge about fasting conditions and medications, nutrition and physical activity between the two groups (P<0.001, P=0.049 and P=0.013, respectively). The educational intervention significantly increased the total knowledge score, as well as the fasting conditions and medications and blood glucose control scores compared to the baseline values; also in comparison with the control group, the scores of fasting conditions and medications, blood glucose control and total knowledge increased significantly in the intervention group. Conclusions: The findings showed an increase the knowledge level and improvement in the HBM components in the intervention group compared with the control group. It seems that focused Ramadan education could increase Ramadan knowledge of patients and empower them to proper management of diabetes during the holy Ramadan.
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