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Abstract This study aimed to examine the association between blood pressure (BP) with health-related quality of life (HRQoL) and emotional states, considering the disease awareness and commitment to treatment among the Iranian adult population. This cross-sectional study uses the data of 7257 and 2449 individuals aged ≥ 20 who had completed data on HRQoL and emotional states, respectively. Linear and logistic regression were used to evaluate the mentioned association. The results showed that commitment to treatment had an inverse association with physical HRQoL in both sexes, except for bodily pain in men. Concerning mental HRQoL, in women, poor medication adherence was linked to a decline in mental HRQoL and social functioning, while good treatment adherence was associated with a reduction in the mental health domain. However, except for a decrease in vitality of hypertensive males with high treatment adherence, no significant association was found between their mental HRQoL and BP. In women, increased commitment to treatment was associated with anxiety, whereas poor commitment was related to depression and stress. The undiagnosed disease was not associated with any HRQoL and emotional state deficits. This study highlights the significance of psychiatric assessment, counseling, and support services while taking into account gender-specific differences among hypertensive patients. It also emphasizes the necessity for customized interventions for both men and women to improve their mental well-being and adherence to treatment.

Abstract Background In this prospective study, we aimed to examine the association between ultra-processed foods and health-related quality of life (HRQoL) and to evaluate the effect of lifestyle and socioeconomic factors on this association. Methods This study included 1766 adults (aged 18 to 78, 54.3% women), who took part in the Tehran Lipid and Glucose study. The Short-Form 12-Item Health Survey version 2 was used to determine HRQoL, which includes the physical component summary (PCS) and mental component summary (MCS) scores. Ultra-processed food consumption was assessed using a validated semi-quantitative food frequency questionnaire. Lifestyle (physical activity and smoking status) and socioeconomic factors (education level and employment status) were also determined. General linear models (GLM) were applied to estimate the mean (95% confidence interval) for MCS and PCS scores across the ultra-processed foods tertiles. Additionally, the effect of lifestyle and socioeconomic factors on the relationship between ultra-processed foods and HRQoL was examined using GLM. Results The median consumption of ultra-processed foods was 11.9% (IQR: 8.2 to 16.8) of total energy intake. There was a significant inverse association between ultra-processed foods consumption and PCS, but not MCS, after adjustment for confounding factors. Significant interactions were observed between ultra-processed food consumption, sex, and occupation on PCS score (all P values

Purpose The current study aimed to investigate the associations between metabolic syndrome (MetS) with health-related quality of life (HRQoL) using multilevel analysis among the Iranian adult population.Methods This cross-sectional study was conducted in the framework of the Tehran Lipid and Glucose Study (TLGS). Participants were 6113 participants (3318 women and 2795 men) aged≥20 years of the TLGS seventh phase who had completed data on HRQoL and MetS. HRQoL was assessed using the short-form 12-item health survey V.2 and MetS defined based on the guidelines outlined in the Joint Interim Statement. The two-level model was fitted to assess the association between MetS and HRQoL.Results The prevalence of MetS and its components was higher in men, and regardless of metabolic status, men exhibited higher HRQoL values. The deleterious impact of MetS on HRQoL was more pronounced in women, while the detrimental effects of MetS on men’s HRQoL were confined to specific subscales. These results were obtained through multilevel analysis, considering both familial and individual variation levels. Moreover, our investigation highlighted the positive influence of leisure-time physical activity on both the physical and mental component summaries (PCS and MCS, respectively), regardless of gender. Education had a greater positive impact on PCS in both sexes. Additionally, a history of cardiovascular diseases was associated with a decline in mental and physical HRQoL, while age was linked to a decline in PCS and MCS, and smoking was associated with a decline in MCS.Conclusion This study revealed the significant influence of gender, as well as the unique characteristics and circumstances of individuals, on the relationship between MetS and HRQoL in a general population with low/middle income.

Objectives This study represents a pioneering attempt to quantify the contribution of age, sex and socioeconomic status (SES) to the observed inequalities in lipid profile components.Design Cross-sectional study.Setting The data from the Ravansar Non-Communicable Disease (RaNCD) Cohort Study were used.Participants 10 000 individuals aged 35–65 years.Main outcome measures Principal component analysis was used to determine the SES of individuals. Using the concentration index (C-index) and curves, the study assessed socioeconomic inequalities in dyslipidaemia in different age groups and genders. Decomposition analysis was used to determine the contribution of sex, age and SES to the observed inequality in the prevalence of dyslipidaemia components between the wealthiest and poorest groups.Results The prevalence of dyslipidaemia was 72.39% of the population and was significantly higher in women than in men (excluding hypertriglyceridaemia). Overall, no significant SES-based inequality in dyslipidaemia was observed (C-index=−0.045, p=0.116), but after adjustment for age and sex, individuals with high SES had increased odds of dyslipidaemia (OR=1.16, 95% CI: 1.03 to 1.31). Hypercholesterolaemia and hyper-low-density lipoprotein (LDL) were more common in individuals with lower SES (C-index=−0.117 and −0.105), while hypo-high-density lipoprotein (HDL) was more prevalent in individuals with higher SES (C-index=0.029), regardless of adjustment for age, sex and confounding factors. SES played a significant role in hypercholesterolaemia and hyper-LDL (322.11% and 400.14%), while sex dominated in hypertriglyceridaemia and hypo-HDL (814.05% and −615.26%) and contributed to the existing inequalities.Conclusion The results highlight the existing inequalities in lipid profiles due to SES, sex and age. Consideration of these factors in interventions and policy decisions is critical to reduce abnormalities and inform future interventions.

Abstract Introduction Type 2 diabetes (T2D) is a common chronic disease that significantly affects an individual’s overall health and well-being. The aim of this study is to investigate the factors that influence the health-related quality of life (HRQoL) of patients with T2D. Methods This study conducted using data from 6th phase (2015–2017) and 7th phase (2018–2022) of the Tehran Lipid and Glucose Study (TLGS). Data were collected through a combination of interviews, physical examinations, and laboratory tests. Quality of life questionnaire (SF-12) that consists of 12 questions was used to assess physical and mental health functioning. The generalized estimating equation model was used to assess the association between socio-behavioral factors and changes in HRQoL. Results The study included 498 patients with T2D. The changes in HRQoL in patients with T2D followed a sex-specific pattern. Analysis of the physical component score (PCS) and the mental component score (MCS) showed a non-significant change in the total score during the three-year longitudinal study. However, the role physical (RP) of the PCS and the social functioning (SF) of the MCS showed a statistically significant change during this period. In addition, sex, body mass index (BMI), and having cardiovascular disease (CVD) and chronic kidney disease (CKD) showed a significant association with RP changes, and only job status showed a significant association with SF changes. Conclusions By recognizing the sex-specific patterns in HRQoL changes and understanding the multifaceted nature of factors such as BMI, CVD and CKD, healthcare professionals can develop targeted interventions that go beyond traditional diabetes management.

Abstract Introduction Hypertension (HTN) is a significant global health concern associated with morbidity and mortality. Recent research has explored the potential relationship between dietary protein intake and the development of HTN. This study aims to investigate the association between dietary amino acids and the incidence of HTN. Methods This nested case-control study utilized data from the Ravansar Non-Communicable Disease (RaNCD) Cohort Study. The study included 491 new HTN cases identified over a 6-year follow-up period. For each case, four controls were randomly selected through density sampling. A food frequency questionnaire (FFQ) consisting of 125 food items was used to calculate dietary amino acid intake. HTN was determined based on systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and/or current use of antihypertensive medication in subjects without pre-existing HTN at the start of the cohort study. Conditional logistic regression was used to estimate crude and adjusted odds ratios for HTN risk. Results The median intake of all amino acids was lower in patients with HTN compared to the control group. After adjusting for various variables in different models, the risk of developing HTN tended to increase with higher dietary amino acid intake (excluding tryptophan and acidic amino acids). Specifically, individuals in the third tertile had a higher risk of developing new HTN than those individuals in the lowest tertile, although this difference was not statistically significant (P > 0.05). Conclusion The findings suggest that there may be an association between increased dietary amino acid intake and the risk of developing HTN, although this association was not statistically significant in this study. Further investigations in diverse populations are needed to explore the relationship between amino acids and HTN, as well as to determine the potential positive and negative effects of specific amino acid patterns on hypertension.

Abstract Background Type 2 diabetes (T2D) is one of the most common chronic diseases and the main risk factors for T2D consist of a combination of lifestyle, unhealthy diet, and genetic factors. Amino acids are considered to be a major component of dietary sources for many of the associations between dietary protein and chronic disease. Therefore, this study amied to determine the association between dietary amino acid intakes and the incidence of T2D. Methods The present nested case-control study was conducted using data from the Ravansar Non-Communicable Disease (RaNCD) Cohort Study. The information required for this study was collected from individuals who participated in the Adult Cohort Study from the start of the study until September 2023. Over a 6-year follow-up period, data from 113 new T2D cases were available. Four controls were then randomly selected for each case using density sampling. Cases and controls were matched for sex and age at the interview. Food frequency questionnaire (FFQ) was used to collect data related to all amino acids including tryptophan, threonine, isoleucine, leucine, lysine, methionine, cysteine, phenylalanine, tyrosine, valine, arginine, histidine, alanine, aspartic acid, glutamic acid, glycine, proline, and serine were also extracted. Binary logistic regression was used to estimate the crude and adjusted odds ratio for the risk of T2D. Results Using the univariable model, a significant association was found between T2D risk and branched-chain, alkaline, sulfuric, and essential amino acids in the fourth quartile. Accordingly, individuals in the fourth quartile had a 1.81- to 1.87-fold higher risk of developing new T2D than individuals in the lowest quartile (P

Background & Objective: Following the COVID-19 pandemic, virtual education was adopted as the only way to prevent the cessation of educational processes. This study aimed to identify the challenges experienced by faculty members and students of the faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, during the COVID-19 pandemic in Tehran, Iran. Materials & Methods: In this cross-sectional study, 218 students from all levels and 31 faculty members participated. Data were collected from February through March 2022, using two separate online questionnaires for students and faculty members to investigate potential problems and challenges in various educational areas. The results of the completed questionnaires were recorded in an Excel file and then transferred to the SPSS software (version 21) for statistical analysis. Results: Students were moderately satisfied with the quality of virtual education (P=0.02). Challenges related to “educational strategies” were the key challenges experienced by the students. Undergraduate students faced the most challenges (P=0.001). From the faculty members’ perspective, challenges related to “technical problems of virtual education” were the most important ones. Both faculty members and students viewed the challenges related to “policy-making, planning, and regulations” as the least important obstacles. Conclusion: This study showed that the capacity development of students and faculty members to develop educational strategies and improving infrastructure to overcome technical problems in virtual education is probably the most important factor that needs to be addressed within the educational system.

Abstract Background Community Readiness Intervention for Tackling Childhood Obesity (CRITCO) is a theory-based intervention being developed to improve the readiness of an Iranian urban population to engage in childhood obesity prevention programs. This study aimed to explore changes in readiness of intervention and control local communities from diverse socio-economic areas of Tehran. Methods This study was a seven-month quasi-experimental intervention implemented in four intervention communities and compared with four controls. Aligned strategies and action plans were developed around the six dimensions of community readiness. The Food and Nutrition Committee was established in each intervention community to make collaborative efforts among different sectors and assess the fidelity of the intervention. The pre-and post- readiness change was explored through interviews with 46 community key informants. Results The total readiness of intervention sites increased by 0.48 units (p

Objectives It is critical to assess community readiness (CR) when implementing childhood obesity prevention programs to ensure their eventual success and sustainability. Multiple tools have been developed based on various conceptions of readiness. One of the most widely used and flexible tools is based on the community readiness model (CRM). This study aimed to adapt the CRM and assess the validity of a community readiness tool (CRT) for childhood obesity prevention programs in Iran. Methods A Delphi study that included 26 individuals with expertise in 8 different subject areas was conducted to adapt the CRM into a theoretical framework for developing a CRT. After linguistic validation was conducted for a 35-question CR interview guide, the modified interview guide was evaluated for its content and face validity. The quantitative and qualitative analyses were performed using Stata version 13 and MAXQDA 2010, respectively. Results The Delphi panelists confirmed the necessity/appropriateness and adequacy of all 6 CRM dimensions. The Persian version of the interview guide was then modified based on the qualitative results of the Delphi study, and 2 more questions were added to the community climate dimension of the original CRT. All questions in the modified version had acceptable content and face validity. The final CR interview guide included 37 questions across 6 CRM dimensions. Conclusions By adapting the CRM and confirming linguistic, content, and face validity, the present study devised a CRT for childhood obesity prevention programs that can be used in relevant studies in Iran.

Background: Atherosclerosis, with its major manifestation, coronary artery disease (CAD) is a chronic inflammatory disease. Dietary fatty acids intakes favorably effect on inflammatory responses. This study was conducted to examine the association between dietary fatty acid intakes and inflammatory markers, interleukin 6 (IL-6) and high sensitivity C-reactive protein (hs-CRP), in CAD patients among Iranian population. Materials and Methods: This hospital-based, cross-sectional study was conducted in Chamran Heart Hospital, Isfahan, Iran in 2012. Patients aged ≥45 years with first ever symptomatic CAD confirmed by angiography were included. A semi-quantitative food frequency questionnaire (FFQ) was used to assess the usual intakes of dietary fatty acids. Results: The energy-adjusted daily intakes (mean ± SD) of saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), linoleic acid, α-linolenic acid, and eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) were 27 ± 9, 22 ± 6, 21 ± 5, 0.4 ± 0.32, and 0.85 ± 0.82 g/d; respectively. After adjustment for potential confounders, SFA was directly related to hs-CRP (P = 0.01) and IL-6 (P < 0.001) concentrations. Intakes of EPA + DHA and MUFA, were significantly adversely related to plasma hs-CRP concentration (P = 0.002 and 0.001, respectively) but not IL-6, albeit MUFA was modestly inversely related to IL-6 (P = 0.08). No significant relationships were observed for other fatty acids, α-linolenic acid, and linoleic acid. Conclusions: These findings suggest that saturated fatty acids, EPA + DHA and MUFA were significantly related to plasma inflammatory markers in CAD patients.