Tehran University Medical Journal

Background: Paraoxonase-1 (PON1) is one of the most important enzymes for removal of the free radicals, and the main protective factor for lipoproteins against oxidative agents. The purpose of this study was to investigate the effects of eight weeks’ rope training on paraoxonase-1 enzyme, insulin resistance and lipid profiles in inactive overweight and obese girls.
Methods: This quasi-experimental study was conducted in Iranian Azarbaijan Shahid Madani University of Tabriz, from November 2016 to January 2017. In this study, 20 healthy overweight and obese in-active girls (20-25 Yr) volunteered and randomly assigned into exercise (n=10) and control (n=10) groups. Exercise protocol was rope training was 8 week for 4 day per week in 45 minute per day. Some anthropometric indexes of subjects were measured before and after exercise. A fasting blood sample was collected as pre-test and post-test, followed by 48 hours of physical inactivity to measure serum levels of PON1 enzyme, Insulin, lipid profiles and other blood variables. Analysis of the data was performed by paired and independent samples t-tests by using the SPSS software, version 20 (IBM, Armonk, NY, USA). The criterion of statistical significance was set as P<0.05.
Results: The paired samples t-test results showed that after exercise intervention, in exercise group, the values of all variables (except low-density lipoprotein) were significantly changed. Also, to compare with control group, the values of PON1 enzyme (P=0.024) and maximum oxygen consumption (P=0.006) significantly increased and insulin resistance index (P=0.028), triglyceride (P=0.046) and body fat percent (P=0.001) were significantly decreased (P<0.05).
Conclusion: The results of this study showed that performing rope training for 8 weeks induced positive changes in paraoxonase-1 enzyme, insulin resistance index, maximum oxygen consumption and some lipid and anthropometric indices in overweight and obese young girls. Therefore, according to these results, rope training, as an aerobic activity it can be useful for all people especially in overweight and obese to control blood fats, body composition and prevent diseases due to obesity such as cardiovascular disease. 

Background: Anemia is the most common nutritional disorder in the world in which iron deficiency is one of its main causes. The prevalence of obesity and risk of iron deficiency anemia in these individuals is increasing. The present study examined the association between iron deficiency, dietary intake and obesity and obesity-induced inflammation in female students.
Methods: This descriptive cross-sectional study was conducted in Ahvaz University of Medical Sciences, Ahvaz, Iran, from May to March of 2016. A total of 170 female students were selected by stratified random sampling. Being in the age of 18-35 years, having a regular menstrual cycle, not following a specific diet and not taking any medication or dietary supplements that could affect iron status were indicators of inclusion in the study. General information and physical activity questionnaire were completed and a semi-quantitative feed frequency questionnaire was used to obtain food intake information. Anthropometric indicators including weight, height, body mass index (BMI), waist circumference and body fat were measured. Obesity was evaluated with 3 different definitions. Biochemical indices such as iron, hemoglobin, hematocrit, transferrin, total iron binding capacity (TIBC), ferritin, and hs-CRP were also measured.
Results: The dietary intake of iron and some nutrients related to iron (including energy, protein, vitamin C and calcium) showed no significant difference in dietary intake between different groups of obesity definitions. Serum iron levels and hemoglobin concentration had a significant negative correlation with BMI and hs-CRP concentrations (P=0.026 and P=0.01 respectively). The relationship between transferrin levels and total iron binding capacity with the index of waist circumference was positive and significant (P=0.040, P=0.034, respectively). Also, there was a significant positive correlation between obesity and hs-CRP levels (P=0.014). There was no significant relationship between other evaluated factors with different degrees of obesity.
Conclusion: Chronic obesity and inflammation which could be caused by obesity, can contribute to iron deficiency, regardless of dietary iron intake.

Background: Disruption of lipid metabolism threatens human life in all countries with different percentages and causes cardiovascular disease. Reducing physical activity and eliminating some of the food medications have exacerbated these complications. The aim of this study was to investigate the effect of ginger supplementation on the lipid profile and body composition of obese women following Pilates exercises.
Methods: This semi-experimental study was carried out at the Medicinal Plants Research Center of Ilam University of Medical Sciences, Iran, from September to December 2012. In this study, 90 pregnant women with type 2 diabetes mellitus were randomly divided into three groups: complement, placebo and control (30 objects in each group). The exercise protocol includes a ten-week Pilates exercise. The supplement group consumed 2 grams of ginger powder daily for ten weeks. The placebo group used starch (placebo) capsules for these ten weeks. The control group did not take any supplement and did not have any activity at all. Blood samples were taken prior to physical activity and 48 hours after the end of 10 weeks Pilates training three sessions per week (30 sessions). In order to investigate intra-group changes, t-test and one-way ANOVA were used to compare the groups.
Results: The results showed that after 10 weeks of using zinc supplements following Pilates exercise training in pretest and posttest, increases in HDL levels and decreased TG, LDL, Tcol, body composition and body weight in obese women. Also, consumption of 10 weeks of ginger supplement after aerobic exercise training on TG (P=0.001), LDL (P=0.02), Tcol (P=0.05) and HDL (P=0.01) in obese women in supplement and placebo groups had a significant impact.
Conclusion: The results of this study showed that Pilates exercises with daily consumption of 2 grams of ginger supplement for 10 weeks caused a significant decrease in lipid profiles, body fat percentage, weight, and hip circumference.

Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications in pregnancy, which is associated with many serious consequences for mother and her fetus. Body mass index (BMI) in pregnant women is considered as one of most effective factor for the incidence of GDM. The aim of this study was to determine the relationship between BMI at pregnant women in the early months of pregnancy and the incidence of GDM.
Methods: In this retrospective cohort study, the case of six hundred fifty-nine pregnant women who referred to health centers in Kermanshah City from September 2010 to September 2012 by convenience sampling method were selected and investigated. This study was sponsored by Kermanshah University of Medical Sciences. Height and weight were measured for each woman at the beginning of pregnancy and maternal body mass index (BMI) was calculated based on height and weight measurements. Then the pregnant women were divided into four groups based on BMI: thin (BMI less than 18.9 kg/m2), normal (BMI between 19 kg/m2 and 24.9 kg/m2), overweight (BMI between 25 kg/m2 and 29.9 kg/m2) and obese (BMI more than 30 kg/m2). Those women who had diabetes at the beginning of pregnancy were excluded from the study. GDM was considered as fasting blood glucose ≥92 between 26-30 weeks of gestation.
Results: The mean±SD age of pregnant women was 27.7±5.85 year and the mean of BMI was 24.4±4.0 kg/m2. The GDM was shown in 30.7% of women. Association between BMI and GDM were statistically significant (P<0.001). The risk of GDM onset was 1.24 times, for each unit increased in BMI, (P<0.001). The risk of GDM was significantly higher in overweight [OR=2.97, CI (2.01-4.39)] and obese [OR=16.89, CI (8.46-33.70)] women. Being underweight increased the risk of GDM onset up to 1.19 times, but not significant.
Conclusion: There is a significant relationship between maternal BMI in pregnant women at the beginning of pregnancy with GDM onset. Increased BMI is correlated with an increase in the incidence of GDM.

Background: Today, overweight and obesity are major health concerns in developed and developing countries. Meanwhile, the issue is particularly important in children due to its consequences in adulthood. This study aimed to investigate the frequency of overweight and obesity in preschool children in Kerman, Iran.
Methods: This cross-sectional survey was conducted from December to March of 2016 among 731 preschool children (5 to 6 years old) who were selected using convenience sampling. The nutritional status of children was assessed according to the World Health Organization (WHO) expert committee guideline and based on body mass index (BMI) curves for age for boys and girls. Data were analyzed by SPSS software, version 21 (SPSS Inc., Chicago, IL, USA). Chi-square test was used for data analysis, and the significance level was considered less than 0.05.
Results: In this study, 376 boys (51.5%) and 355 girls (48.5%) were investigated. The mean and standard deviation of the age of the participants was 68.7±4.2 months, 53% of these children were first children of the family and 30% of them were only children. The prevalence of overweight and obesity was 9.2% and 8.1% respectively. There was no significant relationship between overweight and obesity with gender, number of siblings and parents' education. There was a borderline difference in birth order (P=0.05) and the frequency of overweight and obesity in the firstborn children was more than other birth orders.
Conclusion: The prevalence of overweight and obesity was high in preschool children. Since these risk factors in children are predictors of chronic diseases during adulthood, we need to design and implement interventions to decrease the prevalence of overweight and obesity in children.

Asthma is an inflammatory and chronic disease that affects about 300 million people globally. The disease is more common in developed countries. The increase in the prevalence of asthma is not only due to genetic factors, but also to many environmental factors related to urbanization and type of nutrition. It has been reported that obesity is an independent risk factor for asthma and obese children are at higher risk of asthma. The researchers found that many of the common phenotypes of obesity and asthma are due to genetic effects and some genetic component is common to asthma and obesity. Genetic data suggest that there are areas of genetic overlap between the obesity and asthma genes. These children experience more severe asthma and have a poor treatment outcome. On the other hand, there is an association between vitamin D deficiency in the earlier stages of life and incidence of asthma in the following years. Interestingly, obesity is a common risk factor for both asthma and vitamin D deficiency. Therefore, study on the interaction of asthma, obesity, and vitamin D deficiency may play an important role in unraveling the intricate nature of asthma. Prevalence of Pediatric asthma in 6-7 and 13-14 years-old children has been reported more than 10% in Iran. In this review we aimed to assess the latest findings about pediatric asthma and its association with obesity and vitamin D in Iran and the other countries. In addition, the results of a pilot study that has examined the frequency of overweight and obesity, as well as vitamin D deficiency in children with asthma in Tehran, are briefly presented. Enrolling a national study on obesity and vitamin D levels in children with asthma, can provide excellent information on the effects of obesity and vitamin D deficiency on asthma in Iranian children. Also the results could provide a basis for ecological studies to measure correlation between pediatric asthma and Sunlight and food and cultural habits in different parts of the country. Also, it is recommended that for a better understanding of the subject, experimental studies examine the effect of vitamin D supplementation and vitamin D-rich diets on the prevention and treatment of pediatric asthma in different age groups as well as different ethnicities of Iran.

Background: Obesity is associated with chronic inflammation in obese subjects, which leads to an increase of inflammatory cytokines. This study aimed to evaluate the effect of different intensity circuit resistance training on levels of interleukin 1 beta and interleukin-10 in obese men.
Methods: In a semi-experimental trial during May to August 2020, 44 obese men from Tehran city were selected and randomly divided into 4 groups including 1) control (n=11), 2) low-intensity circuit resistance training (n=11), 3) Moderate intensity circuit resistance training (n=11) and 4) High-intensity circuit resistance training (n=11). Resistance training was performed in different intensities including1) High-intensity circuit resistance training: three sets of 10 repetitions with 80% 1RM 2) Moderate intensity circuit resistance: three sets of 13 repetitions with 60% 1RM and 3) low-intensity circuit resistance training: three sets of 20 repetitions with 40% 1RM, three sessions per week for 12 weeks. Also, the control group had their daily life during the 12-week research period and were prohibited from participating in regular exercise. Serum interleukin-1 beta (IL-1β) and interleukin-10 (IL-10) levels were measured using an ELISA kit. Data were analyzed with covariance analysis at P<0.05.
Results: Twelve weeks of low, Moderate and high intensity circuit resistance training significantly decreased IL-1β levels (P=0.001) and increased IL-10 levels in obese men (P=0.001). The decrease of IL-1β was significant in the high-intensity training group compared to low intensity (P=0.009) and moderate-intensity training groups (P=0.046). Also, the increase in IL-10 levels was significant in the high-intensity training group compared to the low-intensity (P=0.002) and the moderate intensity training group compared to the low intensity training group (P=0.004).

Conclusion: According to our findings, resistance training has a positive effect on inflammatory and anti-inflammatory factors in obese men, and high-intensity circular resistance training had more benefits.

Background: The vertical gastric plication technique leads to poor long-term outcomes and is associated with intolerable reflux, dysphagia, or weight gain in a high percentage of patients. Therefore, in this study, the therapeutic results of two methods with and without plication of the distal part of the stomach in gastric bypass surgery in patients with morbid obesity were compared.
Methods: In this clinical trial randomized single-blind study, 40 patients with morbid obesity who were referred to one of the hospitals affiliated with Jundishapur University of Medical Sciences in Ahvaz during March 2020-February 2021, were randomly divided into two groups: with plication of the distal part of the stomach (n=20) and without plication of the distal part of the stomach (n=20) in Roux-en-Y gastric bypass surgery. Weight loss rate, complications related to surgery, outcomes and satisfaction of patient were noted and followed up for one year.
Results: The mean percentage of weight loss at different times did not show a significant difference between the two groups (p>0.05). The length of hospitalization after surgery was significantly less in the distal gastric plication group (p=0.0001). During one year of follow-up, hypertension, diabetes, HLP, and reflux were well in the distal plication method but showed no significant difference (p>0.05). Satisfaction of the patients was more in the distal plication method and showed no significant difference (p>0.05). One year after the operation, the change of diet showed no significant difference in the two groups (p>0.05).
Conclusion: It looks that using the laparoscopic distal gastric plication method is an effective and safe method and is associated with early ideal weight loss, reduction of complications, and increase in satisfaction of patients with BMI>=35 kg/m2. No need to use a foreign body, stapler or bandage and the possibility of re-operation are the advantages of this technique.

Background: Obesity and overweight are one of the components of metabolic syndrome and the cause of cardiovascular disease and sudden cardiac death. Obesity is associated with a wide range of electrocardiogram (ECG) abnormalities.
Methods: This case-control study was performed on 50 children and adolescents aged 9 to 18 years in Birjand from May to October 2020. In the control group, 25 people with normal weight and in the case group, 25 people with obesity or overweight were included in the study. Individuals with a body mass index of 85-95 percent were defined as overweight, ones with a body mass index above the 95th percentile were defined as obese, and individuals with a body mass index below the 85th percentile were defined as normal. After clinical examination, height, weight and electrocardiogram indices were measured and compared by using statistical tests by SPSS (Version 19) software.

Results: There were 15 boys in the control group and 17 boys in the case group. The mean age of the control and case groups was 11.28±2.13 and 10.96±1.97 years, respectively. The mean distance between the peak to the end of the T wave in the case group was 323.72±120.15 and in the control group was 79.20±13.06. The mean difference between the shortest and longest distance of TP-e in case group was 48±23.04 and in control group was 18.44±5.58, respectively. There was a statistically significant difference between the two indices (P<0.001). But in other variables, no statistically significant difference was observed between the two groups.

Background: Exercise programs can lead to different physiological adaptations, but the effects of low-volume, low-frequency HIIT protocols with varying interval structures have not been thoroughly investigated. This study aimed to explore the impact of HIIT with high compression (HC) and low compression (LC), with or without berberine (BBR) supplementation, on hematological parameters in pre-diabetic men.
Methods: This semi-experimental study was conducted between October and December 2021 at Mazandaran University. Fifty-four overweight/obese men with a mean age of 48.6±6.6 years, a body mass index of 30.7±7.3 kg/m², and a body fat percentage of 34.4±4.3% were randomly and equally divided into one of six groups: HC, LC, HC+BBR, LC+BBR, BBR, and control. The HC group (2:1 work-to-rest ratio) and LC group (1:1 work-to-rest ratio) underwent training programs comprising 2-4 sets of 8 exercises at an intensity of 80-95% of their maximum heart rate twice a week for 8 weeks. Hematological responses to Bruce's incremental exercise test were measured before and after the intervention. Data were analyzed using a two-way ANOVA with Bonferroni's post hoc test, with a significance level set at P<0.05.

Results: Baseline hematological indices showed no significant differences between pre-diabetic and non-diabetic groups (all, P>0.05). Following the 8-week intervention, there were significant decreases in white blood cells (WBCs) in the LC and LC+BBR groups, and in lymphocytes across all intervention groups except BBR (all, P<0.05). Additionally, hemoglobin and hematocrit levels showed significant reductions in the HC and HC+BBR groups (both, P<0.05). However, in response to Bruce's incremental exercise test, a significant decrease in WBCs was observed in the LC and LC+BBR groups, with reductions of 18% and 25%, respectively (both, P<0.05). Conclusion: The LC protocol, even without berberine supplementation, seems to provide better immunological benefits and result in less hemolysis compared to the HC protocol, as evidenced by reductions in white blood cell counts.