Tehran University Medical Journal

Background: According to the previous studies, stress influences on eating behavior and is associated with unhealthy food selection. Furthermore, the research literature indicates that stress, anxiety, and depression can cause polyphagia and overweight. The purpose of present study is to investigate the relationship between depression, anxiety, and stress scales and dietary behavior in female high school students.
Methods: The cross-section study was carried out from April to December 2016 on high school female students of Tehran City by confirmation and protection of Nutrition Sciences and Food Technology Faculty at Shahid Beheshti Medical Sciences University, Tehran, Iran. 400 samples were selected by using multistage cluster sampling method. After receiving consent and recording socio-economic information, the data associated with stress, anxiety, and depression score were collected by a short questionnaire of Depression Anxiety Stress Scales 21 (DASS-21). In order to survey the dietary behavior of students, the 168-item semi-quantitative food frequency questionnaire (FFQ) was applied. In addition, to assess the association between dietary behavior and stress, anxiety and depression, chi-squared test and logistic regression model were employed.
Results: Based on the results of the present paper, 49.8 percent of students, studied in this research, had stress levels, 56.3 percent of them suffered from anxiety and 55.3 percent of them had depression levels. The salt intake amounts of students who had high stress, depression, and anxiety, were more than of normal ones (respectively P=0.01, 0.02, 0.006). Additionally, fast food consumptions of students, suffering from anxiety, were also higher than normal (P=0.07). Subjects, which were categorized in depressed group, rarely eat natural fruit juice (P=0.03), and, stressful students use few natural fruit juices (P=0.006) and few fresh fruits too (P=0.02).
Conclusion: Students with levels of stress, depression and anxiety in comparison to normal students, have more undesirable food habits, such problems may lead dietary behavior to unhealthy foods. More studies are required to clarify the relationships between dietary behavior and stress, depression and anxiety.

Background: Phenylketonuria (PKU) is a genetic metabolic disorder that, if left untreated, leads to irreversible cognitive, behavioral, and neurological damage. Sistan and Baluchestan and West Azerbaijan provinces are among the regions that have reported high rates of the disease due to specific ethnic characteristics. This study aims to compare the frequency and pattern of clinical symptoms in the two provinces of Sistan and Baluchestan and West Azerbaijan. Methods: This cross-sectional descriptive-analytical study was conducted on 60 patients with PKU who had been referred to Imam Ali Hospital (Zahedan) and Urmia Hospital during the past ten years. Data were collected from medical records and structured interviews. Results: The mean age of the patients was 5.67 ± 6.98 years. The mean height, weight, and head circumference were 30.28 ± 113.08 cm, 13.22 ± 25.13 kg, and 1.83 ± 43.36 cm, respectively. The mean serum phenylalanine level at the time of diagnosis was 13.58 ± 14.65 mg/dL. Of the 60 patients, 31 (51.7%) were male and 29 (48.3%) were female. The difference between the two sexes in the occurrence of clinical symptoms was not statistically significant (p<0.05). Psychiatric disorders were reported in 20 (33.3%) of the patients. The prevalence of these disorders was significantly higher with increasing age (p = 0.041). Conclusion: This study indicates the existence of significant regional differences in the clinical manifestations of phenylketonuria; such that patients from Sistan and Baluchestan province experienced a higher rate of psychiatric and neurological symptoms than patients from West Azerbaijan. The severity of symptoms increased with increasing age and duration of illness, emphasizing the importance of early diagnosis and continuous therapeutic follow-up. It was also noteworthy that some patients still had severe clinical symptoms despite having lower phenylalanine levels at diagnosis. Overall, the findings of this study emphasize the need for early diagnosis, equitable access to health services, and sustained metabolic control to improve outcomes for PKU patients in the country.