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Background and objectives: Essential fatty acid deficiency has been found in diabetic patients. Omega-3 fatty acid supplementation could be beneficial in alleviating diabetes complications and glycemic control. However, it may increase oxidative stress. In this study the effects of omega-3 fatty acid supplements on glycemic control, total antioxidant capacity and antioxidant enzymes (superoxide dismutase and catalase) activities were investigated. Materials and methods: In a double-blind, randomized, controlled clinical trial, 81 type-2 diabetic patients were divided into 2 groups. The experimental group took 2714 mg/day omega-3 fatty acids (1548 mg EPA, 828 mg DHA, and 338 mg other omega-3 fatty acids), and the control group took sunflower oil as a placebo, for 8 weeks. Dietary intakes were assessed by a 24h dietary recall, before and after intervention, and analyzed using food processor II. In addition, fasting blood samples were collected for analysis and height and weight were measured, initially and at the end of the trial. Results: At the start of the study there were no statistically significant differences between the two groups with regard to mean weight, height, body mass index (BMI), daily intakes of energy, carbohydrate, protein, total fat, polyunsaturated fatty acids, fiber, vitamins A, B, C, E, folate, cobalamine, zinc, or biochemical parameters. Neither were there any difference in weight, BMI and dietary intakes before and after intervention in either group. The supplementation brought about a significant decrease (P<0.00) in HbA1c% in the experimental group, while in the control group the HbA1c level actually increased (p<0.02). Furthermore, the magnitudes of HbA1c changes were significantly deferent between the two groups (P<0.00). Changes in the fasting blood sugar (163.88 ± 10 vs. 165.6 ± 7.9 mg/dl), total antioxidant capacity (3.79 ± 0.07 vs. 3.62 ± 0.7 mg/dl), and activities of super oxide dismutase (449.22 ± 14.14 vs. 417.16 ± 11.9 U/gHb) and catalase (150.72 ± 9.6 vs. 151.86 ± 12.6 k/gHb) were not statistically significant. Conclusion: Omega-3 fatty acid supplementation may be helpful in glycemic control in type-2 diabetes, but it has no significant effect on the antioxidant enzyme activities.

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Background and objectives: As previous studies on the association between obesity and cardiovascular (CVD) risk factors have been made in limited populations, this study was performed to determine the association in 3 cities in the central parts of Iran. Materials and methods: In this cross-sectional study, data collected in the1st phase of the Isfahan Healthy Heart Program (IHHP), involving 12514 subjects ≥19 years old, conducted during 2000-2001, in Isfahan and the Central Provinces of Iran, were analyzed. Fasting blood sugar (FBS), 2-hour post-load plasma glucose (2hpp), serum lipid profile, anthropometric parameters and blood pressure were determined by standard methods. Results: FBS, 2hpp, serum lipids fractions (except for HDL-C) and blood pressure had significant positive relations with body mass index (BMI) and waist circumference (WC) (all p-values<0.001). As compared to the 1st quartile of WC, odds ratios (OR 95%CI) of hypertension, diabetes and dyslipidemia in the 4th quartile were 2.8 (1.2-3.3), 3 (1.6-4.3) and 2.4 (1.9-3.1) in men and 2.5 (1.8-3.4), 2.7 (1.3-3.8) and 2.5 (2-3.2) in women, respectively. Also, ORs (95%CI) of hypertension, diabetes and dyslipidemic in 4th quartile of BMI, as compared to the 1st, were 1.6 (1.2-2), 2.8 (1.7-3.9) and 3 (2.4-3.8) in men and 1.9 (1.4-2.4), 2.6 (1.4-3.7) and1.6 (1.2-2) in women, respectively. Conclusion: ORs of these risk facrors increased with increasing WC and BMI. Therefore, it is concluded that both obesity indicators increase the chance of CVD risk factors.

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Background and Objectives: Hyperlipedemia is a health problem in type-2 diabetes patients. This study was designed to investigate the effects of carrot juice fortified with ß-carotene on the blood lipids in these patients. Subject and Methods: This controlled randomized double-blind clinical trial was performed on 44 patients with type 2 diabetes. They were randomly divided into two groups receiving, daily for 8 weeks, either 200 ml carrot juice fortified with 10 mg ß-carotene (group A) or 200 ml ordinary carrot juice (group B). All the subjects would drink the juice (exchanged for one serving of bread) at lunch. Twenty-four hour dietary recalls were done on 3 consecutive days and 6 alternate days by a nutritionist at the beginning and the end of the period. Initial and final fasting blood glucose, ß-carotene, and lipids were also measured. The dietary data were analyzed using Nutritionist IV and statistical analysis was done using SPSS 11.5. Results: The serum level of ß-carotene increased and that of total cholesterol and triglyceride, as well as the LDL-C/HDL-C and TC/HDL-C ratios, decreased significantly in group A as compared to group B. The treatments did not affect HDL-C or glucose concentrations in either group. Conclusion: Daily consumption of both 200 ml carrot juice fortified with 10 mg ß-carotene and ordinary carrot juice for 8 weeks brings about desirable changes in some of the blood lipids in type-2 diabetic subjects without any change in the serum glucose level, although fortified carrot juice is more effective. Such an intervention may prevent hyperlipedemia in these patients. Keywords: Type-2 diabetes, Carrot juice, ß-carotene, Blood lipids

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Background and Objective: Although diabetic patients are recommended to increase their intake of fiber, there is evidence showing that these patients have a low fiber intake in Iran. The purpose of this qualitative research project was to investigate the benefits and barriers regarding consumption of high-fiber foods as perceived by type-2 diabetes patients. Materials and Methods: In this qualitative study, conducted in 2010, six focus group discussions (FGDs) were held with 55 type-2 diabetes patients 34 –70 years old. Data analysis was done using the Strauss and Corbin' s analytical method for qualitative studies. Results: Perceived benefits of high-fiber food consumption included better blood sugar control, improved gastro-intestinal function, and prevention and control of some diseases. The main perceived barriers could be classified into 3 groups: personal (lack of awareness, lack of interest, lack of sufficient time, cost, dental problems, false beliefs, fear of hyperglycemia, fatigue, and gastrointestinal problems) social (lack of awareness, lack of family support, and family pressure) and educational (insufficient education and insufficient service accessibilty). Conclusion: The results reveal the benefits of, and the barriers to, high-fiber food consumption as seen by type-2 diabetes patients. These findings can be used in designing educational intervention programmes based on the transtheoretical model, aiming at changing nutritional behavior of these patients leading to increased consumption of high-fiber foods. Keywords: Benefits, Barriers, Dietary Fiber, Type-2 Diabetes

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Background and Objective: Tocotrienols have been demonstrated to play a significant role in preventing diabetic nephropathy due to their immunologic and inflammatory properties.The objective of this study was to determine the effects of a daily intake of canola oil enriched with 200 mg tocotrienol (T3)for 8 weeks on nitrosative stress, inflammation and urinary microalbumin in type-2 diabetic patients. Materials and Methods: This clinical trial was conducted on 50 patients with type-2 diabetes mellitus (fasting blood sugar > 126 mg/dl) randomly divided into 2 groups of 25 each to receive, daily for 8 weeks, either 15 ml T3-enriched canola oil (200mg T3 experimental group) or 15 ml pure canola oil (control group). Initial and final blood samples were collected to measureserum hs-CRP and nitric oxide (NO)levels, and 24-hr urine samples to measure urinary volume and microalbumin and creatinine levels. Physical activity levels, anthropometric parameters and nutrients intakes were determined before and after intervention and compared between the 2 groups. Results: T3-enriched canola oil brought about statistically significant reductions in urinary microalbumin (p=0.004) and hs-CRP (p=0.003). Also, at the end of the study, the intervention group had significantly lower serum hs-CRP and urinary microalbumin than the control group. A nonsignificant decrease was observed in the serum NO level in the T3 group. Conclusion: Based on the findings it may be concluded that tocotrienols can improve the inflammatory status and prevent diabetic nephropathy. However, its effect on nitrosative stress needs furher investigation. Keywords: Tocotrienols, Nitrosative Stress, Microalbuminuria, Inflammation, type-2 Diabetes mellitus

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Background and objective: Dark chocolate has received the attention of researchers due to its cardiovascular protective effects. The purpose of this study was to determine the effects of 8 weeks consumption of dark chocolate on the lipid profile, apo-lipoprotein A-1 (Apo A1), apo-lipoprotein B (Apo B), and hs-CRP in type-2 diabetic patients. Materials and methods: This clinical trial was conducted on 69 diabetic patients randomly assigned to one of two (intervention and control) groups. The intervention (n=32) and control (n=28) groups received daily, for 8 weeks, 25 gr dark chocolate (containing 450mg polyphenols) and a similar amount of white chocolate, respectively. At the beginning and at the end of the period, blood samples were collected to measure total cholesterol, LDL-c, HDL-c, TG, Apo A1, Apo B, and hs-CRP. In addition, anthropometric measurements were made and data were gathered on physical activity, blood pressure and food intake and compared between the 2 groups Results: The intervention brought about statistically significant reductions in the blood levels of TG (p=0.007), apo-lipoprotein A-1 (p=0.045), apo-lipoprotein B (p=0.01) and hs-CRP (p=0.005).There were no significant differences in either group with regard to serum total cholesterol, LDL-c or HDL-c levels at the end of the period neither were observed any intergroup differences. Conclusion: The findings suggest that polyphenol-rich dark chocolate may have desirable effects on the blood triglyceride, apo-lipoproteins A-1 and B and hs-CRP levels in diabetic patients, with no effect on the lipid profile. Keywords: Dark chocolate, Lipid profile, Inflammation, Apolipoprotein, Type-2 diabetes