---

It is generally recognized diabetes in more prevalent in women than men, besides that there is a close relationship between diabet, type of obesity and body fat distribution. In a descriptive-analytical study, 100 diabetic women aged 30-60 years old referring to diabetic clinic compared with 100 healthy subjects who were similar to the sample group with respect to age and sex. The results showed that BMI of majority women on both groups were in the range of 24.9-29.9, on the other hand 33% of women in control group and 26% patients suffered from the grade one obesity. Minimum ratio of waist-to-hip ratio (WHR) in patients was 0.72 and in healthy women was 0.47. In control group 90% and in healthy subjects 74% of women suffered from upper-truncal obesity (WHR>0.8). A significant difference was found (P=0.04) between the WHR ratio in women control and healthy group. To prevent the fat distribution in the area of stomach and upper truncal, increasing activity and dietary control are suggested.

---

Background and Objective: Many factors are known to be involved in a number of human pathologies of obesity including serum leptin and thyroid hormones levels. The purpose of this study was to compare the serum levels of leptin and thyroid hormones in obese and non-obese women, in Shiraz-Iran during 2006. Materials and Methods: In this case- control study, 35 women with BMI≥30 Kg/m2 recruited as an obese group (Case group) and 35 women with healthy BMI (BMI<25 Kg/m2) were selected as a control group. General information data were gathered from each sample using questionnaires and face-to-face interviews. Body weight, height, waist and hip circumferences were measured and BMI, WHR and percent of body fat (%TBF) were calculated for each subject. Venous blood samples were drawn from subjects and serum was separated to determine the concentrations of serum leptin and thyroid hormones (T4, T3 and TSH) levels. Results: Mean serum concentration of leptin was significantly higher in obese group than control group (p<0.001). Serum leptin levels positively correlated to anthropometric indices (BMI, WHR, %TBF). No significant difference was observed between obese and non-obese groups in serum thyroid hormones concentration. Serum leptin levels positively related to serum T3 levels (P<0.05). Conclusion: This study indicated that obese women had higher leptin levels compared to non-obese. The interaction between thyroid hormone in particular T3 and leptin can be one of the reason for increasing the serum leptin level among obse women.

---

Background and Objective: In recent years, the efficacy of low-fat diet has been questioned. One potential adverse effect of reduced dietary fat is a compensatory increase in the consumption of high glycemic index carbohydrate, principally refined starchy foods and concentrated sugar. Such foods other can be rapidly digested or transformed into glucose, causing a large increase in post-prandial blood glucose and insulin level. Review studies have generally found an inverse association between glycemic index and satiety. The aim of this study was to determine the effect of low-glycemic index diet versus low-fat diet on the body weight, body mass index, the percent of body fat mass and waist-hip ratio of obese women. Materials and Methods: In this randomized controlled trial study, 46 obese women with BMI>27 and 18-55 year old randomly divided into low-glycemic index and low-fat diet groups during the course of study and after 6-weeks, body mas index, body fat mass and waist-hip ratio were measured. Data analyzed with t student, t paired student tests. Results: Body weight, BMI, waist - hip ratio, and Triceps skinfold, biceps skinfold, subscapular skinfold, abdominal skinfold decreased significantly in both diet groups. After 6-weeks significant difference was not observed in percent of body fat mass between two dietary groups. Conclusion: This study showed that both low-glycemic index and low-fat diets can equally be effective in body fat, BMI and waist - hip ratio.

---

Background and Objective: The obesity and overweight in the children of many developing countries have dramatically increased. Obesity is associated with numerous health problems. While children spend a significant amount of their time in school daily, the various aspects of children school-life such as academic achievement, social skills and attendance, can be affected by obesity and overweight. This study was done to determine the correlation between obesity and overweight with attention dificit in elementary school girls. Materials and Methods: This descriptive-cross sectional study was carried out on 300 girls student of 7-11 years old, in elementary schools in capital city of east Azarbijan cocated North-West of Iran in 2007. The samples selected based on body mass index and were classified by random sampling in three groups including, normal group, overweight group and obese group. The data, collected by child behavior check list (CBCL). The CBCL have 113 iteams, 9 iteams of them were designed for determination of attention dificit in children. The behaviors were scored on a 3-point ranging scale. SPSS-11.5 software and ANOVA statistical test were used to analyse the data. Results: The results showed that overweight group had greater scores in attention dificit scale than other groups and revealed a significant correlation between obesity-over weight and attention dificit (r=0.177, P<0.05). Conclusion: This study indicated a significant correlation between obesity and attention dificit. Prevention of obesity as a first step for prevention of behavioral problems, seems to be essentieal. The treatment of obesity may be a matter of dealing with behavioral problems in children.

---

Background and Objective: Anthropometric indeces are the best methods for determining of malnutrition and obesity in children and young adulescent worldwide. This study was designed to compare the physical growth status between Turkman and non-Turkman in rural area in Gorgan in North of Iran. Materials and Methods: This cross – sectional descriptive was done on 551 children of 2-5 years of age, Turkman and 895 of non-Turkman in the rural area of Gorgan North of Iran during autumn 2005. Height, weight and personal identification recorded by questioners. BMI percentile and under -1sd ,-2sd and -3sd from NCHS used for comparison. Data were analyzed by using Chi-Square and T-student tests. Results: Mean±SD of height in female Turkman and non-Turkman were 95.3±8.1 and 90.5±8.4 cm respectivly means±SD of height were 96.0±7.6 and 90.9±8.6 cm in Turkman and non-Turkman, respectively. Male childrens mean±SD of weight in were 14.5±2.4 and 14.2±2.9 and in male Turkman and non-Turkman children respectively. Also means±SD of weight were 15.0±2.03 and 14.5±2.3 cm in Turkman and non-Turkman male children, respectively. Turkman children are about 426 gram heavier and 4.9 cm taller than non-Turkman in all of age groups (P<0.05). Stunting and underweight were observed in 13.2% and 1.9% in Turkman group less than non-Turkman respectively by -2sd criterion. There was a significant differences between two groups by stunting (P<0.05). Obesity and overweight exist in Turkman group 24.5% and 2.6% less than in non-Turkman respectively. The difference in obesity statistically was significant between two groups (P<0.05). Underweight was shown in female more than male (7.2% vs 4.2%) and obesity in female less than male (25.6% vs 28.9%). Conclusion: This study showed that secular growth in two groups is incompatible and it is better in Turkman group than non-Turkman group. Malnutrition in Turkmans was less than Non-Turkmans children.

---

Background and Objective: Childhood obesity is a significant public health concern due to its impacts on childhood physical and psychological health with subsequent adulthood complication. The aim of this study was to determine some related factors of obesity and overweight in girls' secondary school. Materials and Methods: This cross-sectional study was performed in Gorgan Northern Iran, during 2005-06. The subjects selected by stratified random sampling. Age, height, weight, BMI, daily time of television watching, frequency of physical activity and snack consumption was recorded by parents in a questionnaire sheet during a week. Data were analyzed by using SPSS-11.5 software, chi-square and ANOVA tests. Results: In this study, 6.3% and 41.7% of subjects were obese and overweight, respectively. The mean of BMI of girls was 19.69±4.6 kg/m2. The prevalence of obesity and overweight in Fars ethnic group was more than others (P<0.05). Average spending time for television watching was 2.35±0.98 hours and the same index was higher among the obese and overweight girls but, this difference was not significant. Food consumption during watching television, frequency and duration of physical activity were significantly related with obesity and overweight (P<0.05). Conclusion: This study showed that low physical activity and imbalanced nutritional behavior are related to obesity and overweight among secondary school girls in Gorgan-Northern Iran.

---

Background and Objective: Hypertension is considered as a major public health problem in most countries due to its association with ischemic heart disease. The aim of this study was to determine people awareness of hypertension in Golestan province of Northern Iran.

Materials and Methods: This cross sectional population based study carried out on 2497 subjects (15-65 years old) including 1500 men and 1247 women in Golestan province- Northern Iran during 2006. The subjects were chosen by proportional-cluster sampling based on sex and age groups. The subjects were interviewed, antropometric indexes and serum biochemical factors were evaluated. Blood pressure was measured three times with 5 minutes interval and defined based on JNC-7 classification. Serum cholesterol and fast blood sugar (FBS) were determined using laboratory kits (enzymatic methods), and spectrophotometery technique. Data was analyzed by SPSS-16 software and Chi-Square test.

Results: In general, the prevalence of hypertension in this region was 23.9%. with higher rate among women urban area by 3.3% and 5% respectively. Only 48.7% of hypertensive patients were aware of their disease and that was significantly more in women than men (P<0.001). Low physical activity, chronical age, diabetes, hypercholesterolemia, general obesity, central obesity and illiteracy were the risk factor for hypertension morbidity (P<0.05).

Conclusion: This study showed, in spite of prevalency of hypertension among 20% of subjects in this area only 48.7% of them were aware about their disorder.

---

Background and Objective: Child obesity is increased in developing countries. This study assessed the prevalence of obesity on children which are exclusively on breast feeding and its duration among children aged 24-59 months in Bandar Turkmen district Northern, Iran.

Materials and Methods: In this descriptive- analytical study, 343 in children aged 24-59 months were selected with stratified random sampling. Obesity was defined as >+2SD NCHS (National Center for Health Surveys) reference. Data were collected by questionnaire, interview with mothers and were analyzed with Chi-Square and Fisher tests and multiple regression logistic models.

Results: In this study, 6.4% of children were obese. Prevalence of obesity was not significantly different between boys and girls (5.4% and 7.4% respectively). Breast feeding duration<18 months (P<0.005) and formula or cow’s milk plus breast feeding up to 6 months old (P<0.01) was significantly correlated with children’s obesity. Breast feeding duration more than 18 months reduced the obesity risk factor with 64%.

Conclusion: This study demonestrated that exclusively breast feeding in the first 6 months of life and breast feeding duration more than 18 months reduce the child obesity.

---

Background and Objective: Ghrelin is an acylated 28-amino-acid peptide that is the most recently identified adipocytokines, but its role in diabetes is poorly clarified. The objective of this study was to determine the relation between serum ghrelin and blood glucose levels in type 2 diabetic obese males.

Materials and Methods: This descriptive study was done on 45 adult obese males with type-2 diabetes in Saveh city, Iran during 2010. Fasting blood glucose, insulin and ghrelin concentrations and Glycosylated hemoglobin HbA1C were measured after overnight fasting. Multiple regression was used for determine ghrelin in relation to glucose, insulin and HbA1C.

Results: The multiple regression analyses revealed that HbA1C is not correlated with serum ghrelin levels, while, fasting blood glucose level had positive corrolation with serum ghrelin concentration (P<0.05). Serum ghrelin level had high negative correlation with insulin (P<0.05).

Conclusion: This study indicated that elevated endogenous ghrelin led to hyperglycemia. Therefore, serum ghrelin is a precise index of blood glucose level in obese male patients with type-2 diabetes.

---

Background and Objective: There is a genetic background for polycystic ovary syndrome (PCOS). Due to increase metabolic disorders, lipoproteins, impaired glucose tolerance, and hypertension in PCOS patients, this study was done to determine the cardiovascular risk factors in first relative member of patients with polycystic ovarian syndrom in Shiraz, Iran. Materials and Methods: This case - control study was carried out on 107 parents and siblings of women with PCOS as cases and 107 non-PCOS parents and siblings of women as controls in Shiraz, Iran during 2007-08. Demographic characteristic, BMI, obesity and blood pressure were recorded for all subjects. Serum lipoproteins including total cholestrol, triglyceride, LDL, HDL and fasting blood sugar were measured in cases and controls. Data were analyzed using SPSS-16.5, independent t-test, Chi-Square and Kappa tests. Results: 35.3%, 26.5%, 11.76% and 5.8% of fatheres in cases were considered as overweight class I, class II, class III of obesity, respectively when compared to controls. This differecne was significant (P<0.05). Waist –hip ratio in mothers in cases (25.6%) and controls (17.9%) were higher than 0.85. Waist –hip ratio among the sisters in case and control groups were 23.5% and 17.6%, respectively (P<0.05). Hypertension was observed in 12.2% of cases and 3.7% of controls. This difference was not significant. High level of triglyceride were determined in 14.94% of cases and 6.5% of controls. A significant correlation was found between BMI and diabete II in case and control groups (P<0.05). Disorder in glucose tolerance test (GTT) in case and control goups were 19.62% and 7.47%, respectively (P<0.05). The obesity was found in 18.7%, 6.54% in cases and controls with disorder in GTT (P<0.05). Conclusion: This study showed that obesity, central obesity, high level of serum lipoproteins and hypertension among first relative member of patients with PCOS are significantly higher than the controls.

---

Background and Objective: Obesity and saturated fat diet have a negative effect on plasma lipoproteins. The best therapeutic regiment for the treatment of obesity and reduction of serum lipoproteins is a diet containing non-saturated fatty acids accompanied with aerobic exercise. This study was carried to evaluate the effect of 8 weeks aerobic training and peanut consumption on serum Lipoproteins levels in overweight and obese men. Materials and Methods: This semi-experimental study was done on 36 obese males with age of 41.82±3.4yr, BMI: 32.38±2.50 kg/m2 in North of Iran during 2009. Subjects were divided in three equal groups: aerobic interval training, peanut consumption aerobic, interval training and control. peanut consumption Training group were consumed 50gr peanuts daily. Prior and after training period, serum lipoproteins levels of subjects were evaluated. Data were analyzed using SPSS-16, ANOVA and LSD tests. Results: There was a significant differences between the reduction of total mean serum cholesterol, triglyceride, low density lipoproteins, high density lipoproteins in experiment group II (aerobic interval training and peanut) compare to other groups (P<0.05). Conclusion: Aerobic interval training plus peanut regiment reduce lipoprotein and specifically triglyceride and low-density lipoproteins in overweight and obese men.

---

Background and Objective: Previous studies have reported inconsistent findings about the effect of endurance training on level of interleukin-18 (IL-18) and high-sensitivity C-reactive protein (hsCRP) in obese individuals. This study was performed to determine the effect of resistance training on serum level of IL-18 and hsCRP in obese men. Materials and Methods: In this clinical trial, eighteen obese men were randomly divided into training and control groups. After 12-hours fasting, height, weight, body mass index, body fat percent, serum level of IL-18 and hsCRP were assessed before and after training period. Resistance training protocol consisted of twelve weeks training, 3 sessions training per week, each session for 60 minutes. Results: Mean±SD of IL-18 were 323.34±46.57 pg/ml and 239.43±53.75 pg/ml in training and control groups, respectively. Mean±SD of hsCRP was 3.83±3.65 µg/ml and 3.03±2.98 µg/ml in training and control groups, respectively. This difference was not significant. Conclusion: Performing resistance training for twelve weeks did not significantly reduce IL-18 and hsCRP in obese men.

---

Background and Objective: Paraoxonase-1 is an important factor in preventing lipid oxidation and formation of oxidized low-density lipoprotein. There are conflicting reports on the impact of physical activity on serum level of Paraoxonase-1. This study was done to determine the effect of four weeks of endurance training on serum level of Paraoxonase-1 and lipid profile in non-athlete obese men. Method: In this clinical trial study, sixteen obese healthy non-athletic men randomly divided into intervention and control groups. Subjects in interventional group were practiced endurance running periodic for four weeks, three sessions a week with 65-80% of maximum heart rate. Blood samples collected 48 hours perior the first and 48 hours following the final training. Serum level of Paraoxonase-1 and lipid profile including cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein were measured by ELISA method. Results: At the end of the training, the serum level of of paraoxonase -1 increased 15.57% (P<0.05) in interventional group and non-significantly reduced in control group (19.25%). The serum level of serum Paraoxonase-1 in interventional group significantly increased compared to controls (P<0.05). The serum level of low-density lipoprotein in interventional group significantly reduced in comparision with controls (P<0.05). Conclusion: 4 weeks of endurance training increased serum level of paraoxonase -1 and decreased low-density lipoprotein in non-athlete obese men.

---

Background and Objective: Bariatric surgery is the most effective treatment for morbid obesity. The classic procedure, jejunoileal bypass, has many complications. This study was carried out to assess the evaluation of clinical complications in morbid obese patients after modified jejunoileal bypass surgery. Method: This descriptive – analytic study was carried out on 120 morbid obese patients referred for bariatric surgery. A modified jejunoileal bypass was performed in which the defunctionalized organ eliminated by anastomosing its ends to the gall bladder and cecum. Weight loss and clinical complications were recorded after one year follow up. Results: The mean weight and body mass index reduced from 136 kg and 48 kg/m2 before surgery to 83 kg and 29/8 kg/m2 after one year follow up, respectively (P<0.05). Before surgery, articular pain (24.3%), dispana (21.6%), cardiovascular disorders (10.8%), fatty liver (5.4%) and sleep disorder (5.4%) due to obesity were recorded. One year follow up after surgery, articular pain (1.5%) and dispana (1.5%) were seen in patiants. No serious post-operative clinical complication was observed. Conclusion: One year follow up after surgery showed that the modified jejunoileal bypass is very effective in reducing body weight and does not lead to serious complication.

---

Background and Objective: Accumulating evidence indicates a relation between aerobic capacity and glucose concentration, although the molecular mechanisms of this relationship are not fully known yet. This study was done to determine the effect of effect of 12 weeks aerobic exercise training on aerobic capacity and glucose concentration in obese men. Methods: In this quasi-experimental study, thirty two adult obese males were divided into interventional and control groups. Anthropometrical indexes, fasting blood glucose and insulin, resting heart rate and aerobic capacity (VO2max) were measured before and after a 12 weeks aerobic exercise in the interventional and control groups. Beta cell function was calculated by fasting glucose and insulin. Results: Long time aerobic exercise led to significant reduction in glucose (112±10 vs. 85±11 mg/dl), anthropometrical indces, BMI (28.44±2.29 vs. 33.24±5.14), increase in VO2max (26.12±4.11 vs. 32±6.41 ml/kg/min), beta cell function (83±23 vs. 181±35) and in interventional group in comparision with controls. A significant correlation was found between the changes in VO2max with changes in beta cell function and glucose level, these correlations were independent of BMI. There was no significant change in insulin level between intervention and control groups. Conclusion: Increased aerobic capacity or cardiovascular fitness by exercise training improve beta cell function of glucose concentration in obese men.

---

Background and Objective: Obesity presented as the most pivotal public health problem. Motivational interviewing is a client-centered and direct technique to improve intrinsic motivation of people to change behavior using search and resolve ambivalence that its beneficial outcomes have widely been confirmed. This study was carried out to evaluate the effect of motivational interviewing on weight loss in women. Methods: In this randomized clinical trial study, 150 women with overweight and obesity were randomly divided into control, motivational interviewing and motivational interviewing and intention implementation groups. Data were collected through a researcher made questionnaire at baseline and 2 month follow up. Results: The score of protection motivation theory constructs including susceptibility, severity, rewards, self-efficacy, response efficacy and cost were significantly increased in the two intervention groups compared to the control group (P<0.05). Anthropometric characteristics were significantly reduced in the motivational interviewing and motivational interviewing with intention implementation group (P<0.05) in compare to the control group (P<0.05). Conclusion: Motivational interviewing integrated into intention implementation causes weight loss and increase the constructs score in women.

---

Background and Objective: The growing evidence suggest on the association between dietary patterns and obesity. This study was done to determine the relation between pattern of nutrient intake and obesity in Isfahanian adults.

Methods: In this descriptive - analytical study, dietary data were collected using a semi-quantitative food frequency questionnaire in 8,691 subjects aged 18-55 years. Complete data of 6,724 and 5,203 adults were available for general and abdominal obesity, respectively. Daily intakes of 38 nutrients and bioactive compounds were calculated for each participant. Factor analysis was applied to derive major nutrient patterns.

Results: Three major nutrient patterns were identified: 1) pattern high in fatty acids, cholesterol, vitamin B12, vitamin E, zinc, choline, protein, pyridoxine, phosphorus, and pantothenic acid; 2) high in thiamine, betaine, starch, folate, iron, selenium, niacin, calcium, and manganese; and 3) high in glucose, fructose, sucrose, vitamin C, potassium, dietary fiber, copper and vitamin K. Men in the highest quintile of the second pattern were less likely to be generally obese in the fully adjusted model (95% CI: 0.20-0.76, OR: 0.39, P<0.05). After adjustment for potential confounders, a significant positive association was observed between the third pattern and general obesity among men (95% CI: 1.04-3.04, OR: 1.77, P<0.05), but it was not in women (95% CI: 0.74-1.88, OR: 1.18, P>0.05).

Conclusion: Nutrient patterns were significantly associated with general, but not abdominal obesity in the male Iranians participating in SEPAHAN study.

---

Background and Objective: Liver diseases accompanied with growing of obesity in children. This study was done to evaluate the effect of aerobic exercise and vitamin C intake on liver transaminases activities in 8-11 years obese girls.

Methods: In this quasi-experimental study, 28 obese girls were randomly divided into four equal groups including control, exercise, supplement (500 mg vitamin C tablet, dailly) and combined (500 mg vitamin C, daily plus exercise) groups. Aerobic exercise was consisted of exercise movements at 50% to 70% maximal heart rate and 3 sessions per week for 8 weeks. Fasting blood samples were collected before and 48 hour after the last intervention. Serum transaminases activities were measured by enzymatic colorimetric method.

Results: 8 weeks of aerobic exercise, vitamin C and the combined intervention were associated with a significant reduction in Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) activities (P<0.05) whereas there was no effect on the Alkaline phosphatase activity. All these interventions were associated with significantly greater reduction in the ALT and AST activities ratio in comparision with control group. Combined intervention induced more reduction on percent of variables changes compared with other interventions (P<0.05).

Conclusion: It seems selected aerobic exercise and vitamin C intake may induce their protective effect in obese girls via improvement in liver function.

---

Background and Objective: Dietary acid load affects acid–base homeostasis, which may be associated with overweight and obesity as well as dietary quality index international (DQI-I), mean adequacy ratio (MAR), energy density (ED). This study was done to determine the association between dietary acid load with weight status and dietary quality indices among women.
Methods: This descriptive-analytic study was randomly performed on 306 women aged 20 to 55years. Dietary acid load was calculated by potential renal acid load (PRAL), net endogenous acid production (NEAP) and dietary acid load (DAL). DQI-I, MAR, ED were estimated for the participants.
Results: The probability of obesity (95% CI=0.97-5.50, OR=2.33, P=0.04), as well as abdominal adiposity (95% CI=1.21-4.50, OR=2.4, P=0.005) was significantly increased with tertile of DAL (P<0.05). While even after control of confounder variables, other dietary acid load indices (PRAL and NEAP) showed no significant association between dietary acid load and obesity, overweight or abdominal obesity. Also ,with increasing dietary acid load scores, DQI-I and MAR significantly decreased whereas energy density showed a significant increased across tertile categories of dietary acid load indices (P<0.05).
Conclusion: DAL was associated with increased risk of obesity and abdominal obesity. PRAL, NEAP and DAL were good indicators of diet quality indices.
 

---

Background and Objective: Increasing the cost of energy in obesity preventing and treating and reducing its complications can be achieved by stimulating the factors including Irisin and FGF21 associated with browning of the white adipose tissue. The aim of this study was to determine the effect of 12 weeks of light and heavy interval exercises on the level of irisin and FGF21 in obese and overweight women.
Methods: This clinical traial study was done on 35 overweight and obese women (39.8±3.85 years old and body mass index 27.1±3.37 kg/m²). The subjects were divided randomly into three groups of interval exercises including Heavy (n=12), light (n=12), and control (n=11) groups. The training program included 12 weeks of heavy and light interval exercises for 25 to 60 minutes per session and three sessions per week. Before and after the training period, irisin and FGF21 serum indices were measured for each subject.
Results: Serum level of FGF21 increased only after 12 weeks of heavy interval training (P<0.05). However, there was no change in serum irisin levels after both heavy and light interval exercises. Body fat percentage, waist to hip ratio, and BMI Subjects of light and heavy interval exercises reduced and VO₂max increased significantly compared to control group (P<0.05).
Conclusion: 12 weeks of low and heavy interval training without altering serum levels of irisin have a beneficial effect on increasing VO₂max and improving body composition. Also, heavy interval training has a significant increase in FGF21, Which can be effective in weight loss through the browning of white adipose tissue.