Papers by Shooka Mohammadi
Conjugated Linoleic Acid (CLA) are thought to pose beneficial effects on inflammatory responses a... more Conjugated Linoleic Acid (CLA) are thought to pose beneficial effects on inflammatory responses and oxidative stress (OS). Thus, the present systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to assess the net effects of CLA supplementation on various OS parameters and antioxidant enzymes. PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched for publications on CLA supplementation effects on OS parameters up to March 2021. The data extracted from eligible studies were expressed as standardized mean difference with 95% confidence intervals and then combined into meta-analysis using the random-effects model. Overall, 11 RCTs (enrolling 586 participants) met the inclusion criteria and were included in meta-analysis; however, since those trials evaluated different OS parameters, meta-analysis was carried out considering different sets for each parameter separately. According to our results, CLA supplementation significantly increases 8-iso-PGF2α urinary concentration (SMD: 2; 95% CI: 0.74, 3.27; I2=87.7%). On contrary, the intervention does not seem to change 15-keto-dihydro-PGF2α urinary concentration, nor the serum levels of CAT, SOD, GPx and MDA. Taken all together, CLA supplementation does not appear to have substantial effects on OS markers in general; albeit due to relatively small sample size and high level of heterogeneity between studies, the obtained findings should be interpreted with caution. Further large well-designed RCTs, investigating the impact of CLA and including various groups of patients, are still needed.
Background: The impact of COVID-19 on asthmatic patients is still uncertain. Objective: This stud... more Background: The impact of COVID-19 on asthmatic patients is still uncertain. Objective: This study intended to examine the associations between the severity of coronavirus dis-ease 2019 (COVID-19), asthma, and some inflammatory markers among pediatric patients. Methods: A retrospective study enrolled pediatric COVID-19 patients who were admitted to Abuzar Hospital (Ahvaz, Iran) during eight months. The diagnosis of COVID-19 was according to the real-time reverse transcription-polymerase chain reaction (RT‐PCR) method. Asthma diagnosis was confirmed by specialists through functional and clinical evaluations (positive bronchodilator reversibility test or positive methacholine challenge test). Demographic and clinical characteristics of the patients were documented. Asthmatic patients with COVID-19 were considered as Group 1 (n= 52) and non-asthmatic COVID-19 patients were assigned as Group 2 (n= 54). Results: The mean age of 106 patients was 71.28 ± 50.09 months (range: 1-16 years). Children with severe and moderate COVID-19 had significantly lower levels of neutrophils and lymphocytes, higher inflammatory markers, and longer hospital length of stay (LOS) than patients with a mild course of COVID-19 (p < 0.001). Patients in Group 1 had significantly longer LOS, higher dry cough, chest radiographic findings, fever, levels of D-dimer, fibrinogen, and C-reactive protein (CRP), as well as lower neutrophil and lymphocyte counts, compared with those in Group 2 (p < 0.001). Conclusion: The presence of asthma in COVID-19 patients was associated with severe COVID-19 in comparison with their non-asthmatic counterparts. Additional studies with large sample sizes are deemed necessary to determine the impact of asthma on the management and incidence of COVID-19 disease.
There is insufficient data about esophageal body dysmotility in patients with refractory gastroes... more There is insufficient data about esophageal body dysmotility in patients with refractory gastroesophageal reflux disease (RGERD) and inadequate response to proton pump inhibitors (PPIs) treatment. This study aimed to assess esophageal motility disorder and reflux parameters among these patients by highresolution manometry (HRM) and intraluminal impedance and pH (MII-pH) monitoring after stopping PPI therapy. A retrospective study was conducted among 100 RGERD patients admitted to Taleghani Hospital (Tehran, Iran) for one year. More than half of them were males (55%). Their mean age was 47.10±6.92, and 50% of patients had ineffective esophageal motility (IEM). Middle, distal, and proximal esophageal pressure (MEP, DEP, and PEP), lower esophageal sphincter (LES) basal pressure (LESP), integrated relaxation pressure (IRP), distal contractile integral (DCI), large breaks, upper esophageal sphincter basal pressure (UESP), and LES length (LESL) in IEM patients were significantly lower than the patients with normal esophageal motility (P<0.001). Furthermore, there were more patients in the IEM group with long-term and abnormal weakly acid reflux compared with the non-IEM group (P<0.05). It seems that the evaluation of reflux parameters and esophageal motility could lead to additional insights into the pathophysiological mechanisms of RGERD. Nevertheless, further studies are suggested to evaluate the effects of esophageal motility disorders among RGERD patients.
MDPI, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Data on pediatric critical care in Iran are insufficient. This study was performed to determine t... more Data on pediatric critical care in Iran are insufficient. This study was performed to determine the outcomes and characteristics of critically ill children admitted to a pediatric intensive care unit (PICU) in Ahvaz, Iran. A retrospective study was conducted among all patients in the PICU of Abuzar Hospital for one year. Their medical documents were reviewed. A total of 400 patients were identified. The average age of patients was 29.94±39.55 months, and 53.8% of them were males. Nearly half of the cases were under age one. The most prevalent causes of PICU admission were respiratory (36.5%), neurological (18.5%), and infectionrelated diseases (15%). Besides, 55.7% of patients (n=223) had no history of underlying health problems. Admissions were more frequent in winter (n=125; 31.3%) and spring (n=101; 25.3%). The mortality rate and the mean hospital length of stay (LOS) were 15.5% and 10.79±6.39 days, respectively. In addition, 231 patients had an abnormal respiratory rate and a quarter of them (n=97) required ventilation support. Moreover, 377 and 82 patients were malnourished and severely underweight, respectively. A significant association was found between the mortality of patients and malnutrition, as well as having consanguineous parents (P<0.001). The death rate was significantly higher in patients with infectious disease than non-infectious, as well as in longstay PICU patients than in short-stay patients (P<0.05). Additional studies are required to find factors contributing to the disease burden among PICU patients in Iran to develop appropriate therapeutic strategies and improve the outcomes of pediatric patients.
Current Respiratory Medicine Reviews, 2022
Background: Chronic obstructive pulmonary disease (COPD) is related to oxidant/antioxidant imbala... more Background: Chronic obstructive pulmonary disease (COPD) is related to oxidant/antioxidant imbalance and systemic inflammation.
Objective: This study was conducted to evaluate associations of serum levels of C-reactive protein (CRP) and malondialdehyde (MDA) with the severity and exacerbations of COPD.
Methods: A matched case-control study was performed among 200 COPD patients (100 cases and 100 controls) who were referred to Masih Daneshvari Hospital in Tehran, Iran. Cases were exacerbators with equal to or greater than two ambulatory exacerbations or one hospitalization; controls were non-exacerbators who had one/no ambulatory exacerbation during the preceding 12 months. Blood samples were collected for CRP, MDA, and erythrocyte sedimentation rate (ESR) analysis. In addition, spirometry, the COPD assessment test (CAT) score, the modified Medical Research Council (mMRC) dyspnea scale, and the BODEx index were applied.
Results: The mean (SD) age of the patients was 65.31 (8.46) years. Those with exacerbations had significantly lower FEV1 and higher CRP, MDA, ESR, BMI, BODEx index, CAT, and mMRC scores compared to non-exacerbators. There were significant differences in CRP, MDA, ESR, FVC, FEV1, FEV1/FVC, BMI, BODEx index, mMRC, and CAT scores between the GOLD group. Moreover, multivariate analysis showed that higher levels of CRP (OR=0.61, p=0.023), MDA (OR=0.28, p=0.001), ESR (OR=0.86, p=0.029), CAT score (OR=0.84, p=0.012), BODEx index (OR=0.89, p <0.001), BMI (OR=0.42, p <0.001), and lower FEV1% (OR=0.77, p <0.001) were independent risk factors for frequent exacerbations.
Conclusion: In conclusion, elevated serum MDA and CRP levels in combination may serve as prognostic indicators of the severity and exacerbation of COPD.
Oxygenation index (OI) based on arterial blood gas (ABG) test is an invasive procedure and requir... more Oxygenation index (OI) based on arterial blood gas (ABG) test is an invasive procedure and requires indwelling arterial lines. However, the oxygen saturation index (OSI) assessed by the pulse oximetry method is simple and noninvasive for monitoring oxygenation saturation in newborn neonates with chronic lung disease. This study aimed to evaluate and compare OI and OSI among neonates in NICU who underwent mechanical ventilation. A cross-sectional study was carried out among fifty neonates (term and preterm) who were admitted to the NICU of Abuzar Hospital in Ahvaz, Iran. All neonates were examined by both ABG and pulse oximetry methods. Approximately 2 cc of arterial blood sample was taken and sent to the laboratory to determine blood gases. At the same time, the level of peripheral capillary oxygen saturation (SpO) was recorded using a pulse oximeter. OI and OSI were calculated according to their formula. Spearman's correlation, linear regression, and Bland-Altman scatter plot were used to determine the correlation, association, and agreement between OI and OSI, respectively. Of the total 50 neonates, 26 were female. The mean (range) gestational age was 35.28±3.01 (28-39) weeks, and post-neonatal age was 6.05±7.04 (1-25) weeks. There was a linear and significant association and correlation between OI and oxygen OSI (P<0.001), while the Bland-Altman scatter plot confirmed the agreement between them in mean values. Therefore, OSI utilizing pulse oximetry as a noninvasive method can be a substitute for OI in neonates with respiratory failure. It can also reduce workloads and costs.
Background and Aims: Vitamin D deficiency is associated with increased vulnerability to respirato... more Background and Aims: Vitamin D deficiency is associated with increased vulnerability to respiratory infections. This study aimed to determine the potential relationships between coronavirus disease 2019 (COVID-19) severity, serum vitamin D concentrations, and some inflammatory markers among pediatric COVID-19 patients in Iran. Methods: A retrospective study was conducted among hospitalized pediatric COVID-19 cases in Abuzar Hospital (Ahvaz, Iran) for 6 months. The COVID-19 diagnosis was based on the real-time reverse transcription-polymerase chain reaction technique. Demographic and clinical data of patients were recorded. Patients with serum vitamin D levels lower than 20 ng/ml were assigned as Group 1 and those with serum vitamin D concentrations equal to or more than 20 ng/ml were considered as Group 2. Results: A total of 144 patients were enrolled. Their mean age was 80 ± 49 months (range: 1-16 years). Patients in Group 1 had significantly lower levels of serum vitamin D, calcium, and lymphocytes, as well as higher fibrinogen, D-dimer, and C-reactive protein (CRP) levels compared with those in Group 2 (p < 0.001). In addition, they had a significantly higher dry cough, fever, chest radiographic findings, respiratory rate, and longer hospital length of stay than patients in Group 2. Serum concentrations of vitamin D were positively correlated with levels of serum calcium, lymphocytes, and neutrophils but negatively correlated with CRP, fibrinogen, and D-dimer values. Furthermore, patients with moderate or severe courses of COVID-19 had significantly higher inflammatory markers (CRP, D-dimer, and fibrinogen), as well as lower levels of serum calcium, vitamin D, lymphocytes, and neutrophils than those with mild COVID-19 (p < 0.001). In the multivariate analysis, fibrinogen level on admission was detected as the independent predictor of severe COVD-19 (odds ratio = 1.06, 95% confidence interval: 1.03-1.09; p < 0.001).
Pediatric complicated pneumonia (PCOMP) is the leading cause of mortality in children under the a... more Pediatric complicated pneumonia (PCOMP) is the leading cause of mortality in children under the age of five. The study was conducted to determine the epidemiological and clinical characteristics of children with PCOMP. A retrospective study was carried out among all pediatric patients who were hospitalized due to complicated pneumonia in Abuzar Hospital (Ahvaz, Iran) during two years. The patients were evaluated in terms of epidemiological and clinical characteristics. A total of 65 hospitalized children and infants were identified. More than half of the patients were females (n=36; 55.3%). Their mean age was 4.21±3.80 years (range six months-15 years), and 64.1% of them (n=42) were under the age of five. There were 12 (19.4%) patients with failure to thrive (FTT). In addition, 58.5% of patients (n=38) had no history of hospitalization, and 66.2% of them (n=43) did not have any underlying disease. The mean length of hospital stay (LOS) was 12.46±6.85 (range 4-45) days. Admission was more common in winter (40%) and autumn (33.8%). Moreover, there were no significant associations between the types of complications and patients' gender, age, FTT, and LOS. Further studies are warranted to identify factors contributing to disease severity and develop appropriate strategies for the prevention and treatment of PCOMP among Iranian children.
Background: Transcatheter closure of atrial septal defects (ASDs) is considered an alternative te... more Background: Transcatheter closure of atrial septal defects (ASDs) is considered an alternative technique to surgery, and appropriate device size selection is essential to an effective procedure. We aimed to compare 2D transesophageal echocardiography (TEE), transthoracic echocardiography (TTE), and balloon sizing methods for device size selection in pediatric patients undergoing ASD transcatheter closure and to establish an accurate and simple procedure for device size selection. Methods: This cross-sectional study was performed on pediatric patients for 8 months in Tehran, Iran. Device size was identified by balloon sizing, 2D TEE, and TTE. Results: This study enrolled 39 children (64.1% female, average age= 7.1±3.1 y) who underwent successful ASD transcatheter closure. The mean defect size by balloon-stretched diameter measurement was significantly greater than the ASD size measured by 2D TEE and TTE. There was a strong, highly significant positive correlation (P<0.001) between the device waist size and different ASD diameters measured by 2D TEE, TTE, and balloon sizing. A good linear association was found between the ASD size measured by device waist size and 2D TEE (device waist size= 0.99×TEE-derived defect size+1.678; P<0.001) as well as TTE (device waist size= 1.01×TTE-derived defect size+1.17; P<0.001), respectively. Conclusions: In this study, TEE and TTE-derived defect sizes were significantly associated with the device waist size. Additionally, the equations generated herein may provide a reliable and good prediction for appropriate device size.
Nutrients
This study evaluated implementing a school-based intervention to promote healthier dietary habits... more This study evaluated implementing a school-based intervention to promote healthier dietary habits in the school environment among Malaysian adolescents using qualitative methods. This qualitative study was conducted in four secondary schools in Perak and Selangor (two urban and two rural schools) that received the intervention (either training or training and food subsidy). A total of eight focus groups (68 students aged 15 years old) and 16 in-depth interviews were conducted with canteen operators, school convenience shop operators, school teachers and school principals in each school. Thematic analysis was used to analyse the qualitative data to identify suitable themes. We found several initiatives and changes by the schools’ stakeholders to change to a healthy school canteen programme. The stakeholders also noticed the students’ food preferences that influence healthy food intake in canteens and convenience shops. The food vendors and school administrators also found that subsid...
Frontiers in Public Health
Introduction: School environments can influence students' dietary habits. Hence, implementing a h... more Introduction: School environments can influence students' dietary habits. Hence, implementing a healthy canteen intervention programme in schools is a recommended strategy to improve students' dietary intake. This study will evaluate the feasibility of providing healthier food and beverage options in selected secondary schools in Malaysia by working with canteen vendors. It also will assess the changes in food choices before and after the intervention. Methods: A feasibility cluster randomised controlled study will be conducted in six secondary schools (intervention, n = 4; control, n = 2) comprising of rural and urban schools located in Selangor and Perak states in Malaysia. Four weeks of intervention will be conducted among Malaysian adolescents aged 15 years old. Two interventions are proposed that will focus on providing healthier food options in the canteen and convenience shops in the selected schools. Interventions 1 and 2 will entail training the canteen and school convenience shop operators. Intervention 2 will be applied to subsidise the cost of low energy-dense kuih (traditional cake), vegetables, and fruits. The control group will continue to sell the usual food. Trained dietitians will audit the canteen menu and food items sold by the school canteen and convenience shops in all schools. Anthropometric measurements, blood pressure and dietary assessment will be collected at baseline and at the end of 4-week intervention. Focus group discussions with students and in-depth interviews with headmasters, teachers, and school canteen operators will be conducted post-intervention to explore intervention acceptability. Under this Healthy School Canteen programme, school canteens will be prohibited from selling "red flag" foods. This refers to foods which are energy-dense and not nutritious, such as confectionery and deep-fried foods. They will also be prohibited from selling soft drinks, which are sugar-rich. Instead, the canteens will be encouraged to sell "green flag" food and drinks, such as fruits and vegetables. Mohammadi et al. A Study Protocol of School-Based Intervention Conclusion: It is anticipated that this feasibility study can provide a framework for the conception and implementation of nutritional interventions in a future definitive trial at the school canteens in Malaysia.
Current Respiratory Medicine Reviews
Background:: Cystic fibrosis (CF) is an autosomal recessive disease, characterized by progressive... more Background:: Cystic fibrosis (CF) is an autosomal recessive disease, characterized by progressive and recurrent lung infection. Objective:: This study aimed to evaluate the levels of pro-inflammatory cytokines and their correlations with lung function in CF patients. Methods:: Methods: Results:: The mean age of CF patients was 15.43 ± 5.970 years (range 4-24). The FVC in a majority of the CF patients (66.7%) was below 60% and only 33.3% of the patients exhibited normal or mild respiratory dysfunction. There were significant differences between FVC and FEV1 measurements before and after bronchoscopy. In addition, IL-8 levels in all three samples (serum, sputum, and BAL) of CF patients and levels of IL-1β and TNF-α in BAL and sputum samples of CF patients were significantly higher than the control group (p<0.001). However, increased cytokine levels were not associated with lung function. Conclusion:: Increased IL-8 and TNF-α levels seemed to be associated with signs of clinical det...
International Journal of Pediatrics
Background. Lower respiratory tract infection (LRTI) is the main cause of pediatric mortality and... more Background. Lower respiratory tract infection (LRTI) is the main cause of pediatric mortality and morbidity in low- and middle-income countries. Purpose. This study was carried out to determine the clinical and epidemiological characteristics of children with LRTI. Method. A retrospective study was conducted on all pediatric patients who were hospitalized due to LRTI in Abuzar Hospital (Ahvaz, Iran) during one year. Incomplete medical records and children who were treated on an outpatient basis, as well as infants younger than 1 month of age, were excluded. The patients were evaluated in terms of epidemiological, clinical, and paraclinical characteristics. Results. A total of 303 hospitalized children and infants were identified. Their mean age was 29.09 ± 38.96 months (range 1 month-15 years), and 59.4% of them were males. The highest frequency of patients was at the age below one year (50.8%, n = 154 ). Pneumonia and bronchitis were the most common LRTIs. Respiratory (54.6%) and n...
International Journal of Environmental Research and Public Health
The increased prevalence of unhealthy eating habits and sedentary lifestyles among Malaysian adol... more The increased prevalence of unhealthy eating habits and sedentary lifestyles among Malaysian adolescents has become a public health concern. The aim of this systematic review was to summarize evidence from observational studies related to diet and physical activity (PA) among Malaysian adolescents (13–18 years) and to recognize the associations between determinants of diet and PA and diet and PA behaviours. A systematic search for observational studies published from August 1990 through August 2017 was conducted via PubMed, Science Direct, Cochrane and Web of Science. A total of 18 studies met the inclusion criteria; these were independently extracted by two reviewers. Gender and ethnicity were the most commonly studied correlates of diet and PA; males were more physically active and they tended to have poorer diet quality and higher energy and macronutrient intakes in comparison to females; Malay adolescents had a lower diet quality and Chinese adolescents spent less time in PA com...
Asian Pacific journal of cancer prevention : APJCP, 2013
Nutritional status and dietary intake play a significant role in the prognosis of breast cancer a... more Nutritional status and dietary intake play a significant role in the prognosis of breast cancer and may modify the progression of disease. The aim of this study was to determine the influence of nutritional status on the quality of life of Iranian breast cancer survivors. Cross-sectional data were collected for 100 Iranian breast cancer survivors, aged 32 to 61 years, attending the oncology outpatient clinic at Golestan Hospital, Ahvaz, Iran. Nutritional status of subjects was assessed by anthropometric measurements, Patient-Generated Subjective Global Assessment (PG-SGA) and three non-consecutive 24-hour diet recalls. The European Organization of Research and Treatment of Cancer Quality of Life form (EORTC QLQ-C30) was used to assess quality of life. Ninety-four percent of the survivors were well-nourished, 6% were moderately malnourished or suspected of being malnourished while none were severely malnourished. Prevalence of overweight and obesity was 86%. Overall, participants had...
Public Health Nutrition , 2020
Objective: To conduct formative research using qualitative methods among stakeholders of secondar... more Objective: To conduct formative research using qualitative methods among stakeholders of secondary schools to explore their perceptions, barriers and facilitators related to healthy eating and physical activity (PA) among Malaysian adolescents. Design: A qualitative study involving eight focus groups and twelve in-depth interviews. Focus groups and interviews were recorded and transcribed verbatim. An inductive thematic analysis approach was used to analyse the data. Setting: Four secondary schools in Perak and Selangor states (two urban and two rural schools) in Malaysia. Participants: Focus groups were conducted with seventy-six adolescents aged 13-14 years, and in-depth interviews were conducted with four headmasters, four PA education teachers and four food canteen operators. Results: Stakeholders thought that adolescents' misperceptions, limited availability of healthy options, unhealthy food preferences and affordability were important challenges preventing healthy eating at school. Low-quality physical education (PE) classes, limited adolescent participation and teachers' commitment during lessons were perceived as barriers to adolescents being active at school. Affordability was the main challenge for adolescents from rural schools. Stakeholders perceived that a future school-based intervention should improve the availability and subsidies for healthy foods, provide health education/training for both adolescents and PE teachers, enhance active adolescent participation in PE and develop social support mechanisms to facilitate engagement with PA. Conclusions: These findings provide important insights into developing school-based lifestyle interventions to improve healthy eating and strengthening PA of Malaysian adolescents.
Asia Pac J Clin Nutr, 2018
Background and Objectives: Type 2 diabetes is a chronic illness which can be managed by patients'... more Background and Objectives: Type 2 diabetes is a chronic illness which can be managed by patients' commitment to self-care and self-efficacy behaviors. Methods and Study Design: A randomized controlled intervention study was carried out to determine the impact of self-efficacy education based on the Health Belief Model (HBM) in 240 patients with type 2 diabetes at the Golestan Hospital, Ahvaz, Iran between October 2014 and August 2015. The education duration was three months followed by a 24-week follow-up visit to determine the progress of the subjects. In this study, reliable and validated diabetes educational booklet and questionnaires based on knowledge, health beliefs and quality of life were used. The participants were randomly allocated to either the intervention group (n=120) or to the conventional dietary counseling group as controls (n=120), and assessed at the baseline, week 12 and week 36. The study was divided into primary outcome measurements consisting of glycated hemo-globin A1c (HbA1c), fasting blood glucose, lipid profile, and anthropometric levels. Secondary outcome measures were related to nutrition knowledge, health beliefs and quality of life. Results: The results showed that subjects in the intervention group had significantly better metabolic and glycemic profiles compared with those in the control group. It also showed that knowledge, health belief and quality of life significantly increased in the intervention group. Conclusions: Findings indicate that through tailored self-efficacy education, the quality of life and metabolic profile of diabetes patients can be improved.
International Journal of Environmental Research and Public Health, 2019
Patterns of physical activity (PA) that optimize both fitness and fatness may better predict card... more Patterns of physical activity (PA) that optimize both fitness and fatness may better predict cardiometabolic health. Reduced rank regression (RRR) was applied to identify combinations of the type (e.g., football vs. skipping), location and timing of activity, explaining variation in cardiorespiratory fitness (CRF) and Body Mass Index (BMI). Multivariable regressions estimated longitudinal associations of PA pattern scores with cardiometabolic health in n = 579 adolescents aged 13-17 years from the Malaysian Health and Adolescent Longitudinal Research Team study. PA pattern scores in boys were associated with higher fitness (r = 0.3) and lower fatness (r = −0.3); however, in girls, pattern scores were only associated with higher fitness (r = 0.4) (fatness, r = −0.1). Pattern scores changed by β = −0.01 (95% confidence interval (CI) −0.04, 0.03) and β = −0.08 (95% CI −0.1, −0.06) per year from 13 to 17 years in boys and girls respectively. Higher CRF and lower BMI were associated with better cardiometabolic health at 17 years, but PA pattern scores were not in either cross-sectional or longitudinal models. RRR identified sex-specific PA patterns associated with fitness and fatness but the total variation they explained was small. PA pattern scores changed little through adolescence, which may explain the limited evidence on health associations. Objective PA measurement may improve RRR for identifying optimal PA patterns for cardiometabolic health.
BMC Public Health, 2019
Background: A sedentary lifestyle and an unhealthy diet are major factors in the increasing preva... more Background: A sedentary lifestyle and an unhealthy diet are major factors in the increasing prevalence of obesity among Malaysian adolescents. The purpose of this systematic review is to compile the evidence from observational and intervention studies among Malaysian adolescents to evaluate the associations between diet and physical activity (PA) as determinants of cardio-metabolic risk factors. Methods: A systematic search of Medline via the PubMed, Science Direct, Cochrane Review and Web of Science databases was conducted for studies on the associations between diet and PA factors and cardio-metabolic risk factors among Malaysian adolescents aged 13-18 years that were published until 31 August 2017. The search results were independently screened and extracted by two reviewers. Results: From over 2,410 references retrieved, 20 full texts articles were screened as potentially relevant. Seventeen (16 cross-sectional and one intervention) met the inclusion criteria for data extraction and analysis. All 17 studies were rated as poor quality and the majority had made insufficient adjustment for confounders. As regards the effect of diet and PA on cardio-metabolic health, the intakes of energy (n = 4) and macronutrients (n = 3) and meal frequency (n = 5) were the most commonly studied dietary factors, while the PA score and level were the most commonly studied PA factors. In addition, BMI and body weight were the most common cardio-metabolic health outcomes. The studies showed that obese and overweight adolescents consume significantly more energy and macronutrients. They are also more likely to skip their daily meals compared to their normal weight peers. In most studies, the direction of the PA effect on body weight was unclear. Some studies found that higher PA is associated with a lower risk of overweight and obesity. However, the associations are often small or inconsistent, with few studies controlling for confounding factors. Conclusions: This review identified a lack of evidence and well-conducted prospective studies on the effect of diet and PA on cardio-metabolic health of Malaysian adolescents.
Uploads
Papers by Shooka Mohammadi
Objective: This study was conducted to evaluate associations of serum levels of C-reactive protein (CRP) and malondialdehyde (MDA) with the severity and exacerbations of COPD.
Methods: A matched case-control study was performed among 200 COPD patients (100 cases and 100 controls) who were referred to Masih Daneshvari Hospital in Tehran, Iran. Cases were exacerbators with equal to or greater than two ambulatory exacerbations or one hospitalization; controls were non-exacerbators who had one/no ambulatory exacerbation during the preceding 12 months. Blood samples were collected for CRP, MDA, and erythrocyte sedimentation rate (ESR) analysis. In addition, spirometry, the COPD assessment test (CAT) score, the modified Medical Research Council (mMRC) dyspnea scale, and the BODEx index were applied.
Results: The mean (SD) age of the patients was 65.31 (8.46) years. Those with exacerbations had significantly lower FEV1 and higher CRP, MDA, ESR, BMI, BODEx index, CAT, and mMRC scores compared to non-exacerbators. There were significant differences in CRP, MDA, ESR, FVC, FEV1, FEV1/FVC, BMI, BODEx index, mMRC, and CAT scores between the GOLD group. Moreover, multivariate analysis showed that higher levels of CRP (OR=0.61, p=0.023), MDA (OR=0.28, p=0.001), ESR (OR=0.86, p=0.029), CAT score (OR=0.84, p=0.012), BODEx index (OR=0.89, p <0.001), BMI (OR=0.42, p <0.001), and lower FEV1% (OR=0.77, p <0.001) were independent risk factors for frequent exacerbations.
Conclusion: In conclusion, elevated serum MDA and CRP levels in combination may serve as prognostic indicators of the severity and exacerbation of COPD.
Objective: This study was conducted to evaluate associations of serum levels of C-reactive protein (CRP) and malondialdehyde (MDA) with the severity and exacerbations of COPD.
Methods: A matched case-control study was performed among 200 COPD patients (100 cases and 100 controls) who were referred to Masih Daneshvari Hospital in Tehran, Iran. Cases were exacerbators with equal to or greater than two ambulatory exacerbations or one hospitalization; controls were non-exacerbators who had one/no ambulatory exacerbation during the preceding 12 months. Blood samples were collected for CRP, MDA, and erythrocyte sedimentation rate (ESR) analysis. In addition, spirometry, the COPD assessment test (CAT) score, the modified Medical Research Council (mMRC) dyspnea scale, and the BODEx index were applied.
Results: The mean (SD) age of the patients was 65.31 (8.46) years. Those with exacerbations had significantly lower FEV1 and higher CRP, MDA, ESR, BMI, BODEx index, CAT, and mMRC scores compared to non-exacerbators. There were significant differences in CRP, MDA, ESR, FVC, FEV1, FEV1/FVC, BMI, BODEx index, mMRC, and CAT scores between the GOLD group. Moreover, multivariate analysis showed that higher levels of CRP (OR=0.61, p=0.023), MDA (OR=0.28, p=0.001), ESR (OR=0.86, p=0.029), CAT score (OR=0.84, p=0.012), BODEx index (OR=0.89, p <0.001), BMI (OR=0.42, p <0.001), and lower FEV1% (OR=0.77, p <0.001) were independent risk factors for frequent exacerbations.
Conclusion: In conclusion, elevated serum MDA and CRP levels in combination may serve as prognostic indicators of the severity and exacerbation of COPD.