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Social isolation matters for health and longevity, but little research examines transitions into or out of social isolation or whether transitions are gendered or socially patterned. We described gender-specific trends in breadth and lack of social participation over 6 years overall and by age, country of origin, geographic location, education, wealth, and household income. We used three waves of CLSA data to evaluate changes in social isolation (0-1 activities) and broad social participation (5+ activities) in adults aged 45-75 (n = 24,788), by gender and socio-demographics, in linear and multinomial logistic regressions with post-estimated predicted probabilities. The number of social activities decreased over time, with greater declines for women. About half the sample (more men than women) stayed not highly socially active (<5 activities) and almost 1 in 5 became not highly socially active. Most adults (77 %) remained not socially isolated and 14 % became or remained socially isolated. Women were more likely than men to remain not highly socially active and less likely to have multiple social isolation transitions. Broad social participation changed over time for several subgroups of women and men, with gender differences notable for income levels. Social disparities in social isolation transitions differed by gender only for education. Older age and socioeconomically disadvantaged adults had higher probabilities of becoming socially isolated or becoming less socially active. Findings indicated the diversity of social activities declined as Canadians age into later life and transitions in both social isolation and social participation differed between genders, especially for specific vulnerable subpopulations.

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Background: Predictive equations have been considered as a practical approach for estimating resting energy expenditure (REE) across multiple populations, but their accuracy for each community remains to be determined. Thus, the purposes of this study were to determine the validity of REE predictive equations and to develop a new REE predictive equation in adults living in Tehran. Methods: The study included 284 subjects (158 females) aged 18-60 years old from two cross-sectional studies conducted in Tehrani populations. Anthropometric measurements were assessed using standard protocols. REE was measured using indirect calorimetry (IC) and was estimated using preexisting equations. A new equation was also developed based on the REE from IC and variables such as age, sex, height, and weight. Measured REE was compared to new equation and preexisting predictive equations via correlation, linear regression, and Bland-Altman tests. Results: The new equation and the equations by Mifflin-St. Jeor, Livingston, Frankenfield, Nichols, Müller, and Ganpule demonstrated the best predictive value at a group level (mean percentage error=-2.2 to 2.4 %). At an individual level, the new equation and the equations by Mara, Frankenfield, Roza, Nikooyeh, and Harris & Benedict showed the greatest accuracies compared to measured REE (accuracy prediction=50-53%). Conclusion: This study highlights the importance of considering race when predicting REE. It also demonstrates that the newly developed equation is more appropriate in a clinical setting at group but not individual level. Thus, further research is needed to examine the new equation in an independent sample.

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BACKGROUND: Social relationships impact health and may affect proximal determinants such as obesity. Our review examined empirical evidence of the impact of changes in social relationships on risk of obesity in aging adults, with attention to gender. METHODS: We systematically searched Medline, EMBASE, Scopus, CINAHL, and ProQuest Dissertations and reference lists of relevant reviews and papers published up to November 2022. Longitudinal studies examining changes in marital status, living arrangement, social participation, and social networks and anthropometric changes or incident obesity were deemed eligible. Relevant data were extracted and synthesized narratively. RESULTS: We identified 41,910 eligible titles, resulting in 252 full texts and 7 included studies. All studies were conducted in the United States and assessed marital transitions only; 3 studies included both women and men. Overall, compared with people who remain non-married, entering marriage leads to a significant increase in body mass index (BMI) for both genders. Conversely, transitioning out of marriage through widowhood or divorce leads to a decrease in weight (kg/lbs), waist circumference, and BMI for both genders. All seven studies were deemed to be of medium quality. CONCLUSIONS: Our review revealed a paucity of prospective evidence on social connections as determinants of obesity among aging adults. There is limited evidence that marital transitions are associated with changes in anthropometric measurements in aging individuals, but no evidence on the effects of changes in living arrangements, social participation, and social networks on anthropometric measurements. More research attention to the social determinants of obesity is warranted.

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Purpose: When examining the underlying processes of obesity, evaluation of gut flora and energy homeostasis can be crucial since disruption of the normal gut microbiota community and energy imbalances are significant factors in the development of obesity. Therefore, this study aimed to compare the relative abundance of important obesity modulator gut microbiota (including Firmicutes, Bacteroidetes, Bifidobactrium spp., Lactobacillus spp., Bacteroides fragilis, Faecalibacterium prausnitzii, Akkermansia muciniphila, and Escherichia coli) in fecal samples of normometabilic and hypometabolic overweight/obese individuals. Methods: This matched case-control study conducted on 36 healthy women aged 18-50 years old. An indirect calorimeter and impedance body analyzer were used to assess resting metabolic rate (RMR) and body composition, respectively. Dietary intake and physical activity were assessed using questionnaires. To determine the abundance of the abovementioned gut microbiota, quantitative polymerase chain reaction (qPCR) method was performed. Moreover, ELISA kits were used to assess leptin, ghrelin, and insulin hormones. Results: The results highlighted higher load of Firmicutes (p = 0.02), F. prausnitzii (p < 0.001), and B. fragilis (p = 0.02) in the normometabolic individuals compared to the hypometabolic ones. Besides, the positive correlation between the abundance of Firmicutes (ß = 7.76 × 10-1, p = 0.01), F. prausnitzii (ß = 1.29 × 10-5, p = 0.01), and B. fragilis (ß = 4.13 × 10-6, p = 0.04) with the RMR have been shown. Whereas the abundance of Bacteroidetes, A. muciniphila, Lactobacillus spp., Bifidobactrium spp., and E. coli showed no significant difference (p > 0.05) and no significant correlation with the RMR except Lactobacillus spp. (ß = 1.73 × 10-4, p = 0.01). Conclusion: It seems that gut microbiota can be a potential target for refining host energy homeostasis and treating obesity and its consequences.

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OBJECTIVES: We aimed to validate dietary assessment methods against the gold standard, doubly labeled water (DLW), for estimating total energy intake (TEI). METHODS: PubMed, Scopus, Web of Science, and Google Scholar databases were searched until May 2023. Inclusion criteria encompassed studies involving participants aged 1-18 years, employing dietary assessment methods like food records, dietary histories, food frequency questionnaire (FFQ), or 24-h recalls estimating TEI alongside DLW to measure total energy expenditure (TEE). Data were pooled using random-effects meta-analysis models. RESULTS: Thirty-three studies were identified, with sample sizes ranging from 9 to 118 participants. Meta-analysis of 22 studies identified underestimation of TEI (mean difference [MD] = -262.9 kcal/day [95% CI: -380.0, -145.8]; I2 = 93.55%) for food records compared with TEE estimated by DLW. Other dietary assessment methods, including food recalls (n = 9) (MD = 54.2 kcal/day [95% CI: -19.8, 128.1]; I2 = 49.62%), FFQ (n = 7) (MD = 44.5 kcal/day [95% CI: -317.8, 406.8]; I2 = 94.94%), and diet history (n = 3) (MD = -130.8 kcal/day [95% CI: -455.8, 194.1]; I2 = 77.48%), showed no significant differences in TEI compared with DLW-estimated TEE. All studies were of high quality. CONCLUSION: Food records may underestimate TEI, yet additional research is needed to identify the most accurate methods for assessing children's dietary intake.

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Objective(s): Cardio-metabolic risk factors are becoming a global health concern. To address this problem, one of the proposed ways is to focus on phytochemical-rich foods consumption. Therefore, we aimed to summarize the results of observational studies (cohorts, case-control, and cross-sectional) that investigated the association between dietary phytochemical index (PI) as a new index for evaluating phytochemical-rich food intake and various risk factors of cardio-metabolic disorders. Methods: We conducted a comprehensive systematic review through PubMed, Scopus, and Web of Science databases. The literature search was performed up to August 2021 with no publication year restriction on observational studies investigating the association between PI and cardiometabolic risk factors on adults and children. A random-effect meta-analysis was used. Results: Overall, 16 articles (cross-sectional, case-control, cohort) were eligible for this systematic review and 8 studies with 99771 participants were included in the meta-analysis. Random effect meta-analysis showed that adherence to higher dietary PI decrease the odds of abdominal obesity (OR: 0.73, 95% CI: 0.58, 0.88, I2: 84.90), generalized obesity (OR: 0.84, 95% CI: 0.69, 0.98, I2: 68.10), hypertriglyceridemia (OR: 0.81, 95% CI: 0.73, 0.89, I2: 0.00), hypertension (OR: 0.86, 95% CI: 0.73, 0.99, I2: 7.02), and MetS (OR: 0.79, 95% CI: 0.69, 0.88, I2: 84.90). However, results considering the associations between dietary PI with glycemic indices, and low high-density lipoprotein cholesterol (HDL-C) were not significant (p<0.05). Conclusion: Evidence showed adverse associations between dietary PI and some cardio-metabolic risk factors such as obesity, hypertriglyceridemia, hypertension and metabolic syndrome.

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Background and aims: Substantial evidence have linked low grade inflammation with the pathophysiology of chronic diseases and psychological impairment. An integral component underlying the link is pro-inflammatory diet. While sleeping is another significant contributor, few studies have addressed the relationship between the sleep quality and inflammatory cascade with the dietary quality as a moderator. The current study assesses the relation between inflammatory potential of the diet and sleep quality in Iranian obese and overweight women. Method: A total of 219 obese and overweight adult women were enrolled in this cross-sectional study. A standard 147-item food-frequency-questionnaire was used to record the dietary intakes; then, the dietary inflammatosry index (DII) was derived from the result-consolidated questionnaires. Pittsburgh Sleep Quality Index (PSQI) was utilized to withdraw the sleep quality and quantity. Results: The mean (±standard deviation) age, body mass index, and PSQI of individuals were 36.49 (8.38) years, 31.04 (4.31) kg/m2, and 5.78(3.55), respectively. Patients in the highest DII quartile were the ones with the higher consumption of pro-inflammatory food, and, ~58% of participants who were in the higher quartile had a sleep disturbance status. Results revealed an inverse relationship between sleep quality and DII in the crude model (ß=-0.17, p=0.01) as well as full-adjusted model (ß=0.24, p<0.001), such that women with higher DII had the poorest sleep quality. Conclusion: Based on the present observational study, obese and overweight females with higher adherence of the anti-inflammatory diet may have better sleeping status.

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BACKGROUND: Unhealthy dietary patterns are the most important modifiable risk factors for obesity and overweight. This study aimed to examine the relationship between Dietary Phytochemical Index (DPI) and resting metabolic rate (RMR), mediated by inflammatory factors, in overweight and obese women. METHODS: A total of 404 women, aged 18-48 years, were included in the cross-sectional study. DPI was calculated using the 147-item food frequency questionnaire (FFQ). Anthropometric measurements, RMR, and blood biomarkers were assessed using standard protocols. RESULTS: There was marginally significant association between adherence to DPI and RMR status in the crude model (OR = 1.41, 95% CI 0.94-2.11, P = 0.09). After adjusting for potential confounders, a significant association was seen between the DPI and increase RMR.per.kg (OR = 2.77, 95% CI 0.98-7.82, P = 0.05). Our results indicated that plasminogen activator inhibitor-1 (PAI-1), transforming growth factor (TGF-ß), and monocyte chemoattractant protein-1 (MCP-1) had a mediatory effect on the association between RMR and DPI (P > 0.05). Indeed, it was shown that, PAI-1, TGF-ß, and MCP-1 destroyed the significance of this association and could be considered as mediating markers. However, no mediating effect was observed for high-sensitivity C reactive protein (hs-CRP). CONCLUSIONS: Adherence to DPI can improve the RMR by reducing levels of inflammatory markers, and may be considered as a treatment for obesity. However, more long-term studies are recommended.

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OBJECTIVE: Low resting metabolic rate (RMR), as a risk factor for weight gain and obesity, can be influenced by many factors. Empirical research has confirmed the role of appetite and related hormones in obesity and energy intake. This study aimed to investigate the relationship between appetite and related hormones in overweight or obese Iranian women with normal and hypo RMR. METHODS: This case-control study was conducted on 42 Iranian adult women (21 cases, and 21 controls), aged 18-48 years. An impedance body analyzer was used to obtain the body composition and an indirect calorimeter was used to assess the RMR. The Flint questionnaire was used to assess appetite, dietary intake, and physical activity were assessed by FFQ and IPAQ questionnaires respectively, and ELISA kits were used to assess leptin, ghrelin, and insulin hormones. RESULTS: The results of the study demonstrated a negative association between ghrelin hormone level (ß = -0.34, 95%CI = -61.70,-3.86, P-value = 0.027) and RMR, and a positive association between insulin hormone level (ß = 0.48, 95%CI = 9.38-34.35, P-value = 0.001) and RMR. Also, results of the appetite questionnaire showed that, in general, both appetite (ß = 0.32, 95%CI = -0.10-2.99 P-value = 0.044) and hunger variable (ß = 0.30, 95%CI = 0.04-5.87, P-value = 0.047) have a positive association with RMR. There was no significant association between leptin levels and RMR. CONCLUSION: It is evident that appetite and related hormones have a potential role in promoting a normal RMR.

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OBJECTIVES: The primary objective of our study was to systematically review all available prospective cohort studies which investigated the association of soy food intake and incident fracture risk. METHODS: We searched PubMed, Scopus, and Embase databases for relevant studies up to June 2021. SYNTHESIS: Of 695 records, a total of 5 cohort studies were included in the current systematic review. Two studies that were performed in China evaluated hip fracture while 2 studies that were done in Singapore evaluated any kind of fractures. The other study was conducted in Japan and evaluated osteoporosis fractures. All studies used a face-to-face interview to assess the dietary intake of soy foods. All 5 cohort studies were determined to be of high quality. One study considered soy food as a part of a vegetables-fruit-soy food dietary pattern. Others reported the association of dietary intake of soy foods with the risk of fractures. CONCLUSION: The evidence from prospective cohort studies was suggestive for a protective role of soy foods, alone or within a dietary pattern, in the risk of incident fracture among Asian women, particularly for those in early menopause and those who used fermented soy products. But for men, the association was not significant. However, more cohort studies, including non-Asian populations, are required to confirm this association fully.

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PURPOSE: Nutrient patterns have been associated with an increased risk for chronic disease. Evidence to confirm a direct relationship between nutrient patterns and obesity and metabolic syndrome (MetS) throughout population-based differences including cultural contexts add complexity is not well established yet. The aim of this study is to investigate the association between nutrient patterns and MetS among overweight and obese Iranian women. METHODS: Three hundred and sixty obese and overweight women (25 < BMI < 40) were included in this cross-sectional analysis. Dietary intake of 19 nutrients was evaluated by a semi-quantitative standard food frequency questionnaire (FFQ). MetS was determined by abdominal obesity > 88 (cm) in females, Triglycerides ≥ 150 (mg/dL), dyslipidemia (HDL < 50 mg/dL), systolic blood pressure > 130/85 (millimeters), and glucose > 100 (mg/dL). Body composition was assessed by a multi-frequency bioelectrical impedance analyzer, InBody 770 scanner. Principle components analysis was applied and four nutrient patterns were identified as following: Pattern 1 (thiamin, iron, carbohydrate, zinc, niacin, protein, magnesium, phosphorus, riboflavin), represented the carbo-vitamin group. Lipid group was showed in pattern 2 (PUFAs, MUFA, vitamin E, trans fatty acids, and Pattern 3 (beta-carotene, vitamin K, vitamin A, vitamin C) represented the anti-oxidant group, finally Pattern 4 was the indicator of the milk group (vitamin D, calcium). RESULTS: A significant positive association was observed between the anti-oxidant group and obesity (OR 1.40; 95% CI 1.09-1.8; P = 0.01). No relationship between other nutrient pattern and MetS was observed. CONCLUSIONS: The nutrient patterns that are highly loading of beta-carotene, vitamin K, vitamin A, and vitamin C in nutrient patterns may be associated to higher risk of obesity in overweight and obese Iranian women. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

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Although epidemiological studies have discerned the association between polycyclic aromatic hydrocarbons (PAHs) exposure and hypertension and/or cardiovascular disease in the general population, the possible mechanisms for this association are not well understood. We sought to examine the association between urinary metabolites of PAHs and cardiovascular diseases (CVDs) and blood pressure in adults, by conducting a meta-analysis of observational studies. We searched PubMed, Scopus, Embase, and Web of science, up to July 2021, for observational studies that investigated the association between urinary metabolites of PAHs and CVDs and blood pressure in adults. Nine prospective studies, including 27,280 participants, were included. Based on overall pooled results, there was a significant positive association between all types of urinary metabolites of PAH and blood pressure (OR: 1.32; 95%, CI: 1.19 to 1.48, p < 0.0001) (I2 = 62.4%, p < 0.0001). There was no significant association between any urinary metabolite of PAH and CHD (OR: 0.93; 95%, CI: 0.83 to 1.03, p = 0.174) (I2 = 0%, p = 0.653). Overall, there was a significant positive association between all urinary metabolites of PAH and CVD (OR: 1.23; 95%, CI: 1.16 to 1.30, p < 0.0001) (I2 = 59.7%, p < 0.0001). The results of the present meta-analysis suggest that different metabolites PAHs are associated with an increased risk of CVD and HTN. Further studies, including randomized clinical trials, are needed to confirm the veracity of our findings.

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OBJECTIVE: Recent studies have shown that increased dietary inflammatory index (DII) score or consumption of pro-inflammatory foods can lead to increased waist circumference (WC) as well as triglyceride (TG) concentrations in obese people. The purpose of this study is to examine the association between DII and hypertriglyceridemic waist circumference phenotype (HTGWCP) in women with overweight and obesity. RESULTS: There was a positive significant correlation between DII and HTGWCPs. In other words, with an increase in DII score or higher consumption of pro-inflammatory foods, the odds of having abnormal phenotypes including; enlarged waist normal TG (EWNT) (OR = 2.85, 95% CI 1.02 to 7.98, P for trend = 0.04), normal waist enlarged TG (NWET) (OR = 5.85, 95% CI 1.1 to 31.11, P for trend = 0.03) and enlarged waist enlarged TG (EWET) (OR = 3.13, 95% CI 0.95 to 10.27, P for trend = 0.05) increase compared to normal waist normal TG (NWNT) phenotype. In conclusion; increasing DII scores can increase abnormal phenotypes and therefore may increase WC and TG levels in overweight and obese women.

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BACKGROUND: Nowadays, use of continuous metabolic syndrome (cMetS) score has been suggested to improve recognition of metabolic syndrome (MetS). The aim of this study was to evaluate the validity of cMetS scores for predicting MetS. METHODS: We searched the electronic databases included MEDLINE/PubMed, Embase, ISI Web of Science, and Scopus from 1 January 1980 to 30 September 2020. Observational studies on participants with different cMetS scores were included in this meta-analysis. The sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR) and diagnostic odds ratio (DOR) with 95% CI were calculated. RESULTS: Ten studies involving a total of 25,073 participants were included. All studies had cross-sectional design. The pooled sensitivity and specificity of cMetS scores for predicting MetS were 0.90 (95% CI: 0.83 to 0.95) and 0.86 (95% CI: 0.83 to 0.89), respectively. Moreover, cMetS scores had the pooled LR+ of 6.5 (95% CI: 5.0 to 8.6), and a pooled (LR-) of 0.11 (95% CI: 0.063 to 0.21). The pooled DOR of cMetS scores to predict MetS were 57 (95% CI: 26 to 127). CONCLUSIONS: The high sensitivity and specificity of cMetS scores indicates that it has a high accuracy to predict the risk of MetS. Furthermore, the cMetS scores has a good ability to rule out healthy people. STUDY REGISTRATION: This study was registered as PROSPERO CRD42020157273.

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OBJECTIVE: Some observational studies investigated the association between dietary energy density (DED) and risk of cancers with inconstant results. In addition, there is no study on such association among patients with prostate cancer (PC). The present study was performed to evaluate the association between dietary energy density (DED) and PC risk. METHODS: In this case-control study, one hundred and twenty-five participants were enrolled (62 cases and 63 controls). Dietary intakes were assessed using 160-item semi-quantitative food frequency questionnaire. In addition, demographic characteristics were collected using a general questionnaire and anthropometric indices were measured based on the available guidelines. The association between DED and PC risk was evaluated using multivariable logistic regression. RESULTS: The results showed that higher DED score was associated with increased risk of PC (OR = 2.59; 95% CI= (1.24-5.40)). Interestingly, after adjusting for potential confounders ((smoking, physical activity, energy intake, education, ethnicity, job, anti-hyperlipidemic drugs, antihypertensive drugs, and aspirin) the results remained significant (OR = 2.87; 95% CI= (1.17-7.05)). CONCLUSION: Our findings suggest that DED may increase the risk of PC. However, more prospective studies are warranted to confirm these results.

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OBJECTIVE: Equivocal association the contribution of 25-hydroxyvitamin D (25(OH)D) and the well-accepted role of vitamin D-binding protein (VDBP) on bioavailability of 25(OH)D or its independent roles, has led to possible association of the VDBP in glucose metabolism. This study was conducted to evaluate the relationships among 25(OH)D, VDBP, glucose/insulin metabolism and homeostatic model assessment (HOMA-IR). Blood samples were collected from 236 obese and overweight women. VDBP and 25(OH)D levels, and biochemical parameters were measured using an enzyme-linked immunosorbent assay (ELISA). An impedance fat analyzer was utilized to acquire the body composition. RESULTS: Using the multivariate linear regression, a reverse relationship was observed between VDBP and (HOMA-IR), such that women with higher VDBP displayed lower insulin resistance. The relationship was independent of age, body mass index, standardized energy intake and physical activity (p = 0.00). No significant relationship between 25(OH)D levels, FBS, body composition or insulin resistance were observed (p > 0.2). Current study observed that higher level of VDBP may be associated with lower levels of insulin and HOMA-IR, thus the evaluation of VDBP in diverse population groups seems to have significant clinical value in evaluating the prevalence of DM or early stage of glucose intolerance.

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AIM: The associations between types of dietary protein intake and child anthropometric measurements have not been fully studied. Therefore, we examined dietary protein pattern in relation to anthropometric indicators among 6-year-old children. METHODS: We carried out a cross-sectional study of 788 randomly selected children from health centres in Tehran, Iran. Dietary intake was assessed using a food frequency questionnaire completed by the mothers. Anthropometric measurements were based on standard protocols. Principle component analysis was performed to identify different dietary protein patterns. We used multivariate logistic regression to evaluate how these patterns were associated with child anthropometry. RESULTS: Three dietary protein patterns were identified: pattern 1 (rich in red and processed meats, dairy products and eggs), pattern 2 (rich in fish and poultry) and pattern 3 (rich in soy and legumes). After adjusting for potential confounders (energy intake, socioeconomic status and physical activity), being in the third compared to the first tertiles of pattern 2 was associated with increased (OR = 1.57; 95% CI: 1.09-2.27; P = .01) and decreased (OR = 0.54; 95% CI: 0.32-0.92; P = .02) risk of overweight/obesity and underweight/wasting, respectively. There was no association between other dietary patterns and risk of overweight/obesity or underweight/wasting. CONCLUSIONS: The present study showed inverse association between the fish/white meat pattern and underweight/wasting and also a positive association between higher fish/white meat protein intake and higher risk of overweight/obesity. Further studies are needed to confirm these results.

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