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Background Waist circumference (WC) is representative of abdominal visceral fat, which is strongly associated with cardiovascular disease (CVD) and its’ outcomes. We aimed to define WC thresholds predicting incident CVD and all-cause mortality within each body mass index (BMI) categories in Tehran Lipid and Glucose Study. Methods In this prospective cohort study, a total of 3344 men and 4068 women were followed up for 18 years. Participants were categorized based on BMI into BMI 30. The sex-specific WC cut-points within each group were estimated by the maximum value of Youden’s index based on incident CVD and all-cause mortality prediction. Results 667 and 463 CVD incidents (incident rate 3.1 to 4.5 in men and 1.1 to 2.6 in women per 1,000 person-years within BMI categories) and 438 and 302 mortalities (incident rate 2.1 to 2.7 in men and 1.2 to 1.4 in women per 1,000 person-years within BMI categories) were happened in men and women, respectively. WC thresholds were 82, 95, and 103cm based on incident CVD and 88, 95, and 103cm based on all-cause mortality among men in BMI 30, respectively. The respective values for women were 82, 89, and 100cm based on incident CVD and 83, 90, and 99cm based on all-cause mortality in BMI

Background: Calcium could impact on vascular functions and structures and cause atherosclerosis. Thus, we aimed to examine the association of long-term calcium and dairy products intake in adolescence with cIMT and MetS in early adulthood.Methods: We considered 217 adolescents aged 12-18 years in the frame work of the Tehran Lipid and Glucose Study (2006-2009) and follow-up them to early adulthood (2015-2017). The valid food frequency questionnaire was used to assess dietary intake. Ultrasound examination was used to measure common carotid artery. The joint interim statement and cook et al criteria were used for adults and adolescents to consider MetS, respectively. Results: Adolescents’ average calcium intake from dairy and non-dairy sources were 395 mg/d and 1088 mg/d, respectively while adults had 212 mg/d and 1191 mg/d. In addition, the mean of cIMT in adults was 0.54 mm. There was no relationship of non-dairy (β: -0.03; P=0.804), and total calcium (β: -0.001; P=0.591) intake with cIMT and TG. None of the dairy products had link with cIMT, MetS and its components, except cream with cIMT after full adjustment of potential confounders (β:0.245; P=0.009). Also, we found that the intake of non-dairy products could increase DBP after controlling for potential confounders (β:0.365; P=0.012). Adolescence with higher quartiles of total calcium intake had no odds ratio of MetS in early adulthood (β:2.05, P=0.371).Conclusions: Adolescence calcium and dairy products intake, with the exception of cream did not increase early adulthood cIMT and MetS and its components.

Ideal cardiovascular health (CVH) is associated with a lower risk of developing cardiovascular diseases. This study aims to investigate the association of CVH metrics with carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis in young adults. A cross-sectional study was performed on 1295 adults, average age of 29.7 ± 4.0 years, selected among the participants of the Tehran Lipid and Glucose Study (TLGS). The participants were divided into two CVH groups: Ideal CVH and poor/intermediate CVH. Multivariate-adjusted linear regression was used to determine the association of ideal CVH score with cIMT. Multivariate-adjusted odd ratios (ORs) were calculated for high cIMT (≥95%percentile). Also, the independent effects of each ideal CVH metric on cIMT were analyzed. The prevalence of ideal CVH was 9.3% in the studied population, and the mean of cIMT was 0.55±0.09 mm. A 1-point increase in CVH score was associated with a decrease of 0.128 mm (Beta [SE] = -0.128 [0. 002], p

Objective To examine the effects of age, period, and birth cohort on weight and waist circumference (WC) changes among the participants of the Tehran Lipid and Glucose Study from 1999 to 2015. Methods This prospective cohort study included 4895 participants aged ≥ 20 years (41.3% men), who were divided based on sex into eleven 10-year age groups. Analyses were conducted to explicitly assess the effects of age vs. period on weight and WC changes. We also implicitly assessed weight and WC variations regarding different cohorts and period-specific experiences across various age groups. Results Upon 15 years of follow-up, the mean weight of men increased from 75.2 ± 12.3 to 80.5 ± 14.3 kg, and this trend was accompanied by an increase in WC from 88.8 ± 10.9 to 97.8 ± 10.4 cm. Men in all age cohorts tended to have a rise in their weight with aging throughout the follow-up period (coefficient for age: 0.69, 95% CI: 0.45–0.93). Considering WC changes, all age cohorts had a rising trend throughout the follow-up period with aging (coefficient for age: 0.77, 95% CI: 0.57–0.96). Women in all age cohorts tended to have a rise in their weight throughout the follow-up period with aging (coefficient for age: 1.48, 95% CI: 1.28–1.68). Considering the changes of WC, all age cohorts had an ascending trend throughout the follow-up period with aging (coefficient for age: 1.32, 95% CI: 1.14–1.50). Conclusion The rise in weight and WC was strongly age-dependent in both sexes. The men born in the recent birth cohorts and the women born in earlier birth cohorts had the most alarming weight and WC gains. More efforts must be spent on obesity prevention policies, especially for younger men.

Background The prevalence of obesity among children and adolescences have been increased, which can consequently increase the prevalence of metabolic and cardiovascular diseases later in life. The objective of this study is to compare the ability of different childhood body mass index cut-offs in prediction of carotid intima media thickness (CIMT) as an indicator of subclinical atherosclerosis. Methods Participants were categorized into normal weight, overweight and obesity group, based on world health organization (WHO), center for disease control and prevention (CDC), international obesity task force (IOTF) and local IOTF cut-offs. After 18 years of follow up CIMT was measured. Akaike’s information criterion and relative efficiency were measured in order to compare regression models on the role of obesity on CIMT. Results In this prospective cohort study, 1295 subjects aged 3 to 18 years old were enrolled. The overall prevalence of overweight was 15.4, 11.5, 16.3 and 14.1 along with obesity prevalence of 6.6, 8.5, 7.7 and 5.0% based on WHO, CDC, local IOTF and international IOTF criteria, respectively. CIMT was higher in obese compare to normal groups across all classification criteria. After regression analysis, international IOTF was the best to predict adulthood CIMT, followed by local IOTF and WHO. CDC had the least discriminatory ability. Conclusion Due to the results of this study, IOTF could be a better tool in national and international surveillances of children in order to define overweight and obesity, which can help us to intervene more effectively in reducing the burden of cardiovascular diseases.

Background Based on data regarding nutrition transition in the Middle East and North Africa, this study aim to investigate the general structure and secular trend of dietary patterns reported from the Tehran Lipid and Glucose Study (TLGS) and adherence to these dietary patterns among Iranian population from 2006 till 2017. Methods We investigated on four examination waves of TLGS, including wave 1 (2006–2008), wave 2 (2009–2011), wave 3 (2012–2014), and wave 4 (2015–2017), using a validated and reliable food frequency questionnaire. Generalized Estimating Equations was used to assess secular trends in anthropometric, biochemical, and dietary variables across the study period. To identify general structure and secular trend of dietary patterns during each waves, principle component analysis (PCA) and K-mean cluster analysis were used, respectively. Results After adjusting for potential confounders including age, sex, body mass index, and total energy intake, the carbohydrate and protein intake gradually increased and the total fat intake decreased during study period (P-valueP-valuesHealthy dietary pattern characterized by higher intakes of vegetable, fruit, dairy products, liquid oil, nuts and seeds, and honey and jam; Western dietary pattern featured by refined grain, solid fat, meat, snack and dessert, potato, and soft drink, and the Mixed dietary pattern, highlighted by tea and coffee, and simple sugar. Based on cluster analysis, 27.8% of participants in wave 4 followed a Western dietary pattern, and 34.1% followed the Mixed dietary pattern. The Healthy dietary pattern was stable among the study population during the last decade. Conclusions The structure and the type of foods that participants preferred to eat changed since 2006, a new secular trend in dietary patterns, including a stability of Healthy dietary pattern, a decline of the Western dietary pattern and an increase in the Mixed dietary pattern was obsereved in our investigation.