fa ارتباط تغییرات الگوهای غذایی با چاقی شکمی در بزرگسالان منطقه‌ی 13 تهران پژوهشی Original <span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><u>مقدمه</u></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA">: چاقی و بیماری‌های غیرواگیر وابسته به آن به یکی از مشکلات بهداشت عمومی ایران تبدیل شده است. هدف از این مطالعه‌ی طولی شناسایی الگوهای غذایی و ارتباط تغییرات آن با چاقی شکمی در گروهی از بزرگسالان منطقه‌ی 13 تهران بود. <u>مواد و روش‌ها</u>: این مطالعه‌ی هم‌گروهی در 206 فرد 18 ساله و بالاتر شرکت‌کننده در مطالعه‌ی قند و لیپید تهران که در هر دو مرحله‌ی مطالعه (80-1378) و (86-1384) شرکت کرده بودند، انجام شد. چاقی شکمی بر مبنای معیارهای </span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">ATP III</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span> و سازمان جهانی بهداشت تعریف شد. ارزیابی تغذیه‌ای از طریق پرسشنامه‌ی یادآمد 24 ساعته و پرسشنامه‌ی تکرر مصرف انجام شد. گروه‌بندی اقلام غذایی بر مبنای محتوای مواد مغذی و مطالعه‌های پیشین انجام شد. برای شناسایی الگوهای غذایی غالب از روش تحلیل عاملی در داده‌های گروه‌های غذایی استفاده شد. امتیاز هر فرد برای هر الگوی غذایی با محاسبه‌ی ترکیب خطی مقادیر گروه‌های غذایی با ضرایب حاصل از تحلیل عاملی به دست آمد و سپس نسبت به میانگین و واریانس امتیاز، استاندارد شد. تغییرات امتیاز الگوهای غذایی و تغییرات نمایه‌های تن سنجی، با تفاضل داده‌های مرحله‌ی اول از داده‌های مرحله‌ی دوم همان فرد به دست آمد. <u>یافته‌ها</u>: میانگین سن مردان (82=</span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">n</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>) و زنان (124=</span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">n</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>) در انتهای مطالعه به ترتیب 11±51 و 14±45 سال بود. میانگین دور کمر در مردان از 4/10±5/89 در مرحله‌ی اول به 1/9±6/97 سانتی‌متر (01/0</span><span dir="ltr"></span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut"><span dir="ltr"></span><</span><span dir="rtl"></span><span dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span> </span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">p</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>) و در زنان از 2/13±8/84 به 4/12±4/88 سانتی‌متر (05/0</span><span dir="ltr"></span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut"><span dir="ltr"></span><</span><span dir="rtl"></span><span dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span> </span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">p</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>) رسید. در هر دو مرحله‌ی مطالعه، سه الگو استخراج و الگوهای غذایی غربی، سالم و مخلوط نام‌گذاری شدند. در الگوی غذایی غربی، سس مایونز و میان وعده‌های شور و در الگوی غذایی سالم، سبزی‌ها بیشترین بار عاملی و غلات کامل بار عاملی کمی را در هر دو مرحله مطالعه داشتند. قدرت پیشگویی تغییرات امتیاز الگوی غذایی غربی برای تغییرات دورکمر در افراد با دور کمر طبیعی پس از تعدیل عوامل مداخله‌گر (01/0</span><span dir="ltr"></span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut"><span dir="ltr"></span> p<</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span> و21/0=</span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">R2</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>، 49/0=</span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">β</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>) نسـبت به الگوی سالم (05/0</span><span dir="ltr"></span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut"><span dir="ltr"></span> p<</span><span dir="rtl"></span><span dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span> <span lang="FA"><font face="Yagut" size="3">و11/0=</font></span></span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">R2</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>،20/0-=</span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">β</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>) بیشتر بود. تغییرات امتیاز الگوی غذایی غربی و سالم با نسبت دورکمر به باسن در افراد با چاقی بالاتنه به ترتیب (05/0</span><span dir="ltr"></span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut"><span dir="ltr"></span> p<</span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA">و21/0=</span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">R2</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>، 21/0= </span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">β</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>)، (01/0</span><span dir="ltr"></span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut"><span dir="ltr"></span> p<</span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA">و22/0=</span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">R2</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>، 23/0-= </span><span style="FONT-SIZE: 10pt FONT-FAMILY: "Times New Roman" mso-fareast-font-family: SimSun mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA mso-bidi-font-size: 11.0pt mso-bidi-font-family: Yagut">β</span><span dir="rtl"></span><span lang="FA" dir="rtl" style="FONT-SIZE: 11pt FONT-FAMILY: Yagut mso-ansi-font-size: 10.0pt mso-ascii-font-family: 'Times New Roman' mso-fareast-font-family: SimSun mso-hansi-font-family: 'Times New Roman' mso-font-kerning: 16.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US mso-bidi-language: FA"><span dir="rtl"></span>) ارتباط معنی‌دار داشت. <u>نتیجه‌گیری</u>: در این مطالعه، کاهش مصرف اقلام الگوی غذایی غربی و پیروی از الگوی سالم پیشگیری کننده از چاقی شکمی بود. </span> <p class="Abstract" style="MARGIN: 0cm 1cm 0pt DIRECTION: ltr unicode-bidi: embed TEXT-ALIGN: justify"><strong><font face="Arial">Abstract</font></strong></p><p class="Abstract" style="MARGIN: 0cm 1cm 0pt DIRECTION: ltr unicode-bidi: embed TEXT-ALIGN: justify"><strong><font face="Arial"><u>Introduction</u>: Obesity and its complications are a major health problem in <country-region w:st="on"><place w:st="on">Iran</place></country-region>. The aim of this longitudinal study was to determine whether changes in food patterns were related to abdominal obesity in Tehranian adults of district 13. <u>Material and Methods</u>: A total of 82 men and 124 women, (≥18 years old), were studied between 1999-2001 and 2004-2007. Subjects with abdominal obesity were defined according to ATPIII and WHO guidelines. Dietary intake was assessed by a food frequency questionnaire and two 24-hour dietary recalls. Food groups were determined according to their nutrients contents and previous literature. Food patterns were derived by factor analysis at each time point. The factor scores for each pattern for each subject were calculated by the amount of the intakes of each of the food groups weighted by their factor analysis coefficient matrix the scores were then standardized (mean=0, SD=1). Changes in food pattern, waist circumference (WC) and waist to hip ratio (WHR) were defined by subtracting the factor score for each food pattern and anthropometric measurements in the two time intervals. <u>Results</u>: Men and women were 51±11 and 45±14 years of age at the end of study respectively. During the two periods of the study, mean WC increased from 89.5±10.4 to 97.6±9.1 in men and from 84.8±13.2 to 88.4±12.4 cm in women (p<0.05). Three dietary patterns were identified and named by factor analysis as follows: Healthy (HDP), Western (WDP) and Mix(MDP). In the WDP, salty snacks and sauces had the highest and in the HDP, vegetables had the highest and whole grain had the lowest loading factors in the two study periods. After adjusting for confounding factors better prediction of WC change was obtained in normal individuals with WDP change(β=0.49, R2=0.21, p<0.01) compared with HDP(β=-0.20, R2=0.11, p<0.05). Change in WDP and HDP were related to the WHR change in abdominally obese persons (β=0.21, R2=0.21, p<0.05), (β=-0.23, R2=0.22, p<0.01) respectively. <u>Conclusion</u>: Results of this study indicate that adherence to HDP and decreasing intake of WDP items prevent central adiposity.</font></strong></p> الگوهای غذایی، تحلیل عاملی، چاقی شکمی Food patterns, Factor analysis, Abdominal Obesity 299 312 http://ijem.sbmu.ac.ir/browse.php?a_code=A-10-81-62&slc_lang=fa&sid=1 F. Hosseini Esfahani فیروزه حسینی اصفهانی 400031947532846004050 400031947532846004050 No P. Mirmiran پروین میرمیران 400031947532846004051 400031947532846004051 No SA Djazayeri سید ابوالقاسم جزایری jazaiers@tums.ac.ir 400031947532846004052 400031947532846004052 Yes Y Mehrabi یداله محرابی 400031947532846004053 400031947532846004053 No F. Azizi فریدون عزیزی 400031947532846004054 400031947532846004054 No